Name:
Utrogestan (Utrogestan)
Pharmacological
action:
Pharmacodynamics. Pharmacological properties The drug is due to progesterone - one of the hormones of the corpus luteum, which contributes to the formation of a normal secretory endometrium in women. Causes the transition of the uterine mucosa from the proliferation phase to the secretory phase, and after fertilization contributes to its transition to the state necessary for the development of a fertilized egg. Reduces the excitability and contractility of the muscles of the uterus and fallopian tubes. Does not have androgenic activity. It has a blocking effect on the secretion of hypothalamic LH and FSH release factors, inhibits ovulation and the secretion of gonadotropic hormones by the pituitary gland.
Pharmacokinetics.
Oral administration. An increase in the level of progesterone in the blood plasma is noted from the 1st hour after ingestion. Cmax of progesterone in blood plasma is detected 1-3 hours after taking the drug (after 1 hour - 4.25 ng / ml, after 2 hours - 11.75 ng / ml, after 4 hours - 8.37 ng / ml, after 6 h - 2 ng / ml, after 8 hours - 1.64 ng / ml). The main metabolites of progesterone, determined in blood plasma, are 20α-hydroxy, δ4α-pregnanolone and 5α-dihydroprogesterone. The drug is excreted in the urine in the form of glucuronic metabolites, the main of which is 3α,5β-pregnanediol (pregnandiol). These metabolites are identical to the metabolites that are formed during the physiological secretion of the corpus luteum.
Intravaginal application. When administered intravaginally, progesterone is rapidly absorbed from the mucosa. An increase in the level of progesterone in the blood plasma begins from the 1st hour, the highest level in the blood plasma is reached 1-3 hours after ingestion.
At the average recommended dose (100 mg of progesterone at night), Utrozhestan allows you to achieve and maintain a physiological and stable level of plasma progesterone (on average at 9.7 ng / ml), similar to that in the luteal phase menstrual cycle with normal ovulation. Thus, Utrozhestan stimulates adequate maturation of the endometrium, promotes embryo implantation.
At higher doses (above 200 mg / day), which are increased gradually, the vaginal route of administration allows reaching plasma progesterone levels similar to those in the first trimester of pregnancy.
Metabolism. Metabolites in blood plasma and urine are identical to those detected during the physiological secretion of the corpus luteum of the ovary: mainly 20α-hydroxy, δ4α-pregnanolone and 5α-dihydroprogesterone were detected in blood plasma. Excretion with urine is carried out by 95% in the form of glucuronic metabolites, the main component of which is 3α,5β-pregnanediol (pregnanediol).
Indications for
application:
The drug is used for corrective therapy for endogenous progesterone deficiency.
Oral use utrogestan capsules:
- menstrual disorders due to anovulation, ovulation disorders,
- mastopathy (fibrocystic),
- premenstrual syndrome,
- in combination with estrogenic agents, it is prescribed as hormone replacement therapy for menopausal syndrome.
Intravaginal use utrogestan capsules:
- maintenance of the luteal phase of the menstrual cycle in preparation for the auxiliary reproductive technologies(in vitro fertilization, egg donation, etc.),
- maintenance of the luteal phase in the induced or spontaneous menstrual cycle,
- in combination with estrogenic agents, it is prescribed as hormone replacement therapy for menopausal syndrome,
- hormone replacement therapy in case of premature menopause,
- infertility due to insufficiency of the corpus luteum of the ovary,
- prevention of endometriosis, uterine fibroids,
- preventive treatment for habitual pregnancy loss due to progesterone deficiency,
- treatment of threatened abortion due to progesterone deficiency.
Mode of application:
The duration of use depends on the nature of the disease.
Ingestion. In most cases, the average daily dose is 200-300 mg in 2 doses (200 mg in the evening at bedtime and 100 mg in the morning if necessary).
With luteal phase deficiency(premenstrual syndrome, fibrocystic mastopathy, menstrual disorders, premenopause) are taken for 10 days (from the 17th to the 26th day of the cycle).
With hormone replacement therapy during menopause, due to the fact that estrogen therapy alone is not recommended, progesterone is used as an adjunct in the last 2 weeks of each course of therapy, following 1 week of replacement therapy, during which withdrawal bleeding is possible.
With the threat of preterm birth appoint 400 mg of Utrozhestan every 6-8 hours until the symptoms disappear. The effective dose and frequency of use are set individually, depending on the clinical manifestations of the threat of preterm birth. After the disappearance of symptoms, the dose of Utrozhestan is gradually reduced to a maintenance dose of 200 mg 3 times a day. At this dose, the drug can be used up to 36 weeks of pregnancy.
Intravaginal administration. The capsules are inserted deep into the vagina.
The average dose is 200 mg of progesterone per day (1 capsule of 200 mg or 2 capsules of 100 mg, in 2 doses, in the morning and evening, which are injected deep into the vagina, if necessary with the help of an applicator). The dose may be increased depending on the response of the patient.
With partial insufficiency of the luteal phase(dysovulation, menstrual disorders) the daily dose is 200 mg for 10 days (from the 17th to the 26th day of the cycle).
With complete insufficiency of the luteal phase
Complete absence progesterone in women with non-functioning (missing) ovaries (egg donation): the dose of progesterone is 100 mg in the morning and evening from the 15th to the 25th day of the cycle. Starting from the 26th day, in case of early diagnosis of pregnancy, the dose is increased by 100 mg of progesterone per day, reaching a maximum of 600 mg per day in 3 divided doses. This dosing regimen must be observed until the 60th day.
