Diferelin 3.75 with eco long protocol. Negative phenomena during treatment with Diferelin

Method in vitro fertilization For many years now it has been giving childless couples a chance to fulfill the dream of a long-awaited child. This technique regulates and controls processes in the female reproductive sphere at all stages of the protocol. And since hormones “control” this issue, medications are selected taking into account the woman’s hormonal background.

One of the components hormone therapy is the use of Diferelin for IVF, reviews of which are extremely contradictory. Some women claim that this drug helped them get pregnant, others believe that it was useless, because conception never happened.

Diferelin has antigonadotropic properties. Its task is to block the work of follicle-stimulating and luteinizing hormones in women, as well as testosterone in men.

These properties of the drug allow it to be used for the following purposes:

Treatment of pathologies: endometriosis and;
Regulation of premature puberty in adolescents;
Use in complex therapy prostate cancer;
Application in IVF programs.

Participation of Diferelin in auxiliary reproductive technique necessary both at the stage of preparation for artificial insemination and after embryo transfer. Due to the ability of the drug to suppress the production of natural luteinizing hormone, the ovaries begin to intensively “supply” follicles, which is necessary before the puncture procedure.

Diferelin in IVF is used for the following purposes:

Stimulate the pituitary gland;
Block the synthesis of LH and FG;
Reduce the amount of androgens and estrogens produced;
Stimulate ovulation;
During embryo transfer according to protocols.

For in vitro fertilization, the medicine is used in the minimum dosage: 0.1 mg. Increased doses of the drug are indicated for the treatment of pathologies: oncology, endometriosis, early puberty.

Diferelin injection is given subcutaneously. In this case, the woman can choose the injection site herself, or the doctor will give his recommendations on this matter. It can be injected into the stomach, thigh or under the shoulder blade.

Diferelin in IVF protocols

Diferelin for IVF is a component of both short and long protocols. Moreover, it is prescribed not only before embryo transfer, but also after the transfer has already been done. The drug increases the chances of successful fertilization several times.

The dosage of the drug in the short protocol is insignificant. The injection solution is prepared by mixing dry powder with a solvent. Injections begin on the second day from the start of the menstrual cycle, using the hCG hormone in parallel. The duration of therapy with Diferelin 0.1 is about 12 injections. HCG needs to be injected one day more.

Sometimes reproductive specialists prescribe Diferelin and Ovitrel simultaneously in the ovulation induction protocol. Ovitrel is an artificial analogue of human chorionic gonadotropin; it promotes the release of a mature egg from the follicle.

Prescriptions in a long-term protocol differ in duration and start of treatment. Therapy begins 21 days from the start of the menstrual cycle. The duration of treatment depends on the changed level of estrogen. As soon as their concentration drops below 50 pg/ml, parallel stimulation with gonadotropin is prescribed. In most cases, this period occurs on days 3-5 of the next menstrual cycle.

The entire treatment process is monitored using ultrasound to determine when dominant follicle will reach sizes of 17-19 mm. The “grown” dominant signals that the injections need to be stopped. A day later, gonadotropin is discontinued and an ovarian puncture is performed.

Do not panic if you have missed one injection of the drug once. The next injection is given according to the scheme prescribed by the doctor.

If an excessive response has been established using ultrasound diagnostics, Diferelin is discontinued, since the drug can cause ovarian hyperstimulation.

In a long-term protocol, it is permissible to use Diferelin 3.75 in a single dose. The medicine is administered into the cavity on the 21st day from the beginning of the menstrual cycle abdominal wall subcutaneously This dosage allows you to form a depot, with the help of which the hormone gradually penetrates into the body over 20 days. bloodstream. Stimulation of ovulation is carried out using the same scheme as with daily use of the medicine.

After embryo transfer, Diferelin is prescribed 2-3 days later to block the natural functioning of the ovaries, that is, to increase the embryo’s chances of successful implantation.

For endometriosis

If infertility is caused by a thinning endometrium, treatment is carried out according to a long or very long protocol. The main goal of therapy is to reduce the area of pathologically thin lesions. And having achieved stable remission, make attempts to successfully conceive.

To build up the endometrium, before artificial insemination, a course of therapy with Diferelin is carried out from two months to six months. Once every 28 days an injection is given that creates a depot. All conditions are being created to deeply suppress natural function ovaries. After the endometrium has grown to required values, carry out active stimulation ovulation.

It is important to say that the chances of successful conception against the background of serious endometriosis, a little. The fact is that pathology is caused by disturbances in immune system and as part of the endometrium. These changes are difficult to correct medications, interfering successful implantation embryo.

Side effects

Negative manifestations of the drug will vary depending on the stage of therapy.

Doctors conventionally divide the duration of taking medication into two stages: the beginning of treatment and the therapy itself. The first 14-21 days of drug administration are the initial treatment cycle. At this time, patients note such negative consequences after taking Diferelin 0.1:

Tides;
Dry vagina syndrome;
Pain and discomfort during intimacy;
Osteoporosis;
Decrease or complete absence sexual desire;
Itching of the skin;
Manifestations of urticaria;
Quincke's edema.

