Order Activella tablets online from a U.S.-based pharmacy partner

Product Name	Activella (estradiol/norethindrone acetate)
Dosage	0.5 mg/0.1 mg; 1 mg/0.5 mg tablets (estradiol/norethindrone acetate)
Active Ingredient	Estradiol and Norethindrone Acetate (combined estrogen/progestin)
Form	Oral Tablets (continuous-combined hormone therapy)
Description	Prescription hormone therapy for moderate to severe menopausal hot flashes and other vasomotor symptoms, treatment of vulvar/vaginal atrophy symptoms, and prevention of postmenopausal osteoporosis in women with a uterus when alternative options are inappropriate. See FDA boxed warnings and safety guidance below.
How to Order Without Prescription	Online pharmacy with U.S.-licensed telehealth evaluation to issue a prescription when clinically appropriate

Activella is a continuous-combined oral hormone therapy that contains estradiol (an estrogen) and norethindrone acetate (a progestin). In the United States, this medication is widely used to manage moderate to severe vasomotor symptoms such as hot flashes and night sweats, to address vulvar and vaginal atrophy symptoms related to menopause, and to help prevent postmenopausal osteoporosis when non-estrogen therapies are not suitable. The tablets are typically available in two strengths—0.5 mg/0.1 mg and 1 mg/0.5 mg (estradiol/norethindrone acetate)—so prescribers can tailor therapy to individual needs and tolerability. Because this is a prescription medicine in the U.S., it should be used under the guidance of a qualified healthcare professional, and patients are encouraged to review the boxed warnings and important safety information before starting treatment. Thanks to modern telemedicine, many adults can complete a short online health assessment, consult with a U.S.-licensed clinician, and, if appropriate, receive an electronic prescription with home delivery. This process streamlines access, maintains regulatory compliance, and ensures that treatment decisions reflect your medical history and goals of care.

This combination is marketed under the brand name Activella and is also available in FDA-approved generic equivalents labeled as estradiol/norethindrone acetate tablets. Some U.S. pharmacies may also stock therapeutically equivalent brands with the same active ingredients. Our partner network serves patients across all 50 states and the District of Columbia, helping eligible adults obtain treatment and ongoing refills with timely shipping and discreet packaging. Because dose needs differ, clinicians aim to prescribe the lowest effective dose for the shortest duration consistent with treatment objectives, revisiting the plan regularly. If you are transitioning from a different hormone therapy (for example, a transdermal patch or a cyclic regimen), your clinician can advise on the best way to switch, minimize breakthrough bleeding, and monitor response. Many users start to notice improvement in hot flashes within the first few weeks, with continued benefits over several months when the therapy is well matched to symptoms and risk factors. As with any hormone treatment, periodic check-ins, routine screenings (such as mammograms based on age and risk), and blood pressure monitoring remain essential components of safe use.

Activella price and savings in the USA

Pricing for Activella can vary across U.S. pharmacies based on strength, quantity, insurance coverage, and the use of coupons or manufacturer savings programs. Many patients also consider FDA-approved generics (estradiol/norethindrone acetate), which frequently offer a lower cash price while providing the same active ingredients and comparable clinical effect. If your clinician does not require a specific brand, choosing a generic may lead to meaningful cost savings over time, especially for long-term therapy. Below is general guidance to help you plan your budget and understand the typical factors that determine total cost, including whether you use mail-order delivery, preferred pharmacy networks, or flexible spending/health savings account funds. Always check your insurance formulary or speak with a pharmacist to confirm your out-of-pocket amount, as benefit designs differ widely among U.S. insurers.

As an illustrative example, a 30-day supply of the 0.5 mg/0.1 mg tablet can sometimes be found between approximately $25 and $60 with common discount cards when paying cash, whereas brand pricing may be higher. Patients who purchase 90-day fills through mail-order services or preferred pharmacies often receive a lower per-tablet price, reducing recurring costs and the number of monthly refills needed. Mail-order refills can also improve adherence by ensuring the next supply arrives before you run out; keep in mind processing and shipping time when you schedule refills. If you are new to therapy, your clinician may start with a 30-day fill to assess tolerability and response before authorizing a 90-day quantity.

