How to use utrogestan capsules. Utrozhestan: instructions for use of capsules and suppositories

Women during pregnancy often have to cope with hormonal disorders, which often lead to miscarriage and even infertility. Statistics show that a common cause of miscarriage is an acute deficiency of progesterone, which is responsible for pregnancy. It is produced by the corpus luteum, which occurs as a result of ovulation and functions throughout the first trimester. If the body for some reason cannot cope with such a duty, the woman is shown Utrozhestan - an analogue of human progesterone. Let's discuss the use of Utrozhestan during pregnancy, and why it is prescribed to women.

Utrozhestan is a remedy from the group of hormones of the gonads. It is a natural progestogen that can completely replace female progesterone.

The active component of Utrozhestan is micronized progesterone, enclosed in a gelatin capsule shell for intravaginal administration, as well as for oral administration. The capsule additionally contains glycerin, oil, gelatin.

Externally, Utrozhestan capsules during pregnancy resemble an elastic gelatin-based dragee, their color is pale yellow, there is no aroma, the shape of capsules with a dose of 100 ml is round, and capsules with a dose of 200 ml are oval.

The special formula of the active substance ensures the full absorption of Utrozhestan by the intestinal or vaginal mucosa. Progesterone, penetrating into the blood, performs all the functions of the female hormone. It takes part in the preparation of the endometrium for implantation of the fetal egg into the walls of the uterus, reduces the muscle activity of the uterus and fallopian tubes, thereby preventing egg rejection. In addition, progesterone supports the fetus until the placenta is fully formed and prepares the female glands for future lactation.

The bioavailability of Utrozhestan is the same for internal and vaginal use. However, Utrozhestan suppositories during pregnancy provide faster penetration of progesterone and a pronounced local effect. Even with the introduction of an average dose of Utrozhestan (100 ml per day), reactive penetration of progesterone into the body occurs, which allows maintaining its normal level of 9.7 ng / ml, which corresponds to the luteal phase. Thus, taking Utrozhestan allows the endometrium to mature from the proliferation phase to the secretory phase and safely implant the fetal egg. A gradual increase in the dose of Utrozhestan to 200 ml completely compensates for the need for progesterone during the 1st trimester.

On a note! Taking Utrozhestan during pregnancy inside has a therapeutic effect after 1-2 hours. And with intravaginal administration, this period is halved.

Utrozhestan: is it possible during pregnancy?

Utrozhestan is not contraindicated in the gestation period, and even vice versa, it often helps to prevent miscarriage, so it is prescribed from the moment pregnancy is confirmed. Often, women start taking it at the stage of preconception preparation, and then continue treatment after a successful conception. Reception of Utrozhestan in the second trimester of pregnancy is also possible. True, during the course of treatment, a woman’s liver parameters must be monitored. But taking Utrozhestan during lactation is undesirable, since the mechanism of its penetration into milk is poorly understood.

Utrozhestan in the 1st trimester of pregnancy

Utrozhestan in the first weeks of gestation is prescribed in the form of vaginal capsules. The drug is administered daily and always at the same time. This intake option prevents pathological effects on the digestive system and toxic liver damage. In addition, oral administration in the first trimester is often not possible, for example, if toxicosis occurs.

The appointment of Utrozhestan in the early stages of pregnancy in an adequate dosage completely eliminates uterine hypertonicity, stabilizes the functioning of the nervous system, and prevents a possible miscarriage, which is associated with progesterone deficiency.

The negative impact of Utrozhestan on the development of the baby is practically absent. However, there is a small risk of hypospadias when progestogens are used to prevent miscarriage. This pathology of the fetus consists in the formation of an anomaly in the development of the posterior wall of the urethra or its complete absence. Therefore, before the appointment of Utrozhestan, a woman should be informed about possible complications in the baby.

Utrozhestan in the 2nd, 3rd trimester of pregnancy

Utrozhestan after the 20th gestational week is prescribed very rarely, since the significance of this treatment at this time is practically reduced to zero. But in exceptional cases, when the placenta cannot cope with the production of progesterone, Utrozhestan in the 2nd trimester of pregnancy can be extended indefinitely.

Most often, such a long-term use of Utrozhestan occurs with IVF, cervical insufficiency, shortening of the uterus. Also, after the 20th week, Utrozhestan can be prescribed if there is a history of miscarriage, surgical intervention on the cervix, premature birth.

Sometimes Utrozhestan tablets during pregnancy are prescribed in the 3rd trimester. Taking gestagens after the 30th gestational week is indicated for premature softening of the cervix, its shortening, and the baby being too low. But such treatment is carried out only in especially dangerous situations, when the risk of premature birth is too high. In addition, in the later stages, taking gestagens can be dangerous in the presence of thrombosis or serious liver disorders. Therefore, if Utrozhestan is indicated, until which week of pregnancy to prescribe it, the obstetrician-gynecologist decides on an individual basis.

Utrozhestan during pregnancy - what is it prescribed for?

Utrozhestan is indicated for women to correct diseases caused by inferiority of the corpus luteum. Reception can take place orally or vaginally, and depends on the pathology.

Internal intake of Utrozhestan during pregnancy is carried out in the presence of such obstetric pathologies:

• risk of abortion;
• prevention of premature delivery.

Outside of pregnancy, Utrozhestan is prescribed to eliminate the following gynecological pathologies:

• premenstrual disorders;
• infertility in violation of the luteal phase;
• violation of the ovulatory process (anovulation, disovulation);
• progestogen deficiency in menopause;
• mastopathy;
• pre-cymacteric period.

Vaginal use of Utrozhestan is appropriate for:

• impossibility of oral ingestion of capsules (toxicosis, diseases of internal organs);
• inability to conceive with infertility;
• the threat of miscarriage;
• risk of premature onset of labor.

Advice! If a woman has a lack of progesterone, Utrozhestan is prescribed during pregnancy in any form, regardless of the gestational age.

Utrozhestan during pregnancy - instructions

The drug fully compensates for the lack of progesterone, without violating the natural hormonal balance of a woman. Competent treatment does not cause complications, does not contribute to gaining excess weight or worsening the course of pregnancy. But the effectiveness of replacement therapy during gestation depends on the adequacy of the prescribed dose and the general regimen.

Utrozhestan during pregnancy - dosage

The treatment course of Utrozhestan depends on the method of its use, the course of pregnancy, the severity of progesterone deficiency.

• Oral administration of Utrozhestan involves the appointment of 200-300 ml of the drug in several doses. For example, 100 ml in the morning and the rest of the dose at night.
• The scheme of Utrozhestan during pregnancy for the prevention of unscheduled onset of labor looks like this: the future woman in labor takes 400 ml of the drug every 7-8 hours until the condition stabilizes, or according to the scheme proposed by the doctor. After the condition improves, the dose of Utrozhestan is reduced to 200 ml. The maintenance dose is taken up to 36 gestational weeks. A longer course of treatment is not recommended.
• Intravaginal use of the drug involves the administration of 200 ml of progesterone daily. If necessary, it is allowed to increase the dose of Utrozhestan during pregnancy up to 400 ml or more.
• To delay premature birth, Utrozhestan 200 during pregnancy is taken from 22 to 36 gestational weeks. With the threat of miscarriage, a woman is prescribed 200-400 ml of Utrozhestan vaginally at the same time with an interval of 12 hours. Therapy lasts up to 12 gestational weeks.

There are no problems with how to insert Utrozhestan during pregnancy. The procedure is quite simple and painless. Before removing the capsule from the blister, you need to wash your hands, then take the capsule and insert it into the vagina in a position convenient for the woman. Applicator is allowed. After the procedure, a woman needs to lie down for some time so that the contents of the capsule dissolve and the substances penetrate into the tissues of the vaginal membrane.

Utrozhestan - contraindications during pregnancy

Utrozhestan may be contraindicated in a pregnant woman if she has the following diseases:

• thrombophlebitis;
• liver damage of various etiologies;
• varicose veins;
• porphyria;
• undiagnosed bleeding;
• neoplasia of the genital organs, mammary glands.

