home Auditorium 8 Utrozhestan: instructions for use of capsules and suppositories. Hormonal assistance for the expectant mother. How to take Utrozhestan tablets and suppositories

Utrozhestan: instructions for use of capsules and suppositories. Hormonal assistance for the expectant mother. How to take Utrozhestan tablets and suppositories

Name:

Utrogestan

Pharmacological
action:

Pharmacodynamics. Pharmacological properties The drug is caused by progesterone, one of the hormones of the corpus luteum, which contributes to the formation of normal secretory endometrium in women. Causes a transition of the uterine mucosa from the proliferation phase to the secretory phase, and after fertilization contributes to its transition to the state necessary for the development of a fertilized egg. Reduces excitability and contractility of the uterine muscles and fallopian tubes. Does not have androgenic activity. It has a blocking effect on the secretion of hypothalamic factors for the release of LH and FSH, inhibits ovulation and the secretion of gonadotropic hormones by the pituitary gland.
Pharmacokinetics.
Oral administration . An increase in the level of progesterone in the blood plasma is noted from the 1st hour after oral administration. Cmax of progesterone in blood plasma is detected 1–3 hours after taking the drug (after 1 hour - 4.25 ng/ml, after 2 hours - 11.75 ng/ml, after 4 hours - 8.37 ng/ml, after 6 h - 2 ng/ml, after 8 h - 1.64 ng/ml). The main metabolites of progesterone detected in blood plasma are 20α-hydroxy,δ4α-pregnanolone and 5α-dihydroprogesterone. The drug is excreted in the urine in the form of glucuronic metabolites, the main of which is 3α,5β-pregnanediol (pregnanediol). These metabolites are identical to the metabolites that are formed during physiological secretion of the corpus luteum.
Intravaginal use. When intra vaginal use progesterone is quickly absorbed in the mucous membrane. An increase in the level of progesterone in the blood plasma begins from the 1st hour, the most high level in blood plasma is achieved 1–3 hours after administration.
At the average recommended dose (100 mg progesterone at night), Utrozhestan allows you to achieve and maintain physiological and stable levels of plasma progesterone (average 9.7 ng/ml), similar to those in the luteal phase menstrual cycle With normal ovulation. Thus, Utrozhestan stimulates adequate maturation of the endometrium and promotes embryo implantation.
With more high doses(above 200 mg/day), which is increased gradually, vaginal method use allows you to achieve a level of progesterone in the blood plasma similar to that in the first trimester of pregnancy.
Metabolism. The metabolites in the blood plasma and urine are identical to the metabolites identified during the physiological secretion of the corpus luteum of the ovary: mainly 20α-hydroxy, δ4α-pregnanolone and 5α-dihydroprogesterone were detected in the blood plasma. Urinary excretion is 95% in the form of glucuronic metabolites, the main component of which is 3α,5β-pregnanediol (pregnanediol).

Indications for
application:

The drug is used for corrective therapy for endogenous progesterone deficiency.
Oral use Utrozhestan capsules:

- menstrual irregularities due to anovulation, ovulation disorders,
- mastopathy (fibrocystic),
- premenstrual syndrome,
- in combination with estrogen drugs is prescribed as a replacement hormone therapy with menopausal syndrome.

Intravaginal use Utrozhestan capsules:
- maintaining the luteal phase of the menstrual cycle in preparation for auxiliary reproductive technologies(in vitro fertilization, egg donation, etc.),
- maintaining the luteal phase in the induced or spontaneous menstrual cycle,
- in combination with estrogen drugs is prescribed as hormone replacement therapy for menopausal syndrome,
- hormone replacement therapy in case of premature menopause,
- infertility due to insufficiency of the corpus luteum of the ovary,
- prevention of endometriosis, uterine fibroids,
- preventive treatment for recurrent pregnancy loss due to progesterone deficiency,
- treatment of threatened abortion caused by progesterone deficiency.

