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Medroxyprogesterone acetate / estradiol valerate

A continuous form of combined hormone replacement therapy, Indivina contains the active ingredients estradiol and medroxyprogesterone. It is manufactured in the UK by Orion.

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A continuous form of combined hormone replacement therapy, Indivina contains the active ingredients estradiol and medroxyprogesterone. It is manufactured in the UK by Orion.

Using our service to get your repeat prescription is easy. You can complete a consultation online in minutes, and have your medication sent to you from our UK based pharmacy.

This content was reviewed by a clinician on

03 May 2022
dr daniel

Dr Daniel Atkinson

(GP Clinical Lead - GMC No. 4624794) 03 May 2022
Product information


Indivina, made in the UK by Orion Pharmaceuticals, is a tablet used as a continuous combined form of HRT to treat symptoms of the menopause. It is also used in the treatment of osteoporosis in women for whom other forms of medication are unsuitable. It comes in three strengths and is for use by women who stopped having periods at least three years previously.

As women approach middle age they stop ovulating, and the menstrual cycle will become disrupted, with periods becoming irregular. Eventually they will stop and the woman will no longer be able to get pregnant. This natural process, known as the menopause, is also accompanied by a drop in the levels of the female sex hormone, known as oestrogen.

The body responds to this process with a number of symptoms, at least some of which will be experienced by most menopausal women. Some of the most common include hot flushes, night sweats, discomfort during sex, mood swings, difficulty sleeping, and trouble with concentration and memory. Postmenopausal women are also at risk of developing osteoporosis, a condition where the decline in oestrogen levels makes bones weak and brittle.

Most women will have symptoms that are relatively mild, but some will find them more severe and that they hinder the quality of their daily life. In these cases they may want to seek medical assistance and begin a course of HRT. Indivina is one kind of HRT and you can buy online from our UK pharmacy.

Indivina contains two active ingredients. Estradiol is a form of oestrogen, hormone which occurs naturally and this compensates for the decreasing levels of the hormone in the body, lessening the effects this decline causes. It also contains a synthetic form of the hormone progesterone called medroxyprogesterone. This ingredient balances the effects of estradiol, which left unopposed can stimulate excess growth of the lining of the womb and cause endometrial cancer. This means that the treatment can be taken by women who have not had their wombs removed. It is known as combined hormone replacement therapy.

This product is also used as a second line treatment for women who are at risk from developing osteoporosis postmenopause and cannot take other available prescribed treatments. Those who are particularly vulnerable include people with a family history of osteoporosis, those who smoke, those with a small frame and women who have recently had a course of corticosteroid therapy. Also at risk are women who began their menopause early.

Indivina is a continuous form of HRT which is taken once daily in the form of a tablet. If you were previously taking a cyclical form of HRT then you should wait for a week after taking the last of your previous treatment. It should only be taken by women who had their menopause at least three years ago.

We only offer HRT on a renewal basis. If you are not currently using menopause treatment, you will need to see your GP in person, so that they can help you find the right medication.

It’s easy to renew your prescription and buy Indivina online with our service. Complete our consultation, and once our doctor has approved your order, your medicine will be dispensed at our UK pharmacy. Shipping on all items is made by tracked next-day courier.

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Page last reviewed:  03/05/2022


You should ensure that you adhere to the instructions given to you by your prescriber so your treatment is efficient and any possible side effects are minimised.

  1. Use as prescribed.
  2. Take one tablet a day with water. You should use the calendar days printed on the blister pack as a guide.
  3. If you forget to take a tablet then simply miss that day and continue the course the following day. Missing tablets may cause some breakthrough bleeding or spotting. Never take a double dose to make up for missed tablets.
  4. If you think you have taken more of the tablets than you should, then consult your doctor.
  5. If you are not having periods, and have either not taken HRT before or are changing from another continuous treatment, you can start the course at any time. If changing from another cyclical treatment, wait seven days before commencing.
  6. If you feel your dose is too low or too high, consult your doctor to discuss the effects this may have. You should also do this if you want to stop taking Indivina.
  7. If you are about to undergo any surgical procedures, be sure to tell the surgeon that you are taking this medicine. You may be required to stop taking it in the weeks leading up to the operation.

These instructions are just a guide. It is vitally important that you also read the patient information leaflet which comes with the medicine and follow any instructions given to you by your practitioner.

Page last reviewed:  03/05/2022
Side effects & Warnings

Side Effects

You should be aware of all the possible side effects of using this item before you start taking it as some will require you to seek medical attention. You must see a doctor right away if you experience: migraines where you have not had them before; a yellowing of the whites of the eyes or skin; anything that could indicate a sharp rise in blood pressure such as tiredness, dizziness or headaches; or symptoms that could signify a blood clot like redness and painful swelling in the legs, chest pains or breathing difficulties. You must also stop taking Indivina immediately if you become pregnant.

