Progestin + Estrogen
Progestin + Estrogen combination

Get your Activelle medication filled online

With Felix, you can get Activelle prescribed by a licensed healthcare practitioner and delivered to your door for free.

At a glance
Estradiol, Norethindrone acetate
0.5mg and 1mg tablets
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Prescribed by a Canadian healthcare professional
Support and resources along your journey
Free and fast shipping to your door
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What is

Activelle is a medication that combines both estradiol (identical to the natural hormone estrogen) and progestin in a single tablet.

It’s used as a treatment for: 

  • Moderate to severe vasomotor symptoms (hot flashes, flushing, sweating), which are associated with lower estrogen levels brought on by menopause
  • Vulval and vaginal atrophy and associated symptoms occurring due to menopause

Activelle should only be used in women that have an intact uterus.

For more resources, including a full list of the risks and benefits of Activelle, please review the product monograph.

How does

As the female body enters the menopausal and postmenopausal life stages, it begins producing less estrogen. This is a natural, universal transition.

However, reduced levels of estrogen can lead to unpleasant symptoms in some women (i.e., heart palpitations, mood changes, hot flashes, etc.).

Activelle works by providing estradiol to the body (virtually identical to the naturally produced hormone estrogen). This reduces the severity of certain vasomotor menopause/postmenopause symptoms (i.e., hot flashes, night sweats, excessive sweating, etc.).

The progestin hormone that is also in an Activelle dosage works in combination with the estradiol to help prevent endometrial hyperplasia (overgrowth of the lining of the uterus), as well as cancer of the lining of the uterus (endometrial carcinoma), if left untreated.

What is
used to treat?

Activelle is used to treat women that have intact uteri, who are experiencing moderate to severe vasomotor symptoms associated with menopause and postmenopause, or vulvar or vaginal atrophy associated with menopause.

These symptoms relate specifically to temperature regulation within the body, leading to things like hot flashes, night sweats, feeling uncomfortably hot, or excessive sweating.

Because Activelle also contains the progestin hormone, it also helps reduce the chances of endometrial hyperplasia (overgrowth of the lining of the uterus) occurring.

How do you take

Activelle tablets are to be taken orally, once a day. It can be taken with or without food.

It’s a good idea to try and take your Activelle doses around the same time each day, so that the medication maintains the highest possible level of efficacy throughout your treatment cycle.

There are 28 pills in each Activelle dial pack, and you should follow the instructions closely on the package, so that you can use the pack to help track your Activelle doses (and avoid missing any).

How long does
last after you take it?

What are the common side effects of

Some potential side effects of Activelle that could occur include:

  • Headaches
  • Irregular vaginal bleeding or spotting, during first 3-6 months of treatment
  • Changes in amount of cervical secretion
  • Vaginal and genital itching
  • Breast pain, tenderness, swelling, or enlargement
  • Hot flashes
  • Bloating
  • Uterine fibroid
  • Back or neck pain
  • Involuntary muscle spasms
  • Leg cramps
  • Heartburn
  • Increase or decrease in weight
  • Hair loss or growth
  • Acne
  • Skin discoloration (i.e., chloasma or vascular purpura)
  • Painful, red skin nodules

If any of these side effects of Activelle start to become severe, be sure to talk to your healthcare practitioner. They may be able to suggest an alternative medication that will work better for you.

MHT is the most effective treatment for menopausal symptoms and has been shown to prevent bone loss.

In menopausal women who start appropriately-dosed MHT prior to age 60 OR within 10 years of their last period, the health benefits outweigh the risks.

Risks of MHT are considered very rare (~1 case per 1000 to 10,000 women on MHT per year) and may include:

  • risks of stroke or blood clots in legs or lungs with oral estrogen (much lower risk with estrogen gel or patch)
  • risks of dementia in women older than 65 years,
  • risk of breast cancer (less than ~1 case per 1000 women on MHT per year)  

These conditions are all rare, but they highlight the importance of having a full discussion with your healthcare practitioner; especially if you’re experiencing moderate to severe side effects.

Individualization is key, and your MHT treatment plan should be reassessed (at least) once a year to monitor your health, as well as ensure that you are on the correct dosage and formulation. Your practitioner can help you find balance between treating your symptoms safely, and avoiding increased risks.