Gestagens tend to retain water in tissues and influence the growth of hormone-dependent tumors. Given this action of Utrozhestan, its use during pregnancy is limited to the following diseases:

• hypertension;
• epilepsy;
• bronchial asthma;
• kidney dysfunction;
• migraine;
• diabetes;
• cardiovascular anomalies;
• lupus erythematosus;
• mastopathy;
• benign neoplasms.

Given the high risk of thromboembolic and metabolic complications, Utrozhestan should be immediately discontinued with the development of such symptoms:

• violation of visual function;
• thrombus formation;
• venous insufficiency;
• severe headache, including a migraine attack.

Important! Utrozhestan is indicated to stop a miscarriage only with diagnosed progesterone deficiency. If the cause of the miscarriage is a genetic disorder, sexual infections, or physical disorders, Utrozhestan is contraindicated.

Utrozhestan during pregnancy - side effects

Negative effects from treatment are rare. Sometimes, if the rules of treatment are not followed or if individual intolerance occurs, some violations of the work of various organs and systems are possible.

From the reproductive system:

• mammalgia;
• amenorrhea;
• bleeding from the birth canal.

Disorders of the nervous system:

• drowsiness;
• distraction;
• headache;
• dizziness;
• depression.

Gastrointestinal disorders:

• diarrhea;
• nausea;
• episodic vomiting;
• constipation.

Skin lesion:

• acne
• hives;
• yellowness of the skin;
• chloasma.

After vaginal administration of Utrozhestan during pregnancy, side effects are local in nature and manifest as unpleasant sensations in the vagina - itching, swelling, burning, hyperemia.

The following side effects may also occur:

• decreased libido;
• localized alopecia;
• thromboembolism;
• short-term fluid retention in tissues;
• slight fluctuations in weight;
• hirsutism;
• anaphylactic shock.

On a note! Women are often afraid of discharge after Utrozhestan during pregnancy. In fact, moderate yellow discharge of an oily structure is normal throughout the treatment course.

How to cancel Utrozhestan during pregnancy

Utrozhestan is a hormonal drug, therefore, it needs to be gradually canceled so as not to provoke a hormonal imbalance. For successful withdrawal of the drug without consequences, the daily dose is reduced by 100 ml every week. If the dose taken is low enough, it is reduced by 50 ml with an interval of three days. At the stage of lowering the dose and until the complete abolition of Utrozhestan during pregnancy, the woman is constantly monitored so that she does not start bleeding.

Which is better: Duphaston or Utrozhestan during pregnancy

To maintain pregnancy, not only Utrozhestan can be prescribed. An analogue of this drug is Duphaston. It is also considered a progestogen, but contains a synthetic version of progesterone. While Utrozhestan contains natural progesterone of plant origin. Otherwise, these two drugs are completely identical.

The attitude of obstetricians-gynecologists to these two drugs is different. Dufaston has long been used in obstetric practice, so its effect on pregnancy is well studied. In addition, the synthetic form of progesterone provides a more pronounced therapeutic effect. Therefore, obstetricians-gynecologists prefer Duphaston, and not Utrogestan during pregnancy with the threat of miscarriage.

Utrozhestan is a relatively new drug with a milder effect on the body. But many doctors are afraid to prescribe it during gestation, citing little experience with its use in this period. At the same time, Utrozhestan is much better tolerated by women and rarely causes them to feel unwell.

It is impossible to say which of these two drugs is better. Therefore, the appointment of a doctor depends on his experience, the condition of the woman and the effectiveness of the chosen treatment.

Utrozhestan during pregnancy - reviews

Capsules Utrozhestan are well tolerated by women. They do not suppress the production of female hormones, therefore they are not addictive, do not participate in metabolic processes, do not affect weight and do not provoke hormonal imbalance in a child. Utrozhestan daily helps many women conceive and bear a baby, as evidenced by many reviews.

Many responses are left by women who were prescribed Utrozhestan during pregnancy with tone. After the start of therapy, the condition of women rapidly stabilized, and the threat of miscarriage passed. There are also reviews about the effectiveness of Utrozhestan during the prevention of the premature birth of a baby, which could be triggered by pathologies of the cervix.

Utrozhestan is a highly effective remedy that allows women with hormonal disorders to conceive and bear a healthy baby. But it is a hormonal drug and can only be taken under the supervision of an obstetrician-gynecologist.

Video "Utrozhestan during pregnancy - features of the reception"

One capsule contains 100 or 200 mg of yam extract progesterone (in micronized form), as well as peanut butter (Arachis hypogaea), (Lecithin) soy , (Glycerol), gelatin (Gelatin) additive E171 (titanium dioxide).

Release form

• Capsules Utrozhestan 100 mg, package No. 30;
• capsules Utrozhestan 200 mg, package No. 14.

pharmachologic effect

Progestogenic.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The effects of Utrozhestan are due to the properties of the progesterone , which is analogous to the natural biological progesterone produced by the corpus luteum of the ovaries after ovulation, and also - in pregnant women - by the placenta.

Influenced progesterone the mucosa lining the uterine cavity thickens and becomes secretory, which contributes to the fixation of a fertilized egg in it and normal development in the future.

In pregnant women progesterone reduces contractility and excitability of the muscles of the uterus and fallopian tubes.

It blocks the secretion of regulating the release of FSH and LH from the pituitary gland, inhibits ovulation and the production of gonadotropins by the pituitary gland. Androgenic properties are not found.

Pharmacokinetics when taken orally

Plasma concentration progesterone begins to rise from the first hour after taking the capsules and reaches maximum values ​​after 1-3 hours. An hour later, this figure is 4.25, after two hours - 11.75, after four hours - 8.37, after six hours - 2, and after eight hours - 1.64 ng / ml.

two thirds of the dose progesterone metabolized in the liver. Mainly found in urine pregnenolone And pregnandiol (metabolites are identical to those formed during physiological secretion).

Specified derivatives progesterone play an important role in the education and exchange of others steroid hormones . From 15 to 60% of metabolic products are excreted by the kidneys, a little less than a third - with faeces.

Pharmacokinetics with intravaginal application

Progesterone when administered parenterally, it is absorbed in the mucosa. Absorption is fast. Plasma concentration begins to rise from the first hour after the use of the drug. Its level reaches its highest values ​​in 1-3 hours.

The use of Utrozhestan 100 mg capsules at night allows you to achieve and maintain a stable and physiological concentration progesterone in plasma, which corresponds to that in the corpus luteum phase (luteal phase) of the cycle in women with normal ovulation.

Thus, the drug stimulates adequate maturation of the internal lining of the uterus and contributes to the normal implantation of the embryo.

The use of a dose exceeding 200 mg / day, intravaginal use of Utrozhestan does not allow reaching plasma levels progesterone , which would be identical to that in the first 3 months of pregnancy.

About 95% of the dose is excreted as (basic - pregnandiol ) with urine.

Indications for use

Utrozhestan: why is it taken orally?

And obstetric practice Utrozhestan is used for threat warnings or ordinary miscarriage against the background of luteal phase insufficiency (NLF), as well as for prevention of the threat of preterm birth .

Also, oral administration of the drug is indicated for those associated with deficiency progesterone gynecological disorders, including PMS, menstrual irregularities (dys- or anovulation), FCD of the mammary glands, premenopausal conditions; , the cause of which is luteal insufficiency; HRT in women with menopausal disorders (in combination with — containing drugs).

Indications for the use of Utrozhestan vaginally

As candles, Utrozhestan is used:

• in hormone replacement therapy for non-functioning ovaries as part of the program oocyte donation ;
• with IVF (to maintain the phase of the corpus luteum at the stage of preparation for fertilization of the egg);
• to maintain the corpus luteum phase in an induced/spontaneous cycle;
• for the prevention of progestogen insufficiency spontaneous / habitual miscarriage ;
• at endocrine infertility ;
• at ;
• at ;
• if there are restrictions for oral use of the drug or if it is impossible.

Contraindications

Contraindications to the use of Utrozhestan:

• severe violations of the liver;
• vaginal bleeding of unknown nature;
• incomplete/unsuccessful ;
• hemorrhage in the brain;
• thromboembolic disorders;
• neoplasia of the genital organs / mammary glands (confirmed or suspected);
• porphyria;
• hypersensitivity to any of the substances contained in the capsules.

