Elleste Duet 1 mg 3 x 28 tablets

Elleste Duet

Elleste Duet 1 mg or 2 mg with LIVVE support

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Elleste Duet
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Once-daily sequential combined HRT

Elleste Duet

Hot flushes, night sweats or sleep interrupted by menopause symptoms? Elleste Duet is a daily HRT tablet that may help. Available in 1 mg and 2 mg strengths, it combines estradiol with a progestogen called norethisterone acetate as part of a monthly treatment plan.

LIVVE product price

£20.00

Pack size: 84 tablets: three 28-day cycles

Medicine cost only. Consultation and ongoing reviews may be separate unless stated in your treatment plan.

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If you have a womb and need a monthly HRT cycle, Elleste Duet may be one of your options. Each strip has 16 oestrogen-only tablets, followed by 12 with both hormones. You take one tablet a day, and a monthly bleed is usually part of the routine.
View product facts How to take it

1 mg and 2 mg strengths

One tablet each day

28-day sequential cycle

Both hormones included in one pack

Regular HRT review

Treatment that fits your symptoms, your health and your everyday life.

Elleste Duet 1 mg 3 x 28 tablets
1/2

Your monthly HRT plan, together in one pack

The first 16 tablets provide oestrogen. The final 12 add a progestogen to help protect your womb lining. Follow the arrows and move straight onto your next strip, with no break in between.

Quick product facts

Elleste Duet at a glance

Key information about the medicine, strengths, tablet sequence and expected bleeding pattern.

  • Medicine type

    Sequential combined HRT

  • Hormones

    Estradiol + norethisterone acetate

  • Strengths

    1 mg and 2 mg

  • How often?

    Once daily

  • Cycle

    28 days

  • Pack size

    84 tablets

    Three 28-day cycles, in the prescribed 1 mg or 2 mg strength

  • Bleeding pattern

    Monthly bleed usually expected

  • Prescription needed?

    Yes

Both strengths follow the same daily routine. Your LIVVE clinician will help you find the lowest strength that works for your symptoms, taking your health and previous treatment into account.

Strengths and price

Elleste Duet 1 mg and 2 mg

Both strengths follow the same 28-day sequence and comes in 84 tablets per pack. We’ll usually review your treatment at around 3 months, then at least annually. Ask for advice sooner if you need it.

Strength Days 1–16 Days 17–28 LIVVE price
Elleste Duet 1 mg White: 1 mg estradiol

Pale green: 1 mg estradiol + 1 mg norethisterone acetate

 £20
Elleste Duet 2 mg Orange: 2 mg estradiol

Grey: 2 mg estradiol + 1 mg norethisterone acetate

 £20

Take the tablets in the correct order. Start with the oestrogen-only tablets and follow the arrows through the pack. Do not switch between colours, alter the sequence or move between 1 mg and 2 mg without clinical advice.

How to take your treatment

A daily routine, one tablet at a time

Take your tablets in the order shown by the arrows. Your dispensing label and the leaflet in your pack will guide you too.

Use the prescribed 1 mg or 2 mg pack. The strength refers to the estradiol dose; it does not change the one-tablet-a-day routine. Do not increase the dose yourself.

Key application steps

  • Check your prescribed strength before starting. Use the day-of-week sticker supplied with the pack to help you follow the sequence.

  • For 1 mg: take one white tablet daily for days 1 to 16, then one pale green tablet daily for days 17 to 28.

  • For 2 mg: take one orange tablet daily for days 1 to 16, then one grey tablet daily for days 17 to 28.

  • Swallow the tablet whole with water, at approximately the same time each day.

  • Follow the arrows and take every tablet in order. Do not swap colours or skip the combined tablets.

  • Start the next strip the day after finishing the previous strip, even if you are still bleeding. There is no tablet-free break.

Practical tips

  • Use the day-of-week stickers and a reminder to help you stay on track.

  • Keep a record of bleeding and any symptoms or side effects.

  • If you take too many tablets, ask a pharmacist or doctor for advice, particularly if you feel unwell.

  • Store 1 mg tablets at no more than 30°C and 2 mg tablets at no more than 25°C, in their original packaging.

