Evorel Sequi

• Evorel Sequi is a patch medication
• Evorel Sequi is a form of HRT
• Evorel Sequi contains two different types of patches that must be used in a sequence
• One patch should be applied to the skin twice a week
• The benefits of using Evorel Sequi must outweigh the risk of side effects 
• It is important to read the patient leaflet for a full list of side effects and cautions.

At the time of the menopause, levels of the hormones oestrogen and progesterone start to fall. This can lead to symptoms including hot flushes, night sweats, hair thinning, mood changes and vaginal dryness. 

Evorel Sequi contains two different HRT patches. One type of patch contains oestradiol (synthetic oestrogen) only, and the other contains a combination of oestradiol and norethisterone (synthetic progesterone). These hormones are absorbed via the skin into the bloodstream.

Using the two patches as prescribed helps to mimic the natural cycle of hormones in a woman’s body, minimising the symptoms of the menopause.

A pack of Evorel Sequi contains two different HRT patches, Evorel 50 and Evorel Conti, that should be used in a sequence. Each cycle lasts for 28 days.

The oestradiol-only Evorel 50 patches should be used for days 1 to 14 of the cycle.

On days 15 to 28, an Evorel Conti patch should be worn. Evorel Conti contains oestradiol and norethisterone (oestrogen and progesterone). 

A subsequent treatment cycle should then follow immediately after.

A patch should be applied to the skin twice weekly. Each patch should therefore be changed every 3 or 4 days (alternating). You may choose to change your patch on a Monday and Thursday, for example. The patch you apply will depend on where you are in the HRT cycle. 

If you no longer have periods, or your periods have become irregular, Evorel Sequi can be started at any time.  

If you still have regular periods, you should start Evorel Sequi within 5 days of the start of your period. 

If you already take a continuous combined HRT medication, you can start taking Evorel Sequi at any time. If you currently take a cyclic or sequential HRT treatment, you should start Evorel Sequi after finishing your current cycle, or following a 7 day hormone free interval.

Each patch should be applied to clean, dry skin of the trunk below the waist. It is best to avoid areas of the skin where the patch may be rubbed, for example by your underwear. The patch must not be applied near or on the breasts. When you replace the patch, apply it to a new area away from the location you have just used. 

The Evorel Sequi patch should remain in place during showering, bathing, and exercise.

After removal, dispose of the patch carefully away from children.

Evorel Sequi contains two different patches.

1. Evorel 50 – this patch releases 50 micrograms of oestradiol every 24 hours
2. Evorel Conti – this patch releases 50 micrograms of oestradiol and 170 micrograms of norethisterone every 24 hours.

The Evorel 50 patches should be used on days 1 to 14 of each cycle. On days 15 to 28, you should use Evorel Conti patches.

Like all medications, Evorel Sequi can have some side effects. The most common side effects include:

• Rash, redness or swelling at the site of the patch
• Mood changes including depression, nervousness, and changeable moods
• Insomnia (difficulty sleeping)
• Migraine and headaches
• Hypertension (high blood pressure)
• Abdominal pain
• Diarrhoea
• Flatulence
• Nausea
• Itching or a rash
• Back pain
• Muscular aches and pains
• Breast pain
• Changes to menstrual bleeding pattern
• Tiredness
• Weight increase
• Vaginal infections.

If these side effects persist, you should speak to your doctor for further advice as a lower dose of HRT may be required.

Using HRT can cause a slight increase in the risk of some cancers including breast and uterine cancer. The risk increases when using a higher strength preparation for a long period. It is important that the benefits of using Evorel Sequi outweigh the potential risks.

Serious allergic reactions happen very rarely. If you have a severe allergic reaction (anaphylaxis) including breathlessness, lip swelling or tongue swelling, call 999 immediately.

Evorel Sequi may not be suitable for everyone. You should tell your prescriber if you:

• Have ever had breast cancer (or suspected breast cancer)
• Have endometrial (or another oestrogen dependent) cancer
• Have undiagnosed vaginal or genital bleeding
• Have endometrial hyperplasia, fibroids, or endometriosis
• Have, or have ever had, a PE (pulmonary embolism) or DVT (deep vein thrombosis) – a blood clot to the lungs or leg
• Have a thrombophilic disorder (blood clotting disorders)
• Have angina or have had a heart attack (myocardial infarction), or any other form of arterial blood clot
• Have had a stroke
• Have liver disease
• Have porphyria
• Have hypertension (high blood pressure)
• Have diabetes
• Have migraine
• Have systemic lupus erythematosus (SLE or lupus)
• Have epilepsy
• Have asthma
• Have otosclerosis
• Have mastopathy (benign, hormone dependent changes in the breast).

If you become pregnant whilst taking Evorel Sequi, the patches must be stopped immediately. Evorel Sequi is not suitable for use when breastfeeding.

Some medications can interact with Evorel Sequi. You may be advised that Evorel Sequi will not suit you if you already take:

• Phenytoin, phenobarbital, carbamazepine, or lamotrigine for seizures or fits
• Ritonavir, telaprevir, or nelfinavir
• Rifampicin
• Rifabutin
• Nevirapine
• Efavirenz
• Bosentan
• St John’s Wort (Hypericum Perforatum).

Because Evorel Sequi may not suit everyone, we will complete a Consultation with you including a health questionnaire. This will ensure that the medication will be suitable for you.

A qualified prescriber will review your current medications, including any herbal remedies or supplements, to ensure that Evorel Sequi will not interact with them. 

Once prescribed, Evorel Sequi will be ordered on your behalf via electronic prescription. Evorel Sequi will then be conveniently dispatched from one of our partner pharmacies.