Divigel when planning pregnancy: how to take? Estrogen drug Divigel

IN last years The list of drugs used in gynecology has expanded significantly. Doctors especially often prescribe hormonal drugs. One of these is Divigel. For what pathologies is it indicated?

Divigel

The active ingredient of Divigel is synthetic 17β-estradiol. In its structure and action it is complete analogue female sex hormone - estradiol. Estradiol, estrone and estriol are grouped together under the name “estrogens”. Without these substances, the functioning of the female reproductive system becomes impossible. This is especially noticeable after the onset of menopause, when symptoms of estrogen deficiency may develop:

• Oppression reproductive function.
• Change lipid spectrum blood and cholesterol levels.
• Osteoporosis.

Divigel is available in the form of a gel in bags of 0.5 and 1.0 g. It is used transdermally, that is, the drug penetrates into the blood vessels through the skin after it is applied to certain areas of the body.

There are strict indications for using Divigel.

Indications

Since Divigel is a synthetic estradiol, the indications for its use will be the same as those natural hormone. These include:

1. Symptoms of estrogen deficiency.
2. Menopause - natural or artificial.
3. Osteoporosis that develops after menopause, when it is impossible to treat with other drugs.

Indications for treatment are determined only by a gynecologist. Since this medicine is a hormonal drug, the consequences of self-prescription and uncontrolled use can be disastrous. You cannot use Divigel on the advice of friends or articles from the Internet.

Estrogen deficiency

Estrogen deficiency can develop due to various reasons. Most often, modern gynecologists encounter this when conducting in vitro fertilization, or IVF.

Why does a woman planning a pregnancy need Divigel?

During normal conception, from the first day of fertilization, the hormonal background in the body changes, this is especially true for the ratio of female sex hormones - estrogen and progesterone. Their balance is controlled by processes occurring in the body from the moment of conception.

However, with IVF the situation is different. Conception is carried out in a test tube, and the woman’s body does not receive the signal under the influence of which production will start necessary hormones. Therefore, estrogen levels are often too low for pregnancy to progress. This is determined by the thickness of the endometrium.

The effect of estradiol on the endometrium

The endometrium is the inner layer of the uterus, rich in blood vessels. This is where implantation of the fertilized egg occurs. If the thickness of the endometrium is small, then attachment will most likely not occur. And, therefore, pregnancy will not occur. This condition is called endometrial hypoplasia and is a contraindication for embryo transfer because the chances of success are too low.

Thus, the thickness of the inner layer of the uterus is today considered as the main diagnostic criterion its condition and allows us to predict the attachment of the embryo during IVF.

It is the thickness according to ultrasound data that demonstrates how prepared the endometrium is by estrogens for implantation.

If this value is less than 5 mm, there is no practical sense in transferring a fertilized egg - it will not take root in the uterine cavity.

IN medical literature Only a few cases have been described in which pregnancy did occur at such rates.

An endometrial thickness of 5–7 mm is considered suboptimal. The chances of success are higher, and implantation is possible. However, the best prognosis is considered when, according to ultrasound, the thickness of the inner layer is from 9 to 12 mm.

As a rule, few women can boast of such indicators, which is why preparation is carried out with Divigel during IVF.

Preparation

Because the hormonal treatment prescribed by a gynecologist, who also determines the treatment regimen. It includes the following parameters:

• The day of the cycle from which the use of the drug begins.
• Duration.
• Combination with other hormones.

For each patient, schemes are calculated individually, taking into account the thickness of the endometrium, condition reproductive health, concomitant diseases.

Divigel is often combined with drugs such as Utrozhestan and Duphaston. These are synthetic analogues of progesterone.

It also belongs to the female sex hormones and is necessary for the secretory activity of the endometrium, maintenance and further progression pregnancy.

Utrozhestan and Duphaston are often prescribed for a long term.

If a doctor has written a patient a prescription for Divigel, she should know that this drug cannot be discontinued abruptly. Even if she changes doctors or discovers a suspected side effect of the medication, withdrawal should occur gradually and under the supervision of a specialist.

Estradiol is prescribed not only for in vitro fertilization, but also when planning a natural pregnancy.

Planning a natural pregnancy

Today, difficulties with conceiving a baby in gynecology are not uncommon. And very often the reason lies precisely in hormonal disorders. If a woman has endometrial hypoplasia with ultrasound examination, it is very likely that implantation will not occur.

