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Utrozhestan 100 and Utrozhestan 200 (capsules, candles) – instructions for use, analogues, reviews

Official instruction approved by the Ministry of Health of the Russian Federation

Composition, description, other information

Registration number: No. JIC-000186

Trade Name: Utrozhestan®

International Nonproprietary Name: progesterone

Dosage Form: capsules

Composition on 1 capsule:

Active substance: micronized progesterone 100 or 200 mg.

Excipients: sunflower oil 149 mg / 298 mg, soy lecithin 1 mg / 2 mg capsule – gelatin 76.88 mg / 153.76 mg, glycerin 31.45 mg / 62.9 mg, titanium dioxide 1.67 mg / 3.34 mg.

Description: 100 mg capsules are round, 200 mg capsules are oval, soft, shiny, yellowish gelatin capsules containing an oil whitish homogeneous suspension (without visible phase separation).

Pharmacotherapeutic group: progestin

ATX Code: G03DA04

Pharmacological properties

The active ingredient of the drug Utrozhestan® is progesterone, identical to the natural hormone of the corpus luteum of the ovary. By binding to receptors on the surface of target organ cells, 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 estradiol, 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. Promotes the formation of normal endometrium. Stimulates the development of the terminal elements of the breast and induces lactation.

Stimulating protein lipase, increases fat stores increases glucose utilization by increasing the concentration of basal and stimulated insulin, contributes to the accumulation of glycogen in the liver increases the production of pituitary gonadotropic hormones, reduces azotemia, increases the excretion of nitrogen by the kidneys.

When taken orally

Micronized progesterone is well absorbed in the gastrointestinal tract (GIT). The concentration of progesterone in the blood plasma gradually increases during the first hour, the maximum concentration in the blood plasma (Сmax) is noted 1-3 h after administration. The concentration of progesterone in the blood plasma increases from 0.13 ng / ml to 4.25 ng / ml after 1 h, to 11.75 ng / ml after 2 h and amounts to 8.37 ng / ml after 3 h, 2 ng / ml 6 h and 1.64 ng / ml 8 h after administration.

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

Excreted by the kidneys as metabolites, 95% of them are glucuron conjugated metabolites, mainly 3-alpha, 5-beta-pregnandiol (pregnandione). These metabolites, which are determined in the blood plasma and urine, are similar to substances formed during the physiological secretion of the corpus luteum.

When administered vaginally

Suction and distribution

Absorption occurs quickly, high concentration of progesterone in the blood plasma is observed 1 hour after administration. Cax progesterone in plasma is reached 2-6 hours after administration. With the introduction of 100 mg 2 times a day, the average plasma concentration remains at 9.7 ng / ml for 24 hours. When given in doses of more than 200 mg / day, the concentration of progesterone corresponds to the first trimester of pregnancy. Communication with plasma proteins – 90%. Progesterone builds up in the uterus.

Metabolized to form predominantly 3-alpha, 5-beta-pregnandiol. The concentration of 5-beta-pregnanolone in the blood plasma does not increase.

Excreted by the kidneys as metabolites, the main part is 3-alpha, 5-beta-pregnandiol (pregnandione). This is confirmed by a constant increase in its concentration (C max 150 ng / ml after 6 h).

Indications for use

Progesterone deficiency in women:

For oral administration:

  • threatened abortion or prevention of habitual abortion due to progesterone deficiency
  • infertility due to luteal insufficiency
  • premenstrual syndrome
  • menstrual disorders due to impaired ovulation or anovulation
  • fibrocystic mastopathy
  • menopausal period
  • menopausal (replacement) hormone therapy (MHT) in peri-and postmenopause (in combination with estrogen-containing drugs).

For intravaginal use:

  • MHT in case of progesterone deficiency with non-functioning (absent) ovaries (egg donation)
  • prevention (prevention) of premature birth in women at risk (with shortening of the cervix and / or availability of anamnestic data of preterm birth and / or premature rupture of the membranes)
  • support of the luteal phase during preparation for in vitro fertilization
  • support of the luteal phase in a spontaneous or induced menstrual cycle
  • premature menopause
  • MHT (in combination with estrogen preparations)
  • infertility due to luteal insufficiency
  • threatened abortion or prevention of habitual abortion due to progesterone deficiency.

