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Klimonorm: instructions for use

Klimonorm is a combined anti-menopausal drug containing a gestagen and estrogen.

Estradiol normalizes mental and emotional state, reduces the degree of climacteric manifestations (irritability, increased sweating, hot flashes). Levonogestrel helps prevent the development of hyperplasia and malignant neoplasms in endometrial tissue.

On this page you will find all the information about Klimonorm: complete instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews of people who have already used Klimonorm. Want to leave your opinion? Please write in the comments.

Release form and composition

The drug is produced in the form of round dragees of yellow and brown color. Each yellow dragee contains 2 mg of the active component of estradiol valerate. There are 9 such dragees in blister.

Each brown dragee contains 2 mg of the active component of estradiol valerate and 150 μg of levonogestrel. There are 12 such jelly beans in a blister.

Pharmacological effect

Klimonorm is an anti-menopausal combination drug that includes estradiol and levonorgestrel. Due to the composition and cyclic regimen (taking estrogen only for 9 days, the subsequent combination of estrogen and progestogen for 12 days and then a 7-day break), women with an unremoved uterus with a regular admission set the menstrual cycle.

Estradiol allows you to compensate for the lack of estrogen in the female body after menopause and provides effective treatment of psycho-emotional and autonomic menopausal symptoms, involution of the skin and mucous membranes, especially mucous membranes of the genitourinary system. Warns bone loss caused by estrogen deficiency.

Drug therapy has a beneficial effect on the collagen content in the skin, on its density and slows down the formation of wrinkles. Helps reduce total cholesterol.

Indications for use

The drug in the form of dragee Climonorm is used for certain problems with the sexual sphere on the basis of hormonal disturbances.

It is effective in:

  1. Urogenital dystrophy,
  2. Ovarian removal as hormone therapy
  3. Irritation of urinary and urinary tract,
  4. Incontinence,
  5. Violations of the menstruation cycle due to menopause,
  6. Prevention of osteoporosis,
  7. Uterine fibroids,
  8. Emotional instability during menopause,
  9. Stress condition in the postmenopausal period.

The drug Klimonorm in the form of dragees is used during menopause for the reason that it can save a woman from the most unpleasant manifestations:

  1. Dizziness
  2. Low libido,
  3. Sweating,
  4. Cardialgia
  5. Migraine,
  6. Nervous excitability,
  7. Hot flushes to the surface of the skin,
  8. Irritability,
  9. Pain in the joints,
  10. Sleep disturbances
  11. Muscle pain
  12. Feeling of dryness in the vagina,
  13. Feelings of pain during intima.


The drug has certain contraindications:

  1. Pregnancy,
  2. Breastfeeding period,
  3. Severe liver disease,
  4. Severe hypertriglyceridemia,
  5. Vaginal bleeding of unknown etiology,
  6. Thromboembolism or acute arterial thrombosis,
  7. Estimated or confirmed diagnosis of breast cancer,
  8. Hypersensitivity to the active substance or auxiliary components of the drug,
  9. Deep vein thrombosis in the acute stage, thromboembolism at present or in history,
  10. Benign or malignant liver tumors now or in history,
  11. Confirmed or presumptive diagnosis of a hormone-dependent malignant tumor or a hormone-dependent precancerous disease.

The drug is taken with caution in the following conditions / diseases: diabetes mellitus, arterial hypertension, cholestatic jaundice or cholestatic pruritus during pregnancy, congenital hyperbilirubinemia (Dubin-Johnson syndrome, Gilbert and Rotor), endometriosis and uterine myoma.

During pregnancy and lactation

In this case, hormone replacement therapy is not carried out. In case of accidental use of hormones in early pregnancy, no teratogenic effect was detected. In women who took hormonal medications before pregnancy, there was no increase in the number of congenital anomalies in children. Data obtained from large-scale epidemiological studies on steroid hormones. Part of the medication is excreted in breast milk.

Instructions for use

The instructions for use indicate that Klimonorm is intended for oral use, the pills are swallowed whole and washed down with a sufficient amount of liquid. To take the drug, the woman chooses a convenient time for her, which should be strictly followed the entire period of treatment.

  1. Patients with a preserved menstrual cycle, the first dragee should be taken on the 5th day of the menstrual bleeding.
  2. With very rare menstruation or their absence, treatment can begin at any time, subject to the confirmed absence of pregnancy.
  3. The dosage of the drug is 1 tablet 1 time per day, for the first 9 days they take yellow pills, then 12 days brown. After taking all 21 dragees, you should take a break for 7 days. For 2-3 days after discontinuation of the drug comes menstrual bleeding.
  4. The first dragee from a new package should be taken after 7 days break on the same day of the week as from the previous package.