The higher-strength option (1 mg/0.5 mg) may be slightly more expensive than the lower strength, although this is not universal. If dose reductions occur after symptom control is achieved, your ongoing expense may decrease accordingly. In some cases, insurers prefer specific manufacturers or require prior authorizations for brand-only prescriptions, so verifying coverage in advance can prevent delays. Your care team or our patient support staff can help you navigate formulary lists, prior authorization needs, and opportunities to apply copay cards, discount codes, or pharmacy-choice optimizations.

For those without insurance, enrolling in a prescription savings program or using a pharmaceutical discount card can lower retail prices significantly. Additionally, some telehealth services bundle the consultation, prescription, and first-month fill under a single transparent fee. If you anticipate long-term therapy, compare the total annual cost of 30-day versus 90-day supplies, and ask whether automatic refills with reminder alerts are available. Thoughtful planning can keep treatment affordable while maintaining continuity of care.

Where can I buy Activella in the USA?

 In the United States, Activella is a prescription medication. You can obtain it through traditional brick-and-mortar pharmacies, mail-order services, or online pharmacy partners that coordinate a licensed telehealth consultation. The process typically involves completing a secure medical intake, answering questions about your symptoms, medical and family history, and current medications, and then meeting virtually with a clinician. If Activella is appropriate for you, the provider will issue an e-prescription to a U.S.-licensed pharmacy for convenient home delivery. This integrated model helps ensure quality standards while saving you time and travel.

Our service supports patients nationwide and emphasizes prompt, discreet shipping, responsive customer service, and ongoing care. Over the past decade, millions of U.S. patients have embraced mail-order pharmacy for routine medications, including hormone therapy, due to its reliability, cost transparency, and automatic refill options. If you are unsure whether Activella or a generic equivalent is right for you, our network clinicians can review alternatives such as transdermal estrogen patches, local vaginal estrogen products, or non-hormonal treatments, tailoring recommendations to your medical profile and preferences.

Online fulfillment is particularly useful for individuals who prefer private consultations, live in areas with limited specialty clinics, or have busy schedules. Our clinicians provide clear instructions on how to start therapy, what side effects to watch for, and how to schedule follow-ups. Pharmacists remain available to answer questions, discuss potential drug interactions, and help you manage refills effectively.

Activella in the United States

Getting Activella in the U.S. is a straightforward process with telehealth-enabled prescribing. After your evaluation, you can choose the appropriate strength—0.5 mg/0.1 mg or 1 mg/0.5 mg—based on your clinician’s guidance. You will then select the quantity (typically 30 or 90 tablets) and complete checkout. Throughout treatment, you will receive reminders for follow-up assessments and renewal, ensuring that dose and duration remain aligned with symptom control and current best practices for menopausal hormone therapy. If your circumstances change—such as the onset of new medical conditions or side effects—the prescribing clinician can reassess and adjust your regimen to maintain a favorable risk-benefit balance.

What is Activella?

 Activella combines two hormones—estradiol (an estrogen) and norethindrone acetate (a progestin)—in a single daily tablet. Estrogen effectively relieves menopausal vasomotor symptoms and treats vulvar/vaginal atrophy symptoms, while the progestin helps protect the endometrium from estrogen-induced hyperplasia in women with an intact uterus. In select patients at risk of osteoporosis who cannot use or do not tolerate non-estrogen options, Activella may also be considered to help prevent bone loss after menopause. As with all systemic estrogen therapies, the FDA advises using the lowest effective dose for the shortest duration consistent with treatment goals, and care teams should periodically reevaluate the need for continued therapy.

