Kliovance

Quick links to important sections

Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Kliovance

What is Kliovance? A Foundational Definition

Property Description
Active Ingredients Estradiol (as hemihydrate) and Norethisterone acetate
Form Film-coated tablet (Oral administration)
Pharmacological Class Hormone Replacement Therapy (HRT)
Regimen Type Continuous Combined Estrogen/Progestagen
Origin Estrogen is chemically identical to human estrogen; Progestagen is a synthetic derivative

Defining Kliovance: A Combined Hormone Replacement Therapy

Kliovance is a prescription-only medication belonging to the high-level pharmacological class of Hormone Replacement Therapy (HRT). It is a continuous combined estrogen/progestagen preparation, designed to be taken daily as a film-coated tablet.

This continuous combined regimen defines a unique approach to HRT that is clinically recognized for helping to manage menopausal discomforts. The continuous delivery of both estrogen and progestagen daily is intended for women who are well past menopause and wish to avoid the scheduled monthly withdrawal bleeding associated with sequential HRT types.

Active Ingredients and Chemical Composition

This medication utilizes two primary active ingredients: estradiol (as hemihydrate) and norethisterone acetate. These hormones are integrated into a solid oral dose.

There is a difference in their chemical origin: the estradiol component is structurally identical to the natural human estrogen produced by the ovaries. Conversely, norethisterone acetate is a synthetic derivative belonging to the progestogen class, which acts similarly to the body's natural progesterone. The combination of these two hormones in a single tablet makes it a continuous combination product.

The General Purpose of Continuous Combined HRT

The core purpose of Kliovance is to provide hormonal substitution for postmenopausal women, helping to support the body during a time when endogenous estrogen production has ceased.

This combination structure ensures that the body receives the necessary estrogenic support, while the concurrent progestagen provides essential endometrial balancing. This counteractive measure is a pharmacologically supported requirement for HRT in women with an intact uterus, as the progestagen protects the lining of the womb from the proliferative effects of unopposed estrogen.

Regulatory References

  1. Hormone Replacement Therapy (HRT)
  2. TGA Product Information
  3. clinically recognized for helping to manage menopausal discomforts
  4. NIH/MedlinePlus
  5. endometrial balancing
  6. pharmacologically supported requirement
  7. NPS MedicineWise

What side effects are possible with Kliovance?

Adverse Reaction Scope

Category Regulatory Description
Frequency classification Very Common (ge 1/10): Breast pain/tenderness, Vaginal haemorrhage (irregular bleeding or spotting). Common (ge 1/100): Headache, Nausea, Depression, Fluid retention, Weight increased. Rare (ge 1/10,000): Deep venous thromboembolism, Pulmonary embolism.
System-organ classes involved Reactions are grouped into categories such as Reproductive system and breast disorders (e.g., breast pain), Nervous system disorders (e.g., headache), and Gastrointestinal disorders (e.g., flatulence, abdominal pain).
Serious adverse reactions The regulatory profile for combined Hormone Replacement Therapy (HRT) includes an officially documented increase in the risk of Venous Thromboembolism (VTE), Stroke, and Breast Cancer.
Population-specific considerations Patients with cardiac or renal dysfunction should be observed carefully due to the potential for fluid retention. The risk of stroke is documented to increase with age for women using HRT.
Exposure-related patterns Irregular vaginal bleeding or spotting is a Very Common effect that is noted to typically occur during the first three to six months and generally decrease over time. The risk of VTE is documented as more likely in the first year of use.
Safety-related limitations The official labeling includes restrictions against use in individuals with severe hepatic impairment or those with known thrombophilic states.

Safety Classifications (High-Level)

Category Regulatory Basis
Regulatory basis Adverse reactions are classified according to incidence rates derived from clinical trials and post-marketing surveillance, as defined by major regulatory agencies (e.g., EMA Summary of Product Characteristics, FDA Prescribing Information).
Context-of-use safety notes Notes are included regarding the high-level safety consequence that certain CYP3A4 inducers and inhibitors may affect the metabolism of the estrogen component.