Support of the luteal phase during the in vitro fertilization cycle: 600 mg 3 times a day (200 mg once every 8 hours).
In case of a threatened miscarriage or for the prevention of habitual miscarriage due to progesterone deficiency: appoint 200-400 mg / day (100-200 mg every 12 hours) up to 12 weeks of pregnancy.
Side effects:
From the reproductive system: intermenstrual bleeding or spotting (rare).
From the side of the central nervous system
: dizziness 1-3 hours after taking utrozhestan, drowsiness.
There may also be hypersensitivity reactions.
Contraindications:
Bleeding from the genital tract of unknown origin,
- tendency to thrombosis (only for oral administration),
- incomplete abortion,
- malignant diseases of the reproductive organs and mammary glands (including suspicion of a malignant process in these organs),
- porphyria,
- severe hepatic impairment (only for oral administration),
- allergic reactions to the components of utrozhestan.
Interaction
other medicinal
by other means:
With hormone therapy menopause with estrogens, it is strongly recommended to prescribe progesterone no later than on the 12th day of the cycle.
If, in the treatment of the threat of preterm labor, Utrozhestan is combined with β-adrenergic agonists, the doses of the latter can be reduced.
Simultaneous use other drugs can change the metabolism of progesterone, causing an increase or decrease in the concentration of progesterone in the blood plasma and, accordingly, lead to a change in the action of the drug.
Powerful inducers of liver enzymes, namely: barbiturates, antiepileptic drugs (phenytoin), rifampicin, phenylbutazone, spironolactone, griseofulvin cause increased metabolism in the liver.
Some antibiotics(ampicillins, tetracyclines) can cause changes in the intestinal microflora, resulting in a change in the hepatic steroid cycle.
It is known that such interactions of drugs are individual and can differ significantly in different groups of patients, so it is unambiguous to predict any clinical manifestations such interactions are not possible.
All progestins can reduce glucose tolerance, which may require an increase in the daily dose of insulin and other antidiabetic agents in diabetic patients.
The bioavailability of progesterone can be reduced by smoking and increased by alcohol.
Pregnancy:
Utrozhestan is not contraindicated during pregnancy. However, in the third trimester, it is prescribed with caution due to an increased risk of developing hepatic impairment. Be wary appoint during breastfeeding.
Overdose:
The above symptoms side effects, as a rule, appear as a result of an overdose. They disappear spontaneously with dose reduction.
In some individuals, the usual dose may be overestimated due to existing or secondary unstable endogenous progesterone secretion, hypersensitivity to the drug, or very low concomitant blood levels of estradiol; in such cases, it is enough to reduce the dose of progesterone or prescribe it in the evening before bedtime for 10 days of the cycle in case of drowsiness or dizziness; postpone the start of treatment to a later period of the cycle (for example, the 19th day instead of the 17th) in case of its reduction or the appearance of spotting; it is necessary to check whether the level of estradiol is sufficient in a patient receiving hormone replacement therapy in the premenopausal period.
Sometimes a woman cannot become pregnant or bear a child. The cause of infertility and miscarriage often lies in hormonal imbalance - insufficient production of progesterone.
In this case, the appointment of Utrozhestan, a drug that can bring the hormonal balance back to normal, can be a salvation.
The ovaries produce a special hormone that is necessary for the onset of pregnancy, for the normal development and preservation of the fetus, as well as the correct course of labor.
If the hormone is produced in insufficient quantities, therapy using hormonal agents is prescribed.
Utrozhestan is a plant analogue of an enzyme produced by the corpus luteum.
The formula of the drug is completely identical to the molecules of progesterone. Therefore, the drug has the same effect on the woman's body as a natural hormone.
Indications:
- fibrocystic mastopathy;
- violation or lack of production;
- the need for hormone replacement therapy - used during menopause, egg donation, if an enzyme deficiency is detected;
- support of the progesterone phase - in the case of an induced or spontaneous cycle, before IVF, with infertility;
- preventive treatment - associated with insufficient production of progesterone, with a risk of developing endometriosis, as well as fibroids.
The scheme and duration of taking the hormone, the recommended dosage depend largely on the general condition of the patient.
So, the duration of oral or intravaginal administration is:
- fibrocystic mastopathy, hormone replacement therapy, dysmenorrhea - 10-12 days;
- egg donation, lack of progesterone as a result of non-functioning ovaries - 2 months;
- support of the progesterone phase during IVF - according to individual indications, the course of administration can stretch for the entire period of pregnancy.
A plant hormone can be prescribed simultaneously with sedative or antispasmodic drugs. It is not recommended to use Utrozhestan on its own.
Most often, Utrozhestan is prescribed if there is no pregnancy for a long time, which is associated with hormonal imbalance.
Signs of insufficient progesterone production can be uterine hyperplasia, menstrual irregularities, and the appearance of cystic formations.
The introduction of an additional dose of the hormone into the body eliminates the problem and helps conception. The treatment regimen with Utrozhestan is developed individually .
But the instructions for the drug mention that the average dosage is in the range of 200-400 mg per day. The doctor may stop the drug if pregnancy occurs. Dose reduction should occur gradually, every 3 days the intake is reduced by 50 mg.
In case of infertility caused by impaired functionality and formation of the corpus luteum, intravaginal administration of the drug is recommended.
Capsules are administered from the 17th day of the cycle. Course duration - 10 days. Even if pregnancy is detected against the background of Utrozhestan, treatment should continue.