During the period of direct therapy, women experience the following: side effects from taking medication:

Blood pressure levels increase;
Nausea appears, often accompanied by vomiting;
The quality of vision is impaired;
Body weight increases (although many say that, on the contrary, they are losing weight);
Happens frequently nervous breakdowns against the background of emotional instability;
In the place where the injection is regularly performed, persistent pain is observed;
Frequent headaches, discomfort in muscles and joint tissue are recorded.

The most common side effect in women after treatment with Diferelin 3.75 is the development of amenorrhea (absence of menstruation). Adverse reactions of the body manifest themselves especially “brightly” in women with endometriosis.

Even after short protocols, the use of the drug causes a delay in the menstrual cycle. “Late” periods, which occur 5-15 days later, are considered normal.

All negative reactions of the body will disappear after the end of treatment, when hormonal background is stabilizing.

Treatment with medication is contraindicated in the following cases:

Individual intolerance to the components of the drug (allergic reaction, especially urticaria or Quincke's edema);
When pregnancy occurs;
During lactation.

Despite the fact that large-scale studies have not been conducted on the dangers of taking Diferelin during pregnancy, doctors can, if necessary, use it during this period.

Balancing risk and possible benefit, the drug is prescribed to women with the following pathologies:

Osteoporosis;
Elevated blood pressure;
Polycystic ovary syndrome.

In the event that pregnancy does not occur after Diferelin therapy, repeat protocol it is not included, replacing it with drugs that have a similar effect.

IVF is a type of assisted reproductive technologies, used to treat infertility. This method helps couples conceive a child even with severe abnormalities in the reproductive function.

IVF means not only artificial insemination eggs and embryo transfer into the uterus, but also preparing the woman’s body for pregnancy. To do this, the patient undergoes examination and treatment, and also applies hormonal drugs. One such remedy is Diferelin. Let's consider why this drug is prescribed for IVF.

Diferelin is a synthetic analogue of gonadotropin-releasing hormone, which is responsible for the release of follicle-stimulating and luteinizing hormones. Diferelin in the IVF protocol helps suppress luteinizing hormone and provoke the formation large quantity follicles. Thus, the drug is prescribed to stimulate superovulation before oocyte puncture.

Diferelin for IVF is prescribed in a minimum dosage of 0.1 mg. V Large dosages the drug is indicated for oncology, premature puberty and endometriosis. The drug can also be prescribed to men for cancer prostate gland with metastases.

Application

In IVF, Diferelin can be indicated in a short or long protocol. In a short protocol, the drug is prescribed in small doses from the 2nd day of menstruation along with hCG hormone. The course of treatment is no more than 12 doses of the drug, and hCG injections are stopped one day after Diferelin is discontinued.

In the long protocol, Diferelin injections begin on the 21st day of menstruation, and on days 3-5 an injection of gonadotropin is indicated. Diferelin is discontinued in a long protocol when the follicles reach a sufficient size, and gonadotropin is discontinued after a day.

If IVF is carried out for endometriosis, then a long protocol with Diferelin is prescribed. The drug helps reduce the manifestations of endometriosis and achieve pregnancy in the protocol.

Many people are interested in why Diferelin is prescribed after embryo transfer. The drug is injected on the second day after replantation to suppress ovarian function and increase the chance of successful embryo implantation.

Diferelin injections are made into the subcutaneous fat in the abdominal area, at a distance of two fingers from the navel. The drug must be administered at an angle of 45 degrees, squeezing the skin into a tight fold. It is best if the first injection is performed by a specialist.

Consequences

The instructions for Diferelin indicate that it is contraindicated during pregnancy, this is due to the lack of data on the effect of the drug on the fetus. Animal studies have been conducted which have shown that the drug congenital deformities doesn't call. Therefore, Diferelin can be used during pregnancy as prescribed by a doctor.

Diferelin significantly increases the chance of pregnancy after IVF, but the drug can cause the following side effects:

decreased sexual desire;
absence of vaginal discharge;
angioedema, allergic rash;
disorders of the gastrointestinal tract;
headaches;
osteoporosis;
myalgia and arthralgia;
tides.

Thank you

Diferelin is a drug with an antigonadotropic effect, that is, in essence, it is an antihormone, since it suppresses the production of follicle-stimulating and luteinizing hormones (FSH and LH) in women and testosterone in men. Therefore, Diferelin is used to treat endometriosis, uterine fibroids, premature ripening in boys and girls, prostate cancer and in in vitro fertilization programs.

Names, release form and composition of Diferelin

Currently, Diferelin is produced in the only dosage form lyophilisate for preparing a solution . However, there are three varieties of the drug containing different amounts active substance and intended for in various ways introductions:

Diferelin 0.1 mg – lyophilisate for subcutaneous administration;
Diferelin 3.75 mg – lyophilisate for intramuscular injection;
Diferelin 11.25 mg – lyophilisate for intramuscular administration.

In everyday speech, both doctors and patients, for the sake of brevity, call the above varieties of the drug, adding numbers to the word “Diferelin” indicating the content of the active substance.

Diferelin contains as an active substance triptorelin pamoate. However, its content in the lyophilisate is indicated in terms of pure triptorelin. That is, Diferelin 0.1 lyophilisate contains 0.1 mg of pure triptorelin and several more milligram triptorelin pamoate. The content of pure triptorelin in the lyophilisate is indicated specifically for the convenience of doctors, since it is the substance in pure form upon release from the salt formed with pamoate, provides immediate therapeutic and pharmacological action. And since the severity of the effect depends on the amount of pure triptorelin, its content is indicated as the dosage in all forms of lyophilisate.

