Consumer Medicine Information (CMI)
What is in this leaflet
This leaflet answers some common questions about Zumenon.
It does not contain all the available information. It does not take the place of talking
to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking
this medicine against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine.
You may need to read it again.
When you must not use Zumenon
Do not use Zumenon or other estrogens, with or without progestogen to prevent heart
attacks, stroke or dementia.
A study called the Women's Health Initiative indicated increased risk of heart attack,
stroke, breast cancer, and blood clots in the legs or lungs in women receiving treatment
with a product containing conjugated estrogens 0.625 mg and the progestogen medroxyprogesterone
acetate (MPA). The researchers stopped the study after 5 years when it was determined
the risks were greater than the benefits in this group. The Women's Health Initiative
Memory Study indicated increased risk of dementia in women aged 65-79 years taking
conjugated estrogens and MPA. There are no comparable data currently available for
other doses of conjugated estrogens and MPA or other combinations of estrogens and
progestogens. Therefore, you should assume the risks will be similar for other medicines
containing estrogen and progestogen combinations.
Talk regularly with your doctor about whether you still need treatment with Zumenon.
Treatment with estrogens, with or without progestogens should be used at the lowest
effective dose and for the shortest period of time.
What Zumenon is used for
Zumenon is a type of treatment called hormone replacement therapy (HRT). Zumenon tablets
contain a hormone called estradiol.
Zumenon is used to help replace the estrogen that the body stops producing around
the time of the menopause.
Menopause ("change of life") is the cessation of menstruation i.e. the time a woman
has her last menstrual period. The term menopause is used to define the years around
that event when the body begins to produce less estrogen. This lower level of estrogen
may cause symptoms in some women.
Zumenon helps to relieve the discomfort many women feel during and after the menopause.
Women with an intact womb should generally be prescribed Zumenon and another tablet,
a progestogen, to protect the lining of the uterus from over stimulation.
HRT should not be used for the long-term maintenance of general health or to prevent
heart disease or dementia.
Zumenon is not suitable for birth control and it will not restore fertility.
How it works
Estradiol is a natural female sex hormone called an estrogen. It is the same hormone
that your ovaries were producing before the menopause.
The menopause occurs naturally in the course of a woman's life, usually between the
ages of 45 and 55. It may happen sooner if the ovaries are removed by surgery (e.g.
total hysterectomy). After menopause your body produces much less estrogen than it
did before. This can cause unpleasant symptoms such as a feeling of warmth in the
face, neck and chest, "hot flushes" (sudden intense feelings of heat and sweating
throughout the body), sleep problems, irritability and depression. Some women also
have problems with urine control or with dryness of the vagina causing discomfort
during or after sex. estrogens can be given to reduce or eliminate these symptoms.
Once you start taking Zumenon, symptoms such as hot flushes and excessive sweating
are usually relieved within a few days, but other symptoms such as skin tone and vaginal
dryness may take a few weeks to be relieved.
After the age of 40, and especially after the menopause, some women develop osteoporosis.
This is a thinning of the bones that makes them weaker and more likely to break, especially
the bones of the spine, hip and wrist. Exercise, calcium and Vitamin D can help reduce
the risk of osteoporosis.
Ask your doctor if you have any questions about why it has been prescribed for you.
Your doctor may have prescribed it for another purpose.
This medicine is available only with a doctor's prescription.
Before you take Zumenon
When you must not take it
Do not take Zumenon if you have an allergy to:
any medicine containing estradiol
any of the ingredients listed at the end of this leaflet
any other medicine containing estrogen, including the birth control pill.
Some symptoms of an allergic reaction include skin rash, itching, shortness of breath
or swelling of the face, lips or tongue, which may cause difficulty in swallowing
Do not take Zumenon if you have or have had:
cancer of the breast or uterus (womb) or any other estrogen dependent cancer
blood clots in your blood vessels, now or in the past. You may have had painful inflammation
of the veins or blockage of a blood vessel in the legs, lungs, brain or heart
abnormal vaginal bleeding
severe liver disease
a condition called porphyria
Do not take this medicine if you are pregnant.
It may affect your developing baby if you take it during pregnancy.
Do not breastfeed if you are taking this medicine.
Do not take it after the expiry date printed on the pack or if the packaging is damaged
or shows signs of tampering.
If it has expired or is damaged return it to your pharmacist for disposal.
Before you start to take it
You must have a through medical check-up before starting HRT for the first time or
Your doctor will give you a thorough examination before prescribing Zumenon and will
give further examinations regularly during treatment. Your doctor is likely to check
your blood pressure, breasts, and stomach. You may also be advised to have a mammogram.