Common reasons for prescribing Activella include frequent hot flashes that interfere with daily life, persistent night sweats that disrupt sleep, vaginal dryness or irritation contributing to discomfort with sexual activity, and systemic support for bone density in appropriate candidates. The decision to start therapy should consider your age, time since menopause, cardiovascular profile, breast cancer risk, history of venous thromboembolism, liver health, and personal preferences. A detailed discussion with your clinician will help you understand potential benefits, safety considerations, and alternatives such as transdermal estrogen or local vaginal therapies that may present different risk profiles. Clinical monitoring typically includes blood pressure checks, age-appropriate breast cancer screening, and regular evaluations of symptom response and side effects.

Some clinicians also consider hormone therapy for patients with significant hypoestrogenic states due to surgical menopause or other causes, but Activella is specifically indicated for postmenopausal use. Regardless of the underlying need, a personalized approach—ideally revisited every 3 to 6 months—supports favorable outcomes while minimizing risks. If unexpected vaginal bleeding occurs at any time, contact your healthcare provider for evaluation.

Activella for relief of menopausal symptoms

 Vasomotor symptoms such as hot flashes and night sweats are among the most common reasons U.S. adults seek hormone therapy. These symptoms may lead to fatigue, sleep disruption, mood changes, and reduced quality of life. By replenishing estrogen levels, Activella can substantially reduce the frequency and intensity of hot flashes for many patients, often within weeks of initiation. In addition, continuous-combined regimens like Activella aim to limit cyclical bleeding by providing a steady dose of progestin alongside estrogen for individuals with a uterus. Over time, many users experience less breakthrough spotting.

Genitourinary syndrome of menopause (GSM)—which encompasses vaginal dryness, itching, irritation, dyspareunia, and urinary symptoms—can improve with systemic estrogen, though local vaginal estrogen may be preferred for predominantly localized symptoms. Your clinician can help you decide between systemic and local therapy or a combination approach. Beyond symptom control, patients often report improved sleep and overall well-being when vasomotor symptoms diminish. The early months of therapy are important for setting expectations, managing transient side effects like breast tenderness or mild nausea, and optimizing the dose.

A comprehensive care plan may also include lifestyle strategies: dressing in layers, limiting hot beverages and alcohol that can trigger flushing, mindful stress management, and regular physical activity. If migraines, cardiovascular risk, or other conditions exist, clinicians may recommend transdermal estrogen as an alternative due to different metabolic effects compared with oral therapy. The flexibility to tailor treatment helps maximize benefit while accounting for individual risk factors.

Why combined estrogen-progestin therapy matters

For individuals with an intact uterus, adding a progestin to systemic estrogen reduces the risk of endometrial hyperplasia and cancer associated with unopposed estrogen use. Continuous-combined products like Activella provide daily estrogen and progestin together, which can eventually lead to amenorrhea for many users. Some patients may experience unscheduled bleeding when starting therapy; this typically decreases over time, but any persistent, heavy, or recurrent bleeding should be evaluated. Selecting the correct dose and monitoring early bleed patterns helps ensure comfort, adherence, and safety throughout treatment.

Boxed warnings and key FDA safety information

 Systemic estrogen therapies carry boxed warnings. Unopposed estrogens increase the risk of endometrial cancer in women with a uterus; progestin co-administration reduces this risk. Estrogen with or without progestin should not be used for the prevention of cardiovascular disease or dementia. Studies of certain estrogen/progestin combinations have shown increased risks of myocardial infarction, stroke, pulmonary embolism, and deep vein thrombosis in postmenopausal women. Estrogen with or without progestin may also increase the risk of probable dementia in women 65 years and older. When prescribing Activella, clinicians aim for the lowest effective dose and shortest duration consistent with treatment goals and periodically reassess the need for continued therapy.

Before starting, discuss your personal and family history of breast cancer, cardiovascular disease, high blood pressure, hypertriglyceridemia, liver disease, gallbladder disease, migraines, and thrombotic disorders. Inform your clinician about tobacco use, as smoking increases cardiovascular risks, especially in older adults. Report any symptoms of blood clot or stroke immediately (unilateral leg swelling, chest pain, sudden shortness of breath, severe headache, slurred speech, vision changes). Routine preventive care remains important during therapy, including mammograms and blood pressure monitoring according to U.S. guidelines. If you undergo major surgery or prolonged immobilization, your clinician may advise a temporary interruption of therapy to lower thrombotic risk.