If you accidentally skip taking the dragee at the scheduled time, the woman should try to take it as soon as possible (in the next 12-24 hours). With a longer interruption of therapy, the onset of vaginal bleeding is possible.

Side effects

The use of medication can cause the following undesirable reactions:

  1. Metabolism: changes in body weight, possible swelling.
  2. Dermatological reactions: sometimes - chloasma, skin rashes, erythema nodosum, pruritus.
  3. Miscellaneous: contact lens intolerance, muscle cramps, allergic reactions, visual impairment.
  4. Cardiovascular system: sometimes - increased blood pressure, heart palpitations, thromboembolism and venous thrombosis.
  5. The digestive system: possible nausea, dyspepsia, recurrent cholestatic jaundice, vomiting, bloating (flatulence), abdominal pain.
  6. Central nervous system: sometimes - fatigue, headache, anxiety, migraine, depressive symptoms or dizziness.
  7. The reproductive system: changes in the intensity and frequency of uterine bleeding, dysmenorrhea, breakthrough bleeding, changes in vaginal discharge, intermenstrual bleeding (weakened during treatment), a condition similar to premenstrual syndrome, changes in libido, enlargement, tension and / or tenderness of the mammary glands.

special instructions

Klimonorm is not used for contraception.

Before starting or resuming HRT, a woman is recommended to undergo a thorough general medical and gynecological examination (including breast examination and cytological examination of cervical mucus), to exclude pregnancy. In addition, violations of the blood coagulation system should be excluded. Periodic control tests should be carried out.

If contraception is necessary, non-hormonal methods should be used (except for calendar and temperature methods). If a pregnancy is suspected, pills should be stopped until pregnancy is excluded.

If any of the following conditions or risk factors are present or worsening, before starting or continuing HRT, the ratio of the individual risk to the benefit of treatment should be evaluated.

Drug interaction

  1. Concurrent use with hormonal contraceptives is contraindicated.
  2. Klimonorm affects glucose tolerance, when combined with oral hypoglycemic agents or insulin, dose adjustment may be required.
  3. The simultaneous administration of certain antibiotics, including the tetracycline and penicillin groups, in rare cases leads to a decrease in estradiol levels. Paracetamol and other substances that are highly conjugated can increase the bioavailability of estradiol.
  4. Drinking high doses of alcohol during hormone therapy may increase the level of estradiol in the blood.
  5. Long-term treatment with certain anticonvulsant or antimicrobial drugs that potentiate the induction of liver enzymes may increase the clearance of sex hormones and reduce their effect. It is characteristic of hydantoins, barbiturates, primidone, carbamazepine and rifampicin to induce liver enzymes, and this feature is expected to be present in griseofulvin, oxcarbazepine, felbamate and topiramate. The induction of enzymes usually peaks after 2-3 weeks of taking the drug and remains stable for at least 4 weeks after discontinuation.

We picked up some reviews of women taking the drug Klemonorm:

  1. Irina . She took Klimonorm for 3 years, I was prescribed by a gynecologist and endocrinologist in connection with the approach of menopause and its initial manifestations. What to say - the state of health was satisfactory, the ebb and flow were gone and never returned. At that stage, this medicine helped me a lot. Later she switched to Femoston, again by the same doctor’s prescription, time passed, and another was needed. Only taking "Klimonorm" should be long and very carefully, without gaps and every day at the same time.
  2. Marina A few months ago, I had my first climacteric symptoms. Disruptions in the menstrual cycle were before, but psycho-emotional disorders were absent. The terrible tides of heat, especially at night, also passed from the use of Klimonorm pills.
  3. Dasha. Saw drug from December to February. After a month of ingestion, the face, chest, shoulders, and back were poured out. From the evening, several red spots appeared on the body, in the morning they became covered with a crust, by the next morning they became larger in volume and size, very painful. March did not take anything. And only now (02,05,2017) began to heal. Although a couple of red spots remain, they hurt and do not heal.

Structural analogues of the active substance drug Klimonorm does not have. The drug contains in its composition a unique combination of hormones.

Drugs with similar pharmacological effects:

Before using analogues consult your doctor.

pharmachologic effect

Klimonorm contains both types of hormones (estrogen and progestogen), the level of which decreases during menopause. Thus, it replaces hormones that are no longer produced in the body. The climacteric period is characterized by symptoms caused by a gradual decrease in the production of hormones by the ovaries. In addition, in some women, a decrease in the level of these hormones may lead to a decrease in bone density (postmenopausal osteoporosis).

