Hormone
replacement therapy HRT: adopted guidelines of the Newcastle and North Tyneside Health District Drug and Therapeutics Committee
Tablets should be offered in preference to patches as they have advantages of
- Avoiding problems associated with patches becoming detached from the skin
- Avoiding local side effects
- Significantly lower cost
Patches should be used in
- Patients where ther is a clinical need to avoid firstpass metabolism of oestrogens eg patients with liver disease, venous thromboembolism or diabetes
- Patients who cannot swallow/take tablets
- Patients who do not tolerate tablets (although some will tolerate Femoston 2/10)
- Patients with poor symptomatic control on oral therapy due to low oestrogen levels
- Patients who express a strong preference or where compliance may be a problem
It is estimated that ideally patches should be used in about 10% of patients.