  • Keep out of the sight and reach of children. Do not use after the expiry date.

  • Return unwanted tablets to a pharmacy for safe disposal.

  • Check with a pharmacist or prescriber if the pack, colour sequence or dispensing instructions are unclear.

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Dose and routine

Tablet sequence and missed doses

Use this table alongside the instructions on your pack.

Stage Instructions
Days 1–16 Take the oestrogen-only tablets: white for Elleste Duet 1 mg or orange for Elleste Duet 2 mg.
Days 17–28 Take the combined tablets: pale green for Elleste Duet 1 mg or grey for Elleste Duet 2 mg.
Next pack Start the next strip immediately the following day. There is no tablet-free break.
Missed within 12 hours Take the missed tablet when you remember, then continue as normal.
Missed over 12 hours Skip and safely dispose of the missed tablet, then take the next at the normal time. Do not double the dose. Missing a tablet may cause spotting.
Monthly bleed A withdrawal bleed will usually occur towards the end of the pack or early in the next one.

Benefits and suitability

How Elleste Duet may help

  1. Fewer hot flushes

    May help make those sudden waves of heat less frequent or intense.

  2. Less night sweating

    May help ease menopause-related sweating at night.

  3. More settled sleep

    You may sleep better as night sweats and other menopause symptoms ease.

  4. Support for everyday wellbeing

    When symptoms feel more manageable, daily life may feel easier too. Tell us about low mood or anxiety that persists so we can help you explore the right support.

  5. Help vaginal symptoms

    It may help dryness or irritation, although local vaginal treatment may still be needed.

  6. A role in bone health

    For some people after menopause, Elleste Duet 2 mg can also help prevent osteoporosis. This use is only for those at high risk of fractures who cannot take other approved prevention medicines because of side effects or medical reasons. It does not apply to the 1 mg strength.

What is Elleste Duet

One daily tablet, with a monthly rhythm

Elleste Duet contains estradiol to replace some of the oestrogen that falls around menopause. During the final 12 days of each cycle, the tablets also contain norethisterone acetate, a progestogen that helps protect your womb lining.

Do I need separate progesterone?

Usually not. The final 12 tablets already contain norethisterone acetate, the progestogen that helps protect your womb lining. Take the full sequence as prescribed, and check with us if you’re unsure about your plan.

Treatment options

Finding an HRT option that fits you

There’s no single HRT that suits everyone. Your symptoms, periods, health history and preferences all matter. We’ll help you compare your options, including how each one fits into daily life.

  • Sequential combined HRT

    Oestrogen is taken every day, with a progestogen added for part of each monthly cycle

    Often considered when periods are continuing or have only recently stopped.

    • Structured monthly cycle
    • Planned withdrawal bleed usually expected
    • Both hormones may be supplied in one pack or as separate medicines, depending on the prescribed regimen.

    Things to consider: the tablets must be taken in the correct order and a monthly bleed is normally part of treatment.

    LIVVE examples

    Elleste Duet Evorel Sequi Elleste Solo + separately prescribed progestogen (separate regimen)

  • Oestrogen-only HRT

    Oestrogen without an included progestogen

    May suit people who have had their womb removed or those using a separate progesterone or progestogen plan.

    • Tablets, patches, gels or sprays
    • Flexible separate progesterone plan
    • Womb protection needed if the womb is present

    LIVVE examples

    Elleste Solo Evorel Estraderm MX FemSeven Mono Oestrogel Sandrena Lenzetto

  • Continuous combined HRT

    Oestrogen and progestogen used continuously

    May suit postmenopausal patients who need both hormones without a planned monthly withdrawal bleed.

    • Both hormones used every day
    • No planned monthly bleed once settled
    • Available as combined products or separate medicines

    Things to consider: spotting can occur during the early months and continuous progestogen can cause side effects for some people.

    LIVVE examples

    Evorel Conti Bijuve Elleste Duet Conti Oestrogen + separate progesterone

For many people, this hormone pattern brings a monthly bleed. You won’t usually need a separate progestogen because it’s already in the final 12 tablets. It’s important to take those tablets too: they help protect your womb lining.