Lyophilisate for subcutaneous injections Diferelin 0.1 contains as excipient only mannitol. And lyophilisates for intramuscular injections– Diferelin 3.75 and 11.25 as auxiliary components contain the following substances:

Polymer of lactic and glycolic acids;
Mannitol;
Carmellose sodium;
Polysorbate – 80.

Diferelin is produced in cardboard boxes containing bottles with lyophilisate, ampoules with solvent and a syringe with two needles. Diferelin 0.1 is used as a solvent saline solution or water for injections. And as a solvent for lyophilisates Diferelin 3.75 and 11.25, mannitol or water for injection is used, which are placed in appropriate ampoules.

Lyophilisate Diferelin 0.1 painted in white and dissolves in the applied solvent, forming a completely transparent solution containing a small amount of suspended particles.

Lyophilisate Diferelin 3.75 colored white or white and cream, and dissolves to form a white or cream opaque suspension.

Lyophilisate Diferelin 11.25 colored yellowish or white, and dissolves to form an opaque suspension, also white or yellowish.

Diferelin - action and therapeutic effects

Dipherelin is an analogue of gonadotropin releasing hormone (GnRH) produced by the hypothalamus. GnRH acts on the pituitary gland, which, in turn, produces tropic sex hormones, such as follicle-stimulating hormone, luteinizing hormone, testosterone, etc. And these tropic hormones regulate the functioning of the female and male genital organs, for example, the ovaries, uterus, testes, prostate gland. Diferelin reduces the production of tropic hormones of the pituitary gland, accordingly, reducing the activity of the ovaries and testes in the synthesis of sex hormones. Thus, the therapeutic effects of the drug are due to its effect on the level of production of the reproductive organs by the ovaries of women and the testicles of men.

Since sex hormones influence the development and course of certain pathologies, the use of Diferelin, which reduces their production, is justified in the complex treatment of diseases caused by increased levels estrogen in women and testosterone in men. This effect Diferelina is called antigonadotropic and antitumor.

Thus, when using Diferelin, stimulation of the pituitary gland is observed during the first 2–3 weeks, but then, throughout the rest of the course of therapy, the drug suppresses the synthesis of follicle-stimulating and luteinizing hormones, and, accordingly, the production of both androgens and estrogens decreases. The maximum severity of the antiandrogenic effect is achieved at 3 weeks from the start of Diferelin use and persists throughout the rest of the course of treatment.

Due to the stimulating effect of Diferelin during the first 2 - 3 weeks of use, it is used to stimulate ovulation and transfer of a fertilized embryo in in vitro fertilization protocols.

Diferelin in the treatment of endometriosis, as a rule, causes amenorrhea (artificial menopause, absence of menstruation). However, after cessation of therapy, menstruation is restored within a certain period of time (from 1 to 12 months), the specific duration of which depends on the individual characteristics of the woman’s body. Most often, the first ovulation occurs by the end of the second month, counting from the last injection of Diferelin, and menstruation begins, respectively, after 2.5 - 3 months.

If endometriosis recurs after one course of therapy with Diferelin, then after 6–12 months, if necessary, you can be treated again. However, when endometriosis recurs, treatment is usually not resorted to. repeat courses treatment with Diferelin, but use other drugs (for example, Buserelin, etc.) or cauterize the lesions during laparoscopic surgery.

Diferelin for premature puberty One dose is administered every 28 days. One dose for children weighing more than 20 kg is 3.75 - that is, one full bottle of lyophilisate. And one dose for children weighing less than 20 kg is only 1.875 mg, that is, half of one bottle of lyophilisate. The duration of therapy is determined by the doctor and depends on the speed of normalization of the condition.

Half the dosage for children weighing less than 20 kg is prepared as follows: take the entire volume of the solvent and add it to the bottle with the lyophilisate. The entire volume of the lyophilisate is dissolved, but only half of the resulting suspension is drawn into the syringe. It is very simple to understand how much half is - divide the volume of the ampoule with the solvent by two. For example, in a sealed ampoule there are 2 ml of solvent, which means half is 1 ml. That is, all 2 ml of solvent is added to the bottle with the lyophilisate, mixed well, but only 1 ml of the finished suspension is taken into the syringe for injection.

Diferelin at female infertility administer one whole bottle (3.75 mg each) on the second day of the menstrual cycle. Treatment is continued for a period of time determined by the doctor.

Diferelin for uterine fibroids is administered for the first time during the first five days of the next menstrual cycle. This means that after the start of the next menstruation, it is necessary to administer the first dosage of Diferelin within five days. Subsequently, the drug is administered every 4 weeks (28 days) for 3 months. Each time, one full bottle of Diferelin is administered, that is, 3.75 mg of the active substance.

During treatment uterine fibroids Diferelin usually causes amenorrhea (cessation of menstruation) in a woman. This has a positive effect on general condition women, since she does not experience blood loss during bleeding and heavy menstruation. After stopping the use of Diferelin, menstruation is restored within several months. During the entire period of use of the drug, it is necessary to regularly perform ultrasound of the pelvic organs, monitoring the rate of decrease in the size of the uterus and fibroids. If the uterus decreases in size faster than fibroids, it is urgent to perform an operation, since this situation is fraught with the development of sepsis.