Side effects of Utrozhestan

Side effects of Utrozhestan when administered orally are most often manifested in the form of:

• changes in the cycle of menstrual bleeding;
• bleeding beginning in the middle of the cycle;

Less common are:

• transient;
• mammalgia ;
• vomit;
• cholestatic jaundice.

In rare cases, nausea may occur.

Also, the possibility of a change in libido, the appearance of discomfort in the chest and / or symptoms characteristic of PMS, hyperthermia, , hirsutism , , venous thromboembolism , changes in body weight, gastrointestinal disorders, fluid retention, anaphylactic-type hypersensitivity reactions.

Transient dizziness and / or drowsiness is especially pronounced with concomitant hypoestrogenism . To eliminate these phenomena (without reducing the therapeutic effect), it is usually sufficient to increase the dosage estrogen or reduce the dose of the drug.

If treatment is started before the 15th day of the cycle, it is possible to shorten the cycle. Occasional bleeding may also occur.

If Utrozhestan tablets are inserted into the vagina, side effects are expressed in the form of hypersensitivity reactions (hyperemia, itching, burning) and the appearance of oily discharge.

Reviews of the side effects of Utrozhestan (including during pregnancy) allow us to conclude that the greatest number of unpleasant phenomena occurs after taking the capsules inside. To reduce their severity, the capsules should be taken at bedtime or switched to an intravaginal route of administration.

Capsules Utrozhestan: instructions for use

The method of application, as well as instructions on how best to take Utrozhestan, how long to continue treatment and how to stop the drug, depend on the indications for use and the clinical manifestations of the pathology.

Instructions for use Utrozhestan inside

Inside, as a rule, the drug is prescribed to be taken at a dose of 200-300 mg / day. The main dose (in the evening, before bedtime) is 200 mg, in the morning (if necessary) another 100 mg are taken.

At luteal insufficiency (PMS, FKB, premenopause, cycle failures) tablets are taken in ten-day courses, starting from the 17th day of the cycle.

With HRT in menopause due to the fact that a separate therapy estrogen— containing preparations is not recommended, Utrozhestan is used as an adjunct to the main treatment.

Start taking the drug should be 7 days after the start of each course of HRT. Duration of application - 2 weeks. It should be remembered that withdrawal bleeding is possible during HRT.

To prevent preterm labor (PR), the drug is taken 3-4 rubles / day, at regular intervals. Single dose - 400 mg. After the disappearance of the clinical manifestations of the threat of PR, the dose is gradually reduced to a maintenance dose of 600 mg / day: the capsules continue to be taken one 3 times a day.

Regarding until which week to take the drug, the following recommendations are given in the instructions: intake during pregnancy at a dose of 600 mg / day. available up to 36 weeks.

Apply progesterone beyond 36 weeks is not recommended.

How to administer Utrozhestan capsules intravaginally?

The capsules are inserted into the vagina as deeply as possible. The average daily dose of the drug for intravaginal use is 200 mg (1 capsule 200 mg 1 r./day or 2 capsules 100 mg 2 r./day). If necessary, for greater convenience, you can use the applicator.

Depending on the woman's response to the prescribed treatment, the dose may be increased.

With partial NLF (“ovulation syndrome”, cycle failures), Utrozhestan is used for 10 days at a dose of 200 mg / day. Treatment begins on the 17th day of the cycle.

With complete NLF in women with absent (non-functioning) ovaries ( oocyte donation ) appoint 100 mg of progesterone in the morning and evening from 15 to 25 days of the menstrual cycle.

If pregnancy is confirmed on the 26th day of the cycle, from that moment the dose is gradually increased by 100 mg / day, bringing it to a maximum of 600 mg / day. (one 200 mg capsule per dose).

In this dosage, Utrozhestan suppositories continue to be used up to 60 days.

During the IVF cycle, 1 capsule of 200 mg is administered once every 8 hours.

During pregnancy, when there is a possibility of its termination, as well as to prevent a habitual miscarriage associated with a progesterone deficiency, a woman should be administered 100 or 200 mg of progesterone every 12 hours until the 12th week.

It is very important to correctly insert the capsules into the vagina, especially when the drug is prescribed for hormonal support in IVF. Before you enter the capsule, you should lie on the bed, while putting a pillow under the buttocks and lower back, spread your legs wide and place the pill as deep as possible into the vagina.

After that, in order for the active substance of the drug to be absorbed into the mucous membrane in the right amount, it is recommended to stay in bed in the same position for another 15 minutes to an hour.

Overdose

Symptoms of an overdose may be manifested by symptoms of side effects of the drug: drowsiness, euphoria, dizziness, metrorrhagia , shortening the cycle time, .

For some women, the standard dose may be too high due to existing or secondary endogenous secretion. progesterone , hypersensitivity to Utrozhestan or a concomitant reduced level of c.

With the appearance of transient dizziness or drowsiness, it is enough to reduce the dose progesterone or prescribe the drug in the evening hours (before going to bed).

By shortening the cycle and metrorrhagia the start of treatment is postponed to a later day of the cycle (for example, from day 17 to day 19).

In patients receiving premenopausal HRT, it is necessary to control the level of estradiol.

Interaction

Women undergoing treatment during menopause estrogen-containing drugs , it is recommended to start taking no later than the 12th day of the cycle progesterone .

If, in the treatment of the threat of PR, the drug is combined with β-agonists , the latter can be used at a lower dose.

Concomitant use of other medicinal products may interfere with pharmacokinetics progesterone , causing an increase or, conversely, a decrease in its concentration in plasma and, thus, leading to a change in the action of the drug.

Drugs that potently induce the liver ( antiepileptic drugs , barbiturates , Phenylbutazone , , , ) contribute to strengthening progesterone in the liver.

Smoking contributes to a decrease in bioavailability progesterone , alcohol - its increase.

Terms of sale

On prescription.

Storage conditions

Capsules should be stored at a temperature not exceeding 25°C.

Best before date

Three years.

special instructions

Due to the likelihood of metabolic disorders and thromboembolic complications it is necessary to cancel the drug when:

• visual disturbances, including vision loss, double vision, retinal vascular lesions , optic disc , proptosis ;
• thrombotic or thromboembolic venous complications (regardless of which area is affected);
• high intensity headache, .

Patients with thrombophlebitis history should be under constant medical supervision.

The absence of menstruation during treatment with Utrozhestan requires tests to confirm or exclude pregnancy, which may be the cause amenorrhea .

More than 50% of spontaneous abortions in early pregnancy are due to genetic complications. In addition, the cause of abortion can be mechanical disorders and infectious diseases . In such cases, the use of drugs progesterone justified only in cases where there is a delay in the expulsion of the fetal egg.

Based on this, the appointment of Utrozhestan on the recommendation of a gynecologist should be provided for cases where a woman's body produces an insufficient amount progesterone .

The capsules should not be taken with food. The best time to take it is before bed. The simultaneous use of food increases the bioavailability of Utrozhestan.

Some women are interested in whether the drug affects the level of hCG. Doctors say that Utrozhestan does not change the results.

Utrozhestan flows out - what to do?

All patients note that the drug leaks when administered intravaginally. The manufacturer and doctors say that such a phenomenon is the norm. The appearance of oily secretions is associated with the dosage form of Utrozhestan and its composition, which contains fatty substances - vegetable oil and soy lecithin.

Some women worry that this may reduce the effectiveness of Utrozhestan. However, doctors are in a hurry to reassure here, assuring that it is not the active substance that flows out, but only the capsule shell.

In some cases, when the drug is used several times a day, the doctor may recommend intravaginal administration of only 1 rub / day - before bedtime, and at other times - in the morning and afternoon - oral capsules.

Utrozhestan and menstruation

Utrozhestan is prescribed to correct cycle disorders caused by endogenous progesterone deficiency , as well as for the correction of disorders caused by excessive production estrogen .

A delay in menstruation against the background of the use of the drug may indicate pregnancy. In this case, a woman must definitely donate blood to determine the level of hCG or do it.