Divigel is often prescribed when planning pregnancy in such a situation; the treatment regimen is developed individually.

Sometimes this medicine is used in combination with other hormonal drugs for anovulatory cycles. It would be incorrect to talk about a direct connection between Divigel and ovulation, however combination therapy has a stimulating effect on the maturation and release of the egg.

But even if ovulation has occurred, this is not an indication for discontinuation of the drug. As a rule, doctors recommend taking hormones both after the release of the egg and during early stages pregnancy. However, it should be remembered that the treatment regimen is within the competence of the treating gynecologist, and it is he, and not the planning woman, who decides how much Divigel should be taken

Menopause

Menopause is natural - due to the physiological decline of a woman’s reproductive function. But sometimes artificial menopause also happens - for example, when the ovaries are removed for malignant neoplasms. However, in both the first and second situations, a woman may suffer from a decrease in estrogen levels.

This is especially true for those patients whose artificial menopause occurred in at a young age. Female sex hormones have significant impact throughout the entire body, and the decrease in their concentration does not pass without leaving a trace.

In this case, gynecologists prescribe Divigel as hormone replacement therapy.

Osteoporosis

During menopause, osteoporosis to one degree or another is observed in almost all patients. This is due to hormonal disorders and primarily with a decrease in estrogen levels. As a rule, this pathology is treated with calcium supplements. Sometimes more serious medications are required - bisphosphonates.

If osteoporosis is left untreated, the risk of bone fractures increases significantly. The most dangerous fracture is the neck femur, since in most cases this leads to disability of the patient.

In case of insufficient effect of conventional medications, their intolerance, or in order to enhance the effectiveness of therapy, women are prescribed Divigel. It helps reduce the manifestations of osteoporosis and slow down the loss of calcium in the skeletal system.

Contraindications

Since Divigel is a sex hormone, the list of contraindications for its use is quite extensive. First of all, these are the following conditions:

1. Breast cancer. This may be a confirmed tumor or only a suspicion of such a pathology. A neoplasm that has been operated on in the past is also a contraindication.
2. Increased endometrial thickness is untreated hyperplasia.
3. Malignant tumor of the endometrium, estrogen-dependent.
4. Unspecified bleeding from the genital tract.

Since many malignant neoplasms The female reproductive system is sensitive to the level of certain hormones; excess estrogen can accelerate an already existing process or cause a relapse. Before prescribing Divigel, the doctor must conduct a thorough examination of the patient, especially her mammary glands and internal genital organs. It is in them that estrogen-dependent tumors most often arise.

In addition, estradiol negatively affects overall health.

Accompanying illnesses

Before appointment hormonal medication it is necessary to conduct a detailed examination of the blood coagulation system, heart and blood vessels, and liver.

The following diseases are contraindications for the use of Divigel:

1. Vein damage (thromboembolism) pulmonary artery history of deep vein thrombosis).
2. Myocardial infarction and angina associated with arterial thromboembolism.
3. Increased blood clotting, laboratory confirmed.
4. Acute liver damage.
5. Metabolic disease – porphyria.

Also a contraindication to substitution treatment Divigel is increased sensitivity to estradiol.

Side effects

Like any hormonal drug, Divigel has an impressive list side effects.

First of all, one should be wary of the influence of excess estrogen on the body and their ability to cause the growth of benign and malignant tumors, polyps.

In addition, during treatment with Divigel, breakthrough bleeding (at the beginning of treatment), thickening and discomfort in the mammary glands.

Side effects of Divigel also include:

• Weight gain.
• Increased appetite.
• Itching at the site of application of the medicine.
• Headache.
• Emotional lability.
• Apathy and depression.
• Dry eyes.
• Increased heart rate.
• Increased blood pressure.
• Tides.
• Nausea and vomiting.
• Bloating.
• Liver dysfunction.
• Acne.
• Contact dermatitis.

Divigel is an effective medicine and can be successfully used when planning pregnancy and symptoms of estrogen deficiency. However, this hormonal drug is prescribed and discontinued only by a doctor.

Nature has given the beautiful half of humanity the opportunity to continue their race and become a mother. However, poor ecology, stress and other factors sometimes make their own adjustments. And even with a very strong desire to give birth to a baby, pregnancy does not always occur immediately. In such a situation, the doctor may prescribe the woman special drugs, for example Divigel.