Contraindications

Hypersensitivity to progesterone or any of the excipients of the drug deep vein thrombosis, thrombophlebitis, thromboembolic disorders (pulmonary embolism, myocardial infarction, stroke), intracranial hemorrhage or the presence of these conditions / diseases in the history of bleeding from vaginal and obscure patterns and using a clear case letter and a case of an unintelligible hemorrhage. neoplasms of the mammary gland and genitals serious liver disease (including cholestatic jaundice, hepatitis t, Dubin-Johnson, Rotor syndromes, malignant liver tumors) at present or in a history of children up to 18 years of age (efficacy and safety have not been established) the period of breastfeeding.

Cardiovascular diseases, arterial hypertension, chronic renal failure, diabetes mellitus, bronchial asthma, epilepsy, migraine, depression, hyperlipoproteinemia, dysfunctions of the liver of mild and moderate severity photosensitivity.

The drug should be used with caution in the II and III trimesters of pregnancy.

Use during pregnancy and during breastfeeding

The drug should be used with caution in the II and III trimesters of pregnancy due to the risk of cholestasis.

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

Dosage and administration

The drug is taken orally in the evening before bedtime, drinking water.

In most cases, with progesterone deficiency, the daily dose of Utrogestan® is 200-300 mg, divided into 2 doses (200 mg in the evening before bedtime and 100 mg in the morning, if necessary).

  • With threatened abortion or to prevent habitual abortion due to progesterone deficiency: 200-600 mg per day daily in I and II trimesters of pregnancy. Further use of the drug Utrozhestan® may be prescribed by the attending physician on the basis of an assessment of the clinical data of a pregnant woman.
  • In case of insufficiency of the luteal phase (premenstrual syndrome, fibrocystic mastopathy, dysmenorrhea, menopausal transition period) daily dose is 200 or 400 mg taken for 10 days (usually from the 17th to the 26th day of the cycle).
  • With MGT in perimenopause while taking estrogen, the drug Utrozhestan® is used 200 mg per day for 12 days.
  • With MGT in postmenopause in continuous mode, the drug Utrozhestan® is used in a dose of 100-200 mg from the first day of taking estrogen-containing drugs. Selection of the dose is carried out individually.

Intravaginal

Capsules are inserted deep into the vagina.

  • Prevention (prevention) of premature birth in women at risk (with shortening of the cervix and / or availability of anamnestic data of preterm labor and / or premature rupture of the membranes): the usual dose is 200 mg at bedtime, from the 22nd to the 34th week of pregnancy.
  • Complete absence of progesterone in women with non-functioning (missing) ovaries (egg donation): during estrogen therapy, 100 mg per day on the 13th and 14th days of the cycle, then 100 mg twice a day from the 15th to the 25th day of the cycle, from the 26th day, and If pregnancy is determined, the dose is increased by 100 mg per day every week, reaching a maximum of 600 mg per day, divided into 3 doses. This dose may be applied for 60 days.
  • Support for the luteal phase during the in vitro fertilization cycle: It is recommended to use from 200 to 600 mg per day, starting from the day of injection of chorionic gonadotropin during the I and II trimester of pregnancy.
  • Support of the luteal phase in a spontaneous or induced menstrual cycle with infertility associated with dysfunction of the corpus luteum: It is recommended to use 200-300 mg per day, starting from the 17th day of the cycle for 10 days, in the case of delayed menstruation and diagnosis of pregnancy, treatment should be continued.
  • In cases of threatened abortion or to prevent habitual abortion, arising on the background of progesterone deficiency: 200-400 mg per day in 2 divided doses daily in the first and second trimesters of pregnancy.

Side effect

The following adverse events are marked when administered orally drug, distributed according to the frequency of occurrence in accordance with the following gradation: often: > 1/100, 1/1000, 1/10000, o C.

Keep out of the reach of children.

Vacation conditions

Prescription.

Manufacturer

Name and address of the legal entity in whose name the registration certificate is issued:
Bezen Healtha S A
Avenue Louise 287,1050 Brussels, Belgium

Names and addresses of manufacturers (all stages of production):
OLIK (Thailand) Limited
Road 16th Quarter, 166, Bangpain Industrial Area, Bangkrason / Bangpain 13160 Province Ayuthaya Province, Thailand

Sindea Pharma SL
Polygono Industrial Emiliano Revilla Sens. Avenida de Agreda, 31 Olvega, 42110 (Soria) Spain
Produced by order of Bezen Healthcare SA, Belgium

Secondary packaging and release control:
Ltd "Dobrolek", Russia
115446, Russia, Moscow, Kolomenskiy passage, 13A.