The drug activates the production of secretory endometrium, stimulates the uterine mucosa to enter the secretory phase and prepares the organ for egg implantation.
Thanks to the drug, the excitability and contractile activity of the muscle tissue of the uterus decreases.
The need to take during pregnancy
As the fetus develops, the placenta takes over the production of progesterone. The lack of the enzyme leads to the threat of miscarriage.
In this case, the woman feels pain in the pelvic area, lower back. The secretions are present. Utrozhestan on early dates pregnancy is prescribed in order to preserve the fetus.
Even if, before conception, the ovaries coped with the production of the enzyme, hormone replacement therapy is recommended in case of a threatened abortion.
The advantage of Utrozhestan is that the drug can be administered intravaginally. Therefore, the course of treatment will be effective even with severe toxicosis.
Often, Utrozhestan is prescribed during pregnancy for prophylactic purposes, if up to this point the woman has already had several miscarriages or the previous pregnancy was accompanied.
Take Utrozhestan in case of a threat of termination of pregnancy should be the entire first trimester of pregnancy.
In case of isthmic-cervical insufficiency, the course can last up to 20 weeks.
Drinking Utrozhestan during pregnancy should be 2-3 capsules per day, containing 200 g of the active substance. That is, the maximum dose of vegetable progesterone is 600 mg per day.
If therapy is ineffective, the daily amount of Utrozhestan can be increased to 800 mg.
Sometimes Utrozhestan in suppositories is prescribed in the 2nd-3rd trimester of pregnancy in complex therapy to reduce the tone of the uterus. On the later dates pregnancy, the drug is administered intravaginally 1 time per day at night. Can be used up to 34-36 weeks.
Candles Utrozhestan, prescribed during pregnancy, are rapidly absorbed, providing a constant concentration of the enzyme in the plasma. However, women themselves sometimes refuse treatment, referring to the inconvenience of introducing capsules.
Cancellation of the drug most often occurs after the 12th week and is carried out gradually.
You can cancel Utrozhestan during pregnancy according to the following scheme: drink 200 mg at night for a week, then 100 mg 1 time per day for a week and 100 mg every other day for another 7 days.
Side effects of Utrozhestan include drowsiness, dizziness, and allergies.
In addition, many pregnant women note an increase in light discharge after the introduction of Utrozhestan vaginally. or, odorless, similar to.
Also, intravaginal administration can cause a burning sensation in the vaginal area. A similar symptom may be a sign of vaginitis.
Such symptoms should be reported to the gynecologist. In this case, it is necessary to reduce the dosage of the drug or replace it with an analogue.
Release form
Utrozhestan tablets are produced in the form of round-shaped soft capsules with a yellowish tinge.
Each capsule contains an oily liquid of a homogeneous consistency. One capsule may contain 100 or 200 mg of the substance.
Gelatin, glycerol, soy lecithin, as well as titanium dioxide and peanut oil are used as auxiliary components.
Packed capsules in blisters, each of which can contain 7 or 15 capsules. The carton contains 2 blisters. On the recommendation of a doctor, capsules are taken orally with water, or injected into the vaginal area.
When taken orally, an increase in the concentration of the enzyme is noted within 1 hour. The maximum level is detected within 1-3 hours.
When introduced into the vaginal area, the absorption of the drug occurs gradually.
The maximum concentration is reached after 2-6 hours. The required level of progesterone is maintained during the day with 2-fold use of capsules with a dosage of 100 mg.
Introduction in the amount of 200 mg per day corresponds to the level of progesterone in the normal course of the 1st trimester. As with oral administration, it is excreted from the body with urine.
Price
To whom the drug is contraindicated
It is not recommended to take Utrozhestan if a woman has acute thrombophlebitis or an increased tendency to thrombosis.
Contraindications are also: hypersensitivity to ingredients, with an unidentified cause, oncology of the reproductive system, porphyria, liver disease, incomplete abortion.
For liver diseases, Utrozhestan can be used intravaginally. When feeding a baby, the drug is taken only as directed by a doctor.
Analogues
If for some reason the use of Utrozhestan is impossible, the drug is replaced by structural analogues:
- Iprozhin - is produced in capsules with an active substance content of 100 mg;
- Crinon - is available in the form of a gel, in the 1st applicator the content of the active substance is 90 mg;
- Prajisan - capsules containing 100 mg of the enzyme;
- Progestogel - gel in tubes of 80 g, the tube contains 800 mg of progesterone;
- Progesterone - in the form of a solution for injection, ampoules 1 and 2.5%.
- - coated tablets containing progesterone 10 mg.
Unlike most analogues, Utrozhestan can be used in a way that is convenient for the woman herself. In addition, the drug is produced from plant materials, which significantly increases its safety and absorption.
The normal course of pregnancy is provided by a number of hormones that are synthesized by the ovaries, pituitary gland and placenta. Due to ailments of the reproductive system or abnormalities in the functioning of the endocrine glands, the expectant mother may experience a lack of hormones, such as progesterone, which leads to the risk of spontaneous abortion. In such cases, doctors prescribe drugs that include natural or synthetic analogues of hormones. One of these means is Utrozhestan.
Utrozhestan - composition and action
Progesterone is the active ingredient in Utrozhestan. It is considered the "hormone of pregnancy". It is he who ensures the successful conception and bearing of the baby, and also prepares the body of a woman for the birth of a child and breastfeeding. The progesterone contained in the drug is identical to that produced by the corpus luteum.