Who shouldn't take

There are certain people that shouldn’t use Activelle, including:

  • If you have a known hypersensitivity to this drug or any of its ingredients, or to components of its container
  • If you have liver disease or liver function issues
  • If you have known or suspected estrogen- or progestin-dependent cancer, or any history of this
  • If you have or have had breast cancer
  • You have any unexplained vaginal bleeding
  • If you are or think you may be pregnant
  • If you’re breastfeeding
  • If you have or have had any blood clotting diseases, of have experienced any blood clots in a vein before
  • If you have vision issues resulting from ophthalmic vascular disease (a blood vessel disease in the eye)
  • If you experience migraines
  • If you have porphyria (a blood pigment disease)

In addition to these people, there are others that should be extra cautious about taking Activelle. Be sure to talk to your healthcare practitioner before starting Activelle if you:

  • Have a history of allergies or intolerances to other medications or substances
  • Have a history of breast disease, breast biopsies, or a family history of breast cancer
  • Have experienced any unusual or undiagnosed vaginal bleeding
  • Have a history of uterine fibroids or endometriosis
  • Have a history of endometrial hyperplasia (an overgrowth of the lining of the uterus)
  • Have a history of liver disease, liver tumours, or jaundice
  • Have a history of itching related to estrogen use or during pregnancy
  • Have a history of migraines
  • Have a history of high blood pressure
  • Have a history of heart disease, heart attacks, or strokes
  • Have a personal or family history of blood clots
  • Have a history of kidney disease, asthma, or epilepsy
  • Have gallbladder disease
  • Have a history of bone disease
  • Have hypothyroidism, and you’re taking thyroid hormone replacement therapy
  • Have hereditary angioedema, or have had episodes of rapid swelling of the feet, face, lips, eyes, tongue, throat, or digestive tract
  • Have lupus
  • Have diabetes
  • Have been diagnosed with porphyria (a disease of blood pigment) 
  • Have a history of high triglycerides or high cholesterol
  • Have very low calcium levels
  • Have depression
  • Are on prolonged bed rest
  • Are pregnant or may be pregnant
  • Are breastfeeding
  • Have had a hysterectomy
  • Have otosclerosis (a disease that affects the eardrum and hearing)
  • Have lactose intolerance
  • Smoke

Drugs that may interact with Activelle include: 

  • Drugs used for the treatment of epilepsy (i.e., phenobarbital, hydantoin, phenytoin, and carbamazepine) 
  • Drugs used for tuberculosis (i.e., rifampicin, rifabutin) 
  • Drugs used for the treatment of HIV or hepatitis infections (i.e., nevirapine, efavirenz, ritonavir, telaprevir, and nelfinavir)
  • Anticoagulant, antidiabetic, and antihypertensive drugs
  • Barbiturates
  • Herbal preparations containing St John’s Wort (Hypericum perforatum)
  • Ketoconazole (a fungicide)

Grapefruit juice may increase the effect of Activelle.    

If any of these conditions apply to you, your practitioner may want to suggest an alternative medication that could work better for you.

What happens if
is taken regularly by men?

02249405, 02309009

We’d love to tell you more

Health Canada regulations require us to confirm your patient status to access further information on Activelle.
The drug identification number (DIN) is easy to find. It’ll be printed on your Activelle packaging and the receipt from your pharmacist.

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Trusted by over 1 million Canadians

Very easy and professional experience. Quick response from the doctor and easy ordering, billing and shipped and delivered on time. Hassle free.
Great service and products. Everything always arrived in a timely manner.
Simple, respectful, professional with good follow up and guidance, and fast service and delivery.
Best place to get birth control. No more annoying doctor visits
Within an hour . . . a doctor contacted me to make sure that particular medication was what I wanted. Doctor was friendly and knowledgeable. Within minutes . . . being confirmed my order was put through and I received my medication after 2 days.
Great service! I really appreciate being able to put my auto-refill on pause.
Easy and simple.
The best service!!! So happy I never have to try and get myself to the pharmacy anymore. This is the future!!!
The whole process of signing up with Felix, the online visit, and getting my prescription in the mail was very easy and very convenient.
Super convenient, and amazing customer service! The team always responds +++ fast and answers every question and concern. Very pleased with Felix!
Discreet, quick, very professional, and feels totally safe. This is such a convenient service and I'm a huge fan already.
Sign up was a breeze, and items shipped faster than expected. A positive, painless experience from start to finish!
Felix gets you into contact with doctors discreetly online to address personal matters that you'd rather not go to a doctor in person to see, you get the prescription best suited to your needs, and they'll deliver it to your local pharmacy or even your house!
Very quick and easy to do. Can ask the doctor any questions about the medication.
The process was a whole lot easier and faster than I imagined. And the doctor was absolutely helpful and answered relatively fast. I highly recommend Felix.
Super convenient and affordable! Much easier than having to book a doctors appointment and wait to get a prescription filled.