Diferelin 11.25 – instructions for use

This variety of Diferelin is also a depot form, and a single administration of a bottle of 11.25 mg of the active substance provides it therapeutic activity within three months. That is, for treatment, Diferelin 11.25 is administered one bottle once every three months.

For prostate cancer in men and endometriosis in women, Diferelin is administered in one bottle every three months. The duration of treatment for prostate cancer depends on the rate of improvement and involution of the formation. And the duration of treatment for endometriosis is 3–6 months, since the drug is not recommended for use for more than six months in a row.

The first injection of Diferelin in men can be made at any time, and in women with endometriosis - only during the first five days of the next menstrual cycle.

Overdose and interaction with other drugs

No interactions of Diferelin with other drugs or cases of overdose have been identified.

The drug does not affect the ability to control machinery, so you can drive a car during the course of therapy.

Use during pregnancy

Diferelin is contraindicated for use during pregnancy. This means that if a woman is already pregnant, it cannot be used.

However, the drug is used to stimulate ovulation, and many women became pregnant after several injections, but without knowing it, they continued to use Diferelin. Such cases made it possible to accurately establish that the drug does not have negative impact on the fetus, does not provoke the development of congenital deformities and does not increase the risk of miscarriage. This suggests that Diferelin is not dangerous to the fetus, but further study of its properties is necessary.

After Diferelin - general condition

Diferelin reduces the production of sex hormones in men and women and, in fact, puts them in a state of artificial castration. That is, under the influence of Diferelin, a hormonal background is created in a man, like a eunuch (castrato), and in a woman, like during menopause or both ovaries have been removed. Naturally, entry and exit from this state accompanied by neuro-vegetative, endocrine-metabolic and psychological disorders and numerous complaints.

After completing the course of using Diferelin, the hormonal balance is gradually restored, but until the balance of hormones is normalized again, a person may experience headaches, irritability, fatigue, hot flashes, sweating, changes in body weight, increased body temperature, depression and other complaints.

The condition usually returns completely to normal within a month and a half after the last injection ends. That is, we can expect normalization of the condition 4.5 months after the last injection of Diferelin 11.25 and 2.5 months after Diferelin 3.75. During this period, sexual and reproductive function is completely restored in men and women and libido is normalized.

Menstruation and pregnancy after Diferelin

Ovarian functions are usually completely restored approximately 1.5 months after the end of the last Diferelin injection administered for the treatment of endometriosis. This means that menstruation should be expected approximately 4.5 months after the last administration of Dipherelin 11.25 and 2.5 months after Dipherelin 3.75. It is during this period that the first menstruation after Diferelin usually occurs, which can be different. However, menstruation is usually painless or slightly painful and scanty. By the second menstrual cycle, menstruation is taken normal character. However, the first menstruation, which began 4 to 6 months after the end of the last injection of Diferelin, is also considered normal.

Since the first ovulation usually occurs a month after the last Diferelin injection ends, if you do not want to get pregnant, you should start using contraceptive methods in advance. It is recommended to start using contraceptive methods from the 15th day after the end of the last Diferelin injection.

When using Diferelin 0.1 in short and long IVF protocols, menstruation is usually delayed for several days - from 5 to 15. In some cases, menstruation stops altogether, and in this case the doctor determines the tactics of further stimulation solely on the basis of test results.

Diferelin - side effects

Side effects of Diferelin vary at the beginning and during treatment. The first 2 to 3 weeks of Diferelin administration are considered the beginning of treatment. And all subsequent time during which Diferelin is administered is considered a therapy process. In addition, there are different side effects in men and women because the drug changes the balance of sex hormones.

The whole range of side effects various dosages Diferelina in men and women is shown in the table.

Any type of Diferelin is contraindicated for use in the following conditions:

Hypersensitivity to the drug;
Pregnancy;

Diferelin 3.75 and 11.25 have the following additional contraindications for use:

Hormone-independent prostate cancer;
Condition after removal of testicles.

In addition, any type of Diferelin should be used with caution for osteoporosis and polycystic ovary syndrome.

Diferelin - analogues

On pharmaceutical market There is one drug synonymous with Diferelin, containing the same active substance - this is Decapeptyl.

In addition, there are analogues of Diferelin, which contain another active substance from the group of GnRH agonists, but have a similar effect. therapeutic effect. Diferelin analogues include:

Buserelin spray;
Buserelin Depot lyophilisate;
Buserelin-long FS lyophilisate;
Zoladex capsules;
Lucrine depot;
Eligard lyophilisate.

One of the most effective medicines designed to combat the most severe pathologies of women and men reproductive system, is the drug “Diferelin”. The instructions and price of this drug are often discussed by patients on specialized forums. As usual, this medicine also has its adherents and opponents. In this article we will look at the mechanism of action of this medicine and its pharmacological features.

Pharmacological group

The drug "Diferelin" is medicine with antigonadotropic effect. In fact, it is an antihormone, as it has the ability to suppress the production of luteinizing and follicle-stimulating hormones in women and testosterone in men. Therefore, the drug “Diferelin” is actively used to treat uterine fibroids, endometriosis, prostate cancer, premature ripening in adolescents and other diseases.