Estradiol contained in Climonorm prevents or alleviates painful symptoms (menopausal complaints), such as hot flashes, increased sweating, sleep disturbances, increased nervous irritability, dizziness, headaches, and involuntary urination, dryness and burning sensation in the vagina, pain during sexual intercourse. Thanks to the addition of progestogen (levonorgestrel) and a 7-day break in the reception of dragees in women with an unremoved uterus, a regular menstrual cycle is established.

The addition of progestogen (levonorgestrel) during 12 days of each cycle prevents the development of hyperplasia and endometrial cancer.

Klimonorm prevents bone loss caused by estrogen deficiency (postmenopausal osteoporosis).

Klimonorm also has a positive effect on the blood lipid spectrum (for example, reduces the level of total blood cholesterol).

Dosage and administration

Drops swallow whole, washed down with a small amount of liquid.

If you still have menstruation, treatment should begin on the 5th day of the menstrual cycle (the 1st day of menstrual bleeding corresponds to the 1st day of the menstrual cycle). In any other case, the doctor may recommend that you start treatment with Klimonorm immediately.

Each package is designed for a 21-day reception.

Every day, for the first 9 days, take one yellow dragee, and then, for 12 days, take one brown dragee daily. After a 21-day drug intake, there is a 7-day break in taking the drug, during which menstrual-like bleeding occurs, caused by drug withdrawal (usually 2-3 days after taking the last bean).

After a 7-day break in taking the drug, they start new packaging of Climonorm, taking the first tablet on the same day of the week as the first tablet from the previous pack.

The time of day when you are taking the drug does not matter, however, if you started taking pills at any particular time, you should stick to this time and beyond.

If you forgot to take the dragee, you can take it within the next 12 - 24 hours. If treatment is interrupted for a longer time, vaginal bleeding may occur.

Side effect

• From the reproductive system and the mammary glands:

changes in the frequency and intensity of uterine bleeding, breakthrough bleeding, intermenstrual bleeding (usually weakened during therapy), dysmenorrhea, changes in vaginal discharge, a condition like premenstrual syndrome, tenderness, tension and / or breast enlargement

• On the part of the gastrointestinal tract

dyspepsia, bloating, nausea, vomiting, abdominal pain, relapse of cholestatic jaundice

• From the skin and subcutaneous tissue skin rash, pruritus, chloasma, erythema nodosum

headache, migraine, dizziness, anxiety or depressive symptoms, fatigue

heart palpitations, edema, increased blood pressure, venous thrombosis and thromboembolism, muscle cramps, changes in body weight, changes in libido, visual disturbances, intolerance to contact lenses, allergic reactions


Studies of acute toxicity did not reveal the risk of acute side effects from accidental use of the drug Klimonorm in an amount many times greater than the daily therapeutic dose. Symptoms that may occur with an overdose: nausea, vomiting, vaginal bleeding. There is no specific antidote, the treatment is symptomatic. In case of overdose, consult a doctor.

Interaction with other drugs

Always tell the doctor prescribing Klimonorm what medicines you are taking. Tell the doctor who prescribes other drugs that you are taking Klimonorm. If you have any doubts about any drug you are using, consult your doctor.

Before you start using HRT, you must stop using hormonal contraceptives. If you need contraception, talk with your doctor about which contraceptives you can use.

Some drugs can reduce the effectiveness of the drug Klimonorm. These include drugs used to treat epilepsy (for example, hydantoin, barbiturates, primidone, carbamazepine) and tuberculosis (for example, rifampicin), antibiotics for treating other infectious diseases (for example, penicillin and tetracyclines).

When conducting hormone replacement therapy for patients with diabetes mellitus, sometimes it may be necessary to adjust the doses of hypoglycemic drugs.

• Alcohol interaction

Excessive alcohol consumption during hormone replacement therapy with Klimonorm affects the effectiveness of the drug.

Application features

Prior to the use of the drug, and then after a certain period of time during treatment (at least 1 time per year), gynecological examinations should be carried out, including an examination of the mammary glands, blood pressure measurement and other necessary studies.

Before treatment, the presence of anterior pituitary adenoma should be excluded.

If hormone replacement therapy is carried out in one of the diseases or conditions listed below, you may need careful medical observation. Therefore, if you have identified one of these conditions, tell your doctor before you start taking Klimonorm:

endometriosis now or in the past

- liver or gallbladder diseases. After suffering hepatitis, the drug may be prescribed no earlier than 6 months (until normalization of liver function indicators),

- jaundice during a previous pregnancy or previous intake of sex hormones,

- arterial hypertension (high blood pressure),

- Chloasma (yellowish brown pigment spots on the skin) now or in the past.If they are, avoid prolonged exposure to the sun or ultraviolet radiation,

- benign breast diseases (mastopathy),

- elevated levels of triglycerides in the blood,

-systemic lupus erythematosus,

- increased risk of vein thrombosis. The risk increases with age. It may also increase if you or your relatives have thrombosis, with varicose veins, overweight.