Consumer complaints sent to:
Ltd "Bezen Helskea ENG"
123022, Moscow, st. Sergey Makeev, 13
Tel: +7 (495) 980 10 67 Fax: +7 (495) 980 10 68

Description from the author


Table of contents

  1. Forms of release, names and composition
  2. Drug action
  3. Utrozhestan – why take it (indications for use)
  4. Instructions for use
    • Rules for choosing the method of use of the drug (inside or in the vagina)
    • Utrozhestan vaginally (candles) – the instruction
    • Acceptance of Utrozhestan inside
    • How much to use utrozhestan?
    • How many weeks of pregnancy to use?
    • Drug withdrawal
    • special instructions
    • Influence on ability to operate mechanisms
    • Overdose
    • Interaction with other drugs
    • Use during pregnancy
    • . when planning pregnancy
    • After utrozhestan
    • Discharge against the use of the drug
    • Changes in the menstrual cycle under the action of the drug
    • Side effects
    • Contraindications
    • Analogs
    • Reviews
    • Duphaston or Utrozhestan?
    • Drug price

    Utrozhestan is a drug containing natural hormone progesterone. Most often the drug is used during pregnancy for the prevention of preterm labor and miscarriage. In addition, Utrozhestan is used to treat various conditions and diseases in which there is a shortage of progesterone, such as premenstrual syndrome (PMS), fibrocystic mastopathy and menstrual disorders (lengthening the cycle, painful, prolonged and too abundant menstruation, etc. .). Also, the drug is used in women during the period of menopause and menopause in complex hormone replacement therapy in combination with estrogen to eliminate the menopausal syndrome (sweating, hot flashes, mood swings, nervousness, etc.).

    Forms of release, names and composition Utrozhestan

    Utrozhestan is currently available in a single dosage form. capsules. Moreover, the capsules are designed for systemic and local application, that is, they can be taken orally, as tablets, or injected into the vagina, as suppositories.

    Utrogestan capsules are available in two dosages – 100 mg each and 200 mg each of the active substance. The appearance of the capsules of both dosages is exactly the same – they are soft to the touch, oval in shape with a shiny yellowish-colored surface. The outer shell of the capsules consists of gelatin, which makes them soft, shiny and yellowish. Inside the casing, capsules of both dosages contain an oily homogeneous suspension, which is colored white and not phase separated.

    As active substance Utrogestan capsules contain micronized natural progesterone in a dose of, respectively, 100 ml or 200 ml. The active ingredient of the drug is a natural hormone, not a synthetic one. In addition, thanks to a special technology, progesterone is micronized, which ensures its best absorption into the bloodstream.

    As auxiliary components of the capsule utrozhestan both dosages contain the following substances:

    • Peanut butter
    • Glycerol
    • Titanium dioxide
    • Gelatin
    • Soy lecithin.

    Currently capsules Utrozhestan in everyday life is often called pills or candles. And called Candles burned women imply a dosage form that can be inserted into the vagina. Accordingly, the names Urozhestan pills or Urozhestan capsules indicated forms for oral administration. However, such everyday names are wrong, because Utrogestan is available only in the form of capsules, which can be simultaneously taken orally, like tablets, and inserted into the vagina, like candles. But women often do not know that the drug is available in one form, intended both for oral administration and for insertion into the vagina, and therefore, by analogy with other drugs, they are looking for appropriate different dosage forms.

    In addition, for a brief and quick labeling of capsules with different dosages, the names are used. Utrozhestan 100 and Utrozhestan 200, where the number indicates the content of the active substance.

    Drug action

    Action of Utrozhestan is provided with its active component – natural progesterone. Accordingly, Utrogestan has the same effect on a woman’s body as progesterone, produced in the corpus luteum in the ovaries.

    It is now established that Utrozhestan has the following effect:
    one. Promotes the formation of a fairly thick endometrium in the second half of the menstrual cycle.
    2 It provides the transition of the endometrium from the proliferative to the secretory phase, in which the mucous membrane of the uterus secretes biologically active substances that provide optimal conditions for the attachment of the ovum.
    3 When pregnancy occurs, the endometrium is transferred to the state necessary to maintain the development of the ovum until the formation of the placenta (up to 6-8 weeks of gestation).
    four. Reduces the contractility of the muscles of the uterus and fallopian tubes, which is necessary to maintain pregnancy (if the activity of uterine muscle contractions during pregnancy does not decrease under the action of progesterone, for example, when it is deficient, a spontaneous miscarriage occurs).
    five. It causes the development of end elements of the mammary glands necessary for breastfeeding (that is, it induces lactation).
    6 It blocks the production of specific substances in the hypothalamus, which trigger the release of luteinizing and follicle-stimulating hormone (LH and FSH).
    7 Increases the production of LH and FSH in the pituitary gland.
    eight. It inhibits ovulation.
    9. Neutralizes the effects of androgenic hormones.
    ten. Increases urination frequency.
    eleven. Increases the amount of body fat in the body.
    12. Increases the amount of glucose used by cells.
    13. Increases the activity and amount of insulin needed for glucose utilization.
    14. Accelerates the accumulation of glycogen in the liver.

