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AMS Guide to Equivalent MHT/HRT Doses New Zealand only

This Information Sheet has been developed as a guideline only to approximately equivalent doses of the different MHT/HRT products available in New Zealand in March 2017. HRT is now referred to as Menopausal Hormone Therapy (MHT). The intention of this sheet is to help physicians change their patients to higher or lower approximate doses of MHT if needing to tailor therapy, or remain within the same approximate dose if needing to change brands of MHT. Private/non Pharmac subsidised script products are marked with an * .

pdfAMS Guide to Equivalent MHT/HRT Doses NZ134.7 KB 

Oestrogen and progestogen combination MHT

Use cyclical oestrogen and progestogen combinations at peri-menopause or if less than 12 months amenorrhoea

Medium dose    
Product Presentation  Composition
Trisequens* tablet        1 and 2mg oestradiol/1mg norethisterone

Continuous oestrogen and progestogen combinations

Should be used if 12 months since LMP or after 12 months cyclical MHT

Low dose    
Product Presentation Composition
Kliovance* tablet 1mg oestradiol/0.5mg norethistrone
Other Low dose hormonal options
Livial*, Xyvion* tablet 2.5mg tibolone
Duavive* (oestrogen/SERM combination) tablet 0.45mg conjugated equine oestrogens / 20mg bazedoxifene
Medium dose    
Kliogest* tablet 2mg oestradiol/1mg norethistrone
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 B oestradiol/140mcg norethisterone acetate (twice weekly application)
Estalis continuous* 50/250 (same oestrogen, more progestogen than Estalis continuous 50/140) transdermal patch 50mcg 17 B 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 B oestradiol
Progynova tablet 1mg oestradiol valerate
Premarin* tablet 0.3mg conjugated equine oestrogen
Estradot 25  transdermal patch 25 or 37.5mcg/24hrs 17B oestradiol (twice weekly application)
Medium dose    
Progynova tablet 2mg oestradiol valerate
Estradot 50 transdermal patch   50mcg/24 hours 17B oestradiol (twice weekly application)
Premarin* tablet 0.625mg conjugated equine oestrogens
Sandrena* gel 1mg oestradiol (daily application)
High dose    
Estradot 75
Estradot 100
transdermal patch 75 or 100mcg/24 hours (twice weekly application)
Oestradiol implants - No longer available
Oestrogen only vaginal therapy  
Product Presentation Composition
Ovestin
Ovestin
cream
pessary
1mg/g oestriol
0.5mg oestriol
Vagifem Low* pessary 10mcg 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 2.5mg tablet* tablet 2.5mg medroxyprogesterone acetate
Primolut N (1/4 of 5mg tablet) tablet 1.25 mg norethisterone
Utrogestan* capsule 100mg micronised progesterone 
Mirena*
(Pharmac indication for
contraception/menorrhagia)
device (5 years) 20mcg/24hrs levonorgestrel

Low dose progestogen-only contraceptive pills (Microlut (30mcg levonorgestrel), and Noriday (both 350mcg 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 in the Cochrane Review (Cochrane Database Syst Rev. 2009 Apr 15;(2):CS000402). 

Medium dose for use with medium dose oestrogen
Product Presentation  Dose 
Primolut N (1/4 of 5mg tablet) tablet 1.25 mg norethisterone
Provera, Ralovera tablet 5mg medroxyprogesterone acetate
Utrogestan* capsule 100mg micronized progesterone
Mirena*
(Pharmac indication for
contraception/menorrhagia)
device (5 years) 20mcg/24hrs 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
Utrogestan* capsule 200mg micronized progesterone

AMS New directions in women's health

Note: Medical and scientific information provided and endorsed by the Australasian Menopause Society might not be relevant to a particular person's circumstances and should always be discussed with that person's own healthcare provider.

This Information Sheet may contain copyright or otherwise protected material. Reproduction of this Information Sheet by Australasian Menopause Society Members and other health professionals for clinical practice is permissible. Any other use of this information (hardcopy and electronic versions) must be agreed to and approved by the Australasian Menopause Society.

Content Updated May 2017

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