Mode of application:

The duration of use depends on the nature of the disease.
Ingestion. In most cases average daily dose is 200–300 mg in 2 doses (200 mg in the evening, before bedtime and 100 mg in the morning - if necessary).
For luteal phase deficiency(premenstrual syndrome, fibrocystic mastopathy, menstrual irregularities, premenopause) are taken for 10 days (from the 17th to the 26th day of the cycle).
With hormone replacement therapy during menopause, due to the fact that estrogen therapy is not recommended separately, progesterone is used as an addition in the last 2 weeks of each course of therapy, occurring after 1 week of replacement therapy, during which withdrawal bleeding is possible.
When threatened premature birth Prescribe 400 mg of Utrozhestan every 6–8 hours until symptoms disappear. Effective dose and the frequency of use is determined individually depending on the clinical manifestations of the threat of premature birth. After the symptoms disappear, the dose of Utrozhestan is gradually reduced to a maintenance dose of 200 mg 3 times a day. At this dose, the drug can be used up to 36 weeks of pregnancy.

Intravaginal administration. Insert the capsules deep into the vagina.
The average dose is 200 mg of progesterone per day (1 capsule of 200 mg or 2 capsules of 100 mg, in 2 doses, morning and evening, which are injected deep into the vagina, if necessary using an applicator). The dose may be increased depending on the patient's response.
For partial luteal phase deficiency(disovulation, menstrual irregularities) the daily dose is 200 mg for 10 days (from the 17th to the 26th day of the cycle).
With complete insufficiency of the luteal phase
Complete absence progesterone in women with non-functioning (absent) ovaries (egg donation): the dose of progesterone is 100 mg in the morning and evening from the 15th to the 25th day of the cycle. Starting from the 26th day, in case early diagnosis pregnancy, the dose is increased by 100 mg of progesterone per day, reaching a maximum of 600 mg/day in 3 doses. This dosage regimen must be followed until the 60th day.
Luteal phase support during your cycle in vitro fertilization: 600 mg 3 times a day (200 mg once every 8 hours).
In case of threatened miscarriage or to prevent recurrent miscarriage due to progesterone deficiency: prescribed 200–400 mg/day (100–200 mg every 12 hours) until 12 weeks of pregnancy.

Side effects:

From the outside reproductive system : intermenstrual bleeding or spotting (rare).
From the central nervous system: dizziness 1-3 hours after taking utrozhestan, drowsiness.
There may also be hypersensitivity reactions.

Contraindications:

Bleeding from the genital tract of unknown origin,
- tendency to thrombosis (only for oral administration),
- incomplete abortion,
- malignant diseases reproductive organs and mammary glands (including suspected malignant process in these bodies)
- porphyria,
- severe impairment of liver function (for oral administration only),
- allergic reactions to the components of utrozhestan.

Interaction
other medicinal
by other means:

With hormonal therapy Menopause estrogen is strongly recommended to prescribe progesterone no later than the 12th day of the cycle.
If, when treating the threat of premature birth, Utrozhestan is combined with β-adrenergic agonists, the doses of the latter can be reduced.
Simultaneous use other drugs can change the metabolism of progesterone, causing an increase or decrease in the concentration of progesterone in the blood plasma and, accordingly, lead to a change in the effect of the drug.
Powerful inducers of liver enzymes, namely: barbiturates, antiepileptic drugs (phenytoin), rifampicin, phenylbutazone, spironolactone, griseofulvin cause increased metabolism in the liver.
Some antibiotics(ampicillins, tetracyclines) may cause changes intestinal microflora, resulting in a change in the hepatic steroid cycle.
It is known that such drug interactions vary from person to person and may differ significantly from person to person. different groups patients, therefore it is clear to predict any clinical manifestations such interactions are not possible.
All progestins can reduce glucose tolerance, which may require an increase in the daily dose of insulin and other antidiabetic agents in patients with diabetes.
The bioavailability of progesterone can be reduced by smoking and increased by alcohol.

Pregnancy:

Utrozhestan is not contraindicated during pregnancy. However, in the third trimester it is prescribed with caution due to the increased risk of developing liver dysfunction. Prescribe with caution during breastfeeding.