    Utrozhestan – why take it (indications for use)

    The general indication for the use of Utrozhestan is the treatment of any conditions and diseases in which there is a shortage of progesterone, confirmed during laboratory blood tests taken on certain days of the menstrual cycle. However, due to differences in the rate of intake and concentration of progesterone in the target organs (uterus, ovaries and fallopian tubes), the indications for taking the capsules inside and for inserting them into the vagina are different.

    So, utrozhestan capsules are indicated for oral administration. in the following conditions and diseases:

    • Infertility due to insufficiency of the second (luteal) phase of the menstrual cycle
    • The threat of premature birth (starting from the 20th week of pregnancy)
    • Prevention of habitual miscarriage in the early stages of pregnancy arising against the background of the luteal phase insufficiency
    • Preventing miscarriage when luteal insufficiency
    • Premenstrual syndrome
    • Menstrual irregularities associated with lack of ovulation or its irregular course, such as amenorrhea (absence of menstruation), oligomenorrhea (scant menstruation), dysmenorrhea (pain during menstruation), dysfunctional uterine bleeding
    • Fibrocystic breast mastopathy
    • Premenopause, menopause and postmenopause, including premature – as a means of hormone replacement therapy in combination with estrogen.

    Utrogestan capsules are indicated for insertion into the vagina. in the following conditions or diseases:

    • Infertility due to failure of the second phase of the menstrual cycle
    • Prevention of habitual miscarriage against the background of the existing failure of the second phase of the menstrual cycle
    • Prevention of threatened abortion in case of insufficiency of the second phase of the menstrual cycle
    • Climax – as a drug for hormone replacement therapy in combination with estrogen
    • Premature menopause
    • Non-functioning or remote ovaries – as a drug for hormone replacement therapy
    • Support of the second (luteal) phase of the menstrual cycle during preparation for the procedure of in vitro fertilization
    • Support of the second (luteal) phase in a natural or induced menstrual cycle
    • Prevention of uterine fibroids
    • Prevention of endometriosis.

    Utrozhestan – instructions for use

    Rules for choosing the method of use of Utrogestan (inside or in the vagina)

    If Utrozhestan is used to treat the following conditions or diseases, then it can be applied in the way most convenient for a woman:

    • Infertility due to failure of the second phase of the menstrual cycle
    • Prevention of habitual miscarriage against the background of the existing failure of the second phase of the menstrual cycle
    • Prevention of threatened abortion in case of insufficiency of the second phase of the menstrual cycle
    • Climax – as a drug for hormone replacement therapy in combination with estrogen
    • Premature menopause.

    That is, with the conditions listed above, Utrogestan can be used both for oral administration and for vaginal administration. Moreover, the choice of method of use of the drug is fully determined by the preferences and usability for the woman herself. However, doctors usually recommend taking Utrozhestan inside. Vaginal administration of capsules in a situation where they can be taken orally is recommended in the following two cases:
    one. Great drowsiness while taking Utrozhestan inside.
    2 Severe abnormalities of the liver, in the presence of which Utrozhestan is not recommended to be taken orally.

    With the threat of premature birth, premenstrual syndrome, fibrocystic mastopathy, as well as menstrual disorders (scanty menstruation, or their complete absence, pain during menstruation, dysfunctional uterine bleeding), the best way to use Utrogestan is to take the capsules orally, as tablets. However, if a woman is worried about severe drowsiness or has severe liver disease, then utrogestan can be inserted into the vagina, however, we repeat that it is preferable to take the capsules inside. With the threat of premature birth (from the 20th week of pregnancy), you should refrain from vaginal administration of Utrogestan capsules, resorting to this method of using the drug only as a last resort, when for some reason it cannot be taken orally.

    When using Utrozhestan to create an artificial hormonal background with non-functioning or absent ovaries, as well as to support the second phase of the menstrual cycle, it is recommended to insert the vagina into the capsule to maintain and maintain pregnancy in the early stages of the capsule. In these cases, it is optimal to introduce Utrozhestan into the vagina, since progesterone of them very quickly is absorbed through the mucous membranes into the local bloodstream and reaches the target organs (ovaries, uterus and fallopian tubes).