The effect of progesterone on different stages gestation:
- In the first days after conception, the hormone prepares the endometrium of the uterus for implantation of the blastocyst. At the same time, it makes the vaginal epithelium denser, and the cervical mucus thicker - subsequently it forms a plug that protects the embryo.
- When the blastocyst is implanted in the endometrium, progesterone reduces the woman's immunity so that the body does not reject the embryo as a foreign element. In addition, the contractile activity of the smooth uterine muscles decreases, which reduces the likelihood of miscarriage.
- Progesterone helps the development of the mammary glands, as well as their ducts. This is necessary for the synthesis of milk and the ability to breastfeed the newborn.
Release form of the drug
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Pharmaceutical companies produce Utrozhestan in the form of capsules. They differ in the content of the active ingredient: there are capsules with 100 mg of progesterone and with 200 mg of the substance. Pharmacy counters sell capsules in packs of 14 and 28 pieces.
They look oval. If you feel them, they are soft, gelatinous. Inside the capsules is an oily pale yellow suspension. As additional components, the suspension contains vegetable oil and soy lecithin. The shell consists of gelatin, glycerol and titanium dioxide.
Some women, having heard that Utrozhestan needs to be put in the vagina, ask for candles in pharmacies. However, pharmaceutical companies do not make this medicine in the form of suppositories. Capsules are allowed to be drunk like tablets and inserted into the vagina like candles.
What are they prescribed for?
When does the doctor prescribe a progesterone-containing drug? Utrozhestan is prescribed for both mothers who are carrying a child, and those who are just planning a pregnancy or have problems with the reproductive system. Progesterone plays an important role in the menstrual cycle, so it is necessary not only for expectant mothers, but also for women who are not yet going to conceive a baby.
The table provides information on the indications for the appointment of Utrozhestan:
During pregnancy When planning fertilization For the treatment of diseases of the reproductive sphere The risk of spontaneous abortion with uterine tone due to low progesterone production by the corpus luteum. Inability to conceive due to luteal insufficiency, which is caused by hypofunction of the corpus luteum. The cause may be dysfunction of the hypothalamic-pituitary system, hyperandrogenism, or inflammation of the appendages. Syndrome of premenstrual tension. The risk of premature delivery in women with birth canal anomalies, such as a shortened cervix, as well as premature rupture of the fetal membranes (more in the article:). Preparatory measures for artificial conception. Failure of menstruation due to ovulation disorders. Cystic overgrowth of breast tissue Hormone replacement treatment in pre- and postmenopause, premature menopause, with ovaries removed. Can it be taken during pregnancy?
Taking the drug Utrozhestan is not only allowed, but also necessary for problems with bearing a child. However, you do not need to take it on your own. Hormone therapy can cause irreparable damage to health if self-medicated.
Utrogestan during pregnancy is allowed to be used only under the close attention of gynecologists and endocrinologists. The doctor plans a treatment regimen taking into account the disease and the individual characteristics of the pregnant woman.
How does Utrozhestan affect the fetus?
Safety studies of Utrozhestan have shown that there is no pathological effect that threatens the development of the fetus. Doctors believe that this medication is not dangerous for the baby and does not cause intrauterine anomalies.
There is an opinion that if the mother long time drank progesterone during pregnancy, this may affect the health of the reproductive sphere in the future. For example, in girls during puberty, the risk of ovarian cysts increases. These data require a comprehensive study and confirmation or refutation.
Instructions for use and rules for admission in different forms of release
The method of application of Utrozhestan differs depending on the duration of pregnancy. There is also a difference if the medicine is taken orally and intravaginally. Despite the fact that the package contains instructions for use, the attending doctor can independently draw up a therapy regimen that a woman will have to follow. How is it necessary to use Utrozhestan in different trimesters?
1 trimester
Why are hormones prescribed in the early stages? In the first trimester, the drug is prescribed to eliminate the tone of the uterus and prevent miscarriage. It is often prescribed to mothers whose previous pregnancies ended in spontaneous abortions. It is prescribed mainly at the 5th week of gestation, when bleeding from the vagina is possible.
On the early stages Utrozhestan with the threat of miscarriage is used in the form of candles. They are placed in the vagina and left until completely resorbed. It is best to administer the suppository at night, attaching a pad to the underwear. Thus, the woman will be protected from unpleasant incidents if the medicinal suspension stains the laundry.
Dosage - 200 - 400 mg / day. Candles must be inserted 2 times a day at the same time. How long do you need to lie down after the introduction of the capsule? As a rule, about an hour, so it is better to inject them at night. If intravaginal administration is not suitable, you can use the medicine as tablets. You can not drink them with food, it is better to use on an empty stomach.
2 trimester
In the second trimester, pregnancy may be at risk due to a sharp decrease in the production of progesterone by the body and an increase in uterine tone. This occurs between 13 and 22 weeks of gestation. Hormone deficiency is determined by the analysis. Sometimes the level is so low that even the amount produced by the placenta is not enough for successful and safe gestation. Future mothers who have conceived with the help of in vitro fertilization, as well as with a pathological condition of the cervix, fall into the risk zone.
At the risk of miscarriage, the treatment regimen is the same as in the 1st trimester. You can use Utrozhestan orally and vaginally, 2 capsules at a dose of 200-400 mg / day. If pregnancy has occurred through artificial conception, the dosage is increased to 600 mg / day.
3rd trimester
Why prescribe hormones at the end of the term? In the third trimester, Utrozhestan is prescribed vaginally for shortening of the cervix, if the fetus has sunk low in the uterine cavity, to prevent preterm labor. Usually reception is prescribed from 30 weeks.