What to expect

What the first few months may look like

  1. The first days

    Hot flushes and night sweats may start to ease, and sleep may improve as symptoms settle. You may also notice headaches, breast tenderness, nausea, bloating or spotting. Let us know if these are troublesome or aren’t settling.

  2. The first few weeks

    You may notice some symptoms easing within a few weeks. We’ll usually review your treatment at around 3 months to see how you’re feeling and whether anything needs adjusting. If side effects or bleeding worry you, ask for advice sooner.

  3. Your monthly bleed

    A monthly bleed is usually part of this HRT routine. It often starts between day 21 of one strip and day 5 of the next, although some people don’t bleed. Keep taking your tablets in order, even during a bleed. Spotting can happen in the first few months; see the bleeding advice below for when to get help.

  4. Around 3 months

    Your review is a chance to talk about what’s improving and what isn’t. We’ll look at your symptoms, side effects and bleeding pattern to check whether your strength and treatment plan still suit you.

Your LIVVE pathway

How assessment and prescribing work

From your first assessment to your treatment review, we’ll help you understand your options and how to use your prescribed HRT.

  1. Complete your assessment

    Tell us about symptoms, periods, bleeding, health history, current medicines and treatment preferences.

  2. Clinician review

    Your clinician considers whether sequential, continuous combined or another HRT option is most suitable.

  3. Personalised prescription

    If suitable, Elleste Duet 1 mg or 2 mg is prescribed with clear instructions for the 28-day cycle.

  4. Ongoing support

    You receive starting guidance, access to LIVVE and reminders when review or repeat prescription is due.

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Ongoing support

Questions or changes along the way

Ask for an earlier review if

Unexpected spotting may occur in the first few months. Arrange assessment promptly if it lasts beyond the first 6 months, starts after more than 6 months of treatment, or continues after stopping. These time points do not mean you should wait if bleeding is heavy or concerning.

  • Symptoms have not improved after around 3 months or become worse.

  • Side effects are persistent, severe or difficult to manage.

  • Bleeding is heavy, prolonged or painful; do not wait for a routine review.

  • You miss tablets repeatedly or are unsure about the sequence, starting date or strength.

  • Your health, medicines or treatment preferences change.

Suitability and safety

Before you start

We’ll help you weigh up the benefits and risks. Share your health and family history, allergies and every medicine or herbal product you use so your clinician can check whether treatment is right for you.

Do not take Elleste Duet if any of these apply

  • You have, have had, or may have breast cancer.

  • You have or may have an oestrogen-sensitive cancer, such as cancer of the womb lining.

  • You have unexplained vaginal bleeding or untreated excessive thickening of the womb lining.

  • You have or have previously had a blood clot in a vein, including a leg clot or a clot in the lungs.

  • You have a known blood-clotting disorder such as protein C, protein S or antithrombin deficiency.

  • You have or have recently had a condition caused by a clot in an artery, such as a heart attack, stroke or angina.

  • You have active liver disease, or previous liver disease with liver tests that have not returned to normal.

  • You have porphyria, or are allergic to estradiol, norethisterone acetate or another ingredient.

Side effects

Possible side effects and when to ask for help

Not everyone has side effects. The following is a summary, not the full list. Read the patient leaflet and the important risks and urgent warning signs in Safety first.

  • Very common side effects

    May affect more than 1 in 10 people: headache, breast pain or tenderness, painful periods and changes to the menstrual cycle.

  • Common side effects

    May affect up to 1 in 10 people: nausea, bloating, indigestion, stomach cramps or diarrhoea; changes in mood, sleep or sex drive; dizziness; skin rash or itching; back or limb pain; swelling or weight increase; heavy or irregular bleeding and vaginal discharge. Other effects are listed in the leaflet.

  • Less common and serious effects

    Other reported effects include migraine, raised blood pressure, gallbladder problems, allergic reactions, blood clots and liver problems. Do not assume a serious symptom is a normal settling-in effect; follow Safety first.

Discuss changes with your clinician

Do not change strength, omit the combined tablets or switch to another HRT yourself. Your clinician can review symptom relief, bleeding, side effects and whether another route is more suitable. If you wish to stop, discuss a plan; symptoms may return. Stop immediately and seek help when the warning signs in Safety first apply.

