Utrozhestan during pregnancy side effects. Vaginally, by inserting the capsules deep into the vagina. Instructions for use and regimen

Registration number No. JIC-000186

TradeName: Utrozhestan ®

International non-proprietary name: progesterone

Dosage form: capsules

Compound for 1 capsule:

Active substance: progesterone micronized 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: capsules 100 mg - round, capsules 200 mg - oval, soft shiny yellowish gelatin capsules containing an oily whitish homogeneous suspension (no visible phase separation).

Pharmacotherapeutic group: gestagen

CodeATX: G03 DA04

PHARMACOLOGICAL PROPERTIES

Pharmacodynamics

The active substance of the drug Utrozhestan ® is progesterone, which is identical to the natural hormone of the corpus luteum of the ovary. 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. 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 mammary gland and induces lactation.

By stimulating protein lipase, it increases fat reserves; increases the utilization of glucose; increasing 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 by the kidneys.

Pharmacokinetics

When taken orally

Suction

Micronized progesterone is well absorbed from 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 (Cmax) is observed 1-3 hours after ingestion. The concentration of progesterone in the blood plasma increases from 0.13 ng / ml to 4.25 ng / ml after 1 hour, to 11.75 ng / ml after 2 hours and is 8.37 ng / ml after 3 hours, 2 ng / ml 6 hours later and 1.64 ng/ml 8 hours after ingestion.

Metabolism

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

breeding

It is excreted by the kidneys in the form of metabolites, 95% of which are glucuronconjugated metabolites, mainly 3-alpha, 5-beta-pregnandiol (pregnandione). These metabolites, which are determined in 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, a high concentration of progesterone in the blood plasma is observed 1 hour after administration. With m ah progesterone in blood plasma is achieved 2-6 hours after administration. With the introduction of 100 mg 2 times a day, the average concentration in blood plasma 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 first trimester of pregnancy. Communication with plasma proteins - 90%. Progesterone accumulates in the uterus.

Metabolism

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

breeding

https://website/autoload/itoc.html

It is excreted by the kidneys in the form of 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).

INDICATIONS FOR USE

Progesterone deficiency in women:

For oral administration:

■ threatened abortion or prevention of habitual abortion due to

insufficiency of progesterone;

■ infertility due to luteal insufficiency;

§ premenstrual syndrome;

§ violations of the menstrual cycle due to violations of ovulation or anovulation;

§ fibrocystic mastopathy;

§ period of menopausal transition;

§ 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 preterm birth in women at risk (with shortening of the cervix and / or the presence 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-containing drugs);

§ infertility due to luteal insufficiency;

§ threatened abortion or prevention of habitual abortion due to lack of progesterone.

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 a history of these conditions / diseases; bleeding from the vagina of unknown origin; incomplete abortion; porphyria; established or suspected malignant neoplasms of the breast and genital organs; severe liver disease (including cholestatic jaundice, hepatitis, Dubin-Johnson syndrome, Rotor syndrome, malignant liver tumors) at present or in history; children under 18 years of age (efficacy and safety have not been established); breastfeeding period.

CAREFULLY

Diseases of the cardiovascular system, arterial hypertension, chronic renal failure, diabetes mellitus, bronchial asthma, epilepsy, migraine, depression, hyperlipoproteinemia, mild to moderate liver dysfunction; photosensitivity.

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

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

METHOD OF APPLICATION AND DOSES

oral

The drug is taken orally in the evening before bedtime, washed down with water.

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

§ In threatened abortion or to prevent recurrent abortion due to progesterone deficiency : 200-600 mg per day daily in the I and II trimesters of pregnancy. Further use of the drug Utrozhestan ® is possible as prescribed by the attending physician, based on an assessment of the clinical data of the pregnant woman.

§ With luteal phase deficiency (premenstrual syndrome,

fibrocystic mastopathy, dysmenorrhea, menopausal transition period) the daily dose is 200 or 400 mg taken for 10 days (usually from the 17th to the 26th day of the cycle).

§ At MHT in perimenopause against the background of taking estrogens, the drug Utrozhestan ®

applied at 200 mg per day for 12 days.

§ At MHT in postmenopausal women in continuous mode, the drug Utrozhestan ®

is used at a dose of 100-200 mg from the first day of taking estrogen-containing drugs. Dose selection is carried out individually.

intravaginally

The capsules are inserted deep into the vagina.

§ Prevention (prevention) of preterm birth in women

from the group risk (with short cervix and/or history of preterm labor and/or preterm rupture of membranes): The usual dose is 200 mg at bedtime, from 22 to 34 weeks of gestation.

§ Complete absence of progesterone in women with non-functioning

(absent ) ovaries (egg donation): against the background of estrogen therapy, 100 mg per day on the 13th and 14th days of the cycle, then 100 mg 2 times a day from the 15th to the 25th day of the cycle, from the 26th day, and on 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. The specified dose can be used for 60 days.

§ Support of the luteal phase during the cycle of extracorporeal

§ Support of the luteal phase in spontaneous or induced menstruation

cycle in 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 case of delayed menstruation and diagnosis of pregnancy, treatment should be continued.

§ In cases of threatened abortion or to prevent habitual abortion ,

arising against the background of progesterone deficiency: 200-400 mg per day in 2 doses daily in the I and II trimesters of pregnancy.

SIDE EFFECT

The following adverse events noted when administered orally drug, distributed by frequency of occurrence in accordance with the following gradation: often: > 1/100,< 1/10; нечасто: > 1/1000, < 1/100; редко: > 1/10000, < 1/1000; очень редко: < 1/10000.

These adverse reactions are usually the first signs of an overdose. Drowsiness, transient dizziness are possible, as a rule, 1-3 hours after oral administration of the drug. These adverse reactions can be reduced by reducing the dose, using the drug at bedtime, or switching to the vaginal route of administration.

Drowsiness and / or transient dizziness are observed, in particular, in the case of concomitant hypoestrogenism. Reducing the dose or restoring higher estrogen levels immediately reverses these effects without reducing the therapeutic effect of progesterone.

If the course of treatment is started too early (in the first half of the menstrual cycle, especially before the 15th day), shortening of the menstrual cycle or acyclic bleeding is possible.

Recorded changes in the menstrual cycle, amenorrhea or acyclic bleeding are characteristic of all gestagens.

