(This information is based on the information and practise for Evorel¹. Other brands may vary slightly in usage/recommendations)

Instructions for How To Take It:
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Read the Patient Information Leaflet
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If there is conflict between what your healthcare provider has told you versus what the leaflet says, it’s generally best to follow your provider’s advice given that they will be aware of your transness and reason for using oestrogen.
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In contrast, the leaflet is typically written for cis women using oestrogen for birth control, with no consideration of the needs of transfeminine people using it.
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However if you have any concerns about which information is best to follow, you can always double check with your provider or another healthcare professional.
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Wash your hands thoroughly with soap and water before handling the medication.
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Prepare the Medication:
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If the medication is in a tablet form, ensure you have the correct dosage.
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If it’s a liquid, measure the prescribed dose accurately.
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Administer the Medication:
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Place the tablet or drop the liquid under your tongue.
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For tablets: Allow the tablet to dissolve under your tongue. Do not chew or swallow it. This may take anywhere from 5 to 25 minutes roughly, depending on how many pills you’re taking and/or the brand. When the pills have dissolved sufficiently (more like the texture of chewed food), it’s okay to swallow the remaining material.
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For liquid: Allow the drops to remain under your tongue for the recommended time, usually 1 to 2 minutes.
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Do Not Eat or Drink Immediately:
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Avoid eating or drinking for at least 10-15 minutes, or until after you are able to swallow the dissolved tablet which may take longer than this.
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This helps to ensure maximum absorption.
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Why might sublingual HRT be recommended to me?
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Sublingual oestrogen is often absorbed more directly into your bloodstream via your mouth, compared to being digested via the stomach following oral consumption, where some of the dose may not be absorbed.
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So if your levels are not where they need to be after some time on oral oestrogen, sublingual may be suggested as an alternative to help raise your levels to the desired range.
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Additionally, oral oestrogen pills may pose a risk to your liver over a long period due to the digestion.¹
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If you have any concerns over your liver or have any pre-existing liver conditions yourself or in your family, consult your healthcare provider who may suggest a different preparation of HRT.
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