Composition and release form

The drug "Difelerin" is currently available in only one dosage form - lyophilisate for creating solutions. In this case, three varieties of the product are produced, differing in the concentration of the active substance and having different purposes:

"Diferelin" 11.25 mg and 3.75 mg - for intramuscular administration;
"Diferelin" 0.1 mg - for subcutaneous injection.

In everyday life, doctors and patients briefly name the above-mentioned varieties of the drug, adding numbers to its name indicating the content of the main substance in it.

As active component in the drug Diferelin, reviews of which are mostly positive, triptorelin pamoate is used. It is he who has a pronounced therapeutic and pharmacological effect on the patient’s body.

The medicine "Diferelin" is sold in cardboard packages, which contain bottles with lyophilisate and a syringe with two needles. In addition, they contain ampoules with solvent. It may be different. If for lyophilizers "Diferelin" 3.75 and 11.25 mannitol is mainly used, then for the drug in a concentration of 0.1 mg it is most often used

Therapeutic effect of Diferelin

From a biochemical point of view this drug is an analogue of the GnRH hormone synthesized by the hypothalamus. It affects the pituitary gland, which is responsible for the production of sex hormones and thereby regulating the functioning of the organs of the female and male reproductive system: prostate gland, ovaries, uterus, testicles. It turns out that the drug Diferelin regulates the level of production of sex hormones.

Reviews of its use indicate that it has a pronounced antitumor and antigonadotropic effect and is effective in the treatment of certain pathologies. For example, in case of infertility, this medicine suppresses the production of luteinizing hormone, which negatively affects ovulation, thereby increasing the likelihood of pregnancy. And in case of prostate cancer, this medication reduces testosterone levels to zero, characteristic of castrates, and increases the patient’s chances of getting rid of malignant neoplasm.

The magical “Diferelin” is also effective for endometriosis. By its effect on the production of sex hormones, it gradually introduces a woman into an artificially created state of menopause and thereby provokes atrophy of endometriotic foci.

Indications for use

Depending on the concentration it has different influence on the body the medicine "Diferelin". The use of this drug in medicine depends on the content of the main active substance. For example, injections of Diferelin 0.1 mg are indicated for infertility, to activate the ovaries and stimulate ovulation during IVF.

The use of this medication in a concentration of 3.75 mg is advisable in the fight against prostate cancer, uterine fibroids, premature ripening, genital and extragenital endometriosis, and IVF protocols.

In the most serious cases, prostate cancer with metastases and chronic endometriosis, Diferelin 11.25 mg is prescribed. Its use can significantly increase the patient's chances of recovery.

Instructions for use

The drug "Diferelin 0.1 mg" is used in short and long IVF protocols under the strict supervision of a doctor. It begins to be administered daily, one ampoule, starting from the second day of menstruation. The duration of such therapy is determined individual characteristics female body.

But the medication “Diferelin 11.25 mg” is administered to patients once every three months. Moreover, men can do this injection at any time, and women - only in the first five days of the menstrual cycle. The duration of treatment with this drug lasts from three to six months, since it is not recommended to use it for more than six months.

Most wide range use of the drug Diferelin 3.75. Reviews from patients indicate the extreme effectiveness of this drug. In addition, it is very convenient to use, as it does not require daily administration over a long period of time. Injections of the drug Diferelin 3.75 mg are usually given once a month. This is enough to ensure that the active substance enters the bloodstream in therapeutic dosages. Let's take a closer look at the use of this medication for various diseases.

Prostate cancer

Men are prescribed the drug Diferelin for prostate cancer. The patient is given injections once every twenty-eight days so that the interval between drug administrations is four weeks. A single dose of the medication is one bottle of 3.75 mg. The duration of the medication is determined by the patient's healing rate.

Endometriosis

Injections of the drug "Diferelin" for endometriosis are given to women in the first five days of their next menstruation. The next dose of medication is taken after four weeks, and the course of therapy lasts a total of 3 to 6 months. It should be remembered that this medicine cannot be combined with the use of oral contraceptives.

In the process of treating endometriosis, the drug Diferelin causes artificial menopause (amenorrhea). Feedback from patients, however, indicates that after cessation of treatment menstrual cycle recovers within several months, sometimes a whole year. Repeated therapy with this medicine for relapses of endometriosis, as a rule, is not prescribed - other, no less effective medications are used for this.

Precocious puberty

For children with relief, the drug "Diferelin" is prescribed once every 28 days. At the same time single dose its use is calculated taking into account the patient’s body weight. Children weighing more than 20 kilograms are given a whole bottle (3.75 mg), and children with lower weights are given half an ampoule (1.875 mg). The duration of therapy is determined by the attending physician depending on the speed of normalization of the patient's condition.

Uterine fibroids

When treating this disease, one bottle of Diferelin medication is administered once a month. Moreover, it should be taken during the first five days of the patient’s menstrual cycle. Subsequent injections of the drug occur every four weeks. The duration of therapy usually does not exceed three months.

Overdose

Currently, not a single case of overdose with Diferelin has been identified. Patient reviews also indicate its relative safety. In addition, this drug does not affect the ability to control moving mechanisms. Therefore, during the course of therapy with this medicine, you can drive a car without fear.