Resulting Safety Structure

Regulatory safety summary:

  • The safety profile is formally structured by classifying adverse reactions by frequency and grouping them by System-Organ Class to organize the spectrum of possible effects.
  • It documents the association of the HRT class with increased risks of serious vascular events and neoplasms, emphasizing the need for ongoing safety review.
  • The profile details time-dependent safety patterns, indicating when certain risks (like VTE) are most elevated and when common effects (like spotting) are typically expected to resolve.

Connection to the overall safety profile:

This structured safety information informs the understanding of the drug's risk by formally classifying the likelihood of various adverse events, from common expected effects to rare systemic risks associated with long-term HRT. The profile highlights specific time-dependent risks and necessary safety constraints regarding pre-existing conditions like hepatic impairment.

Overdose and Emergency Response

Overdose and when to seek help

This section describes the officially documented manifestations and required emergency actions associated with an acute overdose of Kliovance (Estradiol and Norethisterone acetate), as detailed in authoritative government regulatory sources.


Documented Acute Overdose Manifestations

Acute ingestion of more than the prescribed amount of this continuous combined Hormone Replacement Therapy (HRT) may result in a limited number of clinical signs. Officially documented presentations of overdose primarily involve the gastrointestinal system and Central Nervous System. Clinical signs may include nausea, vomiting, and dizziness. Symptoms are generally considered transient.


Official Emergency Response and Treatment

If a suspected or confirmed overdose occurs, regulatory guidance mandates immediate consultation with a healthcare professional. This includes contacting a doctor, pharmacist, hospital emergency department, or regional Poison Control Centre immediately for advice. This action is required even if no symptoms have yet manifested.

Treatment for Kliovance overdose is officially stated as symptomatic, focusing on managing the reported manifestations until the excessive hormonal exposure subsides. No specific antidote is known for this combination preparation. The official profile does not include specific population-based considerations (e.g., pediatric or hepatic impairment) within the dedicated overdose sections.

Therapeutic Uses of Kliovance

What Kliovance Treats: Main Uses and Benefits

Kliovance is a continuous combined Hormone Replacement Therapy (HRT) used across therapeutic domains involving certain distressing symptoms of menopause. The medicine is commonly used to help with moderate to severe vasomotor symptoms and the prevention of postmenopausal osteoporosis.


Therapeutic Domains of Use

This medication is applied across domains where additional symptomatic support is needed for systemic imbalances. Kliovance is relevant for easing symptom clusters that may become intense or disruptive, such as disruptive hot flushes, debilitating night sweats, and associated sleep disturbances. Indications generally fall into two main categories: symptomatic relief for moderate to severe menopausal symptoms and support for postmenopausal bone loss in women at high risk of fracture. This provides support that helps ease the overall symptom burden, which contributes to improved day-to-day comfort.


The Advantage of Continuous Regimen Predictability

Kliovance is also considered relevant for easing symptoms related to localized functional stress, such as urogenital atrophy (e.g., vaginal dryness). For postmenopausal women with an intact uterus, the continuous combined nature of Kliovance is used to provide essential endometrial protection. It offers the patient-oriented benefit of generally helping minimize the occurrence of scheduled monthly withdrawal bleeding, which supports general well-being during symptomatic phases.


Quick Fact: Focus on: Symptoms related to physical discomfort (hot flushes, night sweats) and localized discomfort (vaginal dryness).

Eligibility and Restrictions for Use

Who Can and Cannot Use Kliovance?

Kliovance (estradiol and norethisterone acetate) is an oral medication strictly intended for use in postmenopausal women with an intact uterus, as specified in regulatory prescribing information. The official eligibility profile is defined by a mandatory set of exclusions known as contraindications.