Basics active substance its composition will correct hormonal levels and accelerate the onset of the long-awaited “position”.

Read in this article

Why is Divigel prescribed during natural pregnancy and IVF?

Hormonal medications are selected only by doctors after a complete examination. Such drugs are “bricks” that replace the missing elements in a huge wall called the “female hormonal system.” They are artificial analogues of the necessary chemical substances, which the body, for one reason or another, cannot produce independently and in the required volume.

The drug Divigel consists of synthetic estrogens. Estradiol hemihydrate penetrates the skin into the body and begins to participate in natural processes instead of the missing natural analogues.

Divigel also curbs the level of “bad” cholesterol, but at the same time helps hormones thyroid gland, copper and iron remain in a state high concentration. For women, prescribing this drug makes it possible to increase the chances of maintaining pregnancy for the most early stages. Essentially, it creates the conditions under which a viable embryo can develop.

It is worth noting that the prescription of Divigel at the stage of preparation for conceiving a baby naturally occurs when a particular woman’s estrogen concentration is not enough for pregnancy to begin to develop. At the same time, taking the drug “in advance” does not guarantee that the meeting of the egg and sperm itself will be successful.

Takes over this function. However, the body needs an additional increase in hormone levels, since the “natural” process occurred outside of it, and it does not yet “know” that it is time to produce more estrogen than usual for the growth of the uterus and maintenance special condition vagina and fallopian tubes.

What day should you start drinking when planning?

An excess of estrogen can be just as negative as a lack of it. Therefore, it is important to understand that the hormonal system is not a field for experimentation, especially in the process of preparing for the conception of a new life. The exact regimen and dosage of Divigel is determined by the doctor. In each specific case, a woman’s level of hormones may be different, therefore the amount of their “adjustment” will also differ.

Traditionally, Divigel is recommended for use before the onset. Prepare the endometrium of the uterus during planning normal pregnancy start on the first day after graduation menstrual flow. That is, when the “old” cells were completely out, conditions appeared for the growth of new ones. In this case, the duration of treatment is adjusted by the gynecologist. Typically, the drug is taken from days 5 to 15 or 25 of the cycle.

If a woman is planning an IVF procedure, her doctor may recommend that she start using Divigel two weeks before the expected date of embryo transfer, and then continue using it after the “important event”.

You should not prescribe Divigel yourself and stop it without consulting a doctor. Even if the drug is poorly tolerated or, conversely, the woman feels “already good,” any amateur activity can be fatal.

How to take it correctly

In order for the body to perceive artificial hormones as its own, it is important to properly organize the process of their intake. Divigel is available in the form of convenient sachets filled with a gel-like preparation.

It should only be used externally (even if it seems that taking it internally will enhance the effect, or it just smells “edible”). In this case, the application must be clear and comply with the rules:

• apply Divigel at the same time every day;
• if the procedure did not take place on time, carry it out as soon as possible, but no later than 12 hours after the “initial” schedule;
• in a situation where more than 12 hours have passed since the omission, reschedule the procedure to the next day;
• Apply the product only to clean skin;
• apply applications only to the lower abdomen, buttocks, shoulders, forearms or lower back;
• choose only one area for the procedure every day;
• do not apply the gel to the same location for two days in a row;
• the application area of ​​the drug should be equal to one or two palms;
• Apply the gel in a thin layer without strong rubbing movements;
• Until the drug is completely absorbed, avoid skin contact with clothing or other objects;
• after the procedure, avoid contact with water at the application site for at least two hours;
• Avoid getting Divigel in the eyes, on irritated or injured skin, mucous membranes of organs, chest and face.

During the course of Divigel, the doctor may recommend additional intake of hormonal drugs or other medications necessary for planning pregnancy. But the use of antibiotics during this period will significantly reduce the effect of Divigel. However, the advisability of prescribing such drugs should be determined by the doctor, weighing the level of harm and benefit to the woman’s body.

Watch the video about correct use Divigel gel:

Contraindications

Divigel is, although artificial, very active hormone in high concentration. Therefore, its use has an impressive list of contraindications. You should not be afraid of this fact, since even “harmless” vitamins cannot be taken by everyone and not always.

It is better to warn the doctor in advance about existing prohibitions and discuss with him ways to overcome them. Knowing the characteristics of the female body, he will be able to adjust the dosage regimen or prescribe another drug.