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Frequently asked questions


Felix 101

What is Felix?

Felix is Canada’s first truly integrated healthcare platform. We provide on-demand treatment for everyday health needs like weight loss, mental health, sexual health, and more. Founded in 2019, our digital-first approach to healthcare includes everything from diagnosis to prescription — all accessible from the comfort of home.

Who can use Felix?

Anyone who is 18 years or older older (16 or older for acne and birth control prescriptions), and is located in Alberta, British Columbia, Manitoba, Newfoundland and Labrador, Nova Scotia, Prince Edward Island, Saskatchewan or Ontario. We cannot ship treaments outside of these provinces at this time.

Does Felix replace my doctor?

No. Felix provides a faster, hassle-free way for you to get a prescription to certain medications but our service does not replace your primary care provider. For matters that extend beyond obtaining a prescription lifestyle medication safely and easily, we encourage you to consult your primary health practitioner in person — whether for checkups, personal health concerns, or to inform them about the medications you are currently using.

Can I be accurately assessed remotely?

Absolutely. Our online assessments have been designed to ask all the necessary questions required for diagnosis. We've worked with specialist to create an assessment process that can provide sufficient information for the healthcare practitioner to determine whether or not you are eligible for a prescription and craft an appropriate treatment plan.

It's an emergency. What do I do?

Call 911 or proceed to your nearest emergency room immediately. Felix is not intended for medical emergencies. Once the emergency has been addressed or resolved, contact your prescribing practitioner to inform them of your experience as this may impact your current treatment plan.

Online Visits

How does this visit work?

After creating an account, you will complete a medical assessment for evaluation by one of the Felix healthcare practitioners. 

During your assessment, you will have the opportunity to send your practitioner questions via secure messaging.  

In most cases, practitioners will complete your assessment with secure messaging alone but sometimes they may determine you require an audio or video visit and/or further diagnostic testing to help determine the best treatment plan for you. 

If your practitioner has determined a prescription treatment is appropriate, they will approve your visit and write you a prescription. Our pharmacy will then ship your prescription to your home.

You’ll be able to message your healthcare practitioner if you have questions or want to make changes to your treatment at any time.

Do I need to complete my online visit at a scheduled time?

No. We use an asynchronous telemedicine model so you can complete your online visit in your own time and we save your progress so you can come back later to finish it.

If you are completing a visit in the mental health or weight loss categories, your healthcare practitioner may require a phone or video call to discuss your medical profile further during the assessment process.

Does the online visit require a phone or video appointment?

Most assessments do not require a phone or video conversation. Once a prescriber has reviewed the info in your assessment they will respond to you via secure instant messages that you can access within your Felix account.  

If you are completing a visit in the mental health or weight loss categories, your healthcare practitioner may require a phone or video call to discuss your medical profile further during the assessment process.

How quickly will a healthcare practitioner review my online visit?

You can expect to receive a response from a healthcare practitioner within 24 hours of submission. If you’ve been waiting longer than this, please email and we’ll look into it.

Can I just get the treatment and skip the online visit?

No. A visit with a licensed healthcare practitioner is required for all treatments currently provided through Felix’s service.

Please email our Customer Support team at and they will be able to assist you with the transfer.

Privacy and Security

Is my information private and secure?

Yes, your security is paramount to Felix’s mission. Personal health information provided during your medical assessment is strictly and legally confidential between you and the Felix healthcare practitioner.

Beyond that, all your account information (including the medical assessment, credit card, and shipping information, etc.) is also stored safely and securely. Felix is compliant with all federal and provincial health privacy legislation. It is our duty to protect your data with comprehensive security infrastructure and stringent data policies to ensure it stays private and secure.

Read more on our Privacy Policy.

Is this legal?

Yes! In Canada, only a licensed healthcare practitioner can write a prescription, and only a registered pharmacist can fill that prescription. We are supported by leaders in the Canadian pharmacology and specialized medical fields. Felix adheres strictly to all the regulations set forth by all applicable Colleges of Pharmacists and Colleges of Physicians and Surgeons in which we operate.

Is this safe?