    Also, Utrozhestan capsules are best introduced into the vagina, rather than ingested for the prevention of uterine fibroids and endometriosis.

    Thus, it can be concluded that the intake of Utrozhestan inside is optimal when it is necessary to achieve a systemic effect of the hormone on all organs and systems (pituitary, ovaries, uterus, fallopian tubes, adipose tissue, etc.). And the introduction of capsules into the vagina is optimal only in those cases when a local effect on the ovaries, uterus and fallopian tubes is necessary.

    Utrozhestan vaginally (candles) – instructions for use

    Utrozhestan capsules must be inserted deep into the vagina. To facilitate insertion of the capsule, you can moisten your finger with water or use an applicator.

    It must be remembered that after the introduction of the capsule utrozhestana in the vagina should lie 40 – 60 minutes. Therefore, in the evening it is better to administer the drug at bedtime, already in bed. And in the morning you need to set the alarm one hour before the time when you need to get up to insert the capsule into the vagina and lie down for 40 to 60 minutes.

    Utrozhestan dosages are usually chosen individually by a doctor, but standard recommended doses can also be used. The average daily dosage is 200 mg, divided into 2 doses – in the morning and evening.

    For violations of the menstrual cycle, due to lack of luteal phase (scanty menstruation, or their complete absence, pain during menstruation, dysfunctional uterine bleeding), it is recommended to use Urgentan for 10 days, from 16-17 to 25-26 days of each cycle. However, the day from which it is necessary to apply Utrozhestan can be calculated accurately, and not rely on the average data developed for women with a menstrual cycle length of 28 days. To do this, determine the onset of ovulation with the help of tests or measurement of basal temperature. Starting to enter the capsules of utrozhestan in the vagina should be on day 5 after ovulation, and do so within 10 days. The course of therapy continues for several successive menstrual cycles.

    In the complete absence of progesterone in a woman’s body (with non-functioning or remote ovaries), the utrogestan capsules are administered vaginally according to a certain pattern, which is necessary to sustain a pregnancy obtained during embryo grafting. So, against the background of the continuing use of estrogen on the 13th and 14th days of the cycle, 100 mg of utrogestan should be administered once a day (preferably in the evening). Then from 15 to 25 days of the cycle Utrozhestan is administered 100 mg twice a day – in the morning and in the evening. Next, the pregnancy is diagnosed (ultrasound, hCG), and if it has, then, starting from the 26th day of the cycle, 300 mg of Utrogestan per day should be injected into the vagina (200 mg in the evening and 100 mg in the morning, or vice versa) within a week. Then, the dosage of Utrogestan is increased by 100 mg, injecting 400 mg per day (200 mg in the morning and 200 mg in the evening) for one more week. In the third week, the dose of Utrogestan is adjusted to 500 mg per day, and capsules are administered three times a day at regular intervals of 8 hours. It is optimal to divide the total daily dosage of 500 mg as follows – 200 mg in the morning, 100 mg in the afternoon and 200 mg in the evening. Urozhestan at a dose of 500 mg is also administered during the week. Then, in the fourth week, the dosage of Utrozhestan is adjusted to 600 mg per day, dividing it into three doses with equal intervals between them (approximately 8 hours). That is, capsules are introduced into the vagina in the morning, noon and evening with 200 mg. At a dose of 600 mg, Utrogestan is used for 60 days (two months), that is, until the end of the first trimester of pregnancy.

    To maintain the second phase of the menstrual cycle during IVF, Utrogestan is inserted into the vagina at 400-800 mg per day in two doses (in the morning and in the evening). That is, the daily dosage is divided into two equal (200 – 400 mg), in which capsules are administered in the morning and evening. Begin the use of Utrozhestan from the first day of injection of chorionic gonadotropin and up to 8 – 16 weeks of pregnancy. After reaching 16 weeks, Utrozhestan is used according to the same indications as for women in whom the pregnancy occurred naturally.

    To maintain the second phase in the natural or induced cycle in order to eliminate infertility caused by impaired function of the corpus luteum, Utrogestan needs to begin to enter the vagina 200-300 mg per day (200 mg in the evening and 100 mg in the morning) from 16-17 day of the cycle during 10 days. At the end of 10 days of use of Utrozhestan, pregnancy is detected (ultrasound, hCG), and if it does, continue to use the drug at 200-400 mg 2 times a day.