Divigel is not the most suitable source of estrogen when planning a baby if:

• diabetes mellitus;
• any neoplasms;
• inflammatory diseases of the genital organs;
• tendency to form blood clots;
• excess weight problem;
• bleeding from the genitals not associated with menstruation;
• jaundice and other liver problems;
• allergies or intolerance to any (even additional) components of the drug;
• stroke;
• breastfeeding.

Divigel should be used with caution in case of kidney pathology, heart problems, respiratory problems, or epileptic attacks.

It is also worth discussing with your doctor the safety of prescribing the drug in a situation where women have met with close blood relatives oncological diseases, especially the pelvic organs and mammary glands.

Side effects

Even in the absence of explicit prohibitions, using Divigel may not be very pleasant. External use will reduce the likelihood of many side effects compared to orally hormones. But, unfortunately, it will not eliminate them completely.

Sometimes women who apply Divigel may note:

• unpleasant painful sensations in the stomach area;
• nausea or vomiting;
• impaired fluid excretion (edema);
• vision problems;
• breast swelling;
• “unreasonable” mood changes;
• feeling depressed and tired;
• bleeding.

All these conditions, if they were caused only by the use of Divigel, go away on their own after stopping the medication. Regardless of their severity, you should report them to your doctor.

Independently adjust the regimen and dosage of the gel if side effects do not pose a threat to the life and health of a woman, should not be done. In the most unexpected situations modern conditions

and ethics allow you to contact specialists by phone, especially if they leave their number themselves. This is often practiced after IVF.

Cost of the drug

A standard package of Divigel may include 28 or 91 sachets containing 0.5 or 1 gram of active ingredient. Depending on how many days you have to use the drug and in what concentration, you will have to pay from 450 to 800 rubles for one pack.

The “golden rule” when preparing for pregnancy for women and men should be a mandatory consultation with a doctor before taking any drug.

And even if Divigel approached one girl in a similar situation, there is no guarantee that he would not harm another.

All risks associated with the effect of the drug on the hormonal system can only be assessed by a specialist, and he will certainly prescribe preliminary tests and evaluate family predisposition.

Quotas

Statistics IVF children The treatment cycle of in vitro fertilization involves taking a fairly large range of hormonal drugs. Hormones allow doctors to control the processes that occur in the patient’s body both at the stage of preparation for IVF and after transfer of embryos into the uterine cavity. These drugs exclude spontaneous changes

hormonal levels

, which means they significantly increase the chances of a successful pregnancy.

Divigel is often prescribed. What this drug is, how and why it is prescribed for IVF, and how to discontinue the drug as a result of pregnancy, we will tell you in this article. About the medicine. The active substance is the hormone estradiol, which is necessary for the normal functioning of the ovaries and for bearing a fetus. A lack of this hormone in a woman’s body leads to infertility or recurrent miscarriage.

The hormone in the gel is synthetic, but it is completely identical to the natural one. Without this hormone it would be impossible puberty girls and their subsequent fertility. Estradiol is extremely important for proper development uterus, genital tract, appendages, formation of mammary gland ducts. With the participation of estrogen, representatives of the fair sex are rejected monthly functional layer endometrium, if conception does not occur, menstruation occurs.

When applied externally, the gel is quickly absorbed and promotes the growth of the functional layer of the uterus - the endometrium, which is very important for the subsequent implantation of the embryo. The hormone also adapts female body to an increase in progesterone levels, which is observed in the second phase menstrual cycle and during pregnancy. Wide Application received the drug when planning pregnancy, including naturally.

Application

The success of the IVF protocol depends largely on how correctly the doctor determines the real reason infertility of the couple and what kind of stimulated cycle support is prescribed based on the results of tests and preliminary studies. "Divigel" is usually prescribed from the fifth day of the menstrual cycle, that is, approximately 10-14 days before oocyte puncture and embryo transfer.

If the effect of the drug on the female body is adequate, then the gel should “increase” the uterine endometrium to values ​​that will be considered the most favorable. If the functional layer of the uterus is thin, then it will be difficult for the implanted embryos to implant, and all the efforts of the doctors and the patient will not be successful. It is for the preparation of the endometrium that it is recommended to take Divigel.