Application in clinical practice

When used in clinical practice, the following adverse events were noted when administered orally progesterone: insomnia; premenstrual syndrome; tension in the mammary glands; vaginal discharge; pain in the joints; hyperthermia; increased sweating at night; fluid retention; change in body weight; acute pancreatitis; alopecia, hirsutism; libido changes; thrombosis and thromboembolic complications (during MHT in combination with estrogen-containing drugs); increase in blood pressure.

The composition of the drug includes soy lecithin, which can cause hypersensitivity reactions (urticaria and anaphylactic shock).

When used vaginally

It was reported about individual cases of the development of reactions of local intolerance to the components of the drug (in particular, soy lecithin) in the form of hyperemia of the vaginal mucosa, burning, itching, oily discharge.

Systemic side effects with intravaginal use of the drug at recommended doses, in particular, drowsiness or dizziness (observed with oral administration of the drug), were not observed.

OVERDOSE

Symptoms: drowsiness, transient dizziness, euphoria, shortening of the menstrual cycle, dysmenorrhea.

In some patients, the average therapeutic dose may be excessive due to existing or emerging unstable endogenous secretion of progesterone, special sensitivity to the drug, or too low concentration of estradiol.

Treatment:

In case of drowsiness or dizziness, it is necessary to reduce the daily dose or prescribe the drug at bedtime for 10 days of the menstrual cycle;

In case of shortening of the menstrual cycle or “spotting” spotting, it is recommended to postpone the start of treatment to a later day of the cycle (for example, on the 19th instead of the 17th);

In perimenopause and with MHT in postmenopause, it is necessary to make sure that the concentration of estradiol is optimal.

In case of overdose, if necessary, symptomatic treatment is carried out.

INTERACTION WITH OTHER DRUGS

When administered orally

Progesterone enhances the effect of diuretics, antihypertensive drugs, immunosuppressants, anticoagulants. Reduces the lactogenic effect of oxytocin. Simultaneous use with drugs-inducers of microsomal liver enzymes CYP3A4, such as barbiturates, antiepileptic drugs (phenytoin, carbamazepine), rifampicin, phenylbutazone, spironolactone, griseofulvin, is accompanied by an acceleration of progesterone metabolism in the liver.

Simultaneous administration of progesterone with certain antibiotics (penicillins, tetracyclines) can lead to a decrease in its effectiveness due to a violation of the enterohepatic recirculation of sex hormones due to changes in the intestinal microflora.

The severity of these interactions may vary in different patients, so the prediction of the clinical effects of these interactions is difficult.

Ketoconazole may increase the bioavailability of progesterone.

Progesterone can increase the concentration of ketoconazole and cyclosporine.

Progesterone may reduce the effectiveness of bromocriptine.

Progesterone can cause a decrease in glucose tolerance, resulting in an increase in the need for insulin or other hypoglycemic drugs in patients with diabetes mellitus.

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

For intravaginal use

The interaction of progesterone with other drugs for intravaginal use has not been evaluated. The simultaneous use of other drugs used intravaginally should be avoided in order to avoid impaired release and absorption of progesterone.

SPECIAL INSTRUCTIONS

The drug Utrozhestan ® can not be used for contraception.

The drug should not be taken with food, as 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; impaired liver function of mild and moderate severity; photosensitivity.

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

The composition of the drug Utrozhestan ® includes soy lecithin, which can cause hypersensitivity reactions (urticaria and anaphylactic shock).

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

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

With prolonged treatment with progesterone, regular medical examinations (including a study of liver function) should be carried out; treatment should be discontinued in the event of abnormal liver function tests or cholestatic jaundice.

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.

In the event of amenorrhea during treatment, it is necessary to exclude the presence of pregnancy.

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

Patients with a history of chloasma or a tendency to develop it are advised to avoid UV exposure.

More than 50% of cases of spontaneous abortions in early pregnancy are due to 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 fetal 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 the perimenopausal period, it is recommended to use the drug Utrozhestan ® for at least 12 days of the menstrual cycle.

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

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

Due to the risk of developing thromboembolic complications, the use of the drug should be discontinued in the event of: visual disturbances, such as loss of vision, exophthalmos, double vision, vascular lesions of the retina; 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 the drug Utrozhestan ® with estrogen-containing drugs, it is necessary to 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 prolonged, more than 5 years, the combined use of estrogen-containing drugs with synthetic progestogens. It is not known whether there is an increased risk of breast cancer in postmenopausal women during MHT with estrogen-containing drugs in combination with progesterone.

The results of the WHI study also found an increased risk of dementia when starting MHT at age 65 or older.

Before starting MHT and regularly during it, a woman should be examined to identify contraindications to its implementation. In the presence of clinical indications, a breast examination and gynecological examination should be carried out.

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

Influence on the ability to drive vehicles and mechanisms

When using the drug orally, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

RELEASE FORM

Capsules 100 mg

14 capsules in a PVC / aluminum foil or PVC / PVDC / aluminum foil blister. 2 blisters with instructions for use in a cardboard box (28 capsules in consumer packaging).

Capsules 200 mg

7 capsules in a PVC / aluminum foil or PVC / PVDC / aluminum foil blister. 2 blisters with instructions for use in a cardboard box (14 capsules in consumer packaging).

The synthesis of progesterone in the mid-30s of the last century marked a new era in the treatment of "female" diseases. The use of this hormone in medicine has been limited due to its poor absorption in the gastrointestinal tract, which required the use of high doses. The creation of artificial analogues of progesterone increased its bioavailability, but actualized another problem: an increased risk of unwanted side reactions. The development of the drug Utrozhestan - micronized progesterone from plant components (by the way, the only one of its kind: before, as, in fact, after, progesterone was not synthesized from plant materials) - became a successful solution to the existing problem. Minimization of the particle diameter of the active ingredient (micronization), dressing them in the shell of liposphere carriers increases the rate of absorption of progesterone, its ability to dissolve and enter the blood in an amount sufficient to manifest a pronounced therapeutic effect. The above properties and the possibility of intravaginal and oral administration have made Utrozhestan one of the most popular drugs in obstetrics and gynecology, used in cases of deficiency of one's own progesterone. Conditions such as premenstrual syndrome, infertility, pathological manifestations of menopause are associated with insufficient secretion of this hormone. The optimal way out of this situation is replacement therapy with Utrozhestan, which is fully endowed with all the qualities of natural progesterone. It promotes fertilization, promotes the attachment of a fertilized egg to the endometrium, and exhibits antiestrogenic, antiandrogenic and antialdosterone effects. Like the natural progesterone produced in the female body, Utrozhestan has a hyperthermic and calming effect (especially when taken orally).

One of the characteristic advantages of Utrozhestan is the lack of contraceptive action. The drug does not affect the weight and lipid profile of the patient, does not retain fluid (absence of edema) and does not show a hypertensive effect. The use of Utrozhestan in menopause and in the postmenopausal period reduces the risk of malignant growth of the endometrium, a decrease in bone mineral density and prevents the development of traditional "female" symptoms characteristic of the so-called. "Balzac age". With premenstrual syndrome, in the menopause, with menstrual disorders, oral administration of Utrozhestan is indicated, because. in this case, the antiestrogenic and calming effects will be most pronounced. In turn, the intravaginal use of the drug is indicated as part of replacement therapy in patients with removed or completely lost functionality of the ovaries, to support the corpus luteum phase in the menstrual cycle (including in preparation for IVF), with infertility due to problems with the endocrine system , to prevent or eliminate the threat of miscarriage against the background of a low level of own progesterone. Oral administration of Utrozhestan may be associated with drowsiness, vertigo, shortening of the menstrual cycle, intermenstrual bleeding. Liver dysfunctions are a direct contraindication to oral administration of the drug. Today, the list of countries in which Utrozhestan is sold has crossed the top ten. It is approved for use in the USA by the Food and Drug Administration. The quality and favorable safety profile of Utrozhestan has been confirmed by several large multicenter randomized clinical trials at once.

Pharmacology

progestational drug. Progesterone, the active substance of the drug Utrogestan ® , is a corpus luteum hormone. By binding to receptors on the surface of cells of target organs, it penetrates into the nucleus, where it activates DNA and stimulates RNA synthesis.

It promotes the transition of the uterine mucosa from the proliferation phase caused by the follicular hormone to the secretory phase. After fertilization, it contributes to the 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, stimulates the development of the terminal elements of the mammary gland.

By stimulating protein lipase, it increases fat reserves, increases glucose utilization. By increasing the concentration of basal and stimulated insulin, it contributes to 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, induces lactation.

Promotes the formation of normal endometrium.

Pharmacokinetics

When taken orally

Suction

Micronized progesterone is absorbed from the gastrointestinal tract. The concentration of progesterone in the blood plasma gradually increases during the first hour, C max is observed 1-3 hours after ingestion.

The concentration of progesterone in the 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 - 8 hours after administration.

Metabolism

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

breeding

It is excreted in the urine as metabolites, 95% of which are glucuron-conjugated metabolites, mainly 3-alpha, 5-beta-pregnanediol (pregnandione).

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

When administered intravaginally

Suction

Absorption occurs quickly, progesterone accumulates in the uterus. A high level of progesterone is observed 1 hour after administration. Cmax of progesterone in plasma is reached 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 first trimester of pregnancy.

Metabolism

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

breeding

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

Release form

Capsules are soft gelatinous, oval, shiny, yellowish; the contents of the capsules are an oily whitish homogeneous suspension without visible phase separation.

Excipients: sunflower oil - 298 mg, soy lecithin - 2 mg.

The composition of the capsule shell: gelatin - 153.76 mg, glycerol - 62.9 mg, titanium dioxide - 3.34 mg.

7 pcs. - blisters (2) - packs of cardboard.

Dosage

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

Oral route of administration

The drug should be taken orally with water. In most cases, with progesterone deficiency, the daily dose of Utrozhestan ® is 200-300 mg, divided into 2 doses (morning and evening).

In case of insufficiency of the luteal phase (premenstrual tension syndrome, fibrocystic mastopathy, dysmenorrhea, premenopause), the daily dose of the drug is 200 or 400 mg for 10 days (usually from the 17th to the 26th day of the cycle).

With HRT in perimenopause while taking estrogens, the drug Utrozhestan ® is used at 200 mg / day for 12 days.

With HRT in postmenopausal women in continuous mode, the drug Utrozhestan ® is used at a dose of 100-200 mg from the first day of taking estrogens. Dose selection is carried out individually.

Vaginal route of administration

The capsules are inserted deep into the vagina.

Prevention (prevention) of preterm labor in women at risk (with a short cervix and/or a history of preterm labor and/or preterm rupture of membranes): the usual dose is 200 mg at bedtime, from the 22nd to the 34th week pregnancy.

Complete absence of progesterone in women with non-functioning (absent) ovaries (egg donation): against the background of estrogen therapy, 200 mg / day on the 13th and 14th days of the cycle, then 100 mg 2 times / day from the 15th to 25th day of the cycle, from the 26th day and in case of pregnancy, the dose increases by 100 mg / day every week, reaching a maximum of 600 mg / day, divided into 3 doses. The indicated dose is usually applied for 60 days.

Support of the luteal phase during the in vitro fertilization cycle: it is recommended to use from 200 to 600 mg / day, starting from the day of injection of human chorionic gonadotropin during the first and second trimesters of pregnancy.

Support of the luteal phase in a spontaneous or induced menstrual cycle, with infertility associated with impaired function of the corpus luteum: it is recommended to use 200-300 mg / day, starting from the 17th day of the cycle for 10 days, in case of delayed menstruation and diagnosis of pregnancy, treatment should be be continued.

In cases of threatened abortion or in order to prevent habitual abortion that occurs against the background of progesterone deficiency: 200-400 mg / day in 2 doses daily in the I and II trimesters of pregnancy.

Overdose

Symptoms: drowsiness, transient dizziness, euphoria, shortening of the menstrual cycle, dysmenorrhea.

In case of drowsiness or dizziness, it is necessary to reduce the daily dose or prescribe the drug at bedtime for 10 days of the menstrual cycle;

In case of shortening of the menstrual cycle or "spotting" spotting, it is recommended to postpone the start of treatment to a later day of the cycle (for example, on the 19th instead of the 17th);

In perimenopause and with HRT in postmenopause, it is necessary to make sure that the concentration of estradiol is optimal.

In case of overdose, if necessary, symptomatic treatment is carried out.

Interaction

When administered orally

Progesterone enhances the effect of diuretics, antihypertensive drugs, immunosuppressants, anticoagulants.

Reduces the lactogenic effect of oxytocin.

Simultaneous use with drugs-inducers of microsomal liver enzymes CYP3A4, such as barbiturates, antiepileptic drugs (phenytoin), rifampicin, phenylbutazone, spironolactone, griseofulvin, is accompanied by an acceleration of progesterone metabolism in the liver.

The severity of these interactions may vary in different patients, so the prediction of the clinical effects of these interactions is difficult.

Ketoconazole may increase the bioavailability of progesterone.

Progesterone can increase the concentration of ketoconazole and cyclosporine.

Progesterone may reduce the effectiveness of bromocriptine.

Progesterone can cause a decrease in glucose tolerance, resulting in an increase in the need for insulin or other hypoglycemic drugs in patients with diabetes mellitus.

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

For intravaginal use

Side effects

The adverse events listed below, noted with the oral route of administration of the drug, are distributed according to the frequency of occurrence in accordance with the following gradation: often (> 1/100,< 1/10); нечасто (> 1/1000, < 1/100); редко (> 1/10000, < 1/1000); очень редко (< 1/10000).

Organ system	Adverse events
Organ system	often	infrequently	rarely	very rarely
From the genital organs and mammary gland	Menstrual irregularities Amenorrhea Acyclic bleeding	Mammalgia
From the side of the psyche				Depression
From the side of the nervous system	Headache	Drowsiness transient dizziness
From the gastrointestinal tract	Bloating	Vomit Diarrhea Constipation	Nausea
From the side of the liver and biliary tract		cholestatic jaundice
From the side of the immune system				Hives
From the skin and subcutaneous tissues		Itching acne		Chloasma

Drowsiness, transient dizziness are possible, as a rule, 1-3 hours after taking the drug. These side effects can be reduced by reducing the dose, using the drug at bedtime, or switching to the vaginal route of administration.

These side effects are usually the first signs of an overdose.

Drowsiness and / or transient dizziness are observed, in particular, in the case of concomitant hypoestrogenism.

Reducing the dose or restoring higher estrogen levels immediately reverses these effects without reducing the therapeutic effect of progesterone.

If the course of treatment is started too early (in the first half of the menstrual cycle, especially before the 15th day), shortening of the menstrual cycle or acyclic bleeding is possible.

Recorded changes in the menstrual cycle, amenorrhea or acyclic bleeding are characteristic of all progestogens.

Application in clinical practice

In post-marketing use, the following adverse events have been noted with oral progesterone: insomnia, premenstrual syndrome, tension in the mammary glands, vaginal discharge, joint pain, hyperthermia, increased sweating at night, fluid retention, change in body weight,
acute pancreatitis, alopecia, hirsutism, changes in libido, thrombosis and thromboembolic complications (during HRT in combination with estrogen-containing drugs), increased blood pressure.

The composition of the drug includes soy lecithin, which can cause hypersensitivity reactions (urticaria and anaphylactic shock).

When used vaginally

It was reported about individual cases of the development of reactions of local intolerance to the components of the drug (in particular,
soy lecithin) in the form of hyperemia of the vaginal mucosa, burning, itching, oily discharge.

Systemic side effects with intravaginal use of the drug at recommended doses, in particular,
drowsiness or dizziness (observed with oral administration of the drug) were not observed.

Indications

Progesterone deficiency in women:

oral route of administration:

premenstrual tension syndrome;
menstrual disorders due to ovulation or anovulation disorders;
fibrocystic mastopathy;
premenopause;
hormone replacement therapy (HRT) in peri- and postmenopause (in combination with estrogen-containing drugs).

vaginal route of administration:

threatening abortion or prevention of habitual abortion due to progesterone deficiency;
prevention (prevention) of preterm birth in women at risk (with shortening of the cervix and / or
a history of preterm birth and/or
premature rupture of membranes);
luteal phase support during preparation for in vitro fertilization;
support of the luteal phase in a spontaneous or induced menstrual cycle;
premature menopause;
HRT (in combination with estrogen-containing drugs);
infertility due to luteal insufficiency;
HRT for progesterone deficiency with non-functioning (absent) ovaries (egg donation).

Contraindications

hypersensitivity to the components of the drug;
deep vein thrombosis, thrombophlebitis, thromboembolic disorders (pulmonary embolism, myocardial infarction, stroke), intracranial hemorrhage or a history of these conditions / diseases;
bleeding from the vagina of unknown origin;
incomplete abortion;
porphyria;
established or suspected malignant neoplasms of the mammary glands and genital organs.

When administered orally:

severe liver disease (including cholestatic jaundice, hepatitis, Dubin-Johnson syndrome, Rotor syndrome, malignant liver tumors) at present or in history.

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.

Application features

Use during pregnancy and lactation

During pregnancy, the drug can only be used intravaginally.

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

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

Application for violations of liver function

The use of the drug in porphyria is contraindicated; when administered orally in severe liver diseases (including cholestatic jaundice, hepatitis, Dubin-Johnson syndrome, Rotor, malignant liver tumors) at present or in history.

Application for violations of kidney function

The drug is used with caution in chronic renal failure.

special instructions

The drug Utrozhestan ® can not be used for contraception.

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

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

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

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

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.

In the event of amenorrhea during treatment, it is necessary to exclude the presence of pregnancy.

Patients with a history of chloasma or a tendency to develop it are advised to avoid UV exposure.

The use of the drug Utrozhestan ® to prevent threatened abortion is justified only in cases of progesterone deficiency.

The composition of the drug Utrozhestan ® includes soy lecithin, which can cause hypersensitivity reactions (urticaria and anaphylactic shock).

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

With a continuous regimen of HRT in postmenopausal women, it is recommended to use the drug from the first day of taking estrogens.

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

Due to the risk of developing thromboembolic complications, the use of the drug should be discontinued in the event of:

Visual disturbances such as loss of vision, exophthalmos, double vision, retinal vascular lesions; 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 the drug Utrozhestan ® with estrogen-containing drugs, it is necessary to 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 prolonged, more than 5 years, the combined use of estrogen-containing drugs with synthetic progestogens. It is not known whether there is an increased risk of breast cancer in postmenopausal women during HRT with estrogen-containing drugs in combination with progesterone.

The results of the WHI study also revealed an increased risk of developing dementia when starting HRT at the age of over 65 years.

Before starting HRT and regularly during its implementation, a woman should be examined to identify contraindications to its implementation. In the presence of clinical indications, a breast examination and gynecological examination should be carried out.

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

Influence on the ability to drive vehicles and control mechanisms

When using the drug orally, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

It is prescribed as a replacement therapy when a hormone deficiency leads to miscarriage. Utrozhestan capsules can be taken orally or intravaginally. The drug is not suitable for self-medication, as it affects the entire hormonal background of a woman. The exact dosage and the necessary course of treatment are prescribed only by a doctor.

Dosage form

Capsules for oral administration and introduction into the vagina of 100 and 200 mg.
Description and composition

The capsules are soft, their surface is shiny, yellowish in color. Capsules of 100 mg are round, 200 mg are oval. Inside they contain an oily whitish homogeneous suspension without a visually noticeable phase boundary.

The active substance of the drug is natural micronized. Capsules of 100 mg contain 100 mg of active ingredient, 200 mg - 200 mg.

As additional components, they contain E476 and sunflower oil.

The composition of the capsule shell includes:

gelatin;
titanium white;
glycerol.

Pharmacological group

The active substance of Utrozhestan is the hormone of the corpus luteum. It binds to receptors localized on the surface of target organ cells. It penetrates into their nucleus, activates DNA, stimulates the production of RNA.

Helps to move the endometrium from the proliferation stage, which is caused by follitropin, to the secretory phase. After the connection of the egg with the sperm, it contributes to the transition of the endometrium to a state that allows the development of the embryo. Reduces the excitability and contractility of the myometrium and the muscles of the oviducts, activates the development of the terminal elements of the mammary gland, the growth of the secretory part of its acini, activates lactation.

It affects protein lipase, as a result, lipid reserves increase, glucose uptake increases, glycogen accumulates in the liver. It increases the production of pituitary gonadotropins, reduces the level of nitrogen in the blood and increases its excretion in the urine.

When taken orally, the active substance is absorbed from the gastrointestinal tract. Its content in the blood plasma slowly increases during the first hour and reaches a maximum 1-3 hours after ingestion.

With intravaginal administration, it is rapidly absorbed and deposited in the uterus. A high content of the active substance is observed 1 hour after administration. Its maximum level in blood plasma is observed 2-6 hours after administration.

With the introduction of the drug in a daily dosage of at least 200 mg, the level corresponds to the first trimester of pregnancy.

In the body, the drug is metabolized.

Excreted through the kidneys.

Indications

Utrozhestan is prescribed for deficiency in women.

Inside Utrozhestan is prescribed if diagnosed:

infertility that developed against the background of luteal insufficiency;
menstrual disorders caused by a violation of ovulation or its absence;
fibrocystic disease;
preclimax;
hormone replacement therapy (HRT) in pre- and menopause (in combination with estrogen-containing medications).

It is prescribed intravaginally if there is:

early menopause;
support for the second phase in preparation for IVF, in a spontaneous or induced monthly cycle;
HRT (in combination with estrogen-containing drugs);
infertility caused by deficiency.

Indications for use during pregnancy

Intravaginally during childbearing, the drug is prescribed:

HRT with a deficiency provoked by the absence of ovaries (oocyte donation);
if there is a threat of miscarriage or in order to prevent habitual miscarriage due to deficiency;
to prevent preterm birth in pregnant women at risk (with a shortened cervical canal, a history of miscarriage).

Contraindications

Utrozhestan capsules cannot be prescribed if the patient has:

intolerance to the composition of the drug;
bleeding from the vagina of unknown etiology;
cancer of the breast and reproductive organs or suspicion of it;
hemorrhages in the brain, including a history;
thrombosis and embolism of veins, thrombophlebitis;
porphyria.

The drug should not be administered orally for severe liver pathologies.

Orally, it should be taken with caution if the patient suffers from pathologies such as:

diseases of the cardiovascular system;
high pressure;
chronic renal failure;
bronchial asthma;
epilepsy;
migraine pain;
depressive state;
elevated blood cholesterol levels;
impaired liver function of mild to moderate severity;
photosensitization.

Contraindications during pregnancy

During pregnancy, Utrozhestan is allowed to be used only vaginally. It is forbidden to prescribe when an incomplete abortion is observed.

Dosage and administration

The duration of therapy depends on the clinical picture of the pathology.

When taken orally, the capsules should be taken with water.

As a rule, in case of insufficiency, the daily dosage of the drug varies from 200 to 300 mg, which must be taken 2 times (morning and evening).

In case of insufficiency of the luteal phase (PMS, painful periods, premenopause), the daily dose of the drug is 200 or 400 mg for 10 days (usually from the 17th to the 26th day of the cycle).

With HRT in the premenopausal period, along with estrogens, Utrozhestan should be used at a daily dosage of 200 mg for 12 days.

With HRT during postmenopause in a continuous mode, it should be used at a dosage of 100-200 mg from the 1st day of estrogen intake. The dosage is selected individually.

Treatment regimens during pregnancy

The drug is administered intravaginally.

In this case, the capsules are injected deep into the vagina.

For the prevention of preterm birth in pregnant women at risk (with a shortened cervix, previous pregnancies that ended in miscarriage), the drug is usually prescribed at a dosage of 200 mg at night, from the 22nd to the 34th week of pregnancy.

Utrozhestan can provoke a decrease in glucose tolerance, resulting in an increase in the need for insulin or other sugar-lowering drugs in patients suffering.

With intravaginal use, the interaction of Utrozhestan with other medicines has not been evaluated. Do not simultaneously insert other drugs into the vagina, in order to avoid disruption of release and absorption.

special instructions

Utrozhestan should not be taken simultaneously with food, as in this case it increases bioavailability.

It is necessary to monitor patients with a history of depression, and with the development of its severe form during treatment, it is necessary to cancel therapy.

Patients suffering from cardiovascular pathologies should be regularly observed by a doctor.

With prolonged therapy, it is necessary to undergo medical examinations and, if abnormalities or cholestatic jaundice are detected, treatment should be interrupted.

According to statistics, more than 50% of miscarriages in the early stages are associated with genetic disorders, infections and mechanical damage. Application in these cases can only delay the rejection and evacuation of a non-viable fetus.

When prescribing HRT with estrogens during perimenopause, you need to take Utrozhestan for at least 12 days of the menstrual cycle.

With continuous HRT in postmenopause, Utrozhestan should be taken from the 1st day of taking estrogens.

Against the background of HRT, the likelihood of developing venous thromboembolism, ischemic stroke and coronary artery disease increases.

Due to the risk of thromboembolic complications, it is worth interrupting therapy if:

visual disturbances (impaired vision, bulging eyes, double vision), vascular lesions of the retina;
migraine pain;
thrombosis and venous embolism.

Patients with a history of thrombophlebitis should be under constant supervision.

With HRT in patients over 65 years of age, the risk of developing dementia increases.

Before the start of HRT and during its implementation, the patient should regularly undergo an examination in order to detect contraindications to its implementation.

Treatment with Utrozhestan may change the results of some laboratory tests:

indicators of liver function, thyroid gland;
blood clotting;
concentration of pregnandiol.

When taking the drug inside, you need to be careful when driving.

Overdose

drowsiness;
disorder of the menstrual cycle (its shortening, pain during menstruation);
dizziness;
euphoria.

In some women, even the average therapeutic dosage may be excessive due to intermittent production in the body, hypersensitivity to the drug, or very low levels of estradiol.

if drowsiness or dizziness occurs, you need to reduce the daily dosage or prescribe the medication at night for 10 days of the menstrual cycle;
if the monthly cycle is shortened or “spotting” spotting appears, it is worth postponing the start of therapy to a later day of the cycle (for example, on the 19th day instead of the 17th);
during perimenopause and with hormone replacement therapy in postmenopause, you should make sure that the level of estradiol is optimal.

If necessary, in case of overdose, symptomatic therapy is prescribed.

Storage conditions

Utrozhestan capsules should be stored out of the reach of children at t not higher than 25 degrees. The shelf life of the drug is 3 years.

Analogues

Instead of Utrozhestan, you can take the following medications:

Vanel is a Spanish drug that is a complete analogue of Utrozhestan. It is available in capsules for oral and vaginal administration. The drug can be used during pregnancy. Vanel is not suitable for persons under 18 years of age and breastfeeding.
Iprozhin is an Italian medicine that contains as an active substance. It is produced in capsules taken orally and inserted into the vagina. They are allowed to be used during gestation. The drug is not suitable for children and breastfeeding mothers.
- a domestic medicine, which is produced in the form of an oily injection solution. Injections of the drug must be done into the muscle. They are contraindicated in children, in the II and III trimester, during breastfeeding.
- Indian medicine, which is a complete analogue of the drug Utrozhestan. It is sold in the form of a gel and capsules, which can be used with caution by pregnant and lactating women.

The price of the drug

The cost of Utrozhestan is an average of 412 rubles. Prices range from 356 to 489 rubles.

Unfortunately, the threat of early miscarriage has become a major concern for many couples. One of the main causes of spontaneous abortion is not only the frantic pace of life, stress or other external factors, but the lack of the hormone progesterone. In order to save the child, doctors prescribe utrozhestan during early pregnancy. How does it work?

Read in this article

A little about progesterone

Observations have shown that in most pregnant women, hormone production occurs in insufficient quantities. After conception, he is responsible for giving the woman an egg. Later, the placenta takes over the function. For a normal state, some stable dose of progesterone should be produced, but in no case less. The inability to supply the body with the necessary substances is the number one problem in the modern world. This factor is a threat to the normal course of pregnancy.

Progesterone allows you to create ideal conditions for the fetus in the body of a woman. It is this hormone that is responsible for the condition of the uterus. It controls, calms the nerves and muscles (fallopian tubes, uterus, stomach). Allows you to create a healthy mucosa, participates in tissue growth, which is extremely important during pregnancy. Lack of progesterone leads to a delay in the growth and development of the fetus. This is why progesterone, or the pregnancy hormone, is so important.

Utrozhestan during pregnancy in the early stages is prescribed to save the child, because it contains natural progesterone. It proved to be quite effective in cases of threatened abortion. It is mainly prescribed in the first two trimesters of pregnancy.

It is absolutely impossible to take any medication without a doctor's prescription, especially when planning or in the early stages of pregnancy. Only a doctor can assess your condition and prescribe the use of the drug. Such funds can be attributed in combination with diet, vitamins, fitness, taking into account living conditions. Only in the aggregate will the result be obtained. In no case do not self-medicate! Don't risk your baby's health. Always consult your doctor.

Under what symptoms the doctor will prescribe the drug "Utrozhestan"

Form of release of the drug and dosage in the early stages

The drug "Utrozhestan" is produced in the form of capsules of 100-200 mg of white color, which can be used both as tablets and as candles. During pregnancy and planning, the dose is selected purely individually. Two suppositories of 100 mg twice a day or one of 200 mg are considered optimal for maintaining pregnancy. After the IVF procedure, an increased dose of 300 mg to 600 mg may be prescribed. Doctors will choose a similar scheme at the beginning of a spontaneous abortion.

Cancel utrozhestan during pregnancy is often started from 12 weeks and do it gradually. A sharp decrease in the intake of progesterone produces contractions, as a result, a miscarriage may occur, so the dosage is reduced according to an individually selected scheme. Often, withdrawal is done either at 100 mg per week or at 50 mg daily.

With the appearance of brown discharge, the drug is continued to be taken. In the third trimester, it is prescribed quite rarely, since it can have a negative effect on the liver.

Pros and cons of using the drug "Utrozhestan"

Although hormones are natural substances that are produced by our body, uncontrolled intake is not at all safe and leads to different consequences. In rare cases, the expectant mother may experience a burning sensation, so taking utrogestan is limited to a maximum dose of 600 mg for 24 hours. Among the unpleasant sensations, the drug can provoke dizziness, forgetfulness, drowsiness, lethargy. Possible, heaviness in the abdomen, jaundice, changes in body temperature.

The drug has a number of contraindications, including:

thrombophlebitis;
diabetes;
asthma;
diseased liver;
varicose veins;
problems with the cardiovascular system;
CNS diseases.

Like the studied medicines, utrogestan has adverse reactions. However, they do not appear so often, and the drug is well tolerated. It is necessary only at the beginning of the reception to take into account possible adverse reactions and limit driving a car, work that requires an increased level of attention.

As for the fear of many mothers before weight gain, it is worth reassuring them: utrozhestan is made on a plant basis, therefore it does not affect appetite, does not participate in carbohydrate and lipid metabolism. Adverse reactions are just minor ailments that are simply lost in comparison with the significance of the result!

Candles or pills?

It is more efficient to use candles, since the result of their action is achieved faster. They relieve many side symptoms, especially those associated with the stomach, and even during the period of toxicosis they are a reliable salvation, they protect the baby. In addition, suppositories can be taken even by women with liver problems. Tablets are prescribed when you need to take a small dose.

Women, of course, do not really like the rectal administration of the drug. However, doctors still insist on this particular form of utrogestan as the most effective in the early stages of pregnancy.

Watch the video about the use of Utrozhestan:

Utrozhestan is a unique plant-based drug that has no analogues. His reception allowed many children from all over the world to be born. In the struggle for your child, all means are good, and utrozhestan is one of them! Of course, the price of the drug is quite high, but it is not comparable with the price of the result. And let the heavens, together with doctors and modern science, help all expectant mothers give birth to a healthy, strong baby to the delight of relatives and others!

With insufficient production of progesterone by the female body, it will not be possible to conceive a child for a long time. Having applied for medical help, the specialist will draw up a therapy regimen, which will definitely include gestagens. These are artificial substitutes for progesterone. One of these drugs remains Utrozhestan. Thanks to him, the shortage is replenished and the long-awaited pregnancy occurs. How to take Utrozhestan correctly when planning a pregnancy for maximum effectiveness.

When planning pregnancy, the use of Utrozhestan gives only positive results. But only on condition that the cause of infertility is a lack of progesterone. The active ingredient of the drug is progesterone. It is a corpus luteum hormone. It has the following features:

It leads to the active formation of the secretory endometrium in the body of a woman.
During conception, it leads to a quick and high-quality transition of the uterine mucosa from the cell division phase to the secretory one.
After conception, the uterine mucosa passes into a state that is required for the full development of the egg, being fertilized.
Reduces the contractility and excitability of the muscles of the uterus and tubes.
Stimulates the development of the mammary glands necessary for lactation.
Does not have androgenic activity.

Given such a huge benefit of Utrozhestan for the female body, it is prescribed in specific cases when a long-awaited pregnancy does not occur. But before taking the drug, a woman must undergo an examination. According to its results, it will become clear whether the lack of progesterone is the cause of infertility.

Indications

Utrozhestan when planning pregnancy can be prescribed according to the following indications.

For internal reception:

premenstrual tension syndrome;
fibrocystic mastopathy;
lack of progesterone;
hormone therapy for menopause.

For intravaginal use:

hormone therapy with absent ovaries due to the complete absence of progesterone;
prevention of miscarriage due to a lack of progesterone;
endocrine infertility;
the threat of termination of pregnancy;
Premature menopause;
prevention of uterine fibroids;
menopause and postmenopause;
endometriosis.

All of these pathologies are serious causes of infertility. Only after their elimination, using Utrozhestan, it will be possible to conceive a long-awaited child.

How to take utrogestan when planning a pregnancy

Only a doctor can prescribe a regimen for taking the drug. Here he is guided exclusively by the clinical picture. The use of the drug has its own characteristics:

With the syndrome of premenstrual tension, insufficient luteal phase, fibrocystic mastopathy, dysmenorrhea, premenopause, the drug is taken orally. The daily dose will be 200-300 ml, pour in 2 doses. Reception lead to the 2nd phase of the menstrual cycle. The duration of therapy will be 10 days.
During hormone replacement therapy, Utrozhestan is taken 2 capsules per day. The duration of therapy will be 10-12 days. If menopause occurs, then 1 capsule per day for 25 days. It is advisable to take it before going to bed, drink plenty of water. It is forbidden to drink capsules immediately after a meal or immediately before a meal.
With a lack of progesterone, suppositories are used, 1 suppository once a day. Carry out treatment on the 13-14th day of the menstrual cycle. After removal, it changes - 1 candle 2 times a day (15-25 days of the cycle). Starting from day 26, the dosage is increased by 1 suppository per day. And so every week, until the maximum result is obtained. The limit threshold is 6 suppositories per day, divided into 3 doses. The duration of therapy can be 2 months.
In order to maintain the luteal phase during IVF, the drug is used in the form of suppositories. Introduce them intravaginally, 4-6 pieces per day. Start treatment from the day of gonadotropin injection. The end of therapy at the 20th week of pregnancy.
To support the luteal phase during a spontaneous menstrual cycle, infertility Utrozhestan is administered intravaginally, 2-3 suppositories per day. Carry out therapeutic measures in the 2nd phase of the menstrual cycle. The duration of therapy will be 10 days. If menstruation is delayed or pregnancy is diagnosed, then the prescribed therapy regimen will be extended for a period determined by a specialist.
If there is a threat of abortion, then to prevent miscarriage due to a lack of progesterone, use Utrozhestan intravaginally 2-3 suppositories 2-3 times a day. The duration of therapy lasts until the 20th week of pregnancy.

When planning a pregnancy, the Utrozhestan regimen is prescribed exclusively by a doctor. If you use it on your own, then this is fraught with serious consequences for a woman and for the successful conception of a child. Before taking Utrozhestan, it is important to have a simple examination to determine the existing contraindications.

Side effect

There are situations when you should not take Utrozhestan when planning a pregnancy. This decision is made only by the doctor if the side symptoms are pronounced. This may include:

Regarding the CNS. There is drowsiness, dizziness. Similar symptoms make themselves felt approximately 1-3 hours after taking the capsules.
Concerning the reproductive system. There is a reduction in the menstrual cycle, and the most dangerous side effect is intermenstrual bleeding.

Similar side effects occur only when using Utrozhestan in the form of capsules. If suppositories are used for treatment, they have a milder effect on the body and are actively absorbed into the blood without disturbing the functioning of internal organs. But there are more categorical contraindications for the use of the drug in any form.

Contraindications

Utrozhestan is not prescribed in the following cases:

violations and pathologies in the liver, which are pronounced (this applies to taking capsules inside);
hypersensitivity and individual intolerance to the composition;
third trimester of pregnancy;
breastfeeding period.

In the first and second trimester of pregnancy, Utrozhestan is indicated for use. Pathologically dangerous interaction with other drugs has not been observed. There are certain recommendations, thanks to which it is possible to increase the benefit of the drug during the planning of conceiving a child.

special instructions

To get the maximum benefit from the use of Utrozhestan when planning a pregnancy, you should use the following recommendations:

The action of the drug is aimed at reducing concentration. It should not be taken before driving a car or performing responsible work.
Capsules for internal use are also suppositories for intravaginal use.
It is not recommended to choose a dosage regimen without the knowledge of a doctor.

Utrozhestan or Duphaston?

Today, the question remains very relevant as to which is more effective - Utrozhestan or Dufaston? It is impossible to answer this question unambiguously. The presented medicines belong to progesterone preparations and have the same effect. Each of them has its own advantages and disadvantages, but their effectiveness is fundamentally the same.

The main advantages of Duphaston include the absence of such side symptoms as drowsiness and lethargy. But Utrozhestan has a more obvious advantage - it is the possibility of using not only capsules, but also candles.

Utrozhestan, prescribed by a doctor in the required dosage according to the indications and condition of the patient, gives a quick positive effect without side effects.

Price

You can buy the drug by prescription. The cost in the pharmacy is 450 rubles.

Analogues

Analogues are drugs that have a similar active ingredient - progesterone.

Progestogel

- Belgian drug, which is produced in the form of a vaginal gel. You can buy it at a price of 700-800 rubles. The main component is progesterone. In mammary gland tissues, this hormone reduces the permeability of the capillary walls and the proliferation of the epithelium of the ducts, and also reduces the intensity of the periodic swelling of the connective tissue stroma.

After applying the gel to the skin, the alcohol contained in the composition begins to evaporate instantly, and 10% of the dose of progesterone used is absorbed into the skin. Metabolism of the female hormone is carried out in the mammary glands and skin. Systemic influence is insignificant or completely absent.

To determine the daily dosage of the drug, it is worth using a plastic spatula dispenser. It comes with gel. It is necessary to press on the tube over the ruler of the spatula. One dose should be equal to a column of gel. And its length coincides with the recess, which is present on the ruler.

Progesterone

This is a Russian drug that is produced in the form of a cream and an injection solution. The cost of the medicine is 70-2500 rubles. It all depends on the manufacturer. The main component is progesterone. Its action is aimed at blocking estrogen receptors, which improves the absorption of fluid from the tissues and reduces the compression of the milk ducts.

With the local application of the drug and the creation of a high concentration of progesterone in the area of application, there is no systemic effect, which makes it possible to avoid the development of negative unwanted side symptoms.

Apply 1 application of the gel on the skin of the mammary glands with a dispenser applicator until completely absorbed. Such actions should be carried out 1-2 times a day. It is best to do this in the 2nd phase of the menstrual cycle, the duration of treatment is up to 3 cycles.

It is not recommended to use the medicine during gestation and lactation, since studies on this subject have not been conducted. So only a doctor can determine the possible risks of using the drug. If the use is unavoidable, then the patient should be under the supervision of a physician at all times in order to prevent a detrimental effect on the fetus. If a woman feels the slightest change in her condition, then this is a reason to see a doctor. He will cancel the drug and prescribe a similar one.

Crinon

Swiss drug, which is produced in the form of a gel. You can buy it at a price of 2600-3200 rubles. Due to the main component, progesterone, there is a transition of the uterine mucosa from the phases of proliferation to the secretory. Reduces the excitability and contractility of the muscle tissue of the fallopian tubes and uterus.

As part of the vaginal gel, the female hormone is included in a polymeric delivery system. It binds to the vaginal mucosa and promotes the continuous release of progesterone.

Apply the gel on the first day of embryo transfer. The dosage will be 1.125 g. Enter intravaginally every day. If pregnancy occurs, then continue treatment for up to 12 weeks.

Duphaston

This drug has a similar therapeutic effect. The dosage regimen is determined individually. To get the maximum therapeutic effect, it is worth taking into account the clinical signs of the disease and the phases of the natural menstrual cycle. The waste rate is divided into several methods. It is best to use the drug at regular intervals.

If endometriosis has been diagnosed, then take 10 mg 2-3 times a day. The course of therapy lasts from the 5th to the 25th day of menstruation.

With infertility that has arisen against the background of a lack of progesterone, a medicine is prescribed at 20 mg per day. The duration of therapy will be 3-6 months. When pregnancy occurs, continue therapy at the dosage prescribed by the doctor. With habitual loss of pregnancy and threatened miscarriage, use the drug with a lack of endogenous progesterone.

With a threatened abortion, use the drug at 40 mg. this is the starting dose, then increase it to 10 ml with a break of 8 hours. The duration of therapy is 7 days. After dosage may be reduced. If there are signs of a threatened abortion again, the doctor may again increase the dosage. Reception to lead up to 12-20 weeks of pregnancy.

Prajisan

This is another effective drug that can compete with Utrazhestan. When using it, the following effect is achieved:

the excitability and contractility of the muscle tissue of the fallopian tubes and uterus decreases;
glucose processing is activated;
the mucosal layer develops normally;
increased production of aldosterone;
glycogen is concentrated in the liver.

If the doctor prescribes vaginal capsules, then the dosage is determined taking into account the problem:

If there is an absolute deficiency of progesterone in women with absent ovaries, then the drug is taken for 2 months. The dosage regimen is determined on an individual basis.
In preparation for IVF to support the luteal phase, 200-600 mg per day is taken. The duration of treatment is up to 1-2 trimesters of pregnancy. If there is a threat of termination of pregnancy associated with a lack of progesterone, then the dosage is 200-400 mg.
To support the menstrual cycle as a result of a spontaneous or induced menstrual cycle, as well as infertility that arose against the background of a lack of progesterone, 200-300 mg per day are prescribed, the duration of treatment is 10 days.

If Prajistan is used in the form of a gel, then it is prescribed 1 applicator per day. The dosage is 90 mg of progesterone. The therapeutic course is determined by the following indications:

With luteal insufficiency, which led to infertility, the duration of therapy is 10 days.
When using assisted reproductive techniques to maintain the corpus luteum phase - within 12 weeks after the pregnancy was detected.

Iprozhin

This drug is prescribed instead of Utrozhestan, when a woman has certain contraindications. The doctor develops a certain dosage, taking into account clinical features. Inside is taken at bedtime. Do not do this immediately after a meal or before.

If there is premenstrual syndrome, fibrocystic mastopathy, premenopause, then the drug is prescribed at 200-300 mg per day. The duration of therapy is 10 days. Apply from the 17th to the 26th day of the cycle.

Release the drug in the form of candles. The dosage is prescribed taking into account the following features:

When donating eggs, 100 mg per day. Apply on the 13th and 14th day of the cycle, and then the dosage will be 100 ml 2 times a day. Starting from the 26th day of the cycle or in the case of diagnosing pregnancy, the dosage increases by 100 mg per day. The maximum dose will be 600 mg divided into 3 doses. The duration of therapy is 2 months.
To maintain the luteal phase during IVF, 400-600 mg per day is prescribed. You need to start from the first day of hCG injection and extend up to 12 weeks of pregnancy.
To support the menstrual cycle in the induced and spontaneous menstrual cycle, with infertility that has arisen against the background of dysfunction of the corpus luteum. The dosage will be 200-300 mg per day. Start from the 17th day of the cycle. The duration of therapy is 10 days. If there is a delay in menstruation or pregnancy occurs, then the treatment must be extended. With the threat of a miscarriage or the prevention of abortion, take 100-200 mg 2 times a day. Treatment lasts up to 12 weeks of pregnancy.