Overdose:

The above symptoms side effects usually appear as a result of an overdose. They disappear spontaneously when the dose is reduced.
For some people usual dose may be overestimated due to existing or secondary unstable endogenous secretion of progesterone, hypersensitivity to the drug or a very low concomitant level of estradiol in the blood; V similar cases It is enough to reduce the dose of progesterone or prescribe it in the evening before bed for 10 days of the cycle in case of drowsiness or dizziness; postpone the start of treatment until later late date cycle (for example, the 19th day instead of the 17th) if it shortens or appears bloody discharge; It is necessary to check whether estradiol levels are sufficient in a patient receiving hormone replacement therapy during the premenopausal period.

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

Utrozhestan is a drug from the group of sex gland hormones. It is a natural gestagen that can completely replace female progesterone.

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

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

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

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

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

Utrozhestan: is it possible during pregnancy?

Utrozhestan is not contraindicated in the gestational period and, on the contrary, very often helps prevent miscarriage, so it is prescribed from the moment pregnancy is confirmed. Often women begin to take it at the stage of preconception preparation, and then continue treatment after successful conception. Taking Utrozhestan in the second trimester of pregnancy is also possible. However, during treatment, a woman’s liver parameters must be monitored. But taking Utrozhestan during lactation is undesirable, since the mechanism of its penetration into milk is poorly understood.

Utrozhestan in the 1st trimester of pregnancy

Utrozhestan is prescribed in the form of vaginal capsules in the first weeks of gestation. The drug is administered daily and always at the same time. This method of administration prevents pathological effects on digestive system and toxic liver damage. Besides, oral administration in the first trimester is often impossible, for example, if toxicosis occurs.

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

The negative impact of Utrozhestan on the development of the baby is practically absent. However, there is a small risk of developing hypospadias when using progestins to prevent miscarriage. This pathology the fetus is the formation of developmental anomalies back wall urethra or its complete absence. Therefore, before prescribing Utrozhestan, a woman should be informed about possible complications at the baby's.

Utrozhestan in the 2nd, 3rd trimester of pregnancy

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

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

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

Utrozhestan during pregnancy - what is it prescribed for?

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

Internal administration of Utrozhestan during pregnancy is carried out in the presence of the following obstetric pathologies:

risk of miscarriage;
prevention of premature birth.

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

premenstrual disorders;
infertility due to luteal phase disturbance;
disturbance of the ovulatory process (anovulation, disovulation);
gestagen deficiency in menopause;
mastopathy;
precimacteric period.

Vaginal use of Utrozhestan is appropriate for:

inability to swallow capsules orally (toxicosis, diseases of internal organs);
impossibility of conception due to infertility;
threat of miscarriage;
risk of premature onset of labor.

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

Utrozhestan during pregnancy - instructions

The drug fully compensates for the lack of progesterone without disturbing the natural hormonal balance women. Competent treatment does not cause complications, does not promote recruitment excess weight or worsening pregnancy. But the effectiveness of replacement therapy during gestation depends on the adequacy of the prescribed dose and general scheme reception.

Utrozhestan during pregnancy - dosage

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

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

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

Utrozhestan - contraindications during pregnancy

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

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

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

Considering the high risk of thromboembolic and metabolic complications, Utrozhestan should be immediately discontinued if the following symptoms develop:

visual impairment;
blood clot formation;
venous insufficiency;
severe headache, including migraine attack.

Important! Utrozhestan is indicated for stopping miscarriage only in cases of diagnosed progesterone deficiency. If the cause of the miscarriage is a genetic disorder, sexually transmitted infections or physical disorders, Utrozhestan is contraindicated.

Utrozhestan during pregnancy - side effects

Negative consequences from treatment are rare. Sometimes, if treatment rules are not followed or individual intolerance occurs, some malfunctions are possible different organs and systems.

From the reproductive system:

mammalgia;
amenorrhea;
bleeding from the birth canal.

Nervous system disorders:

sleepiness;
absent-mindedness;
headache;
dizziness;
depression.

Gastrointestinal disorders:

diarrhea;
nausea;
occasional vomiting;
constipation.

Skin damage:

acne;
hives;
yellowness of the skin;
chloasma.