After embryo transfer, the drug can be taken together with other hormonal agents support. Most often, the gel is prescribed simultaneously with drugs such as Proginova or Utrozhestan. Divigel demonstrates excellent compatibility with the drug Duphaston.

The individual dosage of the drug is determined by a reproductologist. “Divigel” for IVF is most often recommended in a dosage of 1 gram once a day.

The dosage may well be reduced by half a gram or increased by the same amount if the attending physician deems it appropriate.

The gel should be applied to skin lower abdomen or forearm, or in the lumbar region and buttocks. A sachet weighing 1 gram is rubbed over an area equal to two attached female palms. The gel-like substance is applied to dry and clean skin, changing the areas of rubbing every day.

Instructions for use do not recommend wetting or washing the treated area of ​​skin for at least 2 hours after application. It is advisable to apply the gel every day at the same time. The duration of treatment is prescribed purely individually.

If a woman forgot to take the drug or was unable to rub it in on time, the gel should be applied no later than 12 hours after missing it, but if more time has passed, then application should be postponed until the next scheduled appointment and continue at the usual time.

Side effects

Like most hormonal drugs, Divigel also has its side effects. They do not appear in every patient, but their development is quite possible:

• increased swelling of the face, legs, arms;
• hypertension;
• unpleasant feeling of heaviness in the stomach, bloating;
• violation visual function, the appearance of signs of poor tolerance to contact lenses;
• engorgement of the mammary glands;
• nausea and lack of appetite;
• the appearance of so-called breakthrough bleeding from the genitals;
• weight gain;
• mood instability, depressive attacks.

Women often complain of headaches and attacks of dizziness while taking Divigel. The appearance of side effects is not a reason for unauthorized discontinuation of the drug or changing its dosage downward. The attending physician must be promptly informed about any changes in the condition, who, at his discretion, can replace the drug with an analogue, or cancel it, or change the dose.

An increase in the baseline risk of hormone-related effects such as breast cancer occurs only after five years of continuous use of the drug.

A family without a child is not a family, but simply 2 people - maybe in love with each other, or maybe just coexisting side by side. Only the appearance of a toddler gives the union loving people meaning – both biological and psychological.

And do not believe couples who claim that they live only for themselves and are not interested in issues of offspring. Either they want it, but they don’t admit it, or it doesn’t work out for physiological reasons.

Let's consider the second case, when health problems prevent you from feeling the joy of the birth of a new life. These problems are within the competence of the gynecologist.

Often, when planning pregnancy, women are prescribed various medications. One of medications may become "Divigel".

"Divigel" - what kind of drug is it?

If you go into the jungle of pharmacology, then “ » refers to estrogenic hormonal drugs. The main active ingredient is female hormone estradiol

Release form– tube with opalescent gel. The concentration of estradiol is 0.1%.

To excipients include carbomers, water, propylene glycol.

This drug is prescribed for the following diseases:

• with a lack of estrogen as replacement therapy;
• after removal of the ovaries;
• when planning pregnancy with a lack of estrogen;
• when planning an IVF procedure.

"Divigel" is an alcohol-based drug. Thanks to this, estradiol quickly penetrates the skin, and residual propylene glycol evaporates from the skin surface.

The dosage is selected individually after the examination. The drug is applied once a day to clean skin. Divigel is quickly absorbed and leaves no traces on the skin.

Can be applied to the buttocks and lower abdomen. The area of ​​treatment with Divigel should be no more than 2 palms.

Application areas can be changed - for example, one day - to bottom part abdomen, the next day – the buttock area is treated. After this, you should wait until the gel is absorbed and do not rinse the skin for 1 hour after application.

If you miss taking the drug, you should apply Divigel as soon as possible. If more than 12 hours have passed since the intended use, then it is advisable to postpone use until the next scheduled application.

Important! The gel is not applied to the skin of the mammary glands, the mucous surface of the vulva, the face and irritated areas of the skin.

The drug "Divigel" is prescribed in combination with progestogens. In the first half of the cycle, a gel is used, in the second half, Duphaston or Utrozhestan should be taken. If pregnancy does not occur, normal menstrual bleeding will begin.

Attention! The drug "Divigel" must be used regularly. If you violate the dosage schedule, bleeding similar to menstrual bleeding may develop.

Indications for use of the drug during pregnancy

Girls are prescribed Divigel when planning pregnancy only in one case - with thin endometrium.