Absolutely. All prescriptions obtained via Felix are provided by licensed Canadian healthcare practitioners—the same as you would get at a hospital, doctor’s office, or clinic. These practitioners do not provide prescriptions unless they deem it medically safe and appropriate to write them based on your medical profile and assessment answers. Our assessments have been crafted by the experts on our medical team. Finally, all Felix Pharmacies are provincially accredited just like any retail pharmacy.

How is my privacy protected?

Your privacy is our top priority. All your data is 256 bit SSL/TLS encrypted, and we take significant steps to keep your data secure. You can read our Privacy Policy for more information. 


How long will it take to get my treatment?

Not long. After completing your assessment, a practitioner will generally respond within 24 hours, and often much sooner.

Treatment plans will be processed within 2-3 business days of your approval date if there is nothing blocking fulfillment.

All packages are shipped via Express Post, which usually takes 2-3 business days. You will receive an email with your tracking number once your treatment has been shipped.

Is your packaging discreet?

Absolutely. All Felix shipments arrive in a nondescript blister package so you can have your treatment shipped wherever makes sense for you as long as there is someone there to sign for it.

Do I have to be home to receive my package?

A signature upon delivery may be required.

How much does it cost to ship my treatment?

There is currently no cost to have your treatment shipped to you from our Felix Pharmacy network.

What courier do you use for shipping?

Our pharmacy partners use Canada Post and/or Purolator for shipping.

Pricing and Payment

How much is the online visit?

Felix charges a fee for the online visit, but only if and when you are approved by the healthcare practitioner. In most cases the fee is $40 but varies by treatment category. The visit fee includes a prescription valid for up to a year (depending on the condition) and on-going support from the healthcare practitioner or pharmacist.

How much will my treatment cost?

It depends. Treatment costs vary but will be in line with what you would pay at a pharmacy in person. You will see the estimated cost of your treatment before insurance, during the online visit but will only be charged once approved. Once approved, your treatment and payment will be processed within one to two days.

Keep in mind that you won’t necessarily need to pay the full price yourself. If you have insurance, Felix’s partner pharmacies will bill your insurer directly. You may also be eligible for financial support in your province.

What payment methods do you accept?

We accept all major credit cards for any aspect of your treatment not covered by insurance or other financial support

When am I charged?

You will be charged for the online visit as soon as it is approved by the healthcare practitioner. From there, and after your prescription is activated by the pharmacy, you will be charged the medication cost for each shipment based on your chosen refill schedule. If you have provided insurance or benefits coverage details, it will be applied according to your plan.


Am I covered by my insurance?

Treatment coverage varies greatly between different insurance plans.

The good news is that if you are covered, Felix can bill your insurer directly, and then process your treatment plan at no additional cost to you. We recommend that you upload your private and/or provincial benefit card during the online visit so that our pharmacy partner can apply any coverage you are eligible for before processing your treatment plan.

Insurance coverage for treatment plans through Felix doesn't include the cost of your visit.

Is the online visit covered by my insurance or provincial health plans?

A Felix online visit is considered asynchronous since it is conveniently completed through a secure chat bases system. Currently, asynchronous visits are not covered by insurance or provincial health plans so you will be charged a visit fee, depending on the category of treatment you are requesting.

Is the medication covered by my insurance or provincial health plans?

Medication coverage varies greatly between different plans, provinces, and has specific criteria that determine eligibility. For private insurance, we recommend contacting your benefits administrator with your details and the Drug Identification Number (DIN) and the drug name to determine your coverage.

For more details on provincial health plan coverage see below:

Alberta: Learn more about AHCIP here. Search for covered drugs here.

British Columbia: Learn more about MSP here. Search for covered drugs here.

Manitoba: Learn more about MHSIP here. Search for covered drugs here.

Newfoundland and Labrador: Learn more about MCP here. Search for covered drugs here.

Nova Scotia: Learn more about MSI here. Search for covered drugs here.

Ontario: Learn more about OHIP+ here. Search for covered drugs here.

Prince Edward Island: Learn more about Health PEI here. Search for covered drugs here.

Saskatchewan: Learn more about Saskatchewan Health Coverage here. Search for covered drugs here.

Is birth control covered by OHIP in Ontario?

OHIP+ covers some birth control for eligible residents of Ontario who are under 25 years old and do not have private insurance. You can check if your birth control medication is covered here. Make sure to upload your Ontario health card during your online visit so our pharmacy partners can apply your coverage directly.

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