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Combined HRT (oestrogen + progestogen)

Estradiol with medroxyprogesterone

Brand names: Indivina, Tridestra

Adult dose

Dose: 1 tablet OD per pack regimen
Route: Oral
Frequency: OD

Clinical pearls

  • Medroxyprogesterone progestogen — observational data suggest higher breast cancer risk vs micronised progesterone (consider alternative)
  • NICE NG23 review of progestogen choice

Contraindications

  • Standard HRT contraindications

Side effects

  • Breast tenderness
  • Bleeding
  • Mood changes
  • VTE
  • Breast cancer risk

Interactions

  • CYP3A4 inducers

Monitoring

  • BP
  • Bleeding pattern
  • Breast awareness

Reference: BNF; NICE NG23; British Menopause Society; https://bnf.nice.org.uk/drugs/estradiol-with-medroxyprogesterone/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.