AMS Guide to MHT/HRT Doses New Zealand only
This Information Sheet has been developed as a guideline only to MHT/HRT products available in New Zealand in September 2024. Hormone Replacement Therapy (HRT) is now referred to as Menopausal Hormone Therapy (MHT). The intention of this sheet is to help clinicians 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 *.
AMS Guide to MHT/HRT Doses NZ107.2 KB
PROGESTOGEN
Suggested alternative doses for use with the oestrogen preparations above where fixed dose therapy is not suitable
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LOW DOSE for use with low dose oestrogen |
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PRODUCT |
PRESENTATION |
COMPOSITION |
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Provera (½ of 5mg tablet) |
Tablet |
2.5mg medroxyprogesterone acetate |
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Provera 2.5mg tablet* |
Tablet |
2.5mg medroxyprogesterone acetate |
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Primolut N (¼ of 5mg tablet) |
Tablet |
1.25 mg norethisterone |
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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 |
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MEDIUM DOSE for use with medium dose oestrogen2 |
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Primolut N (¼ of 5mg tablet) |
Tablet |
1.25 mg norethisterone |
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Provera |
Tablet |
5mg medroxyprogesterone acetate |
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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 |
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Mirena* (Pharmac indication for menorrhagia/anaemia) |
Device (5 years) |
20mcg/24hrs levonorgestrel |
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HIGHER DOSE (for use in cyclic therapy or continuous therapy with high dose oestrogen)2 |
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Primolut N (1/2 5mg tablet) |
Tablet |
2.5mg norethisterone |
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Provera |
Tablet |
10mg medroxyprogesterone acetate |
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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 |
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Can be used daily if compliance is an issue.
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Safe continuous or cyclic dose of micronised progesterone for use with oestradiol 2mg tablets is unknown due to insufficient data.
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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
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LOW DOSE |
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PRODUCT |
PRESENTATION |
COMPOSITION |
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Estrofem* |
Tablet |
1mg oestradiol hemihydrate |
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Progynova |
Tablet |
1mg oestradiol valerate |
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Premarin* |
Tablet |
0.3mg conjugated equine oestrogen |
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Estradot 25# |
Transdermal patch |
25 /24hrs 17Β oestradiol (twice weekly application) |
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Estrogel |
Gel |
0.75mg oestradiol hemihydrate= 1 pump |
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MEDIUM DOSE |
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Progynova |
Tablet |
2mg oestradiol valerate |
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Estradot 50 |
Transdermal patch |
50mcg/24 hours oestradiol (twice weekly application) |
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Premarin* |
Tablet |
0.625mg conjugated equine oestrogens |
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Sandrena*# |
Gel |
1mg oestradiol (daily application) |
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Estrogel |
Gel |
1.5mg oestradiol hemihydrate = 2 pumps |
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HIGH DOSE |
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Estradot 75 Estradot 100 |
Transdermal patch |
75 or 100mcg/24 hours (twice weekly application) |
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Estrogel |
Gel |
2.25mg oestradiol hemihydrate = 3 pumps or |
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Oestradiol implants - No longer available |
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OESTROGEN ONLY VAGINAL THERAPY |
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| If prescribing vaginal oestrogen rather than systemic hormone therapy, a progestogen is not required. | ||
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Product |
Presentation |
Composition |
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Ovestin Ovestin |
Cream Pessary |
1mg/g oestriol 0.5mg oestriol |
# Note Sandrena is only available under Section 29 at online pharmacies.
# 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
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MEDIUM DOSE |
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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
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LOW DOSE |
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PRODUCT |
PRESENTATION |
COMPOSITION |
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Kliovance* |
Tablet |
1mg oestradiol hemihydrate/0.5mg norethistrone acetate |
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OTHER LOW DOSE HORMONAL OPTIONS |
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Livial*, Xyvion* |
Tablet |
2.5mg tibolone |
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Duavive* (oestrogen/SERM combination) |
Tablet |
0.45mg conjugated equine oestrogens / 20mg bazedoxifene acetate |
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MEDIUM DOSE |
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Kliogest* |
Tablet |
2mg oestradiol/1mg norethistrone acetate |
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Content Updated December 2024