Side effects

When using the drug Diferelin, the following side effects may occur:

compression symptoms spinal cord;
increased pain;
Quincke's edema, urticaria, itching;
ureteral obstruction;
headache;
bone demineralization;
decreased potency;
vaginal dryness;
sweating;
testicular shrinkage;
change in breast size;
hypogonadotropic amenorrhea;
ovarian hypertrophy;
menorrhagia;
asthenia;
nausea, vomiting;
hypertension;
tides;
emotional lability;
hematuria;
the appearance of excess weight;
peripheral edema;
fever;
anorexia;
depression;
tachycardia;
alopecia;
dyspnea;
hyperemia of the injection site;
paresthesia.

Contraindications for use

The drug "Diferelin" has certain contraindications for use. They are related to the patient’s health status, as well as his individual physiological characteristics. For example, men should not take this drug if they have hormone-independent prostate cancer or after removal of their testicles, and it is not recommended for women during pregnancy, breastfeeding, or polycystic ovary syndrome. Everyone, without exception, needs to use the medicine "Diferelin" with caution for osteoporosis and hypersensitivity to its components. For any negative symptoms the patient should immediately seek advice from the attending physician.

General condition after use

As mentioned above, the drug “Diferelin” suppresses the production of sex hormones in women and men, thereby introducing them into a state of artificial castration. Of course, immersion in similar condition and exit from it is accompanied by various psychological, endocrine-metabolic and neuro-vegetative disorders.

After completing a course of therapy with this medication, hormonal levels are restored, but during this process the patient may experience irritability, fatigue, headaches, sweating, hot flashes, depression, increased body temperature, and others. unpleasant symptoms. However, within one and a half months after the end of the drug's effect physical condition the patient is completely normal. That is, usually after the last injection of Diferelin 11.25 mg, the hormone balance is restored after 4.5 months, and the effect of the medication with a concentration of 3.75 mg ends after 2.5 months. For specified segments time, women and men are completely rehabilitated reproductive and sexual functions and libido returns to normal.

Use during pregnancy

When carrying a child, treatment with Diferelin is contraindicated. However, this medicine is actively used to activate ovulation. Many women were able to get pregnant after just a few injections of the drug, but, without knowing it, they continued to take the drug Diferelin. The effect of this medication, as it was established, does not harm the unborn child: it does not provoke the risk of miscarriage and does not contribute to the development of congenital deformities. However, the mechanism of action of this medicine on the female reproductive system during pregnancy still requires close study.

Analogues of the drug "Diferelin"

On the modern pharmaceutical market there is only one synonymous drug containing the same active substance - this is “Decapeptyl”. In addition, in pharmacies you can find medicines that have the same therapeutic effect, as the drug "Diferelin". The following have a similar effect on the body: Buserelin spray, Buserelin Depot lyophilisate, Zoladex capsules, Eligardt and Lucrine Depot preparations.

Severe diseases in the male and female reproductive system require the use of highly effective medications. One of these drugs is Diferelin. The product has earned many positive and negative reviews.

The drug is released in the form of a powdery mass to create a solution. The structure of Diferelin is represented by the following elements:

triptorelin – the active active ingredient;
mannitol;
sodium carmellose;
polymers of lactic and glycolic acid;
polysorbate 80.

Diferelin comes in different concentrations:

with 11.25 mg of the main component - for the preparation of a solution for intramuscular administration;
with 3.75 of the main component - it is necessary for intramuscular use;
with 0.1 mg of active substance - for subcutaneous administration.

The manufacturer produces Diferelin in the form of bottles or ampoules.

Impact

Diferelin is a GnRH analogue produced by the hypothalamus. The hormone affects the pituitary gland, which produces sex hormones. They are responsible for stable functioning and its regulation in the male and female genital organs.

With a decrease in the production of tropic hormones, a decrease in the activity of the ovaries and testes is observed in the process of synthesis of sex hormones. hormonal substances. Positive effects medications consist of treating pathologies that arise under the influence of estrogen in women, testosterone in men.

The stimulating effect of the drug affects the process of ovulation and the subsequent transfer of a fertilized egg. After drug therapy, the IVF procedure is permitted.

Indications

Indications depend on the form of administration medicinal product.

During subcutaneous administration, the medication is recommended for the treatment of female infertility:

for additional stimulation of the ovaries;
in the program of in vitro fertilization and embryo transfer;
with other auxiliary reproductive technological processes.

Long-term solution for intramuscular injection is used for therapy:

locally advanced or metastatic prostate cancer;
when registering premature puberty in boys and girls;
with genital and extragenital endometriosis - the appearance of atypical cellular structures (endometrial cells) in the peritoneum, ovaries, fallopian tubes;
with uterine fibroids - benign neoplasm, the drug is prescribed before surgery;
for documented female infertility – used as part of in vitro fertilization programs.

Contraindications

with a malignant neoplasm in the body of the prostate gland, non-hormonal etiology;
after surgical removal testicles in males;
during the period of bearing and feeding a baby;
with the development of spontaneous allergic reactions on the ingredients included in the composition medication.

osteoporosis – a chronic, constantly progressive decrease in bone density;
– characterized by multiple formations in the female gonads.