The medicine is inserted into the vagina 1 time per day. To minimize discomfort, this can be done at bedtime by introducing a suppository at night. Dosage - 200 mg / day.
How long is it absorbed and how is it excreted?
Utrozhestan is absorbed fairly quickly. When used as tablets, it is quickly absorbed in the digestive system, and the maximum plasma concentration is observed after 1 to 3 hours.
When injected into the vagina, the medicine begins to act a little more slowly. The maximum content of progesterone is found through 2 - 6 after administration. The action persists for 24 hours.
The drug is excreted through the kidneys with urine. In the urine, metabolites of progesterone, mainly pregnandione, are found. They are similar to those substances that are secreted by the corpus luteum in natural conditions.
How to cancel?
Abrupt discontinuation of the drug can lead to serious consequences for pregnancy. The female body needs time to gradually get used to a decrease in the dose of progesterone. To do this, doctors develop an individual withdrawal scheme.
How to cancel the medicine? If the daily dose is 400 mg, the Utrozhestan withdrawal regimen during pregnancy may be as follows:
- the dose is reduced to 300 mg, the duration of administration is 2 weeks;
- the next two weeks, the dosage is reduced to 200 mg;
- 100 mg for the next 7 days;
- absolute withdrawal of the drug.
How long to cancel the drug? Cancellation lasts 1 - 1.5 months, depending on the initial dose and the individual characteristics of the woman. With a decrease in the number of capsules, it is necessary to ensure that bleeding does not start. When spotting occurs, you need to temporarily increase the dose of the hormone.
With high dosages of progesterone, it is allowed to reduce the amount of the drug used by 100 mg per week. If the dose was initially small, it should be reduced by 50 mg per week.
Contraindications and side effects
In what cases is the use of Utrozhestan prohibited? Contraindications include the following ailments:
- thrombosis, inflammation of the walls of the veins, the formation of a blood clot that closes the lumen of the vessel, thromboembolism, leading to a heart attack or stroke;
- bleeding from the vagina;
- oncological formations of the genital organs or mammary glands;
- porphyria - a genetic abnormality characterized by a violation of pigment metabolism and a high content of porphyrin in the blood and tissues;
- liver ailments: jaundice, hepatitis, cancer, hereditary Dubin-Johnson syndrome and Rotor syndrome.
What kind side effects at Utrozhestan? Contrary to popular belief, a woman does not gain weight from the use of this hormonal drug, she does not have increased hair growth. With oral use of Utrozhestan in clinical practice, the following side effects were noted:
- pain in the chest, enlargement and increased sensitivity;
- drowsiness, dizziness, headache;
- nausea and vomiting, constipation or diarrhea, bloating;
- acne, itching, rash.
To reduce side effects, it is recommended to either adjust the dose or switch to the vaginal route of administration of the drug. There are almost no side effects when taken vaginally. Occasionally, an individual reaction may occur in the form of itching of the genital organs, abundant vaginal discharge.
What can harm an overdose?
Is an overdose dangerous? With hormonal drugs, you should be extremely careful, because they affect the entire body of a woman and the course of pregnancy.
The recorded effects of a single overdose are dizziness, drowsiness and euphoria. This condition is easily treated, just reduce the dose of progesterone or take the medicine before bedtime, when drowsiness will only benefit.
Analogue of the drug
In pharmaceuticals, there are several analogues of Utrozhestan with active substance progesterone. Each of them has a number of advantages or disadvantages compared to Utrozhestan - based on them, doctors select a drug that is suitable for each particular patient.
The table shows the analogues of Utrozhestan:
No. p / p Name Form Differences 1 Duphaston Tablets Not progesterone is used, but a synthetic analogue of the natural hormone - dydrogesterone. 2 Prajisan Capsules, vaginal gel It is more convenient for many to administer the gel intravaginally, using a special applicator. 3 Crinon Vaginal gel (more in the article:) The gel is contained in disposable applicators. The polymeric delivery method provides good binding to the mucous membrane of the vaginal walls, due to which progesterone is released continuously for 3 days. 4 Iprozhin Capsules Women note that the drug practically does not flow out of the vagina, unlike Utrozhestan. Utrozhestan is an effective hormonal remedy that allows many women to keep a long-awaited child. Some mothers, fearing the threat of a miscarriage, may prescribe progesterone drugs for themselves - it is strictly forbidden to do this, because this is a prescription medication that is prescribed only by doctors after a series of necessary tests.
Utrozhestan is a drug that is often prescribed to women when planning a pregnancy. This drug helps prepare the inner layer of the uterus (endometrium) for the implantation of a fertilized egg into it. After conception, the medication is indicated for female representatives with insufficient thickness of the uterine wall, who have an increased risk of miscarriage in the early stages. Utrozhestan promotes the growth of the endometrium, improving the system of blood vessels in it, designed to nourish the fetus. the main task drug - prevention of miscarriages and the normal course of pregnancy without complications.
Instructions for use Utrozhestan
Before taking Utrozhestan, you must definitely visit a doctor and read all the instructions. Oral administration of Utrozhestan is indicated in the following cases:
- infertility, provoked by insufficient luteinization;
- severe symptoms of premenstrual syndrome;
- disorders of the monthly cycle in women with anovulatory periods and episodes of amenorrhea;
- mastopathy of the fibrocystic type;
- the initial stages of menopause;
- as replacement therapy in women suffering from pathological menopause.