Do not increase the dose yourself. If symptoms remain troublesome, contact LIVVE rather than switching from 1 mg to 2 mg without review. A different HRT route or progesterone may sometimes be more suitable.

FAQs

Frequently asked questions

What is Elleste Duet?

It’s a daily HRT tablet with a monthly sequence: oestrogen-only tablets first, then tablets with oestrogen and a progestogen. It comes in 1 mg and 2 mg strengths, and your clinician will help you choose the right one.

How does the 28-day cycle work?

Take the 16 oestrogen-only tablets first, followed by the 12 combined tablets. Start the next pack the following day without a break.

What is the difference between 1 mg and 2 mg?

The difference is the amount of estradiol: 1 mg or 2 mg in each tablet. Both strengths include 1 mg norethisterone acetate in the final 12 tablets. We’ll aim for the lowest strength that gives you the symptom relief you need.

Do I need separate progesterone with Elleste Duet?

Usually not. The final 12 tablets already contain norethisterone acetate, the progestogen that helps protect your womb lining. Take the full sequence as prescribed, and check with us if you’re unsure about your plan.

Will I have a monthly bleed?

You will probably have a monthly withdrawal bleed, often between day 21 of the current pack and day 5 of the next pack. Some people may not bleed, and irregular bleeding can occur during the first few months.

What if I take the tablets in the wrong order?

It’s easy to lose track. Contact LIVVE or your pharmacist so we can help you work out what to do next. Don’t double up or swap tablet colours to try to put it right yourself.

What if I miss a tablet?

Remembered within 12 hours of your usual time? Take the missed tablet. If it’s more than 12 hours late, skip it, dispose of it safely and take your next tablet at the usual time. Don’t take two to make up for a missed dose. You may notice some spotting.

How long does it take to work?

You may notice a difference within a few weeks. We’ll usually check in at around 3 months to see how treatment is working for you. You don’t need to wait until then if you’re struggling with side effects or have questions.

What side effects might I notice?

You might notice headaches, tender breasts, nausea, bloating, mood changes or spotting. Headaches, breast pain or tenderness, painful periods and menstrual-cycle problems are classed as very common, affecting more than 1 in 10 people. Nausea, bloating, swelling, mood changes and irregular bleeding are common, affecting up to 1 in 10. Tell us if side effects are bothering you. The leaflet has the full list, and the urgent warning advice explains when to get help straight away.

Why might a patch, gel or spray be recommended instead?

A tablet may fit easily into your routine, but it isn’t the right route for everyone. Your clinician may suggest a patch, gel or spray based on your health, blood-clot risk, migraines, side effects or preferences. We’ll talk you through the reasons.

What is the difference between Elleste Duet and Elleste Duet Conti?

Elleste Duet is sequential combined HRT. You take oestrogen every day and a progestogen during the final 12 days of each 28-day cycle, so a monthly withdrawal bleed is usually expected. Elleste Duet Conti contains both hormones every day and is generally considered after periods have stopped, with the aim of becoming bleed-free once treatment has settled.

Does Elleste Duet contain lactose?

Yes, both strengths contain lactose. Let us know about any diagnosed sugar intolerance before starting. Elleste Duet must not be taken with rare hereditary galactose intolerance, total lactase deficiency or glucose-galactose malabsorption. The orange 2 mg tablets also contain Sunset Yellow (E110), which can cause allergic reactions, including asthma, particularly if you’re allergic to aspirin. The leaflet lists all ingredients.

Is Elleste Duet a contraceptive?

No. You may still need contraception while taking HRT. Your clinician can help you work out what you need based on your age and when you last had a natural period.

Let’s talk about your HRT options

Tell us how you’re feeling and what you’d like help with. Your LIVVE clinician can guide you through the options and recommend treatment if it’s right for you.

Start your consultation View product facts

This page provides general information and does not replace individual medical advice. Elleste Duet is a prescription-only medicine and is supplied only when clinically appropriate after assessment. Read the leaflet supplied with your medicine and follow your prescriber’s instructions.