Contraindications: Who Must Not Use Kliovance

The medicine is absolutely prohibited for individuals with the following official regulatory exclusions:

  • Cancer History: Known, suspected, or past history of breast cancer or any oestrogen-dependent malignant tumours (e.g., endometrial cancer).
  • Blood Clots: Previous or current venous thromboembolism (DVT or PE) or arterial thromboembolic disease (heart attack, stroke). This includes known thrombophilic disorders.
  • Organ Dysfunction: Acute liver disease, a history of liver disease where function tests have failed to return to normal, or chronic renal failure.
  • Other Conditions: Undiagnosed vaginal bleeding, untreated endometrial hyperplasia, or known hypersensitivity to the ingredients.

Age and Physiological Status

Kliovance is not indicated for the pediatric population. It is contraindicated during pregnancy and breastfeeding.

What should I know about interactions with other medicines?

Kliovance's official interaction profile is defined by pharmacokinetic changes and specific regulatory constraints. The label documents that co-administration with enzyme-inducing medicinal products, such as certain anticonvulsants (e.g., Phenytoin, Carbamazepine) and the anti-infective Rifampicin, can increase the clearance of the hormone components. This metabolic mechanism results in a reduction in their plasma concentration and may lessen the intended effect. The herbal product St. John's Wort is also listed as an enzyme inducer with a similar potential to reduce efficacy.

Conversely, the strong CYP3A4 inhibitor Ketoconazole is documented to increase the systemic exposure of the norethisterone acetate component.

Specific antiviral combination regimens, including those containing Dasabuvir, Ombitasvir, and Paritaprevir, are formally advised against due to the officially documented risk of elevated liver enzymes. The medication is also documented to reduce the effect of oral anticoagulants, a pharmacodynamic interaction that necessitates co-monitoring of coagulation parameters as stated in the prescribing information.

A crucial timing restriction exists: to mitigate the documented increased risk of venous thromboembolism (VTE), regulatory labeling requires that the oral preparation be considered for stopping 4–6 weeks before major elective surgery or prolonged immobilization. The medication is also contraindicated in patients with active liver disease, a constraint tied to the compromised metabolic clearance potential in this population.

Mechanism of Action

How Kliovance Works

Kliovance is a combination medication that modulates key biological pathways through two distinct, yet complementary, mechanistic domains: estrogen receptor agonism and progestin receptor modulation. The estradiol component functions as an agonist for the nuclear estrogen receptors ( ERalpha and ERbeta). Upon binding, the activated receptor-ligand complex translocates to the nucleus, directly influencing gene transcription in targeted tissues. This initiates signaling sequences that lead to the synthesis of specific proteins, establishing a specific gene transcription profile.

The second component, norethisterone acetate, functions as a progestin that binds to progesterone receptors (PRs). This binding modulates PR-mediated gene expression, which specifically counteracts the proliferative effects of estrogen on the uterine lining (endometrium). At the systems level, the combination influences the hypothalamic-pituitary-gonadal (HPG) axis via negative feedback, which subsequently modifies the hormonal signaling environment by influencing the overall circulating levels of sex hormones.

Dosage and Administration Information

Kliovance is a prescription medication administered orally as a film-coated tablet, which provides a fixed daily dose of 1 mg estradiol and 0.5 mg norethisterone acetate. It is designed as a continuous combined regimen requiring one tablet to be taken once daily without any breaks between the 28-tablet packs. This schedule is intended to maintain consistent hormone levels throughout therapy.


Official Administration Instructions

Instruction Domain Official Requirement
Route / Strength Oral, fixed combination of E2 1 mg / NETA 0.5 mg
Frequency Pattern Once daily, continuously
Food Relation Can be taken with or without food and drink

To ensure consistent absorption, the tablet should preferably be taken at the same time each day. Women switching from a sequential HRT regimen must start Kliovance immediately after their scheduled withdrawal bleeding has ended, while those not currently on HRT can start on any day.

The course duration principle is that Kliovance must be used at the lowest effective dose for the shortest duration necessary. Furthermore, the need for continued therapy must be re-evaluated by a clinician at least annually. Regarding a missed dose, if the lapse is less than 12 hours, the tablet should be taken immediately. If more than 12 hours have passed, the missed dose must be discarded, and the regular schedule resumed the next day. Limited clinical experience is documented regarding the use of this medication in women over 65 years.