Tell your doctor or pharmacist if you have any allergies to any other medicines, foods,
preservatives or dyes.
Tell your doctor if you have or have had any of the following medical conditions:
a family history of breast cancer
nodules, lumps or cysts in your breasts or any other benign breast condition (not
fibroids or other benign tumours of the uterus (not cancer)
unusual or irregular bleeding or spotting from the vagina
liver problems, including yellowing of the skin and whites of the eyes and a condition
a problem in the past with a condition called cholestatic jaundice when you were pregnant
or took an estrogen (eg birth control pill or HRT)
high blood pressure
gall bladder disease
a high level of triglycerides (fats) in the blood
high or low levels of calcium in the blood
hearing loss due to a problem with the bones in the ear called otosclerosis
Tell your doctor if you are likely to have an increased risk of developing blood clots
in your blood vessels. The risk increases as you get older and it may also be increased
anyone in your immediate family has ever had blood clots in the blood vessels of the
legs or lungs
you are overweight
you have varicose veins
you have a disorder called systemic lupus erythematosus
If you have not told your doctor about any of the above, tell them before you take
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including any
that you buy without a prescription from your pharmacy, supermarket or health food
Some medicines and Zumenon may interfere with each other. These include:
herbal medicines containing St John's Wort
some medicines used to treat epilepsy
some antibiotic and anti-infective medicines
some medicines which require precise dosing eg. tacrolimus, ciclosporin, fentanyl
These medicines may be affected by Zumenon, or may affect how well it works. You may
need to use different amounts of your medicine, or take different medicines.
Your doctor or pharmacist has more information on medicines to be careful with or
to avoid while taking Zumenon.
Treatment with estrogens alone over a prolonged period may expose women with an intact
womb to an increased risk of cancer of the lining of the womb.
How to take Zumenon
Follow all directions given to you by your doctor or pharmacist carefully.
They may differ from the information contained in this leaflet.
If you do not understand the instructions on the box, ask your doctor or pharmacist
How much to take
The usual dose is one tablet daily.
If you have not had a period for twelve months or more or if you have had a hysterectomy,
you can start Zumenon immediately.
If you are having irregular periods, start taking Zumenon on day 5 of the menstrual
If your uterus is still intact your doctor will generally prescribe another medicine
to take with Zumenon during part of your menstrual cycle.
How to take it
Swallow the tablet whole with a glass of water.
When to take it
Take Zumenon at about the same time each day.
Taking it at the same time each day will have the best effect. It will also help you
remember when to take it.
The pack is labelled with the days of the week to help you with taking your tablets
You should start each new pack the day after you have finished the current pack.
Do not leave a gap between packs.
How long to take it
Continue taking your medicine for as long as your doctor or pharmacist tells you.
Although some women have no symptoms of the menopause or only mild ones and may not
need extra hormones, other women may need to use Zumenon.
Your doctor can discuss the risks and benefits of long-term treatment with HRT in
your particular case. Some recent studies have shown that women using HRT have a small
increase in breast cancer risk after several years of use. The risk increases with
the length of HRT use.
Recent studies have also shown that HRT is associated with a small increase in the
risk of heart attacks, strokes, blood clots, including clots in the lungs. However,
the risk of hip fractures and bowel cancer may be reduced.
Another study has shown that in women older than 65 years, HRT is associated with
a small increase is the risk of dementia, including Alzheimer's disease. It is not
known if this finding applies to younger women.
If you forget to take it
If it is less than 12 hours before your next dose, skip the dose you missed and take
your next dose when you are meant to.
Otherwise, take it as soon as you remember, and then go back to taking your medicine
as you would normally.
Do not take a double dose to make up for the dose that you missed.
This may increase the chance of getting an unwanted side effect.
If you are not sure what to do, ask your doctor or pharmacist.
If you have trouble remembering when to take your medicine, ask your pharmacist for
If you take too much (overdose)
Immediately telephone your doctor, or the Poisons Information Centre (13 11 26), or
go to Accident and Emergency at your nearest hospital, if you think you or anyone
else may have taken too much Zumenon. Do this even if there are no signs of discomfort
While you are taking Zumenon
Things you must do
Tell your doctor immediately if you have any sore veins or suspected blood clots,
disturbances in vision, sudden onset of migraine, significant increase in blood pressure,
or yellowing of the skin or eyes (jaundice) while taking Zumenon tablets.