The situation when there is no menstruation after taking the drug can also be the result of “blind” support of the 2nd phase of the cycle, when the time of ovulation is not taken into account.

For women planning a pregnancy, doctors recommend taking Utrozhestan not from the 16th day, but one day after ovulation.

Preparations progesterone can be used to call menstruation. Menstrual bleeding is due to the effect of the withdrawal of Utrozhestan. The onset of menstruation usually occurs 2-10 days after stopping the capsules.

Analogues of Utrozhestan

Coincidence in the ATX code of the 4th level:

Analogues with a similar mechanism of action: Oxyprogesterone capronate , Medroxyprogesterone-LANS .

Prajisan and Utrozhestan - the difference?

Prajisan belongs to the group of drugs progesterone and is a generic of Utrozhestan. Therefore, the difference between these means is small.

Prajisan , unlike its structural counterpart, is available not only in the form of capsules for oral and intravaginal use, but also in the form of a gel that is inserted into the vagina using a disposable applicator.

Which is better - Kraynon or Utrozhestan?

A drug Crinon is a vaginal gel produced by the manufacturer in disposable applicators. Active substance - progesterone , which is contained in the drug at a concentration of 90 mg / dose (1 dose \u003d 1.125 g of gel).

A feature of the drug is that the gel is placed in a polymeric delivery system, which ensures a high degree of binding to the vaginal mucosa and a continuous release of the active substance for at least three days.

Iprozhin or Utrozhestan - which is better?

Iprozhin are capsules containing 100 or 200 mg progesterone (micronized). The main difference between the drug and Utrozhestan is that when applied intravaginally, it practically does not flow out of the vagina, which, according to many women, is more convenient.

In the annotation to Iprozhina it is indicated that it can enhance the effect immunosuppressants , diuretics , anticoagulants And antihypertensive drugs , as well as reduce the lactogenic effect .

Alcohol compatibility

Alcohol increases the bioavailability of the drug.

Utrozhestan during pregnancy

Does Utrozhestan help to get pregnant?

Utrozhestan when planning pregnancy is necessary when, during the tests, insufficiency of the 2nd phase of the cycle is detected.

The use of the drug stimulates the formation of a secretory type of endometrium, promotes the transition of the uterine mucosa from the proliferative to the secretory phase, and then, when fertilization occurs, its transition to the optimal state for the development of a fertilized egg.

The endometrium, which swells under the influence of Utrozhestan, becomes loose, making it easier for the egg to attach to the wall of the uterus.

Also, Wikipedia states that progestins also help to reduce the excitability and contractility of the muscles of the uterus and fallopian tubes, prevent an increase in concentration estrogen in the 2nd phase of the cycle and promote nervous relaxation, thus creating conditions favorable not only for conception, but also for maintaining the normal course of pregnancy.

Analyzing reviews of those who helped get pregnant Utrozhestan, we can conclude that the drug is effective in situations where the cause of infertility is a low level endogenous progesterone . If there are no other obstacles to conception, pregnancy against the background of the use of the drug occurs quite quickly.

How to take the drug when planning a pregnancy?

As a rule, when trying to get pregnant, the drug is taken for ten days in each cycle, starting from day 16. On the 25-26th day, you should do a pregnancy test or donate blood to determine the level of hCG.

If pregnancy is not confirmed, the drug is stopped and resumed in a new cycle, following the same regimen.

If there is reason to suspect pregnancy, you cannot stop taking Utrozhestan - abrupt cancellation during pregnancy can cause it to spontaneously terminate. If the test gave a positive result, the use of the drug is continued up to 12-16 weeks.

Women whose ovaries do not produce at all progesterone , Utrozhestan is prescribed intravaginally according to the following scheme:

• 100 mg/day on the 13th and 14th days of the cycle;
• 200 mg / day, divided into 2 doses, from 15 to 25 days;
• from 200 to 800 mg / day. (the dose is increased daily by 100 mg to the maximum) - from the 26th day (provided that the pregnancy is confirmed).

How to take Utrozhestan during pregnancy?

The use of Utrozhestan during pregnancy does not adversely affect the fetus. If it is necessary to use after the third month of pregnancy, it is necessary to control the functional state of the liver.

There is evidence that the use progestogens in pregnant women in order to prevent habitual / spontaneous miscarriage against the background of NFL can lead to the development hypospadias .

In the early stages, with the threat of miscarriage, the drug is recommended to be used vaginally, since with this method the therapeutic effect develops faster, and the load on the liver is minimal. It is also recommended to prescribe candles to women who suffer from severe .

The treatment regimen and dosage for each individual patient are selected by the doctor individually.

When it comes to maintaining a pregnancy, the initial dose is usually 400 to 600 mg. Subsequently, the woman is transferred to maintenance treatment at a dose of 200 mg / day. up to 600 mg / day. With the ineffectiveness of therapy, the dose can be increased to 0.8-1 g / day. Treatment usually lasts up to 18-20 weeks.

In the 2nd and 3rd trimester, the use of Utrozhestan is advisable when the clinic of the threat of abortion is resumed, and also, in a situation where a woman develops ICI ( isthmic-cervical insufficiency ).

The method of administration at this time does not play a role. Reviews of doctors and their patients allow us to conclude that the use of the drug in a daily dose of up to 300 mg up to 36 weeks inclusive is equally effective both when taking the capsules inside and when they are introduced into the vagina.

Up to 34-36 weeks, until the uterine tone is removed, the capsules are taken orally 1 every 8 hours. Then the woman is prescribed maintenance treatment at a dose of 200 mg.

Side effects of the drug

The most common side effects of Utrozhestan are manifested in the form of drowsiness, lethargy and dizziness. However, these unpleasant symptoms occur only when the capsules are taken orally.

Since Utrozhestan is a hormonal remedy, the question naturally arises - is it possible to recover from it? Doctors say that taking the capsules does not cause a change in body weight. This is due to the fact that the drug does not affect carbohydrates and lipids, and also does not retain fluid in the body.

Discharge during pregnancy after the drug (with the intravaginal method of use) is not a side effect if there are no bloody impurities in them - it's just a melted capsule shell. The appearance of bleeding requires dose adjustment.

How much to take Utrozhestan during pregnancy?

Only a doctor can say exactly how long to take Utrozhestan during pregnancy in a particular case. If pregnancy occurs during treatment progesterone , capsules continue to be taken for an average of 2 months, starting from the 26th day of the cycle in which conception occurred.

How to cancel the medicine during pregnancy?

During pregnancy, Utrozhestan is canceled by gradually reducing the dose, since an abrupt cessation of treatment is fraught with spontaneous abortion.

The withdrawal regimen may include a dose reduction of 50 mg every three days or a weekly reduction of 100 mg.

Which is better - Duphaston or Utrozhestan during pregnancy?

Like its counterpart, it is used to compensate for the deficit endogenous progesterone .

The main difference between the drugs is that the first is a synthetic analogue progesterone , and the second is the only one to date progesterone , which is obtained from plant materials.

Efficiency Duphaston and Utrozhestan when planning pregnancy and in pregnant women is comparable.

The advantages of Duphaston are the absence of a sedative effect, which, when using Utrozhestan, is manifested by drowsiness and lethargy, as well as a long experience of use.

The advantages of Utrozhestan are the ability to influence androgen metabolism and suppress the effects oxytocin thus improving the course of pregnancy.

Application for lactation

Ability progesterone pass into breast milk has not been studied, and therefore should avoid the use of the drug during the period.

Use during pregnancy, before and after sexual intercourse, during sports - and other topical issues of the use of the drug.

1. How many capsules are in the package?

There are 2 forms of release of the drug: 100 mg capsules and 200 mg capsules. In each package of the drug with a dosage of 100 mg there are 28 capsules (2 blisters of 14 capsules), and in a package with a dosage of 200 mg there are 14 capsules (2 blisters of 7 capsules).

2. How to take the drug?

The preparation of micronized progesterone has the following ways of application:

Orally - taken orally with water;

Intravaginally - inserted into the vagina.

The choice of the route of administration is carried out in accordance with the diagnosis, on the recommendation of a doctor and taking into account the individual preferences of the patient.

