Evorel Sequi is a sequential combined hormone replacement therapy (HRT); treatment that replaces hormones that fall during menopause. It uses oestrogen-only patches for the first half of each cycle and combined oestrogen and progestogen patches for the second half; the progestogen protects your womb lining.

This guide covers Evorel Sequi patches. Use Evorel 50 patches for the first two weeks, then Evorel Conti patches for the next two weeks. Change patches twice a week on the same set days. A monthly withdrawal bleed; bleeding similar to a period; is expected.

Always follow your prescription and read the patient information leaflet supplied with your treatment.

Evorel Sequi is a form of sequential combined HRT delivered via transdermal patches. Each monthly pack contains two types of patches: four Evorel 50 patches (containing estradiol 50mcg/day only) and four Evorel Conti patches (containing estradiol 50mcg/day and norethisterone acetate 170mcg/day), containing hormones which are steadily released through the skin (transdermal route) into your bloodstream over several days.

Evorel Sequi is used for the relief of menopausal symptoms in perimenopausal and women after menopause who have a womb. It is also licensed for the prevention of osteoporosis (weakened bones that are more likely to break) in women after menopause at high risk of fractures.

You may notice an improvement in symptoms within a few weeks, but it can take up to three months to adjust and feel the full benefit. Speak to your clinical team if symptoms aren’t improving.

Treatment with Evorel Sequi is over a four-week cycle. One patch should be applied to a clean, dry, and non-irritated area of skin on your lower abdomen or trunk, below the waistline. Do not apply it to your breasts or near your waistline where tight clothing might rub it off:

When and how to change a patch: Each patch is worn continuously and replaced twice a week (every 3 to four days). To help you remember, it is best to change your patch on the same two days each week, for example, every Monday and Thursday.

If you forget to change a patch, you should change it as soon as possible and apply the next one at the normal time on your original change days. However, if it is almost time for the next patch, you should skip the missed one and go back to your regular schedule. Only one patch should be applied at a time. There is an increased likelihood of unexpected bleeding and spotting when a patch is not replaced at the normal time. Always follow your prescribed instructions and check with your clinical team if you’re unsure.

Therapy usually begins with one standard dose patch. Treatment is usually started with the lowest effective dose and can be adjusted by your clinician after a few months depending on your response with the dose increased or decreased as necessary. Your clinician will aim to use the lowest effective dose for the shortest time needed to manage your symptoms, with regular reviews.

There are no special dosage requirements for older patients, although experience in treating women over 65 is limited. This medicine is not for use in children.

This treatment isn’t contraception. You may still need contraception, including if it’s been less than 12 months since your last period or you’re under 50. Ask your clinical team for advice tailored to you.

If you become pregnant, stop treatment immediately and contact your clinician. This treatment isn’t indicated during breastfeeding.

The norethisterone (progestogen) component in the second half of each monthly cycle of treatment with Evorel Sequi is to protect the womb lining, which will lead to a monthly withdrawal bleed.

The most common side effect is skin irritation, redness, or itching at the site where the patch is applied. Other common side effects include headache, breast pain, nausea, and irregular bleeding. As a transdermal form of HRT, Evorel Sequi bypasses the liver and carries a lower risk of blood clots (venous thromboembolism) compared to other systemic forms of HRT, such as oral tablets or capsules. The other risks associated with systemic HRT, such as a small increased risk of breast cancer and stroke, still apply, although the overall risk remains low for most patients being treated. For a full list of side effects, please see the Patient Information Leaflet provided with your medication.

Your clinician will review your treatment after three months, then at least once a year. They’ll check your symptoms, side effects, any vaginal bleeding, your weight, and your blood pressure, and decide whether further tests are needed.

Examine your breasts regularly and attend routine screening appointments, including mammograms and cervical screening where appropriate. If you had menopause earlier than expected, discuss how this may affect the benefits and risks of HRT with your clinician.

Stop using Evorel Sequi and seek urgent medical advice if you develop:

If you have difficulty breathing or another life-threatening symptom, call 999. Don’t wait for an email response.

For planned changes or stopping treatment, speak to your clinician. They may recommend reducing your dose gradually to help prevent menopausal symptoms from returning suddenly.

Tell your clinical team if you have any of the following conditions, have had them before, or they worsened during pregnancy or previous hormone treatment. You may need closer monitoring because they can return or worsen during treatment.

Store at room temperature, at or below 25°C, within the original sachet and box. Keep out of reach of children, including used and disposed patches.
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Contact your clinical team if you have questions about your prescribed schedule, side effects, symptoms that aren’t improving, or bleeding that concerns you. For non-urgent questions or to discuss your clinical plan, email [email protected].

Read the patient information leaflet supplied with your treatment for the full list of reasons not to use it, side effects, and precautions. This guide doesn’t replace that leaflet or your clinician’s instructions.

Use the Evorel 50 patches for the first two weeks, followed by the Evorel Conti patches for weeks three and four. Follow your prescribed schedule and check with your clinical team if you’re unsure.
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No. Follow your prescription and speak to your clinical team before changing your dose or treatment schedule.
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No. Ask your clinical team whether you still need contraception and which options are suitable for you.