How to take Diferelin

Suspension for subcutaneous injection

Suspension for subcutaneous injection involves two independent courses of therapy.

The first option - Diferelin is prescribed 0.1 mg daily, starting from the second day of the cycle. At the same time, ovarian stimulation is performed. The course ends one day before the planned introduction of gonadotropin (human, chorionic). The total duration of treatment does not exceed 12 days.

Second, it is recommended to use it from the second day of the menstrual cycle, at a dosage of 0.1 mg daily. With reduced sensitivity of the pituitary gland (approximately 15 days), secondary stimulation of the ovaries with gonadotropins begins.

Intramuscular administration

Diferelin for intramuscular injection with prolonged exposure - injected into the gluteal muscles. The dosage directly depends on the pathology:

For malignant neoplasms in the body of the prostate gland - one injection (ampoules of 3.75 mg of the substance) every month or every quarter of 11.25 mg. If therapy is combined with radiation exposure, then a long course (at least three years) is considered preferable to short treatment for six months.
For accelerated puberty, the medicine is used at a dose of 1.875 mg every 28 days for a child weighing up to 20 kilograms and 3.75 mg for a child weighing more than 20 kilograms.
For endometriosis - once a month, 3.75 mg or once a quarter - 11.25 mg. The primary injection is carried out in the first five days from the start of the menstrual cycle. Total time therapy takes up to six months, its duration is determined by the severity of the process and overall clinical picture. Conducting a secondary course by similar means not recommended.
For female infertility, one dose of 3.75 mg is prescribed on the second day from the start of the cycle. Existing connections with gonadotropins are controlled after a decrease in the activity of the pituitary gland, on the 15th day from the first injection.
For uterine fibroids, 3.75 mg is used monthly. The solution is administered in the first 5 days from the start of the menstrual cycle. Preoperative period with constant use of the drug should not exceed one quarter.

Diferelin is prepared immediately before use - long-term storage of the suspension is under strict ban.

Negative reactions

Non-standard reactions to subcutaneous administration of Diferelin can manifest themselves in a variety of symptoms.

Reproductive department:

increased dryness of the vaginal mucous surfaces;
sudden hot flashes;
decreased sex drive;
painful sensations during sexual contacts.

Digestive department:

nausea leading to vomiting;
increased activity of liver transaminases.

CNS and peripheral part:

changes in visual acuity;
sudden attacks of headache;
emotional lability – unstable mood with constant changes.

Musculoskeletal – pain in joints and muscle tissue.

Long-term therapy with GnRH analogues:

demineralization of bone structures;
risk of osteoporosis.

Other manifestations:

increased blood pressure;
skin rashes;
persistent itching;
hives;
Quincke's edema;
pain at the injection site;
increase in body weight parameters.

A solution with a long-term type of exposure has its own negative effects.

Musculoskeletal department:

demineralization of bone tissue with a high risk of osteoporosis - with long-term use;
temporary enhancement pain syndrome in metastatic areas - at the beginning of the course of therapy for a malignant neoplasm in the body of the prostate gland
ureteral obstruction;
appearance of signs associated with high blood pressure metastases in the spinal cord - disappear in one to two weeks;
increased activity of acid phosphatase in the bloodstream.

Cardiovascular department:

sensations of heat in the body - at standard body temperature indicators;
increased blood pressure – arterial hypertension.

changes in visual acuity;
instability of mood with constant swings and unmotivated outbursts of rage.

Reproductive department:

decreased potency level – in males;
depressive states;
recurrent headaches;
change in sexual desire;
increased functionality of the sweat glands;
change in size of the mammary glands;
increased dryness of the vaginal mucosa;
pain during sexual intercourse;
– when taken mixed with gonadotropins;
discharge mixed with blood from the vagina in girls - in the treatment of premature puberty;
hypogonadotropic amenorrhea - formed under the influence of prolonged therapy.

Other manifestations:

nausea with transition to vomiting - occurs in isolated cases;
rashes on the skin;
persistent itching;
hives;
Quincke's edema - in isolated cases;
pain at the injection site;
increased body temperature;
increase in body weight.

When negative reactions the specialist can stop therapy, select more suitable analogues or change the dosage.

Overdose

There were no clinical cases of accidental or intentional excess of recommended dosages.

Features of application

Before prescribing a treatment regimen, the patient must be examined to rule out an unplanned pregnancy.

Special instructions for subcutaneous solution

With the simultaneous administration of the drug in question with gonadotropins, the ovarian response can significantly increase, especially with polycystic disease. The process of stimulating ovulation is carried out under constant monitoring medical workers And diagnostic studies and biological techniques:

Ultrasound echography is prescribed;
an increase in estrogen in the bloodstream.

If an excessive reaction of the ovaries occurs, the process of stimulation of the organ is interrupted, and the administration of gonadotropin is stopped.

During treatment, some patients experience impaired visual acuity. Must be observed maximum caution when driving personal vehicles and while working with complex mechanisms. It is not recommended to carry out hazardous work, requiring high concentration attention and accelerated psychomotor reactions.

For long-acting intramuscular solution

Diferelin is prescribed with increased caution patients suffering from a malignant neoplasm in the body of the prostate gland. The main danger with this pathology is the risk of compression of the spinal cord or the occurrence of ureteral obstruction. At the beginning of therapy, it is possible to increase symptomatic manifestations diseases.