Utrozhestan is prescribed vaginally:
- conditions that require the use of hormone replacement therapy drugs due to a lack of progesterone caused by dysfunction or absence of the ovaries;
- prevention of miscarriages in pregnant women with endometrial insufficiency;
- ensuring normal luteinization in patients who are being prepared for in vitro fertilization;
- premature menopause;
- in combination with estrogen preparations, which are used as hormone therapy for various pathological conditions of sex sulfur in women;
- infertility caused by deficiency of the luteinization phase;
- a woman has a history of habitual abortions or a threat of miscarriage due to a lack of progesterone in the body.
When administered orally, the drug should be taken in the evening and washed down with a sufficient amount of water. Standard scheme taking the drug - 200-400 mg per day, divided into two doses. In case of violations of the menstrual cycle due to insufficient luteinization, the medicine is prescribed from the 17th to the 28th day of the cycle, that is, within 10 days. During menopause, as hormone replacement therapy, Utrozhestan is recommended to be taken in courses of 12 days at a daily dosage of 200 mg.
Vaginally, Utrozhestan suppositories are best placed before bedtime to ensure their long-term stay in the body in its horizontal position. To facilitate the passage of the capsule into the vagina, it should be moistened or use an applicator that will allow the suppository to be inserted to the maximum depth.
If the patient is diagnosed with progesterone deficiency, then Utrozhestan should be used together with estrogens, starting from the 14th day of the monthly cycle:
- 13-14 days - 200 mg once a day;
- from 15 to 25 days - 100 mg twice a day;
- from the 26th day after the intended conception, the dose of the drug is increased weekly by 100 mg until reaching 600 mg (the maximum dose can be taken continuously for no more than 0 days).
To prevent miscarriage or early childbirth, the drug is prescribed at a dose of 200 mg per day for 22-34 weeks of pregnancy. To prevent abortion, the drug is indicated in the first trimester of pregnancy, 100 mg twice a day until the threat disappears completely.
To ensure the luteal phase in preparation for in vitro fertilization from the day of hCG administration, the patient is prescribed 200-600 mg of Utrozhestan per day. Then, after the embryo is fixed, Utrozhestan 200 continues to be used during pregnancy in the same amount. The duration of such use is 1 and 2 terms of gestation.
Contraindications to the use of the drug include:
- individual intolerance to the components of the drug;
- deep vein thrombosis, history of thromboembolism;
- partial abortion;
- hemorrhages in the brain cavity;
- vaginal bleeding of unknown origin;
- porphyria;
- cancers of the genital organs.
Before you start taking Utrozhestan, you should ask not only why the drug is needed, but also how it is canceled. Most experts believe that drug withdrawal should be carried out gradually so that the body can learn to produce the required amount of progesterone on its own. With a sharp cessation of hormone use in women for 2-3 days, there may be bloody issues from the vagina and even bleeding.
Candles - application features
The main active ingredient of the drug is progesterone, which is introduced in suppositories in the amount of 100 mg and 200 mg. The drug is intended for oral and intravaginal use, depending on the recommendations of the doctor. Penetrating into the body, the drug promotes the transition of the endometrium from the proliferation stage to the secretion phase, which contributes to its thickening and successful pregnancy.
With the introduction of suppositories into the vagina, progesterone is very quickly adsorbed and deposited in the uterine cavity. Its metabolites are usually excreted from the body in the urine. If necessary, the doctor may suggest oral administration of the drug.
Utrozhestan 200
The hormonal drug is produced in the form of capsules (tablets similar to pills of a round or oval shape). Depending on the purpose, drug forms can be taken orally or vaginally, using as suppositories. When using Utrozhestan orally, it is customary to call it capsules, and when injected directly into the vagina, it is called suppositories.
Utrozhestan suppositories (capsules) containing 200 mg of the hormone progesterone differ from the 100 mg preparation only in their form. They have an oval appearance, enclosed in a white-yellow body, inside which is a white suspension. Capsules are packaged in blisters of seven pieces. Each package contains two such blisters.
Utrozhestan 100
Capsules Utrozhestan 100 contain, respectively, 100 mg of the active substance progesterone each. They are round in shape and appearance very reminiscent of Utrozhestan 200 capsules. Inside such a suppository is an oily suspension of a uniform white consistency. Utrozhestan is packaged in blisters. The package contains 28 or 30 capsules.
Price in pharmacies
The drug is one of the funds certified on the territory of our state, so it can be bought at any pharmacy without any problems. The cost of a drug can hardly be called affordable for most of our fellow citizens, so patients are often offered to purchase cheaper analogues of a drug. In online pharmacies, the medicine is somewhat cheaper, but in this case, you should make sure that it is authentic and has quality certificates.
Analogues of Utrozhestan
Currently, on the pharmaceutical market, you can find synonyms and analogues of Utrozhestan. Synonyms for the drug include medicines, which include micronized progesterone, while analogues contain a synthetic hormone.
The most famous and popular analogues of Utrozhestan are:
- Crinon (England) - a generic drug that is available in the form of a gel for intravaginal use (it has a rather high cost, but at the same time it has a pronounced efficiency and ease of use);
- Iprozhin in French-made capsules to stimulate ovulation - has very few side effects and is not inferior in cost to Utrozhestan;
- Dufaston is a drug for oral use, the main active ingredient of which is dydrogesterone (when prescribing Utrozhestan or Dufaston to the patient, the doctor draws attention to the characteristics of her body and the nature of the response to drugs with a similar effect).
Utrozhestan and its analogues are used only after consulting a doctor. Self-administration of dosage forms can provoke undesirable consequences in the form of complications during pregnancy and uterine bleeding.