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

The following adverse reactions may also occur:

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

How to cancel Utrozhestan during pregnancy

Utrozhestan is a hormonal drug, therefore it needs to be gradually withdrawn so as not to provoke a hormonal imbalance. To successfully discontinue the drug without consequences, the daily dose is reduced by 100 ml every week. If the dose taken is low enough, it is reduced by 50 ml at intervals of three days. At the stage of dose reduction and until Utrozhestan is completely discontinued during pregnancy, the woman is constantly monitored so that she does not start bleeding.

Which is better: Duphaston or Utrozhestan during pregnancy

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

The attitude of obstetricians and gynecologists towards these two drugs is different. Duphaston has long been used in obstetric practice, so its effect on pregnancy has been well studied. In addition, the synthetic form of progesterone provides a more pronounced therapeutic effect. Therefore, obstetricians-gynecologists give preference to Duphaston rather than Utrozhestan during pregnancy when there is a threat of miscarriage.

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

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

Utrozhestan during pregnancy - reviews

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

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

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

Video “Utrozhestan during pregnancy - features of administration”

The fusion of sperm and egg is not always completed desired pregnancy, because ovum should get into favorable conditions in order to successfully gain a foothold in the uterus and develop normally. One of these conditions is a certain level of the hormone progesterone, so if the corpus luteum does not produce it or the amount of this hormone is insufficient, pregnancy will not occur.

To eliminate this problem, doctors often prescribe Utrozhestan. How does it affect the female body and how is it taken correctly when planning pregnancy?

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Release form

Utrozhestan is manufactured in the form of gelatin soft capsules, which contain a whitish homogeneous oily suspension. The color of such capsules is yellow, and the shape depends on the dosage - round capsules are produced with a smaller amount of the active ingredient, and the drug with a higher dosage has an oval shape.

The number of capsules in a pack is also different - if the dosage is lower, then the package contains 28 capsules in blisters of 14 pieces, and medicine with a higher hormone content is sold in 14 pieces in a pack in blisters of 7 capsules.

Compound

The main ingredient of Utrogestan is micronized progesterone in a dosage of 100 mg or 200 mg. Auxiliary components are soy lecithin and sunflower oil, and glycerol, titanium dioxide and gelatin are used to make the capsule shell.

How does it work?

Progesterone, which is the basis of Utrozhestan, is called one of the most important hormones for the normal course of pregnancy. This substance has many properties, it:

reduces the contractility of the muscles of the uterus, as well as the fallopian tubes;
ensures changes in the endometrium so that the uterine wall accepts the fertilized egg (prevents termination of pregnancy at the implantation stage);
regulates the menstrual cycle (if the hormone is insufficient, delayed menstruation is observed);
affects metabolic processes, important for bearing a baby;
prevents endometriosis by normalizing the condition of the endometrium;
affects changes in the mammary gland and is important for lactation.

Normally, progesterone should be produced by the corpus luteum, which is active in the second phase of the menstrual cycle.

Indications

The main reason to prescribe Utrozhestan is the lack of progesterone in a woman’s body. When planning pregnancy, the drug is used:

If in a woman’s body in the second phase of the menstrual cycle the level of progesterone drops asymptomatically. This situation prevents conception and poses a danger if pregnancy occurs.
If a woman has been diagnosed with infertility, the cause of which is luteal insufficiency.
If a woman has a miscarriage caused by a decrease in progesterone levels in the first weeks after conception.

To make sure that a woman wishing to become pregnant requires Utrozhestan, laboratory tests should be carried out.

In addition, the medication is prescribed in other cases, for example, when fibrocystic mastopathy, premature menopause, preparation for IVF or egg donation.

Contraindications

Utrozhestan should not be taken by women with:

thrombophlebitis, thromboembolic disorders, deep vein thrombosis or intracranial bleeding;
bleeding from the vagina, the cause of which has not been established;
incomplete abortion;
porphyria;
suspicion of malignant tumor in the genitals or mammary gland, as well as when it is detected;
severe liver pathologies or serious illnesses of this organ in the past;
hypersensitivity to progesterone or any additional component of the capsules.

In addition, the medicine should not be taken or inserted into the vagina during breastfeeding and in girls under 18 years of age.