    When threatened with miscarriage or for the prevention of habitual miscarriage against a background of progesterone deficiency, it is necessary to administer utrozestan 100-200 mg twice a day (every 12 hours) during the first and second trimesters of pregnancy (that is, up to 26 weeks).

    Acceptance of Utrozhestan inside

    Capsules must be taken orally with water. It is best to take Utrozhestan 15 – 30 minutes before a meal, but if this is not possible, then you can drink the capsules at any time, regardless of the meal.

    Dosages and duration of therapy are recommended to be selected individually in each case. However, standard dosages can be applied, developed and adopted as a kind of averaging standard suitable for the vast majority of women. Changing the standard dosage is only necessary if they are not suitable for this particular woman.

    For all diseases caused by insufficiency of the second phase of the menstrual cycle (premenstrual syndrome, fibrocystic breast mastopathy, early menopause, scanty menstruation, or their complete absence, pain during menstruation, dysfunctional uterine bleeding), It is recommended to take utrozhestan 200 to 300 mg day, divided into two doses – in the morning and evening. That is, in the morning it is necessary to take 100 mg of Utrozhestan and in the evening 100 – 200 mg. Moreover, between the two methods of capsules, it is necessary to maintain an interval of 10 to 12 hours. Utrozhestan take from 16 – 17 to 25 – 26 days of each menstrual cycle for several months in a row. At the same time, if a woman tries to get pregnant, then on the 25th-26th day of each cycle it is necessary to make an early pregnancy detection (ultrasound, hCG), and if one has occurred, then utrogestan should continue to be taken in the same dose until the end of the 12th week of gestation.

    To prevent miscarriage and eliminate the threat of termination of pregnancy Utrozhestan should be taken 100 – 200 mg, 2 times a day (morning and evening) during the entire first trimester of pregnancy (up to 12 weeks inclusive). If necessary, taking Utrozhestan can be continued during the second trimester of pregnancy, that is, up to 26 weeks.

    With the threat of preterm labor, Utrozhestan should be taken every 6 to 8 hours, at 400 mg, up to the normalization of the condition and the disappearance of symptoms, indicating a near onset of labor activity. After the disappearance of these symptoms, Utrozhestan is not canceled, but continues to take 200 mg 3 times a day until 36 weeks of gestation.

    Urozhestan with premenopausal (a period when menstruation becomes rare and irregular, but not yet stopped) is used as a means for hormone replacement therapy, along with estrogen. The drug is prescribed 200 mg 1 time per day (preferably in the evening) for 10-14 days. For women who are already in menopause (menstruation is absent for more than a year), Utrozhestan is prescribed 100 mg once a day in a continuous mode for a long time.

    How much to use utrozhestan?

    The duration of Utrozhestan is determined by the purpose of its use. That is, in fact, Utrozhestan should be applied until the goals are achieved. For example, if a woman takes Utrozhestan on the background of insufficiency of the second phase of the menstrual cycle in order to become pregnant, then the drug should be taken until conception occurs. And after conception, it is necessary to continue taking Utrozhestan without interruption until the end of the first trimester of pregnancy.

    If a woman takes Utrozhestan to save pregnancy in the face of the threat of miscarriage, then the capsules should be used until the danger is completely eliminated. As a rule, the risk of miscarriage persists throughout the first trimester of pregnancy, that is, until the 13th week of gestation. This means that you need to take Utrozhestan before the start of 13 weeks or even longer – up to 18 – 20 weeks of pregnancy. If Utrozhestan is used to eliminate the threat of preterm birth, it should be taken before 36 weeks of gestation.

    If therapy is carried out fibrocystic mastopathy or premature menopause, then you should continue to take Utrozhestan until the condition is normalized. In the period of menopause Utrozhestan can be taken for a long time (for years), as long as there is a need and opportunity to maintain hormonal levels in the body at the level of the fertility period.

    How many weeks of pregnancy to use?

    The answer to this question depends on what occasion Utrozhestan is taken on, and what is the course of the pregnancy. So, if a woman took Utrozhestan with the purpose of becoming pregnant, then the capsules should continue to be used until the end of the 12th week of pregnancy in order to prevent a possible miscarriage. Further, at 12–13 weeks, a survey is carried out, and if there is no threat of miscarriage, then Utrozhestan is canceled. If the threat of miscarriage still persists, the drug continues to take up to 16 – 18 weeks.

