Livial Tablet 28's belongs to the class of medicines called synthetic steroids used to treat postmenopausal symptoms and prevent osteoporosis (weak and brittle bones) caused in menopausal women. Livial Tablet 28's is a hormone replacement therapy (HRT). Postmenopause is a condition in which women have not had a period of 12 months or longer. The oestrogen levels decrease in postmenopausal women resulting in symptoms such as hot flushes (hot neck, face and chest). Osteoporosis is a bone disease that weakens and thins bones by decreasing bone density which is common in post-menopausal women.

Livial Tablet 28's contains Tibolone which works by mimicking the activity of natural hormones progesterone, oestrogen and testosterone. Thereby, it reduces menopausal symptoms by restoring hormone levels in the body. Also, Livial Tablet 28's prevents osteoporosis in postmenopausal women by restoring oestrogen levels in the body and preventing bone loss and fractures.

Take Livial Tablet 28's as prescribed by your doctor. You are advised to take Livial Tablet 28's for as long as your doctor has prescribed it for you based on your medical condition. In some cases, you may experience stomach pain, breast pain, vaginal bleeding or spotting, unusual hair growth, weight gain, vaginal itching or irritation. Most of these side effects of Livial Tablet 28's do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor.

If you are allergic to Livial Tablet 28's or any other medicines, please tell your doctor. Avoid taking Livial Tablet 28's if you are pregnant or breastfeeding and consult a doctor. Livial Tablet 28's is not recommended for children. You are recommended to avoid alcohol consumption with Livial Tablet 28's as it may increase the risk of breast cancer. If you have premature menopause, inform your doctor before taking Livial Tablet 28's so that the risks and benefits may be compared.

Livial Tablet 28's contains Tibolone, a hormone replacement therapy (HRT) used to treat postmenopausal symptoms and prevent osteoporosis (weak and brittle bones) caused by menopause in women. Livial Tablet 28's mimics the activity of natural hormones progesterone, estrogen, and testosterone. Thereby restoring hormone levels in the body and reducing menopausal symptoms. Also, Livial Tablet 28's prevents osteoporosis in postmenopausal women and prevents bone loss and fractures. The risk of breast cancer and blood clots is less with Livial Tablet 28's than with other HRT.

• Stomach pain
• Breast pain
• Vaginal bleeding or spotting
• Unusual hair growth
• Weight gain
• Vaginal itching or irritation

If you are allergic to Livial Tablet 28's or any other medicines, please tell your doctor. Avoid taking Livial Tablet 28's if you are pregnant or breastfeeding and consult a doctor. Livial Tablet 28's is not recommended for children. If you have premature menopause, inform your doctor before taking Livial Tablet 28's so that the risks and benefits may be compared. Avoid taking Livial Tablet 28's if you have recently had a stroke, heart attack, or angina (chest pain).  If you have very high levels of fat (triglycerides) in blood, inform your doctor before taking Livial Tablet 28's. You are recommended to avoid alcohol consumption with Livial Tablet 28's as it may increase the risk of breast cancer. If you experience sudden chest pain, difficulty in breathing, or painful swelling and redness of your legs, stop taking Livial Tablet 28's and consult a doctor immediately as these might be signs of a blood clot.

Drug-Drug Interaction: Livial Tablet 28's may interact with a blood thinner (warfarin), anticonvulsants (phenytoin, carbamazepine, phenobarbital), and antitubercular drugs (rifampicin).

Drug-Food Interaction: Livial Tablet 28's may interact with St. John’s wort (herbal medicine to treat depression).

Drug-Disease Interaction: If you have high blood pressure, gallstones, diabetes, migraine, epilepsy (fits), asthma, fluid retention due to kidney or heart problems, unexplained vaginal bleeding, breast cancer, liver disease, systemic lupus erythematosus (an autoimmune disease), estrogen-sensitive cancer, porphyria, fibroids in the womb, endometrial hyperplasia (excessive thickening of the womb lining), blood clotting disorder or blood clot in the vein, inform your doctor before taking Livial Tablet 28's.

• WARFARIN
• PHENYTOIN
• CARBAMAZEPINE
• PHENOBARBITAL
• RIFAMPICIN

• Include dairy products like milk, yogurt, cheese, or milk-based custard in your diet.
• Eat daily a serving of broccoli, cabbage, bok choy (Chinese white cabbage), spinach, and other green leafy vegetables.
• Snack on calcium-rich nuts like Brazil nuts or almonds.
• Sprinkle sesame seeds over your food, vegetables, and salads. Sesame seeds are high in calcium.
• Avoid or reduce the intake of caffeine, soft drinks, and alcohol that inhibit calcium absorption.
• Replace the meat with tofu or tempeh for extra calcium in your food.

• Regular breast screening is recommended while taking Livial Tablet 28's.
• Check your breasts regularly for any changes in the nipple, dimpling of the skin or any lumps. 

Hormone replacement therapy (HRT): It is a treatment to relieve menopause symptoms. It replaces hormones that are at a lower level as you approach menopause.

Osteoporosis: It is a bone disease that weakens and thins bones by decreasing bone density. As the density of bones decreases, they weaken and are more likely to break. Post-menopausal women are more likely to develop osteoporosis than men because, at menopause, a woman’s ovaries stop producing estrogen (a female hormone) which is essential to keep bones healthy. Following menopause, bone loss occurs, making bones weak and more likely to break. Also, long-term use of steroids may affect bone strength and cause osteoporosis in both men and women. Signs and symptoms include back pain caused by a fractured or collapsed vertebra, loss of height over time, a stooped posture, and a bone that breaks much more easily than expected.