Who should not take Activella?

Do not use Activella if you have undiagnosed abnormal genital bleeding; known, suspected, or history of breast cancer; known or suspected estrogen-dependent neoplasia; active deep vein thrombosis, pulmonary embolism, or a history of these conditions; active or recent arterial thromboembolic disease (e.g., stroke, myocardial infarction); liver dysfunction or disease; known hypersensitivity to any ingredients; or if you are pregnant. If any of these conditions are identified during treatment, contact your clinician immediately for reassessment. Individuals with risk factors for angioedema or hereditary angioedema should also exercise caution, as estrogens may exacerbate angioedema symptoms.

Activella and bone health

 Bone mineral density declines after menopause due to reduced estrogen levels. For women at elevated fracture risk who cannot use alternative non-estrogen therapies, Activella may help prevent postmenopausal osteoporosis by mitigating bone loss. Decisions to use systemic hormone therapy for bone health should weigh benefits (such as improved bone mineral density) against potential risks, considering age, years since menopause, family history of fractures, and the presence of other risk factors like low BMI, smoking, or long-term corticosteroid use. Non-estrogen strategies such as weight-bearing exercise, adequate calcium and vitamin D intake, fall prevention, and medications like bisphosphonates or selective estrogen receptor modulators may be preferred in many cases; a clinician can help you choose the best plan for your situation.

Bone health is multifactorial, so periodic reassessment is recommended. If Activella is being used primarily for vasomotor symptoms, the contribution to bone preservation can be a secondary benefit; if your primary goal is osteoporosis prevention, your provider may discuss additional targeted options and how long to continue systemic hormones. Remember that systemic estrogen is not approved to treat established osteoporosis or to reduce fracture risk in all populations—its role is prevention when other options are inappropriate.

Starting Activella: dosing and administration

 Activella is taken by mouth once daily at approximately the same time each day. It can be taken with or without food; if mild nausea occurs, taking it with the evening meal may help. Swallow the tablet whole with water and do not crush or chew. Your clinician will select either the 0.5 mg/0.1 mg or 1 mg/0.5 mg tablet based on symptom severity, tolerance, and safety considerations. If you are transitioning from a cyclic regimen or another form of hormone therapy, follow your clinician’s instructions carefully to minimize unscheduled bleeding during the switch. This therapy is not a contraceptive and should not be used during pregnancy; use appropriate contraception if you are perimenopausal and could still conceive, and inform your provider about any missed periods or suspected pregnancy.

If you forget a dose, take it as soon as you remember unless it is almost time for the next dose; do not take two tablets at the same time to make up for a missed dose. Many patients benefit from daily reminders, 90-day supplies, or synchronized refills to maintain adherence. Your provider may schedule a follow-up after 8 to 12 weeks to evaluate symptom relief, bleeding patterns, and side effects, and to determine whether a dose adjustment is warranted. Keep all follow-up appointments and communicate any new medical diagnoses or medication changes.

Evidence supporting menopausal hormone therapy includes decades of clinical experience and large studies of various estrogen and progestin formulations. While individual products differ, a consistent theme is that patient selection, route of administration, and timing relative to menopause influence the overall risk-benefit profile. Oral therapies like Activella are appropriate for many adults, but your clinician may consider transdermal options if you have specific concerns such as elevated triglycerides or higher thrombotic risk. Ongoing shared decision-making remains central to optimizing outcomes.

Mechanism of action

 Estradiol binds to estrogen receptors in target tissues, influencing gene transcription and protein synthesis that restore physiologic estrogen effects diminished after menopause. This leads to reduced vasomotor instability (fewer hot flashes), improved vaginal epithelium integrity and lubrication, and favorable effects on bone turnover. Norethindrone acetate, a progestin, counteracts estrogen’s stimulatory effect on the endometrium, reducing the risk of hyperplasia and cancer in women with a uterus. Together, these hormones provide symptom control while maintaining endometrial protection in an easy, once-daily regimen.