3. Can I take the drug with food?

4. Can the drug leak after use?

Micronized progesterone is an oil-based progesterone capsule. The amount of oil in each capsule is negligible (about 1 ml), so it cannot lead to any pronounced discharge. However, if there are still slight discharges after ingestion (in rare cases), then these are discharges not of progesterone itself, but of auxiliary elements. Progesterone itself is very quickly absorbed into the bloodstream. There should be no anxiety or inconvenience here.

5. What to do if after taking the drugdrowsiness occurs?

Drowsiness is a consequence of the anxiolytic effect of progesterone: its alpha metabolites have a calming effect on the nervous system. When this effect occurs, it is recommended to either switch from the oral to the vaginal route of administration, or take the drug orally at bedtime.

6. Are there any special considerations when administering progesterone vaginally?

7. Can I administer micronized progesterone before and after intercourse?

Since the drug is rapidly absorbed into the vagina, you can enter it at any time.

8. When is the best time to administer the drug?

There is no strictly defined time for the administration of this drug, however, when taken orally, micronized progesterone is preferably administered in the evening before bedtime. The optimal time of admission will be recommended by the doctor.

9. Are allergic manifestations possible with vaginal administration of the drug?

10 . Are allergic reactions to the drug possible when taken orally?

Yes, in very rare cases, an allergic reaction to the components of the drug that make up the composition is possible.

11 . Can micronized progesterone cause changes in body temperature?

Yes maybe. In a normal menstrual cycle without additional administration of progesterone, body temperature also slightly increases after ovulation. The increase in temperature depends on the amount of progesterone in the blood.

12 . Is it possible for the capsule to fall out?

No, because the vaginal cavity is anatomically located almost horizontally. In addition, the drug is very well and quickly absorbed.

13 . Can micronized progesterone be used vaginally during sports or exercise?

Sports or exercise are not an obstacle to the vaginal use of the drug, as it is very quickly and well absorbed.

14 . What happens if the course of treatment starts too early?

If the course of treatment began in the first half of the menstrual cycle (especially before the 15th day), there may be a shortening of the menstrual cycle or the appearance of "spotting" spotting. Such manifestations are characteristic of all progestogens. In this case, it is recommended to postpone the start of treatment to a later day of the cycle (for example, on the 19th day).

15 . In what diseases can the use of the drug cause undesirable effects?

The drug should be used with caution in diseases of the cardiovascular system, arterial hypertension, chronic renal failure, diabetes mellitus, bronchial asthma, epilepsy, migraine, depression, hyperlipoproteinemia, impaired liver function of mild and moderate severity, photosensitivity.

Also, the drug should be used with caution in the II and III trimesters of pregnancy and lactation.

16 . Can micronized progesterone be used while breastfeeding?

Progesterone passes into breast milk, so the use of the drug is contraindicated during breastfeeding.

micronized progesterone during pregnancy

17. How long can the drug be usedin preparation for pregnancy?

As a rule, at the stage of preconception preparation, the course of the drug can be several cycles (from 1 to 3) until the onset of pregnancy. But according to the decision of the doctor, the number of cycles can be increased.

18. Is it possible to immediately stop the drug during pregnancy if the critical period has passed?

19. Why can the drug be used during pregnancy only up to the 34th week?

This is due to the degree of maturity of the organs and systems of the fetus and the period of the possible onset of childbirth. It is recommended to cancel the drug approximately 2-4 weeks before a possible birth - by this time the organs and systems of the fetus are already practically formed. And from 37 weeks, the pregnancy is considered full-term.

20 . When can you start using the drug?

Unlike other synthetic progestogens, micronized progesterone can be used before conception, in preparation for pregnancy (preconception preparation) and throughout pregnancy, up to 34 weeks (according to the instructions).

The regimen for taking the drug is as follows:

In preparation for pregnancy (with luteal phase deficiency):

The daily dose is 200 or 400 mg. Reception period: 10 days (usually from the 17th to the 26th day of the cycle).

In the treatment of infertility (to support the luteal phase):

Daily dose: 200-300 mg per day, starting from the 17th day of the cycle. Duration of admission: 10 days (in case of delayed menstruation and diagnosis of pregnancy, treatment should be continued).

When conducting an IVF cycle (support of the luteal phase):

Daily dose: 600 mg per day. Duration of admission: starting from the day of the injection of human chorionic gonadotropin during the I and II trimester of pregnancy.

With threatened abortion or warninghabitual abortion due to progesterone deficiency:

The daily dose is 200-600 mg in 2 doses daily. Duration of admission: I and II trimesters of pregnancy.

Prevention (prevention) of preterm birth in women at risk (with shortening of the cervix, the presence of preterm labor and / or premature rupture of membranes in history):

Daily dose: 200 mg at bedtime. Reception period: from the 22nd to the 34th week of pregnancy.

21 . Why is oral administration prescribed in one case, and intravaginal in the other?

Each application has its own challenges and benefits.

When administered orally, the systemic effects of progesterone are more pronounced - including effects on the nervous system, which manifests itself in reducing anxiety and improving sleep. This method of administration is used mainly in gynecology.

With the vaginal route of administration, progesterone immediately enters where it is most needed during pregnancy - in the endometrium of the uterus, where all the processes of implantation of a fertilized egg and the further development of the unborn baby take place. Therefore, during pregnancy, the maximum effect is observed precisely with the vaginal route of administration of the drug.

The presence of bloody discharge with the threat of termination of pregnancy in the early stages does not limit vaginal use and does not reduce the effectiveness of treatment. However, for women who prefer an alternative route of administration, transition is possible for oral use at a dose of up to 600 mg until relief of acute symptoms, followed by a transition to the vaginal route after the elimination of acute clinical manifestations.

Taking into account the stress factors associated with the threat of miscarriage, experts often consider it appropriate to use the drug in combination (400 mg vaginally and 200 mg orally) to enhance the anxiolytic effect of micronized progesterone.

22. What is the effect of micronized progesterone during pregnancy?

1. Causes changes in the endometrium necessary for the onset and maintenance of pregnancy.

2. Relaxes the muscles of the uterus, protecting a woman from premature birth (contractions are muscle contractions, and progesterone has a relaxing effect on muscle fibers).

3. Due to the immunomodulatory effect of progesterone in the mother's body, there is no rejection of the fetus.

4. Regulates water metabolism and prevents stagnation of excess fluid in the body.

5. Due to the unique metabolites of progesterone (which are not formed in full when using synthetic progestogen preparations), micronized progesterone has a beneficial effect on the mother's nervous system: relieves irritability, reduces anxiety.

6. Progesterone favorably affects the development of the unborn baby. Including affects the processes of myelination of nerve fibers. And they are directly related to the speed of transmission of nerve impulses - the more fully formed the myelin sheath, the more perfect the function of impulse conduction. Also, the drug helps to exercise physiological control of the level of androgens, and this contributes to the correct sexual differentiation of the brain of boys (for the male version of brain development, exposure to androgens produced by the testicles of the fetus is necessary - it is progesterone that is the substrate for the synthesis of testicular testosterone).

Utrozhestan®

International non-proprietary name

Progesterone

Dosage form

Capsules 100 mg, 200 mg

Compound

1 capsule contains

activeohsubstancesO - progesterone natural micronized 100 mg or 200 mg

Excipients: soy lecithin, sunflower oil,

composition of the capsule shell: gelatin, glycerin, titanium dioxide (E 171)

Description

Round soft, shiny yellowish gelatin capsules containing an oily whitish homogeneous suspension (no visible phase separation) (for a dosage of 100 mg).

Oval soft, glossy yellowish gelatin capsules containing an oily whitish homogeneous suspension (no visible phase separation) (for a dosage of 200 mg).

Pharmacotherapeutic group

Sex hormones and modulators of the reproductive system. Progestogens. Pregnene derivatives. Progesterone.

ATX code G03DA04

Pharmacological properties

Pharmacokinetics

When taken orally

Micronized progesterone is absorbed from the gastrointestinal tract. The concentration of progesterone in the blood plasma gradually increases during the first hour, the maximum concentration in the blood (Cmax) is observed 1-3 hours after ingestion. Communication with plasma proteins - 90%.