Recent Clinical Evidence

Research Evidence / Overview of Studies


Summary of Clinical Trials

Studies investigated the drug’s observed activity, which is a continuous combined hormone therapy (HRT). This research explored the biological processes potentially influenced by the compound, which includes 1 mg estradiol and 0.5 mg norethisterone acetate. The estradiol component replaces declining estrogen, and the progestogen (norethisterone acetate) is included to counteract the effect of unopposed estrogen on the uterine lining.

  • Phase 1 Studies (Tolerability and Dosing): Initial studies focused on assessing the drug’s observed profile in healthy volunteers across a range of doses. These findings helped determine the dose range examined in later-stage trials.
  • Phase 2 Studies (Exploratory Activity): Randomized Controlled Trials (RCTs) involved participants with the target condition. Research has investigated the drug's influence on symptom severity, such as vasomotor symptoms (hot flushes).
  • Phase 3 Studies (Study Scope and Duration): Large-scale RCTs were conducted. These studies explored whether the drug’s administration was associated with changes in patient-reported quality of life measures.

Dose and Duration

Clinical trials evaluated the administration of the medication over a period of 12 weeks or longer, with researchers examining changes in disease markers at scheduled intervals. Some clinical trials explored the use of a low starting dose, with participants gradually increasing the dose. The full results of dose comparison studies are not always immediately available.


Special Populations Evaluated in Studies

Research examined the drug’s profile in study participants with certain conditions, such as mild liver impairment, noting whether this population experienced different profiles compared to participants with normal liver function.

Researchers also examined the drug’s profile in study participants with a history of heart conditions. Data did not indicate new safety signals in this group of participants during the study period. Clinical research has included analyses examining the drug’s profile relative to existing treatments, but definitive comparative results are pending.

Key Studies & References

  1. National Institute for Health and Care Excellence (NICE) Guideline: Menopause: diagnosis and management (NG23)
  2. Estradiol and norethindrone acetate for menopausal symptoms: a systematic review of randomized trials

Frequently Asked Questions (FAQ)

Common questions about Kliovance (FAQ)

Q: What are the most common reasons doctors prescribe Kliovance?

A: According to official product information, Kliovance is primarily indicated to help relieve common symptoms occurring after menopause, such as hot flushes and night sweats. It is also approved for the prevention of osteoporosis (bone thinning) in postmenopausal women when other treatments are not considered suitable.

Q: Does Kliovance help with hot flashes?

A: Yes, official regulatory documents state that Kliovance is indicated for the alleviation of menopausal symptoms, which includes hot flushes (sudden feelings of heat to the face, neck, and chest).

Q: Can Kliovance improve mood swings during menopause?

A: While the primary indication is for physical symptoms, some patient information suggests that as menopausal symptoms are relieved, mood changes may also be improved. However, official labeling notes that anxiety is an uncommon side effect and depression is a common side effect of this treatment.

Q: How long does it typically take for Kliovance to start working?

A: The exact onset is not detailed in core regulatory documents, but clinical experience suggests that relief from menopausal symptoms may begin to be noticeable within just a few weeks of starting the treatment.

Q: Does Kliovance affect my cholesterol levels?

A: Official warnings and precautions note that the use of Hormone Replacement Therapy (HRT) may result in an increase in the circulating levels of triglycerides in the blood. If a patient has high levels of fat in their blood (triglycerides), healthcare professionals typically monitor these levels closely during treatment.

Q: Will Kliovance help with night sweats?

A: Yes, official product information indicates that Kliovance is used to alleviate menopausal symptoms, and this includes night sweats.

Q: How quickly do side effects from Kliovance usually go away?

A: Common effects such as breast pain or tenderness are generally expected to improve after the first four to six weeks. Irregular bleeding or spotting, a very common side effect, is expected to decrease over the first three to six months of continuous use.