This list of side effects is a guide and is not comprehensive. Please read the leaflet that comes with this medicine for a more detailed list.

Common (1 in 10 people or less):

Changes in weight, fluid retention, hot flushes, dizziness, headaches, tiredness, depression, increased sweating, nausea, vomiting, flatulence, abdominal pain, painful or tender breasts, menstrual and vaginal disorders, vaginal discharge, spotting or bleeding,

Uncommon (1 in 100 people or less):

Benign tumours in the womb or breast, breast enlargement or tenderness, womb lining growth, sleeplessness, anxiousness, sudden changes in mood, changes in libido, joint pain, increased appetite, raised levels of blood cholesterol or blood pressure, hypersensitivity, dry eyes, trembling, tingling and prickling sensations in the skin, flu like symptoms, blocked nose, bladder problems, indigestion, heartburn, diarrhea, hair loss, excessive hair growth, and fever.

Rare (1 in 1,000 people or less):

Skin rashes, discomfort while wearing contact lenses, blood clots, changes to liver function and bile flow, menstrual pain and symptoms similar to premenstrual syndrome.


Taking it with other medicines

When you are completing our questionnaire remember to tell us about any medication you are currently taking, both prescription and nonprescription. Some medicines, when taken with Indivina, can cause irregular bleeding. These include treatments for HIV like nevirapine, ritonavir, efavirenz and nelfinavir, anticonvulsants for epilepsy such as phenobarbital, phenytoin and carbamazepine, antibiotics for tuberculosis like rifampicin and rifabutin, and herbal remedies that have St John’s Wort as an ingredient.

Conditions to look out for

You should answer all of the questions about your medical information in the online consultation in full so we can be sure that this medicine is suitable for you. You should not take Indivina if you have, or have ever had: breast cancer or any cancer which is responsive to oestrogen; untreated endometrial hyperplasia (thickening of the womb lining); vaginal bleeding that is unexplained; blood clots in the veins or a blood clotting disorder; the rare hereditary blood condition porphyria; a liver problem where your liver has not achieved full recovery; angina, stroke or heart attack; or if you are allergic to any of the ingredients, which include estradiol valerate and medroxyprogesterone acetate.

Special care should be taken if you have or have ever had any of the following, as it is recommended that you have more frequent check-ups in case these conditions return or worsen: womb fibroids; excessive womb lining growth; lining growth outside the womb (endometriosis); a family history of oestrogen sensitive cancer or breast cancer; diabetes; gallstones; asthma; migraines; high blood pressure; an increased risk of blood clots; lupus; a liver disorder; a disease affecting the hearing or eardrums; high levels of triglycerides; hereditary angioedema; or cardiac or liver related water retention.

Regular check-ups

You will need to consult with your GP to review your HRT on a regular basis (usually at least once a year).

HRT and cancer

Consult the leaflet for more information on HRT and cancer risk.

Pregnancy and breastfeeding

This product is not to be used by anyone who is pregnant or breastfeeding. If while using this medication you become pregnant, stop using it and see your GP.

Driving and using machinery

Indivina is not likely to inhibit your ability to drive or operate machinery.

Lactose intolerance

Indivina contains lactose. Let your prescriber know if you are lactose intolerant during consultation.

Page last reviewed:  03/05/2022

Can I still drink alcohol?

Yes. Indivina is not affected by drinking alcohol.

Will I still be able to drive?

Yes, it does not interfere with your capacity to drive, but if you suffer with side effects that may interfere with it you should refrain from doing so and see your doctor.

Can I take the medicine while pregnant?

This treatment is only for use in postmenopausal women. If you do become pregnant, stop taking it at once and consult your GP.

How should I store it?

Keep the original packaging for your reference and store at room temperature below 25°C.

Am I allergic to anything in the medicine?

These tablets contain estradiol valerate, medroxyprogesterone acetate,magnesium stearate, lactose monohydrate, maize starch and gelatin. Do not use if you have an allergy to any of these ingredients. This item also contains lactose, so you should tell your doctor before taking it if you are lactose intolerant.

Is it available over-the-counter?

It is not available over-the-counter, but it is possible to renew your prescription for this HRT product and buy Indivina online. You can do this by taking our consultation.

Is it right for me?

The HRT treatment you use will be decided upon by your doctor during a face-to-face consultation. They will start a prescription once they have discussed suitable options with you.

How can I buy Indivina online?

You can renew your prescription for Indivina now by completing our assessment form. If it is approved by one of our GMC-registered doctors, our UK based pharmacy will issue your medication. Most orders are shipped in 24 hours by our trusted delivery partners.

Page last reviewed:  03/05/2022
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