Description
How it works
Elleste Duet Conti is a continuous combined HRT, which means you take oestrogen and progestogen every day without a break.
- Estradiol replaces the oestrogen your body no longer makes after the menopause, helping to relieve symptoms such as hot flushes, night sweats, sleep disturbance, mood changes and vaginal dryness.
- Norethisterone acetate is a progestogen that protects the lining of the womb (endometrium) from becoming too thick under the influence of oestrogen, reducing the risk of endometrial hyperplasia and endometrial cancer in women who still have a uterus.
By maintaining more stable hormone levels, Elleste Duet Conti:
- Eases menopausal symptoms caused by oestrogen deficiency
- Helps reduce bone loss and can be used to help prevent osteoporosis in postmenopausal women at high risk of fractures who cannot take other osteoporosis medicines
It is not a contraceptive and will not prevent pregnancy.
Who it may be suitable for
Elleste Duet Conti may be suitable for:
- Postmenopausal women who are at least 1 year since their last natural period and have troublesome menopausal symptoms
- Postmenopausal women at high risk of future fractures (osteoporosis) who are intolerant of, or contraindicated for, other bone-protection medicines
- Women who still have their womb, and therefore require both oestrogen and progestogen as part of their HRT
Experience in women over 65 years is limited, so treatment in this age group requires particular care and regular review.
Who should not take Elleste Duet Conti
Do not take this medicine if you:
- Have breast cancer now, have had it in the past, or are suspected of having it
- Have or are suspected of having an oestrogen-dependent tumour (e.g. cancer of the womb)
- Have unexplained vaginal/genital bleeding
- Have untreated endometrial hyperplasia (thickening of the womb lining)
- Have ever had a venous blood clot (deep vein thrombosis or pulmonary embolism)
- Have a known thrombophilic disorder (e.g. protein C, protein S or antithrombin deficiency)
- Have active or recent arterial thromboembolic disease (e.g. angina, heart attack, stroke)
- Have acute liver disease, or a history of liver disease where liver tests are still abnormal
- Are allergic to estradiol, norethisterone or any of the ingredients
- Have porphyria
- Are pregnant or breastfeeding
It is not for use in children.
Use with extra care / medical supervision
You may still be able to use Elleste Duet Conti, but you will need regular monitoring if you have or have had:
- Fibroids (uterine leiomyoma) or endometriosis
- Risk factors for blood clots (obesity, prolonged immobility, major surgery, strong family history of thrombosis, SLE, cancer)
- Strong family history of breast cancer or other hormone-dependent tumours
- High blood pressure
- Liver problems (including liver adenoma)
- Diabetes, with or without blood vessel involvement
- Gallstones
- Migraine or severe headaches
- Systemic lupus erythematosus (SLE)
- Previous endometrial hyperplasia
- Epilepsy, asthma or otosclerosis
- Markedly raised triglycerides
- Tendency to fluid retention, heart or kidney disease
Treatment should be reviewed at least once a year, and only continued while the benefits outweigh the risks.
Side Effects
Like all medicines, Elleste Duet Conti can cause side effects, although not everyone gets them. The most commonly reported include:
Very common / common (may affect up to 1 in 10 people or more):
- Breast symptoms
- Breast pain or tenderness
- Breast enlargement or feeling of breast tension
- Bleeding changes
- Irregular vaginal bleeding or spotting
- Menstrual-type cramps (dysmenorrhoea)
- Heavier, lighter or altered pattern of bleeding in women who are still perimenopausal
- Mood and nervous system
- Headache, migraine
- Depression, low mood, nervousness, mood swings
- Dizziness, difficulty sleeping (insomnia)
- Digestive system
- Nausea, abdominal pain or discomfort
- Abdominal bloating or distension, indigestion, diarrhoea; occasionally vomiting
- Skin and hair
- Rash, itching, dry skin
- Acne
- Increased hair growth (hirsutism) or hair loss (alopecia)
- Muscles and joints
- Back pain, pain in arms or legs
- Muscle cramps or spasms
- General
- Fluid retention and swelling (e.g. swollen ankles/legs)
- Weight increase
- Tiredness, general pain or feeling unwell
- Liver and gallbladder
- Gallbladder problems or gallstones
- Cholestatic jaundice (itching and yellowing of skin/eyes)
- Circulation
- Raised blood pressure
- Varicose veins
Less common side effects include venous blood clots (deep vein thrombosis or pulmonary embolism), which are more frequent among HRT users than non-users.
Stop taking Elleste Duet Conti and seek urgent medical help if you notice:
- Painful swelling, redness or warmth in one leg
- Sudden chest pain, breathlessness, or coughing up blood
- Sudden severe headache or migraine, especially with visual or speech problems
- Yellowing of the skin or eyes (jaundice), severe itching, or dark urine
- A new breast lump or nipple changes
- Sudden or very heavy vaginal bleeding, especially after being period-free for a while
Any persistent, new or troublesome symptoms should be checked by a doctor or pharmacist.