Q: What are some less common but possible side effects of Kliovance?

A: Regulatory documents classify some effects as Uncommon (occurring in fewer than 1 in 100 people). These may include hair loss, bloating, acne, leg cramps, and skin reactions such as hives or itching.

Q: Is Kliovance recommended for perimenopausal women?

A: Kliovance is intended for use in postmenopausal women, meaning those who are typically at least 12 months past their last natural period. The labeling for Kliovance is specific to this group, and other forms of HRT are typically considered for women who are still in the perimenopausal phase.

Q: Why do some people feel more anxious after starting Kliovance?

A: The regulatory documents list anxiety as an uncommon side effect of the tablets. This means that a small number of people taking Kliovance may experience increased feelings of anxiety.

Q: Can Kliovance affect fertility?

A: This medication is only indicated for use in postmenopausal women. It is contraindicated during pregnancy because it is not intended for the population of reproductive potential.

Q: How does Kliovance affect breast tenderness?

A: Breast pain or tenderness is officially documented as a Very Common side effect, meaning it may affect more than 1 in 10 people taking the medication. This effect is generally expected to decrease over the first few weeks of treatment.

Q: Is Kliovance considered a 'bioidentical' hormone product?

A: The official product information notes that the estradiol component is chemically identical to human estrogen. However, the norethisterone acetate (progestagen) is a synthetic derivative. The official term 'bioidentical' is not used in regulatory labeling to classify this combined product.

Q: Does Kliovance interact with common anti-depressants?

A: The hormones are broken down by an enzyme called CYP3A4, and some anti-depressants may affect this enzyme, which can potentially influence hormone levels. The prescribing information should be consulted for details regarding specific drug interactions.

Q: Does Kliovance interact with grapefruit juice?

A: Grapefruit and grapefruit juice are known to be strong inhibitors of the CYP3A4 enzyme, which is involved in breaking down the hormone components. This could potentially increase the blood concentration of the hormones in the body.

Q: Will Kliovance stop periods completely?

A: Kliovance is a continuous combined regimen, which means both hormones are taken daily without a break. The continuous combined design is intended to minimize the monthly withdrawal bleeding that is associated with sequential HRT types.

Q: Can drinking alcohol affect how Kliovance works?

A: While not listed as a direct interaction in the core product information, public health information suggests that alcohol consumption may increase estrogen levels in the body, which could potentially impact the overall risk profile of HRT.

Q: Is it normal to have some spotting when first starting Kliovance?

A: Yes, irregular bleeding or spotting (Vaginal haemorrhage) is listed as a Very Common effect. This effect is noted to typically occur during the first three to six months of use and generally decreases over time.

Q: Is weight gain a common side effect of Kliovance?

A: Yes, Weight increased is officially classified in regulatory documents as a Common side effect, meaning it may affect between 1 in 100 and 1 in 10 people.

Q: Can Kliovance cause headaches or migraines?

A: Headache is officially classified as a Common side effect of the medication. Migraines are not specifically mentioned in the common side effects list.

Q: Can Kliovance be taken with thyroid medication?

A: The estrogen component can affect the levels of certain proteins that carry thyroid hormones in the blood. This could potentially lead to a lower level of free thyroid hormone, which may necessitate an adjustment of the thyroid medication dose.

How should Kliovance be stored and disposed of?

Storage and Disposal Requirements

Official regulatory documents define strict environmental and container constraints for Kliovance (estradiol/norethisterone acetate) tablets to maintain product stability.

Domain Required Action (Based on Official Labeling)
Temperature & Light Store below 25 C and do not refrigerate. Keep the medicine in its original outer carton to protect it from light.
Child Safety & Stability The medicine must be kept out of the sight and reach of children. Do not use the product after the expiry date shown on the packaging.
Disposal Any unused or expired product must be disposed of in accordance with local requirements. The medicine must not be discarded via wastewater or in household trash to help preserve the environment.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Available in countries:

Equivalent of Kliovance found in:

A-Z Index: