Instructions for use Utrozhestan capsules 200 mg 14 pcs

Compound

It consists of female sex hormones, and its main active ingredient is progesterone. It also consists of peanut butter, soy lecithin, gelatin, glycerin and titanium dioxide (E171). This is a thyroid hormone that is involved in a woman's ovarian cycle. It also ensures that the uterus is in perfect condition to receive a fertilized egg.

This hormone can also regulate irregular or heavy bleeding cycles.

These drugs come in several forms:

• Pack of 15 capsules of 200 mg active ingredient: Utrozhestan 200 mg
• Pack of 30 capsules progesterone 100 mg: Utrogestan 100 mg

Specialists

Makatsaria Alexander Davidovich

Obstetrician-gynecologist, famous scientist, founder of clinical hemostasiology.
It will help you plan and maintain your pregnancy if you have had cases of fetal loss, thrombosis, obstetric complications or blood coagulation disorders. You can also contact your doctor for a transcript of hemostasis tests.

Akinshina Svetlana Vladimirovna

Obstetrician-gynecologist, hemostasiologist with an academic degree.
Pregnancy management S.V. Akinshina will help avoid severe complications: gestosis, placental insufficiency, fetal loss syndrome.

The doctor's expertise includes hemostasis disorders and immunological infertility.

Margiani Fatima Abdurashidovna

Doctor of Medical Sciences, qualified diagnostician of female infertility factors.
Provides competent support for late, multiple or problematic pregnancies. A consultation and examination with Fatima Abdurashidovna will help determine the cause of failure to conceive a child or recurrent miscarriage.

Petreykov Evgeniy Rafailovich

If you are planning a pregnancy, IVF, or have a history of fetal failure in the first trimester, contact Dr. Petreikov.
A gynecologist of the highest category, Candidate of Sciences, will help determine the risk and cause of obstetric complications, and also prescribe supportive treatment for a genetic predisposition to thrombosis.

Instructions for use

Any treatment with Utrozhestan must be monitored very carefully, trying to individualize the dose and duration of treatment for each patient as much as possible. The recommended dose depends on the level of hormones in the blood. Utrozhestan is usually prescribed for a period of 12 to 14 days.

When porgesterone treatment is started, some bleeding may occur. It is important not to confuse this bleeding with bleeding during your period because it is lighter, shorter and less painful. If Utrogestan is administered orally, the average recommended dose is 200 to 300 milligrams (mg) per day, usually 200 mg at bedtime or 100 mg in the morning and 200 mg at bedtime.

It is recommended to take each day at the same time on an empty stomach, since eating increases the absorption of the drug. For vaginal administration, the average recommended dose is 100 to 600 mg per day. The capsules, also called eggs, must be inserted into the vagina and pushed with your fingers.

If you forget to take Utrozhestan once during treatment, it is important not to take a double dose to make up for the missed dose.

Utrozhestan® (Utrogectan®)

Utrozhestan® should not be used for contraception.

The drug should not be taken with food, since food intake increases the bioavailability of progesterone.

The drug Utrozhestan® should be taken with caution in patients with diseases and conditions that may be aggravated by fluid retention (arterial hypertension, cardiovascular disease, chronic renal failure, epilepsy, migraine, bronchial asthma); in patients with diabetes mellitus; liver dysfunction of mild to moderate severity; photosensitivity.

Patients with a history of depression should be monitored, and if severe depression develops, the drug should be discontinued.

Utrozhestan® contains soy lecithin, which can cause hypersensitivity reactions (urticaria and anaphylactic shock).

Patients with concomitant cardiovascular diseases or a history of them should also be periodically observed by a doctor.

The use of Utrozhestan® after the first trimester of pregnancy may cause the development of cholestasis.

During long-term treatment with progesterone, regular medical examinations (including liver function tests) are necessary; Treatment should be discontinued if abnormal liver function tests or cholestatic jaundice occur.

When using progesterone, it is possible to reduce glucose tolerance and increase the need for insulin and other hypoglycemic drugs in patients with diabetes mellitus.

If amenorrhea occurs during treatment, pregnancy must be excluded.

If the course of treatment begins too early in the menstrual cycle, especially before the 15th day of the cycle, shortening of the cycle and/or acyclic bleeding is possible. In case of acyclic bleeding, the drug should not be used until the cause is determined, including a histological examination of the endometrium.

If there is a history of chloasma or a tendency to develop it, patients are advised to avoid UV irradiation.

More than 50% of spontaneous abortions in early pregnancy are caused by genetic disorders. In addition, the cause of spontaneous abortions in early pregnancy can be infectious processes and mechanical damage. The use of the drug Utrozhestan® in these cases can only lead to a delay in rejection and evacuation of a non-viable fertilized egg. The use of the drug Utrozhestan® to prevent threatened abortion is justified only in cases of progesterone deficiency.

When conducting MHT with estrogens during perimenopause, it is recommended to use the drug Utrozhestan® for at least 12 days of the menstrual cycle.

With a continuous MHT regimen in postmenopause, it is recommended to use the drug from the first day of taking estrogen.

When conducting MHT, the risk of developing venous thromboembolism (deep vein thrombosis or pulmonary embolism), the risk of developing ischemic stroke, and coronary heart disease increases.

Due to the risk of developing thromboembolic complications, the use of the drug should be discontinued if: visual disturbances such as loss of vision, exophthalmos, double vision, vascular lesions of the retina occur; migraine; venous thromboembolism or thrombotic complications, regardless of their location.

If there is a history of thrombophlebitis, the patient should be closely monitored.

When using Utrozhestan® with estrogen-containing drugs, you must refer to the instructions for their use regarding the risks of venous thromboembolism.

The results of the Women Health Initiative Study (WHI) clinical study indicate a slight increase in the risk of breast cancer with long-term, more than 5 years, combined use of estrogen-containing drugs with synthetic gestagens. It is unknown whether there is an increased risk of breast cancer in postmenopausal women when undergoing MHT with estrogen-containing drugs in combination with progesterone.

The WHI study also found an increased risk of dementia when starting MHT after age 65 years.

Before starting MHT and regularly during it, a woman should be examined to identify contraindications to its implementation. If clinically indicated, a breast examination and gynecological examination should be performed.

The use of progesterone may affect the results of some laboratory tests, including liver and thyroid function tests; coagulation parameters; pregnanediol concentration.

Contraindications

Utrozhestan should not be taken in any of the following cases:

• Allergy to progesterone.
• Suffering from thromboembolism.
• Prolonged vaginal bleeding.
• Suffering from liver problems.

Because this drug may cause drowsiness, special attention should be taken when driving or using heavy machinery. For this reason, it is recommended to take the dose at night, that is, before going to bed.

Progesterone passes through breast milk. For this reason, it is not recommended to take during breastfeeding. Regarding pregnancy, since progesterone is a hormone that increases during pregnancy, taking it during pregnancy may not have side effects.

How to take utrozhestan?

A specialist should draw up an exact treatment regimen based on test results, the individual characteristics of the woman’s body and other factors. So, if during pregnancy planning progesterone is not synthesized at all, vaginal use of utrozhestan in the form of suppositories is indicated, according to the following scheme:

• Days 13-14 of the menstrual cycle - 100 mg of the drug per day;
• 15-25 days - 2 times a day, 100 mg.
• from day 26 and if pregnancy occurs, it is necessary to increase the dosage by 100 mg every day, up to 800 mg.

It is very important not to cancel utrozhestan, which was taken when planning pregnancy, when it occurs, since this is fraught with spontaneous miscarriage. During pregnancy, you should continue to take the drug until the second trimester of pregnancy. It is better to use vaginal forms of the medicine, since capsules may not be completely absorbed during toxicosis. If progesterone levels are normal, then the daily dose should be 200-300 mg (divided into 2 doses).

Despite the fact that utrozhestan has a minimum of contraindications, is a fairly gentle drug and is prescribed during pregnancy, you should definitely consult with your doctor before using it.

Prepare for pregnancy with the specialists of our Center: you can take the necessary tests and receive recommendations from leading specialists in the field of obstetrics and gynecology at a time convenient for you.

Indications for use of the drug Utrozhestan

Disorders caused by progesterone deficiency. Oral administration: premenstrual syndrome, menstrual irregularities (disovulation, anovulation), fibrocystic mastopathy, premenopausal period, menopause (in combination with estrogen therapy), infertility with luteal insufficiency, prevention of recurrent miscarriage or threatened miscarriage due to luteal insufficiency, threat of premature childbirth Intravaginal use: Reducing the possibility of fertilization in case of primary or secondary infertility with partial or complete luteal insufficiency (disovulation, support of the luteal phase during preparation for in vitro fertilization, egg donation program); prevention of recurrent miscarriage or threatened miscarriage due to luteal insufficiency.

Interactions of the drug Utrozhestan

When treating the threat of premature birth, Utrozhestan is combined with β-adrenergic agonists, the dosage of the latter can be reduced. When used simultaneously with liver enzyme inducers (barbiturates, phenytoin, rifampicin, phenylbutazone, spironolactone, griseofulvin) or antibiotics (ampicillins, tetracyclines), an increase or decrease in the concentration of progesterone in the blood plasma is possible. Progestins reduce glucose tolerance, and it may be necessary to increase the daily dose of insulin and other antidiabetic agents in patients with diabetes.

Overdose of the drug Utrozhestan, symptoms and treatment

The side effects symptoms described above usually appear as a result of an overdose. They disappear spontaneously when the dose is reduced. In some individuals, the usual dose may be too high due to the existing or secondary appearance of unstable endogenous secretion of progesterone, increased sensitivity to the drug, or a very low concomitant level of estradiol in the blood; in such cases, it is enough to: reduce the dose of progesterone or prescribe progesterone in the evening before bed for 10 days of the cycle in case of drowsiness or dizziness; postpone the start of treatment to a later period of the cycle (for example, the 19th day instead of the 17th) in case of its contraction or bleeding; It is necessary to check whether the level of estradiol is sufficient in a patient who is receiving premenopausal hormone replacement therapy.

Pharmacological properties of the drug Utrozhestan

Pharmacodynamics. The pharmacological properties of the drug are due to progesterone, one of the hormones of the corpus luteum, which promotes the formation of normal secretory endometrium in women. Causes a transition of the uterine mucosa from the proliferation phase to the secretory phase, and after fertilization contributes to its transition to the state necessary for the development of a fertilized egg. Reduces the excitability and contractility of the muscles of the uterus and fallopian tubes. Does not have androgenic activity. It has a blocking effect on the secretion of hypothalamic factors for the release of LH and FSH, inhibits ovulation and the secretion of gonadotropic hormones by the pituitary gland. Pharmacokinetics. Oral administration. An increase in the level of progesterone in the blood plasma is observed from the first hour after oral administration. The maximum concentration of progesterone in the blood plasma is observed 1–3 hours after administration (after 1 hour it averages 4.25 ng/ml, after 2 hours - 11.75 ng/ml, after 4 hours - 8.37 ng/ml , after 6 hours - 2 ng/ml, after 8 hours - 1.64 ng/ml). The main metabolites of progesterone detected in blood plasma are 20α-hydroxy,d4α-pregnanolone and 5α-dihydroprogesterone. The drug is excreted in the urine in the form of glucuronic metabolites, the main of which is 3α,5β-pregnanediol (pregnanediol). These metabolites are identical to the metabolites that are formed during physiological secretion of the corpus luteum. Intravaginally. When administered intravaginally, progesterone is quickly absorbed by the mucous membrane. The maximum concentration in blood plasma is observed 2–6 hours after intravaginal administration and remains for 24 hours at an average level of 9.7 ng/ml after application of 100 mg in the morning and evening. This indicator is identical to the concentration of progesterone, which is noted during the luteal phase. When used in doses above 200 mg/day, the concentration of progesterone is similar to its concentration in the first trimester of pregnancy. The drug is excreted in the urine, mainly in the form of pregnanediol. The metabolites that are detected in urine and blood plasma are similar to the metabolites that appear during the physiological secretion of the corpus luteum.

Side effects of the drug Utrozhestan

When administered orally, the following side effects are observed:

Drowsiness and/or dizziness are observed in case of concomitant hypoestrogenism. Reducing the dose of the drug or increasing the dose of estrogen eliminates these phenomena without reducing the therapeutic effect. If the course of treatment begins at the beginning of the monthly cycle, before the 15th day, a shortening of the cycle or occasional bleeding occurs. In general, changes in menstruation, amenorrhea, or mid-cycle bleeding occur when taking progestins. For intravaginal use: no side effects.