The concentration of progesterone in blood plasma increases from 0.13 ng/ml to 4.25 ng/ml after 1 hour, up to 11.75 ng/ml after 2 hours and is 8.37 ng/ml after 3 hours, 2 ng/ml after 6 hours and 1.64 ng/ml after 8 hours.

The main metabolites that are determined in the blood plasma are 20-alpha-hydroxy-delta-4-alpha-pregnanolone and 5-alpha-dihydroprogesterone.

Excreted in the urine as metabolites, 95% of which are glucuron-conjugated metabolites, mainly 3-alpha, 5-beta-pregnandiol (pregnandione)

The indicated metabolites, which are determined in the blood plasma and in the urine, are similar to the substances formed during the physiological secretion of the corpus luteum.

When administered vaginally

Absorption occurs quickly, progesterone accumulates in the uterus, a high level of progesterone in the blood plasma is observed 1 hour after administration. Cmax of progesterone in plasma is achieved 2-6 hours after administration. With the introduction of the drug at 100 mg 2 times / day, the average concentration remains at the level of 9.7 ng / ml for 24 hours.

When administered in doses of more than 200 mg / day, the concentration of progesterone corresponds to the 1st trimester of pregnancy. Communication with plasma proteins - 90%.

It is metabolized with the formation of predominantly 3-alpha, 5-beta-pregnandiol. The level of 5-beta-pregnanolone in plasma does not increase.

It is excreted in the urine as metabolites, the main part is 3-alpha, 5-beta-pregnandiol (pregnandione). This is confirmed by a constant increase in its concentration (Cmax 142 ng / ml after 6 hours).

Pharmacodynamics

Progestogen, corpus luteum hormone. By binding to receptors on the surface of cells of target organs, it penetrates into the nucleus, where, by activating DNA, it stimulates RNA synthesis. It promotes the transition of the uterine mucosa from the proliferation phase caused by the follicular hormone to the secretory phase, and after fertilization 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, stimulates the development of the terminal elements of the mammary gland.

By stimulating protein lipase, it increases fat reserves, increases glucose utilization, increases the concentration of basal and stimulated insulin, promotes the accumulation of glycogen in the liver, increases the production of gonadotropic hormones of the pituitary gland; reduces azotemia, increases the excretion of nitrogen in the urine. Activates the growth of the secretory part of the acini of the mammary glands and induces lactation. Promotes the formation of normal endometrium.

Indications for use

Progesterone deficiency states.

Oral route of administration

Gynecological:

Progesterone deficiency disorders:

Premenstrual syndrome

Irregular menstrual cycles with dysovulation or anovulation

Benign mastopathy

premenopause

Menopause therapy (in addition to estrogen therapy)

Infertility due to luteal insufficiency.

Obstetrics:

Threatened miscarriage or prevention of habitual miscarriages due to established luteal insufficiency

Threat of preterm birth

INaginal route of administration

Hypofertility, primary or secondary infertility associated with partial or total luteal insufficiency (dysovulation, support of the luteal phase during in vitro fertilization, oocyte donation)

The threat of early miscarriage or the prevention of habitual abortions associated with luteal insufficiency

Dosage and administration

The duration of treatment is determined by the nature and characteristics of the disease.

Oral route of administration

On average, the dose is 200-300 mg of progesterone per day, divided into 1 or 2 doses, i.e. 200 mg in the evening at bedtime and 100 mg in the morning as needed.

Atluteal insufficiency(premenstrual syndrome, menstrual disorders, premenopause, benign mastopathy): treatment should be carried out for 10 days per cycle, usually from the 17th to the 26th day inclusive.

Atmenopause therapy: Since estrogen therapy alone is not recommended, progesterone is added in the last two weeks of each therapeutic course, followed by the cessation of any replacement treatment for about one week, during which abstinence bleeding may occur.

Atrisk of preterm birth: 400 mg of progesterone every 6-8 hours depending on clinical results obtained during the acute phase, then at a maintenance dosage (eg, 3 times 200 mg per day) until the 36th week of pregnancy.

Vaginal route of administration

The average dose is 200 mg of progesterone per day (i.e. 1 capsule of 200 mg or two capsules of 100 mg divided into 2 doses, 1 in the morning and 1 in the evening), which is 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.

Atpartial luteal insufficiency(dysovulation, menstrual disorders): treatment should be carried out for 10 days per cycle, usually from the 17th to the 26th day at the rate of 200 mg of progesterone per day.

Atinfertility with complete luteal phase deficiency (oocyte donation): the progesterone dose is 100 mg progesterone on days 13 and 14 of the transfer cycle, then 100 mg progesterone in the morning and evening from days 15 to 25 of the cycle. In the case of the initial stage of pregnancy, starting from the 26th day, the dose is increased from 100 mg of progesterone per day to a maximum of 600 mg of progesterone per day, divided into three doses. This dosage should be observed until the 60th day.

Supported byluteal phase during in vitro fertilization treatment should be carried out starting from the evening of the transfer day, at the rate of 600 mg of progesterone in three doses - in the morning, afternoon and evening.

With the threat of a miscarriage or with the prevention of a habitual miscarriage due to luteal insufficiency

the average dosage is 200-400 mg of progesterone per day in two doses until the 12th week of pregnancy.

The capsule must be inserted deep into the vagina.

Side effects:

The following adverse events have been reported with oral administration:

Often>l/100;<1/10 :

Menstrual irregularity

Amenorrhea

Intermenstrual bleeding

Headache

Infrequently>l/1000;<1/100:

Mammalgia

Drowsiness

Transient feeling of dizziness

cholestatic jaundice

Rare >l/10000;<1/1000:

Nausea

Very rarely<1/10000:

Depression

Hives

Chloasma

For vaginal use:

Despite the possibility of local irritation (soy lecithin), no local intolerance (burning, itching or greasy discharge) was observed in various clinical studies.

Contraindications

Hypersensitivity to the active or auxiliary components of the drug

Tendency to thrombosis, acute forms of phlebitis or thromboembolic diseases

Bleeding from the genital tract of unknown origin

Abortion incomplete

porfiria

Established or suspected malignant neoplasms of the mammary glands and genital organs

Severe liver dysfunction

WITHcaution

Diseases of the cardiovascular system

Arterial hypertension

Chronic renal failure

Diabetes

Bronchial asthma

Epilepsy

Migraine

Depression

Hyperlipoproteinemia

lactation period

Drug Interactions

With hormonal therapy of menopause with estrogen, it is necessary to prescribe progesterone for at least 12 days per cycle.

Combined use with other drugs may cause an increase in progesterone metabolism and a change in the action of the drug.

This happens in cases where:

Liver enzyme inducers such as barbiturates, antiepileptic drugs (phenytoin), rifampicin, phenylbutazone, spironolactone, and griseofulvin (these drugs cause increased metabolism at the liver level)

Some antibiotics (ampicillins, tetracyclines) cause changes in the intestinal microflora, the consequence of which is a change in the enterohepatic steroid cycle.

Progestogens can cause a decrease in glucose tolerance, therefore it is necessary to increase the need for insulin or other antidiabetic drugs in a diabetic patient.

The bioavailability of progesterone can be reduced in patients who smoke and with excessive alcohol consumption.

special instructions

IS NOT A CONTRACENTIVE.

Treatment should be carried out in accordance with existing recommendations.

If the course of treatment is started too early at the beginning of the monthly cycle, especially before the 15th day of the cycle, a shortening of the cycle or bleeding may occur.

In case of uterine bleeding, the drug should not be prescribed until their cause is clarified (for example, examination of the uterine cavity).

Due to thromboembolic and metabolic risks, which cannot be completely ruled out, it should be discontinued if:

Visual disturbances (such as vision loss, double vision, retinal vascular lesions)

Thromboembolic venous or thrombotic complications (regardless of their location)

Severe headaches.

With a thrombophlebic history, the patient should be closely monitored.

If amenorrhea occurs during treatment, it is necessary to make sure that we are not talking about pregnancy.

More than 50% of early spontaneous abortions are caused by genetic complications. The appointment of progesterone on the recommendation of a doctor is indicated in case of insufficient secretion of the corpus luteum.