Utrozhestan is a medication, the main active ingredient of which is progesterone (an important hormone in the corpus luteum of the ovary), extracted from natural plant elements. Progesterone in this preparation is contained in a special micronized form, the molecules of which are surrounded sunflower oil and soy lecithin.
Outside, the drug is coated with gelatin, glycerol and a small amount of titanium dioxide (food additive). It is used to get pregnant and maintain hormonal levels in the early stages of conception, but it also has other therapeutic properties.
Utrozhestan is hormonal or not?
Many patients are concerned about the question of whether this drug is hormonal. According to the composition, Utrozhestan is a hormonal drug used in cases where the amount of necessary hormones in the body increases from the outside. Hormones are not vitamins, they cannot be replaced with special nutrients, when doctors see a lack of a certain hormone, they immediately prescribe hormonal drugs.
The main difference of this drug is that Utrozhestan is a hormone extracted from the natural environment, while analogues are synthetic and are prohibited for use in European countries.
Utrozhestan (progesterone)
The active substance of the drug interacts with the following hormonal classes of the body:
- Gestagen. A subclass of steroid hormones responsible for a woman's ability to conceive and subsequently maintain a pregnancy.
- Estrogen. These hormones enhance the physiological effects of progesterone. Only with the combined effect of estrogen and progesterone on the body does the lobuloalveolar formation of the mammary glands and the appearance of milk for feeding the baby occur.
- Chorionic gonadotropin (hcg). A hormone that is produced 6 or 8 days after the egg has been fertilized. The correct indicators affect the successful development of the fetus, and at a lower level, a miscarriage or pregnancy outside the uterus is expected.
The drug has a preparatory effect on the uterus, helps the egg to be fertilized and develop after that. While the process of gestation is in progress, it reduces contractility and excitability in the muscles of the uterus and fallopian tubes, thereby preventing miscarriage. In addition, it promotes the formation of the endometrium, induces the lactation process, increases fat reserves and promotes the removal of nitrogen from the body. Do not take the medicine as a contraceptive, it does not have a contraceptive property. You need to know exactly when using Utrozhestan, what it is attributed to and in what situations the medicine should not be used.
Utrozhestan. Is it better to drink or bet?
Since the medication is prescribed for oral and vaginal administration, people are wondering: Is Utrozhestan a suppository or a tablet? The original medicine is not available in tablets or suppositories, but in capsules. Elongated, coated with soft gelatin, they are excellent for oral administration and in cases where they need to be inserted vaginally.
The method of administration depends on the disease and is prescribed by doctors.
Utrozhestan application
The following are the diseases for which Utrozhestan is prescribed vaginally:
- in the treatment of cysts;
- in the treatment of endometriosis (also for the prevention of the disease);
- in the treatment of endometritis (in chronic endometritis, preventive, hormonal treatment with an anti-inflammatory effect is prescribed);
In the same way, the medicine is administered when:
- adenomyosis (as a preventive);
- adnexitis;
- inflammation of the ovaries;
- hormonal failure;
- cyst (cysts) of the ovary;
- multifollicular ovaries;
- polycystic ovaries;
- uterine polyp;
- PCOS (full name - polycystic ovary syndrome);
- fibroadenoma;
- follicular cyst;
- endometrioid ovarian cyst.
In the treatment of infertility and in the early stages of pregnancy, Utrozhestan is used in the following cases:
- with androgenism, hyperandrogenism (an increased number of male hormones in a woman's body);
- with an anovulatory cycle (anovulation);
- to preserve the fetus in antiphospholipid syndrome (AFS);
- elimination of endometrial hyperplasia (the main consequence of the disease, the inability of a woman to become pregnant);
- to prepare the endometrium for the moment of embryo implantation;
- after insemination (the process of introducing sperm into the uterus without sexual intercourse);
- with tsn (isthmic-cervical insufficiency), when the cervix opens too early;
- in cases of mastopathy, including fibrocystic mastopathy;
- with myoma, including fibromyoma;
- with insufficiency of the corpus luteum in the ovaries;
- with low progesterone in the body;
- in pregnancy planning, to increase the chances of egg fertilization;
- with thin endometrium;
- with the threat of miscarriage (termination of pregnancy);
- in the case of eco-fertilization, when the embryo is grown in a test tube and then placed in the uterus;
- with cervical erosion.
For oral administration in connection with menstrual irregularities (sometimes to induce menstruation), Utrozhestan is prescribed for:
- amenorrhea, secondary amenorrhea (menses do not occur; their absence is noted for three cycles in a row);
- ovarian dysfunction;
- long cycle (long periods);
- menopause;
- violation (failure) of the menstrual cycle (menstruation): with an irregular cycle, with a short cycle, a long cycle (long periods);
- cases of insufficiency of the luteal phase;
- prolonged absence of menstruation;
- lack of ovulation;
- early ovulation;
- early menopause;
- PMS (facilitates the flow of premenstrual syndrome).
The reaction of the body to Utrozhestan may be different.
Usually the substance is well tolerated, but side effects occur when taken in tablets, for example:
- cycle disorders and lack of menstruation;
- acyclic bleeding; mammalgia;
- headache, drowsiness, dizziness;
- bloating, nausea, vomiting, constipation, diarrhea;
- depressive state;
- cholestatic jaundice;
- urticaria, itching, acne;
- chloasma.
Taking Utrozhestan, dizziness and drowsiness occur as a reaction to the oral route of administration. These unpleasant symptoms are leveled by lowering the dose after consultation with a specialist, as well as the vaginal method of administration. If you feel sleepy after a dose of medication, take it just before going to bed.