The pharmacologic effects of oral estrogen undergo first-pass hepatic metabolism, which can influence clotting factors, triglycerides, and certain binding proteins. This is one reason clinicians sometimes consider non-oral routes for patients with particular risk profiles. Nonetheless, for many users, oral therapy offers effective relief, predictable dosing, and convenient administration. Close monitoring and individualized selection help ensure safe, effective use.

Safety

Most people tolerate Activella well, particularly at the lowest effective dose. Common side effects may include breast tenderness, mild nausea, headache, bloating, fluid retention, mood changes, or breakthrough spotting during the initial months. Many of these effects lessen with continued use. However, serious risks are possible with systemic hormone therapy: venous thromboembolism (deep vein thrombosis, pulmonary embolism), stroke, myocardial infarction, gallbladder disease, elevated triglycerides, and, in some populations, increased risk of breast cancer with combined estrogen-progestin use. Because individual risks vary, clinicians evaluate your history and monitor regularly, adjusting treatment as needed. Avoid smoking, maintain a healthy weight, stay active, and keep blood pressure controlled to support a safer experience with therapy.

Activella dosage for adults

 Typical starting regimens include 0.5 mg/0.1 mg or 1 mg/0.5 mg once daily. Your clinician may prefer initiating at the lower strength, then titrating up if symptoms persist and you tolerate the medication. Therapy should be reviewed at regular intervals—usually every 3 to 6 months—to confirm that benefits still outweigh risks and to reassess dose. If your primary symptoms are vulvar or vaginal, your clinician may discuss a local estrogen product, either alone or in addition to systemic therapy, depending on your needs and safety profile.

If you are switching from another hormone product, your provider will suggest a transition plan that minimizes unpredictable bleeding and maintains symptom control. When stopping therapy, some users taper the dose to reduce the chance of symptom recurrence; others may stop abruptly under medical supervision. There is no single right approach for everyone, so follow your clinician’s guidance.

Titration and duration of therapy

 Use the lowest effective dose for the shortest duration consistent with treatment goals and risks. Periodic reevaluation ensures that your regimen continues to make sense over time, particularly if your health status, family history, or personal preferences change. Some people benefit from treatment for a limited period to control peak symptoms, then taper; others may continue longer with close supervision. If significant risk factors arise—such as a new clotting disorder or uncontrolled hypertension—your clinician may advise switching therapies or discontinuing systemic hormones.

Reasons to consider dose adjustments or regimen changes include:

• ongoing vasomotor symptoms despite adequate adherence and time on therapy
• troublesome side effects such as breast tenderness, headaches, or mood changes
• recurrent unscheduled bleeding after the first few months of continuous-combined therapy

Managing unscheduled bleeding on therapy

Breakthrough bleeding can occur when initiating continuous-combined therapy like Activella, especially in the first 3 to 6 months. Keep a log of bleeding episodes to share with your clinician at follow-up. If bleeding persists or becomes heavy, an evaluation may be warranted to exclude other causes. Dose adjustments, changes in regimen, or alternative formulations (including transdermal routes) may improve bleeding patterns and overall tolerability. Always report unexpected bleeding promptly, particularly if it occurs after months of amenorrhea.

Using Activella for osteoporosis prevention

For select postmenopausal women who are at risk for osteoporosis and cannot use non-estrogen therapies, Activella may be considered to help prevent bone loss. This use should be individualized based on risk assessment, time since menopause, and competing options that may carry fewer systemic risks. Incorporate bone-healthy habits—adequate calcium and vitamin D intake, weight-bearing exercise, tobacco avoidance, and moderation of alcohol—as part of a comprehensive plan. Your clinician may monitor bone mineral density at intervals consistent with U.S. guidelines to verify that your strategy remains effective and safe.

How to take Activella

 Take one tablet daily at about the same time. Consistency supports stable hormone levels and symptom control. If gastrointestinal upset occurs, try taking the tablet with food. Do not use Activella for birth control and do not take it if you are pregnant. Keep the medication in its original container, away from moisture and heat, and out of the reach of children. Check the expiration date prior to use, and dispose of any expired tablets according to pharmacy guidance or local regulations.