Utrozhestan contains soy lecithin and may cause hypersensitivity reactions (urticaria and anaphylactic shock).

Pregnancy and lactation

The use of UTROZHESTAN vaginal route of administration, capsules is not contraindicated during pregnancy, including in the first weeks. (see section: "Indications for use."

The passage of progesterone into breast milk has not been adequately studied. Therefore, its administration should be avoided during breastfeeding.

Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

The attention of drivers of vehicles and persons working with mechanisms should be drawn to the risk of drowsiness and / or dizziness associated with the use of this drug orally. Taking the capsules at bedtime avoids these side effects.

Care should be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Overdose

Symptoms: an increase in side effects indicates an overdose.

They spontaneously disappear with a decrease in the dose of the drug.

In some patients with a history of unstable endogenous secretion, the usual dose of progesterone may be excessive and manifest as special drug sensitivity or too low concomitant estradiolemia.

Treatment: dose reduction or administration of progesterone EVENING BEFORE SLEEP for ten days. In case of drowsiness or transient feeling of dizziness, it is necessary to postpone the start of treatment to a later date in the cycle (for example, the 19th day instead of the 17th). In case of cycle shortening or spotting, it is necessary to check that estradiolemia is sufficient in premenopause and during menopausal hormone replacement therapy.

Release form

14 capsules in a blister pack made of PVC / aluminum foil or PVC / PVDC / aluminum foil.

2 blisters, together with instructions for medical use in the state and Russian languages, are put into a pack of cardboard (for a dosage of 100 mg).

7 capsules in a blister pack made of PVC / aluminum foil or PVC / PVDC / aluminum foil.

2 blisters, together with instructions for medical use in the state and Russian languages, are put into a pack of cardboard (for a dosage of 200 mg).

Storage conditions

Store at a temperature not exceeding 25°C.

Keep out of the reach of children!

Shelf life

Do not use after the expiry date stated on the packaging.

Terms of dispensing from pharmacies

On prescription

Name and country of the marketing authorization holder

Bezen Healthcare SA, Belgium

Name and country of the manufacturing organization

Name and country of the packaging organization

OLIK (Thailand) Limited, Thailand

Name, address of the organization accepting product quality claims on the territory of the Republic of Kazakhstan, responsible for post-registration monitoring of the safety of the medicinal product

Representation of the company "Bezen Healthcare Czech Republic s.r.o" in the Republic of Kazakhstan, Almaty, microdistrict Samal-2, 77A office 3/2

09.05.2017 / Heading: / Mari no comments

With joyful news, a colossal amount of information also falls upon the future mother. And so being under the influence of hormones, moms get nervous and listen to all their feelings, and then there are so many all kinds of horror stories, prejudices and myths.

When doctors prescribe Utrozhestan during pregnancy, many take it with caution: “it’s hormonal!” But after all, some hormones are simply necessary for the baby to be conceived and born. On the other hand, even those hormones that the body itself produces sometimes give a side effect, not to mention special drugs. You should figure out when Utrozhestan is useful and when it is not. And is there always a reason for such an appointment?

What role do hormones play in the development and maturation of the crumbs?

Although the content of hormones in the blood is very small, it is on them that the main responsibility lies in the body of the expectant mother. They are responsible for the coherence of all systems. The totality of these biologically active substances can be compared with a set of computer settings. As soon as one of the settings goes astray, the end result changes. Therefore, balance is so important, especially for an interesting position.

Hormonal imbalance can lead to the following consequences:

1. difficulties in conceiving a child;
2. infertility;
3. premature birth;
4. miscarriages;
5. various diseases of the female genital organs and mammary glands.

Hormones regulate everything from ovulation, fertilization and the attachment of a fertilized egg to the uterine wall, to the onset of childbirth. By suppressing or strengthening the action of certain hormones, the body is rebuilt first for bearing and preserving the child, and then for childbirth.

What is Utrozhestan?

Hormonal drug. Contains synthetic progesterone, the so-called "pregnancy preservation hormone". A distinctive feature of this drug is the maximum proximity to the structure of natural progesterone, which allows you to minimize the side effect. Therefore, in many Internet publications it is often stated that the drug contains a natural substance.

When is Utrozhestan prescribed?

This drug is prescribed to prevent miscarriage, against the background of hormonal disorders in the body of the expectant mother, namely, insufficient production of progesterone.

The peak risk of miscarriage due to pregnancy hormone deficiency occurs in the first trimester. To save the pregnancy and ensure its normal course, a drug is prescribed.

It is also used by gynecologists to treat PMS and menstrual disorders. In scientific terms, this sounds like this: "to achieve an anti-estrogenic effect." And speaking in simple terms, to alleviate the condition with:

• engorgement and pain in the area of ​​the mammary glands;
• pain during menstruation;
• extended cycle;
• profuse menstruation.

Gynecologists often prescribe Ultragestan during pregnancy as part of complex therapy in the treatment of fibrocystic mastopathy.

Pregnancy hormones and how they work

Women often hear such concepts as: “hormonal background”, “hormonal balance”, “estrogen”, “progesterone”. This article is also built around them. Therefore, for a better understanding of the mechanism of action of Utrozhestan, why and how to take it correctly, you need to understand the work of the female body's own hormones. If some “act” in the body constantly, then some are determined in the blood only after conception.

HCG is the first hormone of a long-awaited pregnancy, which is present in the blood only after the embryo has attached to the uterine wall. HCG is the main signal for the body to completely rebuild the hormonal background of the body of the future mother.

It is this unique substance that makes it possible for the expectant mother to learn about the good news in a week using a simple test from a pharmacy. Since it is excreted in the urine, and every two days the concentration doubles. The maximum is reached at 7-10 days. In the future, the proportion of hCG in the blood decreases and remains unchanged in the 2nd half of pregnancy.

Estrogens and progesterone are biologically active substances of the "yellow body", which occurs instead of a burst follicle. In order not to use complex medical terminology, let's put it simply: the follicle is a sac where the egg matures until the day of ovulation. On a certain day of the cycle (14/15th day), it breaks and a female cell ready for fertilization comes out (the day of ovulation).

The corpus luteum is a temporary gland. Up to 12 weeks, she will maintain the required level of these substances. From 12 to 17 weeks, the corpus luteum gradually disappears, transferring its functions to the placenta.

At week 14/16, the placenta is fully ready to perform its functions, and becomes the main source of a whole cocktail of hormones. Which will collect the miracle of nature in the cells - a new life. But more about this in other articles. Let us dwell on the functions of the two hormones mentioned above.

Estrogens - hormones of fetal development

A group of hormones that are responsible for the development of the fetus. After the onset of pregnancy, the mother's body produces increased estrogen, its content in the blood increases 30 times. They are of great importance in the proper formation of the embryo, regulate:

• the rate of cell division of a growing organism at different times;
• enlargement of the uterus;
• development of milk ducts, enlargement of the mammary glands, preparation for lactation, etc.

The level of certain hormones in this group is monitored at 16-18 weeks - "triple test". A decrease in the level of estrogen in the blood may indicate an intrauterine infection, a delay in the development of the fetus or placenta.

Progesterone - a guarantee of maintaining pregnancy

Progesterone is very important for maintaining pregnancy until the day when the baby is ready for independent living. The analyzes may indicate 17-OH-progesterone.

Thanks to him, the uterus prepares for the “meeting” of the fertilized egg: it helps it to be well fixed, it contributes to the proper nutrition of the future crumbs.

This substance literally “guards” pregnancy:

• relaxes the uterus to prevent early labor
• protects a small organism from mother's immunity, preventing the embryo from being perceived as a foreign body;
• forms a mucous plug that blocks the path to various infections;
• prevents the next ovulation;
• reconfigures the nervous system of the future mother for bearing and giving birth to a toddler.

Whims, causeless tears, drowsiness and a hundred shades of mood a day - this is the work of progesterone. And he is not very picky and, along with the muscles of the uterus, relaxes all the smooth muscles that ensure the work of many organs: the esophagus and stomach, intestines, blood vessels. Because of this “side effect”, an interesting situation is associated with a number of ailments: nausea; constipation; swelling of the legs, varicose veins, pressure drops, respectively.