Women are usually interested in whether Utrozhestan and thrush are related or not? Indeed, in gynecological practice, there have been cases when, while taking the medicine Utrozhestan, the thrush showed its symptoms, but the effect was short-lived. The balance of the microflora of the vagina is largely dependent on hormones, and the addition of a hormonal drug affects the overall hormonal background organism. At the same time, a drug consisting of micronized progesterone is not capable of causing candidiasis by itself. Utrozhestan is often prescribed for thrush just for the treatment of this condition as part of complex therapy. WHO advises choosing natural neutral progestogens for pregnant women, which are structurally similar to endogenous progesterone.
If a woman has previously had tachycardia against the background of diagnosed cardiovascular diseases, she should be periodically observed by a specialized doctor while taking the medication. Concomitant complaints from patients at Urozhestan are often related to the breasts: someone's breasts grow, sometimes the chest hurts, but when the correct dose is prescribed, the chest does not hurt. After stopping the course, everything usually returns to normal.
Frequent urination is not included in the list of side effects, but may be associated with the onset of pregnancy.
Utrozhestan: temperature
Since the drug resembles endogenous progesterone, Utrozhestan can raise body temperature and also have a sedative effect. With a body temperature reaching 37.0 ⁰С - 37.4 ⁰С, a woman should not worry: the so-called "progesterone" temperature may be an indirect sign of a long-awaited pregnancy. Utrozhestan and basal temperature, respectively, behave in a similar way - it can be normal or slightly elevated, but the artificial hormone does not directly affect it.
Utrozhestan and weight
Some girls are worried when taking Utrozhestan, is it possible to get better? Does he get fat? Indeed, weight gain when taking hormonal medications can be observed, but this is not a direct effect of artificial progesterone, but only a consequence of a general imbalance of hormones in the female body. Weight gain, especially against the background of the onset of pregnancy, is a variant of the norm. Excess weight removed after the course or after the resolution of pregnancy. Whether your weight gain is acceptable or not, decide with your personal doctor on an individual basis.
Utrozhestan with discharge
Pink discharge after menstruation is known in gynecological practice, including due to the use of hormonal drugs (the so-called "spotting" - mini-bleeding with oral contraception based on hormones). Mucous pinkish discharge, similar to raw egg white, that occurs in the middle of the cycle, as a rule, is not dangerous and is associated with increased levels of progesterone and the onset of ovulation.
Utrozhestan with a daub has the peculiarity of increasing the amount of discharge. It is recommended to wear a pad if a large therapeutic dose is prescribed. A daub during pregnancy can have several shades, it is necessary to check with thick curdled discharge, dangerous symptoms- bright scarlet blood, brown, copious watery fluid.
For pain in the lower abdomen
Gynecologists often prescribe Utrozhestan for abdominal pain. The medicine will not work immediately, but after drinking it in a course, it relieves the pain of PMS. If the pain in the abdomen during the state of pregnancy is pulling, insignificant - this is a variant of the norm.
Utrozhestan for miscarriage and other pathologies
There are a number of pathologies in which this hormone helps:
- at ectopic pregnancy;
- with a frozen pregnancy;
- with a delay in menstruation (menstruation).
Delay
If you delay while taking artificial progesterone, show restraint and calmness: in rare cases, the drug can cause cycle changes. Failure should not exceed five days.
To induce menstruation with this medication, the gynecologist prescribes drinking in capsules from the 16th to the 25th day of the cycle or in the form of vaginal capsules to reject the uterine mucosa for 10 days.
Utrozhestan at conception
Utrozhestan and ovulation are interconnected. It is prescribed after ovulation to support the second phase of the cycle. Utrozhestan is not prescribed for ovulation stimulation, although it does not interfere with this process. When stimulated, other substances are prescribed to maintain ovulation.
Utrozhestan promotes conception with long-term, correct and clear therapy without gaps, with a correctly calculated dosage.
Utrozhestan and menstruation (menstruation)
When taking Utrozhestan, menstruation may behave in an unusual way. In particular, menstruation does not come, and this may indicate both pregnancy and a delay (it is usually believed that up to 5 days can be waited). Did your period start earlier? Sometimes under the influence of the hormone there is a reduction in the cycle, as well as minor uterine bleeding between periods. When acyclic bleeding occurs, it is better to stop taking it, and find out the cause of the bloody discharge as accurately as possible. If progesterone is normal, and this is indicated by the results of examinations, do not self-medicate, so as not to upset the hormonal balance in the body.
Utrozhestan: complications
The drug should be administered with the following precautions:
- with thrombophilia;
- with an infection;
- with gastritis;
- with varicose veins;
- with multiple sclerosis;
- at diabetes reduces glucose tolerance;
- with thrombosis;
- with cystitis.
The thyroid gland, as well as the stomach (when taken orally) should be healthy. With all potential complications, especially if the patient is pregnant, it is necessary to arrange monitoring of the condition.
Utrozhestan while breastfeeding
With HB, this hormonal agent is contraindicated, since progesterone passes into breast milk. Utrozhestan when breastfeeding is taken only if the baby is transferred to artificial feeding, at this time, lactation can be tried to be preserved, but milk should not be given to the child.
Getting used to Utrozhestan
There is evidence from the reviews of women that the abrupt withdrawal of the drug can provoke the termination of the onset of pregnancy. With the vaginal method of introducing addiction was not observed. Dose reduction should occur under the strict supervision of a physician.
