Australasian Menopause Society - AMS Guide to Equivalent HRT Doses

AMS Guide to Equivalent HRT Doses

This Information Sheet has been developed as a guideline only to approximately equivalent doses of the different HRT products available 1st August 2011. The intention is to help physicians change their patients to higher or lower approximate doses of HRT if needing to tailor therapy, or remain within the same approximate dose if needing to change brands of HRT.

AMS Guide to Equivalent HRT Doses 541.73 Kb

Products which are underlined are Australia only; products in italics are NZ only.

Products with an * meaning Private/non PBS script.

Oestrogen & progestogen combination HRT
Cyclical oestrogen & progestogen combinations use these at peri-menopause and until at least 12 months amenorrhoea
Medium dose
Product	Presentation	Composition
Trisequens*	tablet	1 and 2mg oestradiol/1mg norethisterone
Femoston	tablet	2mg oestradiol/10mg dydrogesterone
Estalis sequi 50/140	transdermal patch	50mcg 17 β oestradiol/140mcg norethisterone acetate (twice weekly application)
Estalis sequi 50/250 (same oestrogen, more progestogen than Estalis sequi 50/140)	transdermal patch	50mcg 17 β oestradiol/250mcg norethisterone acetate (twice weekly application)
Continuous oestrogen & progestogen combinations should be used if 12 months since LMP or after 12 months cyclical HRT
Low dose
Product	Presentation	Composition
Angeliq1/2*	tablet	1mg oestradiol/2mg drospirenone
Kliovance*	tablet	1mg oestradiol/0.5mg norethisterone
Livial, Xyvion (generally suitable for older women or at least 1 year post-menopause)	tablet	2.5mg tibolone
Medium dose
Kliogest*	tablet	2mg oestradiol/1mg norethisterone
Premia 2.5 continuous*	tablet	0.625mg conjugated equine oestrogens/2.5mg medroxyprogesterone acetate
Premia 5 continuous* (same oestrogen, more progestogen than Premia 2.5 continuous)	tablet	0.625mg conjugated equine oestrogens/5mg medroxyprogesterone acetate
Estalis continuous 50/140	transdermal patch	50mcg 17 β oestradiol/140mcg norethisterone acetate (twice weekly application)
Estalis continuous 50/250 (same oestrogen, more progestogen than Estalis continuous 50/140)	transdermal patch	50mcg 17 β oestradiol/250mcg norethisterone acetate (twice weekly application)

Oestrogen only therapy only use these if patient has had a hysterectomy or in combination with a progestogen or Mirena if intact uterus
Low dose
Product	Presentation	Composition
Estrofem*	tablet	1mg 17 β oestradiol
Progynova	tablet	1mg oestradiol valerate
Ovestin*	tablet	2mg oestriol
Premarin*	tablet	0.3mg conjugated equine oestrogen
Climara 25, Femtran 25	transdermal patch	25mcg/24hrs 17 β oestradiol (weekly application)
Estradot 25 or 37.5	transdermal patch	25 or 37.5mcg/24hrs 17 β oestradiol (twice weekly application)
Estraderm 25 MX	transdermal patch	25mcg/24hrs 17 β oestradiol (twice weekly application)
Estraderm 25 MX (to be discontinued mid 2012)	transdermal patch	25mcg/24hrs 17 β oestradiol (twice weekly application)
Medium dose
Estrofem*, Zumenon	tablet	2mg 17 β oestradiol
Progynova	tablet	2 mg oestradiol valerate
Premarin*	tablet	0.625mg conjugated equine oestrogen
Climara 50, Femtran 50*	transdermal patch	50mcg/24hrs 17 β oestradiol (weekly application)
Estradot 50, Estraderm 50 MX	transdermal patch	50mcg/24 hours 17β oestradiol (twice weekly application)
Sandrena	transdermal gel	1mg oestradiol (daily application)
High dose
Climara 75	transdermal patch	75mcg/24hrs oestradiol (weekly application)
Estradot 75, Estradot 100	transdermal patch	75 or 100mcg/24 hours (twice weekly application)
Climara100, Femtran99	transdermal patch	100mcg/24hrs oestradiol (weekly application)
Estraderm 100 MX	transdermal patch	100mcg/24hours 17 β oestradiol (twice weekly application)
Estraderm 100 (to be discontinued mid 2012)	transdermal patch	100mcg/24hours 17 β oestradiol (twice weekly application)
Oestradiol implants - No longer available
Oestrogen only vaginal therapy
Ovestin	cream	1mg/g oestriol
Ovestin ovula	pessary	0.5mg oestriol
Vagifem	pessary	25mcg oestradiol
Progestogen suggested alternative doses for use with the oestrogen preparations above where fixed dose therapy is not suitable
Low dose for use with low dose oestrogen
Product	Presentation	Composition
Provera (1/2 of 5mg tablet)	tablet	2.5mg medroxyprogesterone acetate
Provera 2.5 mg tablet*	tablet	2.5mg medroxyprogesterone acetate
Primolut N (1/4 of 5 mg tablet)	tablet	1.25 mg norethisterone
Mirena* (PBS indication for contraception/menorrhagia)	device (5 years)	20mcg/24hrs levonorgestrel
Low dose progestogen-only contraceptive pills (Microlut* (30mcg levonorgestrel), Noriday, Micronor (both 350 mcg norethisterone)) are used by some clinicians in various doses but there is limited data for dosages of these pills required for endometrial protection. 1 mg norethisterone was considered the minimum dose (cyclical or continuous) for adequate endometrial protection when combined with 2mg 17β oestradiol in the Cochrane Review (Cochrane Database Syst Rev. 2009 Apr 15;(2):CS000402).
Medium dose for use with medium dose oestrogen
Primolut N (1/4 of 5mg tablet)	tablet	1.25mg norethisterone
Provera, Ralovera	tablet	5mg medroxyprogesterone acetate
Uterogestan (NZ only)	capsule	100 mg micronised progesterone
Mirena* (PBS indication for contraception/menorrhagia	device (5 years)	20 mcg/24 hours levonorgestrel
Higher dose (for use in cyclical therapy or continuous therapy with high dose oestrogen)
Primolut N (1/2 5mg tablet)	tablet	2.5mg norethisterone
Provera, Ralovera	tablet	10mg medroxyprogesterone acetate
Uterogestan (NZ only)	capsule	200 mg micronised progesterone

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Content Updated December 2011

Last Updated (Sunday, 04 December 2011 18:08)