If a woman has diabetes, epilepsy, depression, renal failure, bronchial asthma, high blood pressure blood and some other health problems, the use of Utrozhestan requires medical supervision.

Side effects

Some women who take Utrozhestan orally experience headache, bloating. Occasionally, the medication provokes allergic reaction(due to the presence in the composition soy lecithin), drowsiness, weakness, dizziness, vomiting, changes in stool, jaundice. Very in rare cases Taking medication by mouth causes nausea or depression.

To eliminate such negative reactions The doctor may reduce the dosage or suggest that the patient switch to vaginal use. With this method side effect manifests itself much less frequently and occurs only with intolerance (it is represented by itching, burning or hyperemia).

If you start taking Utrozhestan before ovulation, your cycle may shorten or bleeding may occur. The use of the medication from the 4th month of pregnancy (in the second and third trimesters) sometimes provokes cholestasis, so use from the 13th week should be monitored by a gynecologist when prescribing additional examinations.

After stopping the medication, reddish or brown discharge may appear. They are often moderate or scanty and are considered normal reaction to stop taking progesterone. Such discharge should disappear within 5-10 days after discontinuing the capsules.

Instructions for use

Utrozhestan, depending on the diagnosis, can be prescribed in a dose of 200 to 600 mg per day. The dosage of capsules required for a particular patient is selected by the attending physician.

The medicine is used either at night or twice a day (in the morning and before bed). The capsules should not be swallowed with food as this will increase the absorption of progesterone.

The drug is taken in two ways:

Swallow without biting. It is recommended to do this 15-20 minutes before meals. The swallowed capsule is washed down with clean water.
Inserted into the vagina as a suppository. With this application, the drug must be injected deeply, and after that you need to lie down for about 40-60 minutes.

The medication should be taken after ovulation. The most common dosage regimen when planning pregnancy is from the 16th to 25th day of the cycle. However, if the duration of the menstrual cycle is non-standard (for example, if ovulation is late), as well as for other reasons for use, the scheme will be different.

Discontinuation of the drug is carried out very carefully and under the supervision of a physician. To do this, it is important to make sure that there is no conception by doing highly sensitive tests or donating blood to determine the level of hCG.

If the fertilized egg has implanted and pregnancy has occurred, Utrozhestan is not canceled, but taken until 7-8 weeks or the entire first trimester, and sometimes longer. To complete the treatment, the dosage is reduced gradually.

Overdose

If the dosage of Utrozhestan is chosen incorrectly and is too high for a woman, then the drug causes dizziness and drowsiness (with such symptoms the daily dose is reduced), a decrease in the duration of the menstrual cycle and the appearance of spotting (in such a situation, the start of administration is postponed to a later date, for example, on day 18 or 19).

When used intravaginally, the drug does not interfere with treatment with other drugs taken by mouth, but should not be combined with the use of any other drugs that are introduced into the vagina, so that they do not affect the release and absorption of progesterone.

Purchase and storage

To purchase capsules at a pharmacy, you must obtain a prescription from your doctor. The average price of one package of Utrozhestan is in the range of 400-450 rubles.

The drug should be stored at home at a temperature below +25 degrees. The shelf life of the capsules is 3 years.

Prescribed as replacement therapy when 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 women. The exact dosage and necessary course of treatment are prescribed only by a doctor.

Dosage form

Capsules for oral administration and insertion into the vagina, 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. 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 each contain 100 mg of active ingredient, 200 mg capsules contain 200 mg.

They contain E476 and sunflower oil as additional components.

The capsule shell contains:

gelatin;
titanium white;
glycerol.

Pharmacological group

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

Helps the endometrium transition from the proliferation stage, which is caused by follitropin, to the secretory phase. After the union of the egg with the sperm, it promotes the transition of the endometrium to a state that allows the development of the embryo. Reduces the excitability and contractility of the myometrium and oviduct muscles, activates the development of the end elements of the mammary gland, the growth of the secretory section of its acini, and activates lactation.