Pregnancy and breastfeeding

Activella is contraindicated in pregnancy. If you become pregnant or suspect pregnancy, stop taking the medication and contact your clinician. Systemic estrogens can reduce the quantity and quality of breast milk; breastfeeding individuals should discuss risks and alternatives with a healthcare provider. In general, systemic estrogen therapy is not recommended during lactation. If you are perimenopausal and still ovulating, use effective contraception and inform your clinician of any missed periods to avoid inadvertent exposure during early pregnancy.

Pharmacist’s tips for taking Activella

 Take your tablet at the same time each day to help build a routine. Consider using a phone reminder or pill organizer if you travel or keep irregular hours. Keep up with age-appropriate screenings—mammograms, pelvic exams, and blood pressure checks—as advised by your clinician. Inform all of your healthcare providers, including dentists and specialists, that you are taking an estrogen/progestin combination. If you will be immobilized for a period (e.g., after major surgery or during extended travel), ask whether temporarily stopping therapy is advisable to reduce the risk of blood clots. Limit smoking and manage cardiovascular risk factors to support safer use.

If unexpected vaginal bleeding occurs after the first few months of continuous use, or if you experience symptoms such as new-onset severe headaches, chest pain, leg swelling, shortness of breath, or jaundice, seek medical attention promptly. If you take thyroid replacement, anticonvulsants, or other medications with potential interactions, ask the pharmacist to review your list and coordinate with your prescriber as needed.

Maintaining an up-to-date medication list—including over-the-counter products and supplements—helps your pharmacist identify potential issues early. Store Activella at room temperature, and keep it out of bathrooms to avoid excess humidity that may affect tablets over time.

Safety Precautions

 Do not use Activella if you have any contraindications described above. Use caution if you have risk factors for clotting, gallbladder disease, migraines, or hypertriglyceridemia. Avoid smoking to reduce cardiovascular risks associated with systemic hormone therapy. If you are scheduled for major surgery or expect prolonged immobilization, ask your clinician about pausing the medication in advance. Always read the FDA Medication Guide and patient information leaflet that accompany your prescription, and keep a copy for reference.

Alcohol may exacerbate flushing in some users and can influence liver metabolism; moderation is advised. If you have liver impairment, your clinician may recommend against systemic estrogen use or choose an alternative route or therapy. Report any new diagnoses, lab abnormalities, or changes in family history that could bear on your risk-benefit assessment.

Because Activella contains a progestin, some users may notice mood changes or breast tenderness; if these effects persist or become bothersome, discuss options such as dose reduction or switching formulations with your clinician. Individualized adjustments can improve comfort and adherence without compromising symptom relief.

Activella side effects

 Not everyone experiences side effects, and many are mild and temporary. Common effects may include breast tenderness, headache, nausea, bloating, abdominal discomfort, fluid retention, mood shifts, or breakthrough spotting (particularly early in therapy). Serious side effects can occur and require immediate medical attention: symptoms of a blood clot (sudden leg swelling or pain, chest pain, shortness of breath), stroke warning signs (sudden severe headache, slurred speech, vision changes, weakness on one side), signs of liver problems (yellowing of skin or eyes, dark urine, severe abdominal pain), or severe allergic reactions (hives, facial swelling, breathing difficulty). Your clinician can help you distinguish between expected early effects and warning signals that require evaluation.

Breast changes such as tenderness or fullness often improve over time; persistent unilateral lumps or nipple discharge should be assessed promptly. Gastrointestinal symptoms can sometimes be mitigated by taking the tablet with food or at bedtime. Keep track of any adverse effects and share details during follow-ups so your prescriber can consider dose adjustments or alternative therapies if necessary.

People with multiple risk factors for thromboembolism, cardiovascular disease, or estrogen-sensitive cancers require especially careful evaluation before and during treatment. Collaborative care—including primary care, gynecology, and pharmacy—supports safer, more informed decision-making throughout your therapy journey.

