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AMS Guide to 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 June 2024. 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 MHT/HRT Doses NZ142.79 KB

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 (½ of 5mg tablet)

tablet

2.5mg medroxyprogesterone acetate

Provera 2.5mg tablet*

tablet

2.5mg medroxyprogesterone acetate

Primolut N (¼ of 5mg tablet)

tablet

1.25 mg norethisterone

Utrogestan*

capsule

100mg micronised progesterone orally for 25 days out of a 28-day cycle1 or 200mg orally daily for 12 days out of a 28-day cycle

Mirena*   
(Pharmac indication for menorrhagia/anaemia)
device (5 years) 20mcg/24hrs levonorgestrel

Medium dose for use with medium dose oestrogen2

Primolut N (¼ of 5mg tablet)

tablet

1.25 mg norethisterone

Provera

tablet

5mg medroxyprogesterone acetate

Utrogestan*

capsule

100mg micronised progesterone orally for 25 days out of a 28-day cycle1 or 200mg orally for 12 days out of a 28-day cycle

Mirena*

(Pharmac indication for menorrhagia/anaemia)

device (5 years)

20mcg/24hrs levonorgestrel

Higher dose (for use in cyclic therapy or continuous therapy with high dose oestrogen)2

Primolut N (1/2 5mg tablet)

tablet

2.5mg norethisterone

Provera

tablet

10mg medroxyprogesterone acetate

Utrogestan* capsule 100mg micronised progesterone orally for 25 days out of a 28-day cycle1 or 200mg orally for 12 days out of a 28-day cycle

Mirena*

(Pharmac indication for menorrhagia/anaemia)

device (5 years)

20mcg/24hrs levonorgestrel

  1. Can be used daily if compliance is an issue.

  2. Safe continuous or cyclic dose of micronised progesterone for use with oestradiol 2mg tablets is unknown due to insufficient data.

  3. Safe continuous or cyclic dose of micronised progesterone for use with high dose oestrogen (75mcg patch or higher, or high dose oestrogel gels) is unknown due to insufficient data.

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 oestradiol hemihydrate

Progynova

tablet

1mg oestradiol valerate

Premarin*

tablet

0.3mg conjugated equine oestrogen

Estradot 25#

transdermal patch

25 /24hrs 17Β oestradiol (twice weekly application)

Estrogel*^

gel

0.75mg oestradiol hemihydrate= 1 pump

Medium dose

   

Progynova

tablet

2mg oestradiol valerate

Estradot 50

transdermal patch

50mcg/24 hours oestradiol (twice weekly application)

Premarin*

tablet

0.625mg conjugated equine oestrogens

Sandrena*#

gel

1mg oestradiol (daily application)

Estrogel*^

gel

1.5mg oestradiol hemihydrate = 2 pumps

High dose

   

Estradot 75

Estradot 100

transdermal patch

75 or 100mcg/24 hours (twice weekly application)

Estrogel*^

gel

2.25mg oestradiol hemihydrate = 3 pumps or
3.0mg oestradiol hemihydrate = 4 pumps

Oestradiol implants - No longer available

Oestrogen only vaginal therapy

If prescribing vaginal oestrogen rather than systemic hormone therapy, a progestogen is not required.

Product

Presentation

Composition

Ovestin

Ovestin

cream

pessary

1mg/g oestriol

0.5mg oestriol

# Note Sandrena is only available under Section 29 at online pharmacies.

^Note Estrogel is only available under Section 29 direct from supplier Pharmaco.

#Note there is currently a shortage of Estradot so please prescribe Oestradiol patches to allow for substitutes to be dispensed.

Cyclical oestrogen and progestogen combination MHT

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

Medium dose

   

Trisequens*

tablet

1 and 2mg oestradiol hemihydrate/1mg norethisterone acetate

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 hemihydrate/0.5mg norethistrone acetate

Other Low dose hormonal options

Livial*, Xyvion*

tablet

2.5mg tibolone

Duavive* (oestrogen/SERM combination)

tablet

0.45mg conjugated equine oestrogens / 20mg bazedoxifene acetate

Medium dose

   

Kliogest*

tablet

2mg oestradiol/1mg norethistrone acetate

 

AMS Empowering Menopausal Women

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Content Updated 4 June 2024