The risk of deep vein thrombosis is temporarily increased as a result of surgery, serious injuries or prolonged immobility. If you use Klimonorm, tell your doctor about any planned hospitalization or surgery (4-6 weeks).

Do not use hormone replacement therapy for the prevention of heart attack or stroke.

The following warnings related to the use of HRT should also be considered when using Klimonorm.

With prolonged use of estrogen alone, the likelihood of cancer of the uterine lining (endometrial cancer) increases. Progestogen, used in Klimonorm, reduces this risk.

Tell your doctor if you often have cycle breakthroughs or breakthrough bleeding while taking Klimonorm.

• Mammary cancer

The results of several studies have shown that in women who have used hormone replacement therapy (HRT) for several years, breast cancer is observed more often than their peers, who have never used HRT. The relative risk increases with increasing duration of treatment and possibly further increases with the combination of estrogens and progestogens. This increase is comparable to the increase in the risk of breast cancer in women with every year delay in the onset of natural menopause, as well as obesity and alcohol abuse.

It is not known whether this difference is due to HRT. It may be due to the fact that women using HRT are more frequently examined, and therefore their breast cancer is detected at earlier stages.

The increased risk gradually decreases to the usual level during the first few years after the termination of HRT.

According to most studies, breast cancer found in women who take HRT is usually more differentiated than women who do not. HRT increases the mammographic density of the mammary glands, which in some cases may make it difficult to X-ray detection of breast cancer. For this reason, the doctor may choose other diagnostic methods.

In rare cases, the use of sex hormones observed the development of benign, and even more rarely - malignant liver tumors. In some cases, bleeding from such tumors into the abdominal cavity posed a threat to life. Communication with ongoing HRT is not proven. Although such cases are extremely unlikely, you should tell your doctor if you have unusual sensations in the upper abdomen that do not go away for a short time.

Reasons for immediate discontinuation of Clemonorm

You should immediately stop treatment and consult a doctor if you have any of the following conditions:

• a first migraine attack (characterized by throbbing headache and nausea, preceded by visual impairment),

• exacerbation of an existing migraine, any unusually frequent or unusually severe headaches,

• sudden visual or hearing impairment,

• vein inflammation (phlebitis).

If you have a thrombosis during the treatment with Climonorm, or there is a suspicion that this could happen, you should immediately stop taking the drug and consult a doctor. Warning signs of possible thrombosis include:

- coughing up blood

- unusual pain in the arms or legs or their swelling,

- sudden lack of air - loss of consciousness.

Admission Klimonorm should also immediately stop in case of pregnancy or the development of jaundice.

Impact on laboratory results

Taking sex steroids can affect the results of some laboratory tests. Always inform your doctor if you are using Klemonorm.

Klimonorm is not used for contraception.

• If contraception is necessary, non-hormonal methods should be used (except for calendar and temperature methods). If you suspect a pregnancy should stop taking the drug until pregnancy is excluded.

Influence on ability to drive and use mechanisms

Release form, composition and packaging

Dragee round, yellow (9 pieces in a blister).

Excipients: iron oxide yellow, purified water, carnauba wax, dextrose (glucose), gelatin, calcium carbonate, potato starch, lactose monohydrate, magnesium basic carbonate, magnesium stearate, macrogol 35 000, povidone K25, sucrose, talc, titanium dioxide.

Dragee round, brown (12 pieces in a blister).

Excipients: iron oxide brown, iron oxide red, purified water, carnauba wax, dextrose (glucose), gelatin, calcium carbonate, potato starch, lactose monohydrate, magnesium hydroxycarbonate basic, magnesium stearate, macrogol 35 000, povidone K25, sucrose, talc, titanium dioxide .

21 pieces - blisters (1) - packs cardboard.
21 pieces - blisters (3) - packs cardboard.

- hormone replacement therapy (HRT) for menopausal disorders, involutional changes of the skin and urogenital tract, menopausal depressions, as well as symptoms of estrogen deficiency due to natural menopause or hypogonadism, sterilization or primary ovarian dysfunction in women with an ovoid uterus,

- prevention of postmenopausal osteoporosis,

- normalization of irregular menstrual cycles,

- treatment of primary or secondary amenorrhea.

