Supply scenarios
Supply scenarios
Which of the following patients may be suitable for Gina?
Mrs N is 55 and her periods stopped 3 years ago. She is distressed as she tells you about her symptoms and the impact they have on her life and her relationship with her husband. She has found sex increasingly uncomfortable and, as a result, stopped having an interest in or participating in sex. She used to be a keen triathlete but now even sitting on the saddle of her bike is uncomfortable. She asks if Gina would be suitable for her. She is not currently using a local oestrogen therapy and she has no contraindications or relevant risk factors.
CorrectShe would start on the initial dose
IncorrectMrs N is suitable for supply.
She would start on the initial dose
Ms V is 48 and postmenopausal. She had her last period 6 months ago. She has symptoms of VA, for which her GP prescribed a local oestrogen therapy and she has been using it for the last 6 months. She responded well to treatment; her VA symptoms are well-controlled, and she has no other medical conditions of concern. Her friend told her about Gina and she would like to try it instead of her prescription medication.
IncorrectMs V is under 50 and it has been less than a year since her last period. She should be referred to her GP
CorrectShe should be referred to her GP
Click continue to assessment to answer some further questions to test your understanding and record this learning in your learning log.
Pharmacists and pharmacy technicians can use this training module to help support their GPhC revalidation.
1. Novo Nordisk. Gina SMpC. Available from: www.medicines.org.uk/emc/ [Accessed August 2022]
2. Nilsson K, Heimer G. Low-dose oestradiol in the treatment of urogenital oestrogen deficiency-a pharmacokinectic and pharmacodynamics study. Maturitas. 1992;15(2):121–127.
3. Mylan. Elleste Solo 1mg SmPC. Available from: https://www.medicines.org.uk/emc/product/9512/smpc [Accessed August 2022]
4. Simon J, Nachtigall L, Gut R, et al. Effective treatment of vaginal atrophy with an ultra–low-dose estradiol vaginal tablet. Obstet Gynecol 2008; 112(5):1053–1060.
5. Novo Nordisk. Pharmacy Guide for the Supply of Gina [2022]. https://www.medicines.org.uk/emc/rmm/2509/Document
6. Gina Patient Information Leaflet
7. Ayres, J et al. British Menopause Society - HRT Guide. July 2020. Available from: https://thebms.org.uk/wp-content/uploads/2020/07/04-BMS-TfC-HRT-Guide-JULY2020-01D.pdf [Accessed June 2022]
8. Kongnyuy WJ, Norman RJ, Flight IH, Rees MC. Oestrogen and progestogen hormone replacement therapy for peri-menopausal and post-menopausal women: weight and body fat distribution. Cochrane Database Syst Rev 2000;(2):CD001018.
All references last accessed June 2024
Further information about this product, including essential supply information, adverse reactions, precautions, contraindications, and method of use can be found at: https://www.emcpi.com/pi/41923