If there is a threat of premature birth, then the woman periodically takes certain tests so that the doctor can prescribe treatment in a timely manner, a decision is made on hospitalization. The use of progesterone preparations is possible both to maintain pregnancy and at the stage of its planning.

Why is the balance between estrogen and progesterone important?

Estrogens are involved not only in the development of the baby, but also assist in childbirth. Under their influence, the cervix opens. Starting from the 36th week, the placenta changes its functions from bearing a child to childbirth, that is, the level of estrogen increases, and progesterone decreases.

The kid is getting ready to meet his parents. An increase in the estrogen component, in turn, provokes the production of substances that trigger the mechanism of childbirth.

Thus, low levels of 17-OH-progesterone in early pregnancy can trigger preterm labor. That is why the issue of maintaining the balance of hormones in the female body is especially relevant when she is waiting for replenishment in the family.

Important! Natural progesterone is not absorbed by the intestines, so all drugs are made on the basis of synthetic. Natural this drug is called conditionally. It is understood that the substance in the composition of the drug is as identical as possible to the natural one, was obtained from natural plant materials and has a positive effect on maintaining pregnancy to the same extent.

How to take medicine?

According to the instructions, it is best to drink Utrozhestan before meals for 15-30 minutes with water. If it is not possible to comply with such a scheme, you can take the medicine regardless of food, observing the interval between doses of 10-12 hours.

It is not recommended to independently make a decision about the use of the drug or changing the dosage. The course of treatment should be under the supervision of a physician. Dosages and regimens can be changed by a specialist in each individual case.

The instructions indicate the doses that are suitable for most women to achieve the maximum positive effect. Usually Utrozhestan is taken 100-150 mg twice a day. Since the drug is available in capsules with a dosage of 100 and 200 mg, one capsule (100 mg) should be taken in the morning, and two 100 ml each in the evening.

When planning pregnancy, the drug is drunk from the 16/17th to the 25/26th day of each female cycle, with constant monitoring of the desired event with a test or ultrasound on the 26th day. If everything went well, then the medicine is used until the end of the 12th week of pregnancy according to the same scheme.

Another medicine is prescribed for the treatment of menstrual disorders according to the following scheme:

• menopause - twice a day, 100 ml for 14 days;
• menopause - in the same dosage continuously.

Doctors also prescribe a drug containing estrogens.

Is the drug necessary in all cases or is it just “insurance”? Alternative opinion

On the Internet and among doctors, there is an opinion that in many cases, taking Utrozhestn and its analogues in an interesting position has rather a psychological effect for the expectant mother as a guarantee of the completion of pregnancy with the birth of a healthy baby at the appointed time.

On the other hand, the doctors themselves prescribe the medicine "just in case" to make sure. If a qualified gynecologist or any other specialist makes appointments with the words “let it be”, then, probably, one should doubt his competence.

European experts are sure that the main prerequisites for a miscarriage (spontaneous) are the defectiveness of the female cell itself (sometimes it happens and is not an anomaly). In this case, it is impossible to maintain the pregnancy or ensure the proper development of the fetus, no matter how many hormonal preparations are prescribed.

With repeated miscarriages, we can already talk about the lack of the second phase of the cycle (luteal phase). There are much fewer women suffering from just such an ailment than domestic doctors diagnose. Since the reason for the termination of pregnancy may also be the lack of the first phase of the cycle - a low level of estrogen.

The reason for prescribing the mentioned drugs is the lack of the luteal phase of the menstrual cycle, that is, the uterus is not ready to accept a fertilized cell due to progesterone deficiency.

What is the reason for the “abuse” of such a diagnosis?

Often the basis for the diagnosis is the analysis of the level of progesterone on the 21st day of the female cycle. It is believed that this day is the peak of its production. For many women, the menstrual cycle consists of 28 or more days, respectively, the maturation of the egg and the normal level of progesterone will be observed later. In this case, the analysis on the 21st day will show a lack of the hormone and appropriate treatment will be prescribed.

To obtain accurate information, it is necessary to carry out such analyzes 3-4 times within 3 cycles at least (that is, 12 or more analyzes). With such an examination, it is necessary to plot a curve for the production of progesterone.

Modern experts do not consider it correct to prescribe hormonal drugs as a prophylaxis in the absence of apparent reasons. Since, if conception has occurred and pregnancy has occurred, then everything is in order with progesterone.

I would like to emphasize that this paragraph does not dispute the effectiveness of progesterone drugs, Utrozhestan in particular, but draws attention to the negative trends in domestic gynecology. When such drugs are prescribed not only when they are necessary and will have a significant therapeutic effect, but also when their use "does not hurt." Agree, not a very scientific approach!

How long can I take progesterone containing medicines?

The duration of the course of treatment is determined by the doctor depending on the reason for such an appointment:

1. pregnancy planning when diagnosing a progesterone deficiency - until a confirmed conception, the medication is maintained throughout the first trimester of bearing a child;
2. with the threat of premature birth - up to 36 weeks;
3. in the treatment of a number of female diseases (menopause, mastopathy) - until the patient's condition improves, with menopause Utrozhestan can be taken for years until the treatment is effective;
4. with the threat of miscarriage - up to 13-20 weeks.

Allocations

Women may experience discharge after Utrozhestan and throughout the course, which do not need any treatment and completely disappear 5-10 days after the end of treatment. They can be brownish, reddish in color, liquid and transparent (like water), flaky in a small (spotting) or moderate volume. If the discharge increases, the attending physician should be informed about this.

When is the drug taken vaginally?

This drug is not available in the form of candles. The capsules can be taken by mouth or inserted into the vagina.

If, after Utrozhestan, adverse effects are observed inside in the form of drowsiness or the patient has chronic kidney or liver disease, as well as during artificial insemination, then gynecologists recommend inserting capsules into the vagina.

As candles Utrozhestan during pregnancy should be used in the 1-2 trimester. After the 20th week, the drug is canceled in order to eliminate a large load on the liver and avoid intoxication of the body.

Also, capsules are used in this way in the prevention of diseases in women caused by excess estrogen:

• uterine fibroids;
• mastopathy;
• endometriosis.

The average dose of the drug is 100 mg twice a day. The dose can be adjusted by the doctor based on the results of monitoring the patient's health. For example, if there is a threat of miscarriage, the dose can be increased to 400 mg per day.

Cancellation of prejudice

There is an opinion that Utrozhestan should not be canceled immediately after the normalization of women's health. And you need to reduce the dose gradually.

We hasten to assure you that the body does not get used to this drug. And the abolition of Utrozhestan cannot provoke a miscarriage, premature birth or a sharp deterioration in women's health (except in cases of self-cessation of the drug). This has been confirmed by numerous studies. Western doctors do not use this technique, and future mothers feel great.

When is it not possible to administer the drug vaginally?

Capsules are not inserted into the vagina for bleeding or spotting (without determining the exact causes), severe forms of metabolic disorders (metabolism), unwanted hormone-dependent neoplasms (various tumors in the female genital organs and breasts).

The drug is absorbed into the walls of the uterus bypassing the liver, so side effects are most often manifested with internal use. But still, Utrozhestan is prescribed with extreme caution and constant monitoring of the patient's condition with:

• severe diseases of the liver and kidneys;
• cardiovascular pathologies;
• diabetes mellitus;
• obesity
• varicose veins;
• severe headaches (migraines);
• epilepsy;
• nervous disorders, depression;
• epilepsy;
• after the 20th week of pregnancy.

There may be individual intolerance. Taking the drug can have negative consequences such as: a decrease in the menstrual cycle; allergies, bleeding. They often occur due to incorrect dosages. And to get rid of them enough to reduce the dose.

Important! This article is for informational purposes to understand the mechanism of action of the drug and its analogues, as well as the reasons for its appointment. Do not take the article as a guide to self-treatment.

Based on the foregoing, we conclude that the biggest threat to the normal bearing of a baby is panic and self-medication. Therefore, dear mothers, carefully select specialists, follow all the recommendations, and even for a moment do not allow the thought that something is wrong with you or your future child.

3 / 5 ( 8 votes)