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Side effects

From the reproductive system: there may be changes in the frequency and intensity of uterine bleeding, breakthrough bleeding, intermenstrual bleeding (usually weakened during therapy), dysmenorrhea, changes in vaginal discharge, a condition like premenstrual syndrome, tenderness, tension and / or breast enlargement, changes in libido.

From the digestive system: possible dyspepsia, bloating, nausea, vomiting, abdominal pain, relapse of cholestatic jaundice.

From the side of the central nervous system: sometimes - headache, migraine, dizziness, anxiety or depressive symptoms, fatigue.

Since the cardiovascular system: sometimes - heart palpitations, increased blood pressure, venous thrombosis and thromboembolism.

Metabolism: possible swelling, changes in body weight.

Dermatological reactions: sometimes skin rash, pruritus, chloasma, erythema nodosum.

Other: muscle cramps, visual impairment, intolerance to contact lenses, allergic reactions.

Pregnancy and lactation

HRT is not carried out during pregnancy and lactation.

Large-scale epidemiological studies of steroid hormones used for contraception or HRT did not reveal an increase in the risk of birth defects in children born to women who took these hormones before pregnancy, as well as the teratogenic effects of hormones when they are accidentally taken in early pregnancy.

A small amount of sex hormones can be excreted in breast milk.

Indications for use Klimonorm

  • Replacement therapy with a lack of female sex hormones after a normal, premature or surgically caused menopause.
  • Mental and autonomic symptoms of menopausal disorders in the pre- and postmenopausal period, postmenopausal osteoporosis.
  • Diseases of the cardiovascular system in the pre- and postmenopausal period when taking Klimonorm are amenable to prevention.

Analogs Klimonorm list

  1. Abufene (oral tablets),
  2. Angeliq (Angeliq) Tablets,
  3. Klimadinon (Klimadynon) Drops for intake,
  4. Klimadinon (Klimadynon) Tablets oral,
  5. Climodien (Climodien) oral tablets,
  6. Klimadinon Uno (Klimadynon Uno) oral tablets,
  7. Klimen (Climen) Dragee.

Drugs from the same category "anti-menopausal drug":

Important - instructions for use Klimonorm, price and reviews to analogues do not apply and can not be used as a guide for the use of drugs of similar composition or action. All therapeutic appointments should be done by a doctor. When replacing Klimonorm with an analog, it is important to get expert advice, it may be necessary to change the course of therapy, dosages, etc. Do not self-medicate!

The anti-menopausal combination drug, as well as its analogues, should be prescribed only by a doctor. Independent use of HRT is unacceptable and can lead to undesirable side effects and deterioration of the patient’s health.

Composition of Klimonorm

The medicine is available in the form of a dragee. 1 carton pack contains 1 blister with calendar scale, 21 drops of Klimonorm - 12 pcs. brown and 9 pcs. yellow color. According to the instructions, the active ingredients of this combined drug are estrogen and gestagen. The features of the chemical composition of the product are as follows:

levonorgestrel (150 mcg)

estradiol valerate (2 mg)

Dosing and Administration

Klimonorm tablets are intended for oral administration. A single dose is required to be swallowed whole, without first chewing in the oral cavity, and drink plenty of water. While maintaining menstruation, the treatment regimen provides for the beginning of the course from the fifth day of the menstrual cycle. With rare periods or amenorrhea, drug therapy is allowed on any given day. Previously it is important to ensure that there is no progressive pregnancy.

According to the instructions, it is recommended to begin conservative treatment with oral administration of yellow tablets - daily drink 1 pc. for 9 days without a break. Then you need to go to the brown dragee: use 1 pc. within 12 days. Next is a week break, which often occurs during the menstruation period. Then the treatment must be resumed, following a similar pattern.

How long can you take Klimonorm

The course of treatment is long. For example, for the prevention of osteoporosis, the drug is used for 10 years with interruptions previously agreed with a specialist. The duration of drug therapy is 5 years. During this time, 1-2 breaks are allowed in consultation with the gynecologist. Once every six months, the patient will undergo a full examination to rule out the development of such diseases, as follows:

  • breast cancer, uterus, endometrium, liver, brain,
  • thrombosis, thromboembolism, severe obesity,
  • coronary heart disease.

Climonorm and pregnancy

Instructions for use of Klimonorm states that when carrying a fetus and during breastfeeding the specified drug is not recommended. If a woman took pills, not knowing about pregnancy, you can not fear for fetal development - there is no teratogenic effect. Treatment with Klimonorm before pregnancy also does not provoke the mutagenic development of the embryo.