Regular medical check-ups are recommended, including the pelvic organs, cervical smear
(if necessary), and breast examination, particularly if you have breast lumps or a
family history of breast cancer.
If you are still having periods of any kind, you should continue to use non-hormonal
contraceptive methods (such as a condom) to prevent pregnancy.
If you become pregnant while using Zumenon, tell your doctor immediately.
Zumenon should not be used while you are pregnant.
Check your breasts each month and report any changes promptly to your doctor.
Your doctor or nurse can show you how to check your breasts properly.
See your doctor at least once a year for a check-up. Some women will need to go more
often. Your doctor may:
check your breasts and order a mammogram at regular intervals
check your uterus and cervix and do a pap smear at regular intervals
check your blood pressure and cholesterol level.
Tell your doctor that you are using Zumenon well in advance of any expected hospitalisation
or surgery. If you go to hospital unexpectedly, tell the doctor who admits you that
you are using it.
The risk of developing blood clots in your blood vessels may be temporarily increased
as a result of an operation, serious injury or having to stay in bed for a prolonged
period of time. If possible, this medicine should be stopped at least 4 weeks before
surgery and it should not be restarted until you are fully mobile.
If you are about to be started on any new medicine, remind your doctor and pharmacist
that you are taking Zumenon.
Tell any other doctors, dentists and pharmacists who treat you that you are taking
Things you must not do
Do not use this medicine to treat any other complaints unless your doctor or pharmacist
tells you to.
Do not give this medicine to anyone else, even if they have the same condition as
Do not stop taking Zumenon, or change the dosage, without checking with your doctor.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you
are taking Zumenon.
All medicines have some unwanted side effects. Sometimes they are serious but most
of the time they are not. You may need medical attention if you get some of the side-effects.
Do not be alarmed by this list of possible side effects. You may not experience any
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor or pharmacist if you notice any of the following and they worry you:
irregular vaginal bleeding or spotting (if bleeding is heavy, check with your doctor
as soon as possible)
tender, painful or swollen breasts
vaginal itching, inflammation or discharge
swelling of the lower legs, ankles, fingers or abdomen due to fluid retention
nausea (feeling sick), stomach ache, vomiting, heartburn, wind, diarrhoea
rise in blood pressure
weakness or dizziness
depression, nervousness, rapid changes in mood, difficulty sleeping
change in sex drive
acne, itchy or dry skin, skin discolouration
The above list includes the more common side effects of your medicine. They are usually
mild and short-lived.
If any of the following happen, tell your doctor immediately or go to Accident and
Emergency at your nearest hospital:
signs of allergy such as rash, itching or hives on the skin; swelling of the face,
lips, tongue or other part of the body; shortness of breath, wheezing or troubled
signs that blood clots may have formed, such as sudden severe headache, loss of coordination,
blurred or loss of vision, slurred speech, numbness or tingling, painful swelling
in the calves or thighs, chest pain, coughing blood
pain or tenderness in the abdomen, which may be accompanied by fever, loss of appetite,
nausea and vomiting
a yellow colour to the skin or eyes.
The above list includes very serious side effects. You may need urgent medical attention.
These side effects are rare.
Tell your doctor or pharmacist if you notice anything else that is making you feel
Other side effects not listed above may occur in some people.
After using Zumenon
Keep your tablets in the pack until it is time to take them.
If you take the tablets out of the box or the blister pack they may not keep well.
Keep the medicine in a cool, dry place where the temperature stays below 30°C.
Do not store it or any other medicine in the bathroom, near a sink, or on a windowsill.
Do not leave it in the car.
Heat and dampness can destroy some medicines.
Keep it where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place
to store medicines.
If your doctor or pharmacist tells you to stop taking this medicine, or the medicine
has passed its expiry date, ask your pharmacist what to do with any that are left
What it looks like
Zumenon tablets are round, biconvex, brick-red, film-coated tablets of 7mm diameter
each containing 2 mg estradiol bearing the inscription "379" on one side.
Zumenon is available in boxes of 56 tablets.
Each Zumenon tablet contains 2 mg of estradiol anhydrous as the active ingredient:
It also contains
colloidal anhydrous silica
Opadry OY-6957 Pink
The estradiol contained in Zumenon tablets is of plant origin.
Zumenon tablets do not contain gluten.
Zumenon is made in the Netherlands.
Zumenon is supplied in Australia by:
Mylan Health Pty Ltd
Level 1, 30 The Bond
30-34 Hickson Road
Millers Point NSW 2000
Phone: 1800 314 527
This leaflet was prepared September 2017
Australian Registration Number(s)
AUST R 75888