It affects protein lipase, resulting in increased lipid reserves, increased glucose absorption, and glycogen accumulation in the liver. Increases the production of pituitary gonadotropins, reduces the level of nitrogen in the blood and increases its excretion in the urine.

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

When administered intravaginally, it is quickly 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.

When the medication is administered in a daily dosage of at least 200 mg, the level corresponds to the first trimester of pregnancy.

The drug is metabolized in the body.

Excreted through the kidneys.

Indications

Utrozhestan is prescribed for deficiency in women.

Oral Utrozhestan is prescribed if diagnosed:

infertility that developed against the background of luteal insufficiency;
menstrual irregularities caused by impaired ovulation or its absence;
fibrocystic disease;
premenopause;
Hormone replacement therapy (HRT) in pre- and menopause(in combination with estrogen-containing medications).

It is prescribed intravaginally if:

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 lack of .

Indications for use during pregnancy

The drug is prescribed intravaginally during pregnancy:

HRT for deficiency caused 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 premature birth in pregnant women at risk (with shortened cervical canal, history of miscarriage).

Contraindications

Utrozhestan capsules should not be prescribed if the patient has:

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

The medicine should not be prescribed orally for severe liver pathologies.

It should be taken orally with caution if the patient suffers from such pathologies as:

CVD diseases;
high pressure;
chronic renal failure;
bronchial asthma;
epilepsy;
migraine pain;
depression;
increased blood cholesterol levels;
dysfunction of the liver, lungs and medium degree heaviness;
photosensitization.

Contraindications during pregnancy

During pregnancy, Utrozhestan can only be used vaginally. It is prohibited to prescribe it when there is an incomplete abortion.

Directions for use and doses

The duration of therapy depends on clinical picture pathology.

When taken orally, capsules should be taken with water.

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

For luteal phase insufficiency (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).

When using HRT during the premenopausal period, Utrozhestan should be used simultaneously with estrogens in a daily dosage of 200 mg for 12 days.

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

Treatment regimens during pregnancy

The drug is used intravaginally.

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

To prevent premature birth in pregnant women at risk (with a short cervix, previous pregnancies that ended in miscarriage), the drug is usually prescribed in a dosage of 200 mg at night, from the 22nd to 34th weeks of pregnancy.

Utrozhestan can provoke a decrease in glucose tolerance, resulting in an increased need for insulin or other sugar-lowering medications in patients suffering from.

When used intravaginally, the interaction of Utrozhestan with other medications has not been assessed. Do not simultaneously insert other medications into the vagina 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 if a severe form develops during treatment, therapy should be discontinued.

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

Long-term therapy requires medical examinations and in case of detection of deviations from normal indicators or cholestatic jaundice, treatment should be interrupted.

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

When prescribing HRT with estrogen during perimenopause, Utrozhestan must be taken for at least 12 days of the menstrual cycle.

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

Against the background of HRT, the likelihood of developing venous thromboembolism increases, ischemic stroke and IHD.

Due to the risk of thromboembolic complications, therapy should be interrupted if:

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

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

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

Before starting HRT and during it, the patient should regularly undergo examinations in order to detect contraindications to its implementation.

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

indicators of liver and thyroid function;
blood clotting;
pregnanediol concentration.

When taking the drug orally, you must be careful when driving.

Overdose

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

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

if drowsiness or dizziness occurs, reduce daily dosage or prescribe medication at night for 10 days of the menstrual cycle;
when shortening monthly cycle or if 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 during postmenopausal hormone replacement therapy, ensure that estradiol levels are 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 a temperature not exceeding 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 complete analogue Utrozhestan. It is available in capsules for oral and vaginal administration. Medicine can be used during pregnancy. Vanel should not be used by persons under 18 years of age or while 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 pregnancy. The drug is not suitable for children and breastfeeding mothers.
- domestic medicine, which is produced in the form of oil injection solution. Injections of the drug must be given into the muscle. They are contraindicated for children in the second and third trimesters, during breastfeeding.
- Indian medicine, which is a complete analogue of the drug Utrozhestan. It is sold in the form of gel and capsules, which should be used with caution by pregnant and breastfeeding women.