When hypoplasia is diagnosed, the fertilized egg cannot attach to the uterus. If the thickness of the endometrial layer is less than 5 mm, the probability of a normal pregnancy is only 1%.

The thickness of the endometrial layer increases only with normal estrogen production. If the maturation processes of the dominant follicle are disrupted, then all the prerequisites for hypoplasia arise.

To put it more simply, nothing comes from nothing. This rule also applies to the endometrium. The main active ingredient of the drug is estradiol, which stimulates the thickening of the endometrial layer. The drug also promotes the development of the uterus, mammary ducts, vagina - the entire reproductive system of a woman.

Important! Do not prescribe Divigel for pregnancy on your own, on the advice of a friend or acquaintance. Get examined by a gynecologist, pass necessary tests and take the medications prescribed by your doctor. Hormones prescribed independently can worsen the situation - cause in the body hormonal disbalance. And this makes pregnancy impossible.

The drug "Divigel" before the IVF procedure

IVF is a serious and complex intervention in the female reproductive system.

Hormonal stimulation is carried out high doses medicines. This is necessary for the maturation of several eggs and successful implantation of the embryo.

A woman must constantly monitor the level of estrogen and progesterone in the body. One of the drugs of choice may be Divigel.

They begin to use the gel 2 weeks before the procedure for transferring the embryo into the uterine cavity. During the first weeks of pregnancy, estradiol levels should be maintained between 5,000 and 10,000 pmol/L.

The use of Divigel should be stopped gradually after the IVF procedure. The doctor must calculate the dose and schedule the drug withdrawal regimen strictly by day.

Do not violate the doctor's instructions - this risks bleeding and miscarriage.

Contraindications to taking the drug

Be sure to tell your doctor about any chronic or concomitant diseases you have.

The drug "Divigel" is not used for the following conditions:

• oncopathology of the mammary glands and pituitary gland, genital organs. Prohibited for use in benign neoplasms;
• diabetes;
• history of uterine bleeding;
• inflammatory processes in women's reproductive system– adnexitis, salpingitis and so on;
• endometrial hyperplasia;
• varicose veins and a tendency to form blood clots;
• metabolic disorder;
• lactation period;
• with an existing pregnancy;
• individual intolerance to the components of the drug;
• disorders of the liver and kidneys. WITH special attention it is necessary to approach patients with diseases of the urinary system. The drug retains fluid in the body;
• tumor diseases of the liver;
• sickle cell anemia;
• itchy skin in previous pregnancies;
• disorders in the ENT organs - proliferation of bone structures in the inner ear system;
• various neurological diseases: migraine various localizations, epilepsy;
• history of strokes and heart attacks.

It is advisable not to use when bronchial asthma, neurological disorders, swelling of the extremities, renal failure.

Side effects of Divigel

Doctors say the drug is well tolerated and side effects after using Divigel are unlikely.

The following side effects are possible:

• problems with the gastrointestinal tract - nausea and vomiting, colic and pain, drug jaundice may develop;
• neurological symptoms – headaches, migraines, dizziness, depression;
• hypertension;
• cutaneous allergic reactions– redness, swelling, rash in the area where the drug was applied;
• gynecological problems - endometrial hyperplasia, scanty periods, ovarian sclerocystosis, sexual desire disorders, manifestations of various vaginosis;
• endocrine system - insulin resistance, weight gain, breast engorgement may develop;
• metabolic processes – fluid retention in the body;
• disturbance in the organs of vision.

Special instructions:
The drug "Divigel" may interact with certain medications:

• enhances the effect of medications to lower blood sugar levels;
• reduces negative action male hormones;
• reduces the effect of diuretics and anticoagulants;
• enhances the absorption of estrogen when used simultaneously anticonvulsants, medicines containing St. John's wort herb extract;
• effectiveness decreases when taking certain antibiotics;
• when taking thyroid hormones and folic acid the effect of the drug is enhanced.

Important! Before prescribing Divigel for pregnancy, you must undergo an examination and inform your doctor about all the medications you are taking. medicines. During the course of treatment, you will have to periodically take tests, do an ultrasound of the pelvic organs and mammary glands. The frequency is set by the doctor for each patient individually.

Drug overdose

There is no specific treatment for overdose. All discomfort disappears when the dose is reduced or the drug is discontinued.

Patients' opinions