Patient Information Leaflet
Please see HERE for the Patient Information Leaflet
Additional Info
Key points about Elleste Duet Conti:
- Type of medicine: Continuous combined HRT tablet (oestrogen + progestogen)
- Active ingredients: Estradiol 2 mg and norethisterone acetate 1 mg per film-coated tablet
- Use:
- Treatment of oestrogen deficiency symptoms in women one year since last menses
- Prevention of osteoporosis in postmenopausal women at high fracture risk who cannot take other osteoporosis treatments
- Endometrial protection: Designed for women who still have their womb – the continuous progestogen component helps protect against endometrial hyperplasia and endometrial cancer
- Lactose content: Each tablet contains lactose monohydrate (60.8 mg) – not suitable for women with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose–galactose malabsorption
- Driving and machines: Has no or negligible effect on the ability to drive or use machines
- Interactions:
- Medicines that induce liver enzymes (e.g. some epilepsy drugs such as carbamazepine, phenytoin, phenobarbital; rifampicin, rifabutin; certain HIV medicines; and St John’s wort) may reduce HRT effectiveness and alter bleeding patterns
- HRT may affect some laboratory tests, including thyroid function and other hormone-binding proteins
- HRT may reduce lamotrigine levels, possibly lowering seizure control
- Caution is advised with certain hepatitis C antiviral regimens due to potential liver enzyme changes
- Monitoring: Women needing thyroid hormone replacement may require more frequent thyroid function checks during HRT.
HRT does not improve memory or cognitive function, and starting combined HRT after age 65 may be linked with an increased risk of probable dementia.
Directions
Always take Elleste Duet Conti exactly as directed by your prescriber.
- Dose:
- This is a continuous combined HRT – one grey tablet is taken every day, with no tablet-free break.
- When to start:
- If you are not currently on HRT, you can usually start on any convenient day, provided you are at least one year since your last period.
- If you are switching from a cyclical / sequential HRT, complete your current cycle and then start Elleste Duet Conti the next day with no break.
- If you are switching from another continuous combined HRT, you can usually start Elleste Duet Conti at any time if you are not having regular bleeding, or on the first day of bleeding if you still have cyclical bleeds.
- How to take:
- For oral use.
- Swallow the tablet whole with a drink of water.
- Try to take it at the same time every day to help you remember.
Your dose and duration of treatment should always be the lowest effective dose for the shortest time needed to control symptoms.
Missed a dose?
If you forget a tablet:
- If less than 12 hours have passed since your usual time, take the missed tablet as soon as you remember, then take the next tablet at the normal time.
- If more than 12 hours have passed, skip the missed tablet and take your next tablet at the usual time.
- Do not take a double dose to make up for a forgotten tablet.
Missing tablets may increase the chance of breakthrough bleeding or spotting.
FAQs
What is Elleste Duet Conti used for?
Elleste Duet Conti is a continuous combined HRT used to relieve menopausal symptoms in women at least one year past their last period and to help prevent osteoporosis in high-risk postmenopausal women who still have their womb.
Is Elleste Duet Conti a contraceptive?
No, Elleste Duet Conti does not prevent pregnancy, so you may still need non-hormonal contraception like condoms if you are under 50 or less than 12 months since your last natural period.
What does “continuous combined” HRT mean?
Continuous combined HRT involves taking one tablet daily containing both oestrogen and progestogen without breaks to protect the womb lining, and while it is intended to prevent monthly periods for postmenopausal women, some irregular spotting may occur initially.
Will I still get bleeding while taking Elleste Duet Conti?
Some women experience light spotting or cramps during the first few months of use which usually settles, but you must consult a doctor if bleeding persists, restarts after stopping, or occurs after a period of no bleeding as all unexplained bleeding requires investigation.
What if I miss a tablet?
If you miss a dose by less than 12 hours you should take it immediately, but if more than 12 hours have passed you should skip it and resume your normal schedule without doubling up, though this may cause some spotting.
Does Elleste Duet Conti cause weight gain?
Weight gain and fluid retention are possible side effects but do not affect everyone, and since menopause is naturally associated with weight changes, maintaining a healthy diet and regular exercise remains important while on HRT.
What serious risks are associated with HRT like Elleste Duet Conti?
Systemic HRT carries small increased risks of breast, endometrial, and ovarian cancers, as well as blood clots, stroke, and heart disease, all of which will be discussed during regular reviews with your 24 HR Pharmacy clinician to ensure continued treatment is appropriate.
Can I take Elleste Duet Conti with my other medicines?
Certain medications for epilepsy, HIV, or tuberculosis, as well as St John’s wort, can reduce HRT effectiveness or alter bleeding patterns, and HRT can also affect thyroid tests and lamotrigine levels, so you must disclose all supplements and medicines to your provider.
How long can I stay on Elleste Duet Conti?
There is no fixed duration for treatment, but the general recommendation is to use the lowest effective dose for the shortest necessary time with at least one annual review to decide if you should continue, adjust, or stop the medication.
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