Adverse effects by system and severity

Common, usually mild effects include:

• breast tenderness or swelling
• nausea, abdominal bloating, or mild stomach upset
• headache or lightheadedness
• mood changes or irritability
• fluid retention or ankle swelling
• breakthrough spotting or changes in bleeding pattern

Potentially serious effects to report immediately include:

• chest pain, shortness of breath, or coughing up blood (possible clot)
• severe headache, trouble speaking, facial droop, or vision loss (possible stroke)
• calf or thigh pain/swelling, warmth, or redness (possible DVT)
• yellowing of the skin or eyes, dark urine, severe abdominal pain (possible liver issue)
• rapid-onset severe dizziness or fainting
• new breast lump or concerning breast changes

Additional considerations during early therapy:

• unscheduled bleeding or spotting is common initially and often improves over several months

Other infrequent or rare events reported with estrogen/progestin therapy may include:

• gallbladder disease, pancreatitis in the setting of high triglycerides
• worsening of hereditary angioedema
• elevations in blood pressure or changes in lipid profile
• migraine exacerbation or new-onset aura (seek evaluation)
• skin changes such as melasma, particularly with sun exposure
• changes in libido or vaginal discharge

Reporting side effects

 If you experience side effects, contact your clinician or pharmacist. For severe or life-threatening symptoms, call 911 immediately. You may also report adverse events to FDA MedWatch at 1-800-FDA-1088 or online at www.fda.gov/medwatch. Sharing detailed information—onset, duration, pattern, and any steps you’ve taken—helps your care team manage symptoms and adjust therapy if needed.

Drug interactions with Activella

 Estrogens and progestins can be affected by or affect other medications via hepatic metabolism and protein-binding changes. Provide your clinician and pharmacist with a complete list of all prescription and over-the-counter drugs, vitamins, and herbal supplements you use. Strong CYP3A4 inhibitors may increase estrogen/progestin exposure; CYP3A4 inducers may decrease effectiveness. Estrogen therapy can increase thyroid-binding globulin and alter thyroid replacement dose requirements. Estrogens may reduce lamotrigine concentrations via increased glucuronidation. Your clinician may adjust doses, monitor levels or clinical response, or recommend alternative therapies when interactions are likely.

Medicines and substances that may interact with Activella include (not exhaustive):

• strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir-boosted regimens)
• strong CYP3A4 inducers (e.g., rifampin, carbamazepine, phenytoin, phenobarbital, St. John’s wort)
• lamotrigine (estrogens may lower lamotrigine levels)
• levothyroxine and other thyroid hormones (dose adjustments may be required)
• cyclosporine or tacrolimus (monitor for increased effects)

This list does not cover all potential interactions. Keep an updated medication list and share it at every visit. Ask your pharmacist to perform an interaction check whenever you start, stop, or change any medicine, including supplements and herbal products.

Recommendations from our specialists

 If menopausal symptoms are disrupting your sleep, work, or quality of life, consider speaking with a U.S.-licensed clinician about whether Activella or an FDA-approved generic is appropriate for you. Our care team encourages a shared decision-making approach that balances symptom relief with safety, tailoring dose and duration to your personal goals. With nationwide telehealth access, U.S.-licensed prescribing, and direct-to-door delivery, getting started can be efficient and private. Keep routine screenings up to date, adopt heart-healthy habits, and stay in touch with your prescriber if anything changes. When managed thoughtfully, hormone therapy can be an effective part of your comprehensive menopause care plan.

Ready to feel like yourself again? Order Activella today!

Take control of menopausal symptoms with convenient, clinician-guided care. Complete a brief online assessment, meet with a U.S.-licensed provider, and—if appropriate—receive a prescription for Activella delivered to your door with secure, discreet shipping anywhere in the USA.

• Licensed telehealth included — fast evaluation and U.S. e‑prescription when appropriate
  
• Reliable home delivery — tracked, discreet shipping across the United States
  
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