In vitro fertilization requires careful monitoring of the level of stimulation of the cycle to identify patients with symptomatic manifestations of overstimulation. If such patients are detected, therapy human chorionic gonadotropin stops.

During gestation and feeding

During pregnancy, the use of the drug is strictly prohibited. Therapy may cause abnormalities intrauterine development fetus or cause spontaneous abortion.

Before treatment begins, procedures are carried out to exclude possible unplanned conception. During the entire course of treatment, patients are recommended to use non-hormonal contraceptives until the full menstrual cycle is restored.

Use Diferelin for breastfeeding strictly prohibited.

Storage rules

Diferelin should be stored at a room temperature of no higher than 25 degrees. The medicine must be hidden from children.

Shelf life:

powder for subcutaneous administration - no more than two years;
mass for intramuscular injection - with a dosage of 3.75 mg - no more than 2 years, with a volume of the active component of 11.25 mg - up to three years, the included solvent - up to five years.

Diferelin is a prescription drug pharmacological agents, prohibited from free distribution through pharmacy chains.

Analogues

Analogues of the drug:

Decapeptyl depot;
Buserelin;
Buserelin depot;
Buserelin long FS;
Visanne;
Danazol;
Danoval;
Danodiol;
Danol;
Derinat;
Duphaston;
Indinol;
Lucrine depot;
Nemestran;
Norkolut;
Omnadren 250;
Orgametril;
Nor will be mowed down;
Prostap;
Epigallate.

Without the approval of the attending physician, any independent replacement of the main product is strictly prohibited. Uncontrolled reception pharmacological substances can cause serious negative reactions in response to the drug used.

Reviews

Gynecology specialists unanimously speak positively about Diferelin.

Negative opinions of patients are more often associated with the appearance adverse reactions on active ingredient. After adjusting the dose and changing the duration of therapy, no negative reactions were recorded.

Price

The cost of Diferelin depends on the form of release:

powder for making a solution for subcutaneous administration - costs 2580-2750 rubles;
for the preparation of a long-term suspension of 3.75 mg - from 6,700 to 7,500 rubles;
at a dosage of 11.25 mg - from 19,600 to 22,000 rubles.

Prices may vary depending on different regions and pharmacy chains.

Diferelin for IVF

In vitro fertilization or IVF procedure allows the use of Diferelin in long and short protocols.

In a short protocol, the drug is taken on the second day after the start of the menstrual cycle. The total treatment time does not exceed 12 days. The medication is administered once a day, subcutaneously. The concentration of the active ingredient is minimal - 0.1 mg. In parallel, human chorionic gonadotropin is used.

If the protocol is long, assignment is allowed different types drug - 0.1 or 3.75 mg.

Diferelin with a concentration of 0.1 mg is used daily, from the onset of the 21st day of the cycle. When determining low indicators concentrations (less than 50 pg/ml) produce stimulation with gonadotropin. The end of the course of therapy occurs when the follicles grow to 199 mm. The condition of the ovaries is assessed using ultrasound.

General condition

Diferelin is intended to reduce the production of sex hormones in women and men. The drug puts the body into a state similar to artificial castration. Under the influence of a medication, the following is observed:

in men - hormonal levels, equal to indicators eunuch (castrato) hormones;
in women, the condition is similar to the moment of menopause or after surgical removal of both ovaries.

Entering and exiting such a state is accompanied by:

psychological disorders;
metabolic disorders;
pathologies of the endocrine department;
neurovegetative lesions;
constant complaints from patients.

After completing the course of therapy, it is noted gradual restoration standard hormone indicators. Until the moment of complete return to normal state, patients may experience:

sudden bursts of headaches;
increased irritability;
persistent fatigue;
sensations of heat at standard body temperature levels;
increased functionality of sweat glands;
changes in weight;
increase in body temperature;
depressive states.

A return to previous norms is observed a few months later - after the end of the effect of the last injection:

with therapy with a concentration of 3.75 mg, the body will recover in 2.5 months;
after 11.25 mg – after 4.5 months.

Patients experience normalization of sexual desire and restoration of the functionality of the reproductive department.

After treatment

The first menstrual cycle (from the moment of its cessation under the influence of the drug) is characterized by scanty discharge, absence of pain or its minimal manifestations. The normal range includes the first menstruation, which came within six months - after the end of the last injection.

Taking into account the doctors’ ban on conception during the first half of the year – from the moment of undergoing therapy, patients are recommended to use contraceptives.

Diferelin is highly effective drug to suppress symptomatic manifestations serious illnesses. Treatment of female and male infertility The process is labor-intensive and not always effective. Carefully following the recommendations of your treating specialist will help you achieve the long-awaited event - pregnancy and the subsequent birth of a healthy child.

	Side effects of Diferelin 0.1	Side effects of Diferelin 3.75	Side effects of Diferelin 11.25
At the beginning of treatment	Ovarian hyperstimulation syndrome
		Increased bone pain in men	Bone pain in men
		Ureteral obstruction in men	Difficulty urinating in men
		Bone marrow compression in men	Pain when urinating in men
		Increased activity of acid phosphatase in the blood in men	Incomplete emptying of the bladder in men
		Decreased potency in men	Increased activity of AST and ALT in the blood of men