Livial drug interactions: a practical overview
Drug interactions are the single biggest cause of preventable medication problems. Livial (Tibolone) interacts to varying degrees with several classes of medication and with a smaller list of foods. This page summarises the practically important ones at 2.5mg, framed for a real-world prescription review rather than an exhaustive PDF list.
High-priority interactions for Livial
For Tibolone, the most clinically relevant interactions are typically with strong CYP3A4 inhibitors and inducers, with cardiovascular medications (notably nitrates for several Hormones and Birth Control agents), with central nervous system depressants, and with medications affecting blood pressure or heart rate. Tibolone in Livial is rapidly converted to three active metabolites with tissue-selective activity.
Working with the pharmacist
A pharmacist review of all current medications is the practical safeguard against unintended interactions with Livial. According to the prescribing information for Tibolone, the full medication list — prescription, OTC, supplements and recreational substances — should be reviewed before starting and at every dose change at 2.5mg.
Frequently asked questions
What's the most important Livial interaction to know? ▾
For most Hormones and Birth Control medications, the highest-priority interaction is with nitrate medications used for chest pain — this combination is often a hard contraindication. After that, strong CYP3A4 inhibitors (some antifungals, macrolides) are the next concern at routine 2.5mg doses.
Do I need to tell the pharmacist about supplements? ▾
Yes. Supplements and herbal products can interact with Livial in ways that prescription drug-drug interaction databases miss. The pharmacist needs the complete picture — including supplements like St John's Wort, grapefruit-containing products and high-dose vitamins — to flag risks at 2.5mg.
More on Livial
- With alcoholLivial and alcohol — is it safe to drink?
- With foodShould Livial be taken with food?
- Side effectsLivial side effects: common, rare and warning signs
- Dosage guideLivial dosage guide: how much to take and when
- OnsetHow fast does Livial start working?
- DurationHow long does Livial last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.