Estradiol is a form of estrogen, a female sex hormone that regulates many processes in the body.

Activella is a combination medicine used to treat menopause symptoms such as hot flashes and vaginal changes, and to prevent osteoporosis (bone loss) in menopausal women.

Norethindrone is a form of progesterone, a female hormone important for regulating ovulation and menstruation.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

If you need major surgery or will be on long-term bed rest, you may need to stop using this medicine for a short time. Any doctor or surgeon who treats you should know that you are using Activella.

Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment. Self-examine your breasts for lumps on a monthly basis and have a mammogram every year while using Activella.

Store at room temperature away from moisture, heat, and light.

Estradiol may increase your risk of developing a condition that may lead to uterine cancer. Call your doctor at once if you have any unusual vaginal bleeding while using Activella.

An increased risk of PE, DVT, stroke and MI has been reported with estrogen plus progestin therapy. An increased risk of stroke and DVT has been reported with estrogen-alone therapy. Should any of these occur or be suspected, estrogen with or without progestin therapy should be discontinued immediately.

If feasible, estrogens should be discontinued at least 4 to 6 weeks before surgery of the type associated with an increased risk of thromboembolism, or during periods of prolonged immobilization.

Endometrial hyperplasia (a possible precursor of endometrial cancer) has been reported to occur at a rate of approximately 1 percent or less with Activella.

A 2- to 4-fold increase in the risk of gallbladder disease requiring surgery in postmenopausal women receiving estrogens has been reported.

In women with pre-existing hypertriglyceridemia, estrogen therapy may be associated with elevations of plasma triglycerides leading to pancreatitis. Consider discontinuation of treatment if pancreatitis occurs.

• Body aches or pain
• chills or fever
• cold or flu-like symptoms
• itching of the vagina or genital area
• nonmenstrual vaginal bleeding
• pain during sexual intercourse
• thick, white vaginal discharge with no odor or with a mild odor
• changes in sexual ability, desire, drive, or performance
• excess air or gas in the stomach or intestines
• increased hair growth, especially on the face
• patchy brown or dark brown discoloration of the skin
• trouble wearing contact lenses

How should I use this drug?

Take this medicine by mouth with a drink of water. You may take this medicine with food. Follow the directions on the prescription label. You will take one tablet daily at roughly the same time each day. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I store this drug?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.