    If a woman becomes pregnant naturally and takes Utrozhestan to prevent the threat of miscarriage in the early stages, then it should be drunk until 7–8 weeks, since it is during this period that the placenta is formed and the probability of spontaneous abortion is reduced to almost zero. If, later on, during pregnancy, the threat of miscarriage or premature birth recurs, then Utrogestan is taken again, and continues until the state normalizes and the danger is eliminated.

    If a woman takes Utrozhestan for the prevention of preterm labor, the capsules should be drunk before the beginning of the 37th week of pregnancy.

    If Utrozhestan was used as support in the IVF program, then it will continue to be taken until 7–8 or 16–17 weeks of gestation. Foreign experts prescribe Utrozhestan only until the 8th week of pregnancy, because after that the placenta is fully formed and takes on the production of the required amount of progesterone. That is, the retention and development of pregnancy no longer depends on the corpus luteum, and therefore there is no point in continuing hormonal support. Doctors from the countries of the former USSR prescribe Utrozhestan before the 16th week of pregnancy, because traditionally they consider the drug not only hormonal support for pregnancy in early periods, when an inadequate corpus luteum can cause miscarriage, but also to prevent the threat of spontaneous abortion.

    Cancel Utrozhestan

    In Russia and other CIS countries, there is a widespread opinion and the practice of gradual abolition of Utrogestan is widespread, since it is a hormonal drug and the body gets used to it. However, this position is incorrect and is based solely on speculative ideas. In fact, in the course of numerous clinical observations and experiments on animals, it was shown that Utrogestan is not addictive and therefore it can be canceled immediately and completely, without any gradual reduction in dosage. In Western countries, this is exactly what they do, that is, they cancel Utrozhestan immediately and completely. At the same time, it is necessary to be prepared for the fact that after drug withdrawal within 2 to 7 days a spotting may be observed, which is a normal reaction of the body. If the amount of discharge does not increase, then everything is fine, and there is no need to consult a doctor. If the amount of discharge increases over time, then you should consult a doctor.

    However, in the CIS countries, traditionally, it is recommended to cancel Utrozhestan gradually, reducing the dosage by two times every 4 to 5 days. For example, if a woman took Utrozhestan 200 mg per day, then after 5 days it is necessary to reduce the dosage to 100 mg per day. After another 5 days, cancel completely, since less than 100 mg can not reduce the dosage of Utrogestan, since the capsule cannot be cut due to liquid contents.

    special instructions

    Utrozhestan can not be used as a contraceptive. The dosages of the drug, currently used, do not have any contraceptive effect.

    At the beginning of the application of Utrozhestan in the first phase of the menstrual cycle, that is, before ovulation (especially before 15 days), bleeding or shortening of the cycle may occur.

    In the presence of uterine bleeding, it is impossible to use Utrozhestan without examining the state of the endometrium and identifying the cause of this pathology.

    Reception of Utrozhestan should be immediately canceled when the following symptoms appear:

    • Vision loss
    • Double eyes
    • Vascular lesions of the retina
    • Thrombosis or thromboembolism of any arteries and veins
    • Strong headache
    • Migraine.

    If a woman has any of the above symptoms after using Utrozhestan, you should immediately consult a doctor.

    Influence on ability to operate mechanisms

    Overdose

    Interaction with other drugs

    When taking Utrozhestan with inducers of liver enzymes (for example, barbiturates, Phenytoin, Rifampicin, Phenylbutazone, Spironolactone, Griseofulvin) or antibiotics (Ampicillin, Amoxicillin, Amoxiclav, Tetracycline, Doxycycline), the concentration of progesterone in the blood is invented. Therefore, when applying Utrozhestan with these drugs, it is recommended to reduce its dosage.

    Urozhestan increases the effects of diuretic and antihypertensive drugs, as well as immunosuppressants and anticoagulants (warfarin, heparin, Fraxiparin, etc.).

    Utrozhestan reduces glucose tolerance, so in women with diabetes, it is necessary to increase the dosage of insulin or other antidiabetic drugs against the background of its use.

    Urozhestan during pregnancy

    Utrozhestan is allowed for use in the I and II trimesters of pregnancy (until the 27th week). In the third trimester (from the 27th week up to the birth) it should be applied with care and strictly according to indications. When applying Utrozhestan in the gestation period of more than 13 weeks, it is necessary to regularly monitor the condition of the liver by taking a blood test for the activity of AST, ALT and ALP.

    In pregnancy, Utrozhestan is used to prevent miscarriage and premature delivery. Currently, it is shown that the drug actually reduces the likelihood of losing pregnancy if the woman has progesterone deficiency or complete ovarian dysfunction. However, progesterone deficiency and ovarian dysfunction in reality are extremely rare, and Utrozhestan is assigned to almost every pregnant woman in the countries of the former USSR.