Drug price

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

Progesterone in a woman’s body it is produced by the adrenal glands, the corpus luteum and the placenta.

This steroid compound is often called pregnancy hormone. After all, his enough level indicates efficiency, without which fertilization cannot occur.

During pregnancy the concentration of this hormone in the blood gradually increases. This is explained by the functioning of the placenta and is why important factor, which supports pregnancy.

Yours pronounced action progesterone manifests itself already during the preparation of the endometrium (inner shell uterus) to fix the fertilized egg. And the substance ends its accompaniment of the process only at the end of bearing a child when the expected due date approaches.

Indications for the use of Utrozhestan

Utrozhestan has almost the only indication– insufficient amount of progesterone. But clinically this is expressed by various conditions: cyst formation, endometrial hyperplasia, symptoms of hyperandrogenism, which is manifested by severe acne and hair growth characteristic of the male sex.

When planning pregnancy, Utrozhestan is prescribed only in three cases:

Asymptomatic decreased progesterone levels in the blood. This is very common occurrence, which is dangerous not only during pregnancy, but also reduces the chances of conception. Utrozhestan continues to be taken even while carrying a child, if it is in the early stages or is possible. This drug is especially often prescribed in the first weeks of pregnancy.
Infertility, which is caused by a lack of progesterone.
Miscarriage which occurred due to hormonal imbalance towards reducing the amount of progesterone in a woman’s body.

To make sure you need to take this drug, held special laboratory test.

In this case, it is important to know the day of the menstrual cycle, since the analysis of this indicator is recommended to be carried out in its second half.

Contraindications and side effects

A woman who approaches pregnancy planning seriously and responsibly should not forget that Utrozhestan is indeed the patient’s last hope in many situations.

But its use is possible only as prescribed by a gynecologist. After all, only a doctor can trace the severity of conditions that are contraindications for the use of this hormonal drug.

In this case, it does not matter at all which dosage form you will be assigned: suppositories or tablets.

TO contraindications relate:

thrombophlebitis;
pronounced, as well as complications of this disease;
liver problems;
malignant tumors of certain locations.

A lot of pathological conditions are the reason for refusing to prescribe Utrozhestan. With bronchial cardiovascular diseases, take the drug with caution.

Side effects of Utrozhestan are extremely rare. Only some women note that the pills cause slight and insignificant drowsiness. But this is not dangerous in everyday life.

Unless, if such symptoms occur, doctors may recommend that you stop driving, because progesterone slightly depresses the central nervous system. nervous system, which can negatively affect the reaction speed when driving.

Side effects from the reproductive system are even less common: intermenstrual bleeding or spotting may begin. Hypersensitivity reactions are also sometimes recorded.

How to take Utrozhestan?

Dosage of the drug when planning a pregnancy in most cases it is 200-300 mg(capsules).

The dose is divided for two doses And hormonal agent used morning and evening. Basically the remedy is taken from 16 to 25 days of the menstrual cycle (course 10-12 days).

Utrozhestan capsules are taken orally, without chewing, and washed down with water.

In case of infertility due to lack of progesterone in female body Utrozhestan is also prescribed 200-300 mg per day intravaginally (starting from the 17th day - 10 days in total).

Since Utrozhestan suppositories are absorbed into the blood faster when planning pregnancy, this use of the drug has less side effects. The suppository must be administered in a lying position and preferably before bedtime.

If fertilization has taken place, therapy is continued. The duration of taking this drug is determined only by your doctor.

But most often a pregnant woman should drink Utrozhestan throughout the first trimester. At the same time, there is often a need to extend treatment until pregnancy.

This depends on the presence or absence of any complications during pregnancy. Utrozhestan, although not contraindicated during pregnancy, is in the third trimester it is prescribed with extreme caution because of increased risk development of liver function disorders.

Cancellation of Utrozhestan during pregnancy

Specifics hormonal drugs thing is they need to be phased out gradually, since abruptly stopping its use can negatively affect the condition of the placenta. And this, in turn, is fraught with miscarriage.

That's why cancellation this tool if pregnancy occurs, it is carried out under strict medical supervision: the dose of the hormone is reduced by 50 mg every 3 days.