    This means that in the overwhelming majority of cases, pregnant women in the post-Soviet countries are prescribed Utrozhestan for "prophylaxis" and for complacency. Under "prevention" implies such a widespread diagnosis as "risk of miscarriage", which put almost all women and, accordingly, appoint Utrozhestan. Naturally, in most cases there is actually no threat of terminating a pregnancy, but women are very much afraid of miscarriage and, accordingly, are nervous about any unfamiliar sensations, looking for "the signs" something bad. As a result, a woman literally exhausts herself by having "risk of miscarriage", "micro-egg of the ovum" and other fantastic states that lead, in her opinion, to the loss of pregnancy, to prevent what she goes to the doctor.

    The psychological state of such women is such that they need help not from a gynecologist, but from a psychologist or psychotherapist. However, doctors prefer not to engage in long conversations with women, but simply go towards patients, helping them not only physically endure the child, but also providing psychological comfort, which is also very important.

    Under "complacency" the desire of the doctor to prescribe is understood, and women to take something to improve pregnancy and reduce the theoretically possible risk of miscarriage. It is intuitively clear that such a position is also not correct, but from the point of view of psychological comfort it seems quite justified.

    Use when planning pregnancy

    When planning a pregnancy, Utrozhestan is prescribed for the purpose of hormonal support for the second phase of the menstrual cycle, if the woman has a deficiency of the corpus luteum. By deficiency of the corpus luteum implies insufficient progesterone production in the ovaries, as a result of which the second phase of the menstrual cycle is extended, the endometrium does not increase to the required level, and pregnancy does not occur or ends in miscarriage in the early stages. In this case, taking Utrozhestan provides a normal level of progesterone in the blood, which is not produced in sufficient quantities by the corpus luteum in the ovaries, and gives the woman the opportunity to become pregnant and bear the child.

    When planning pregnancy, Utrozhestan is usually taken from 16–17 to 25–26 days of each menstrual cycle. Moreover, if the pregnancy results from the test results (ultrasound, hCG), then, as a rule, Utrozhestan is continued until 7–8 or even 12 weeks of gestation, as this allows you to prevent miscarriage due to insufficiency of the corpus luteum.
    Read more about pregnancy planning.

    After utrozhestan

    Discharge against the use of the drug

    Changes in the menstrual cycle under the action of Utrozhestan

    Utrozhestan can change the normal or normal for each woman’s menstrual cycle. Moreover, the cycle can be lengthened and shortened. In most women, the menstrual cycle is extended by 2–14 days, while in the lesser part, on the contrary, it is shortened by 2–10 days or remains unchanged. In some cases, when taking Utrozhestana menstruation becomes more scarce or completely disappear. After discontinuation of the drug, the menstrual cycle, as a rule, is fully restored to the variant that was before the initiation of utrogestan.

    If a woman has shortened the cycle or there were spotting on the background of Utrozhestan’s application, then it is recommended to postpone the beginning of its reception on the 19th day and take up to the 28th day of the menstrual cycle, and not from 16 – 17 to 25 – 26.

    Side effects

    Contraindications

    Utrozhestan is contraindicated for oral and topical use in the following diseases or conditions:

    • Hypersensitivity or allergic reaction to any components of the drug
    • Bleeding from the vagina of unknown origin
    • Incomplete miscarriage
    • Porphyria
    • Suspected or diagnosed malignant neoplasms of the mammary glands and genitals.

    Besides, in addition to the above for the reception of Utrozhestan inside have the following contraindications:

    • Thrombosis propensity
    • Sharp phlebitis
    • Thromboembolism
    • Severe liver disease
    • Liver failure.

    The listed contraindications are absolute, that is, if they exist, take Utrozhestan under no circumstances. In addition to these absolute, there are relative contraindications, in the presence of which utrozhestan can be applied, but with caution and under the supervision of a physician.

    Relative contraindications The application of Utrozhestan include the following:

    • Diseases of the cardiovascular system
    • Hypertonic disease
    • Chronic renal failure
    • Diabetes
    • Bronchial asthma
    • Epilepsy
    • Migraine
    • Depression
    • Hyperlipoproteinemia (elevated levels of various lipid fractions in the blood – triglycerides, HDL, LDL, VLDL)
    • Breastfeeding period.

    Author: Nasedkina A.K. Specialist in conducting research on biomedical problems.

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