Buy Progynova dragee 2mg N21

Progynova dragee 2mg N21

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Active ingredients

Estradiol Valerate

Release form

Dragee

Composition

Active ingredient: Estradiol valerate (Estradiol valerate) Active ingredient concentration (mg): 2

Pharmacological effect

Progynova contains estrogen - estradiol valerate, which in the human body turns into natural 17β-estradiol. While receiving Progynova, ovulation is not suppressed, and hormone production in the body remains almost unchanged. Estradiol compensates for the estrogen deficiency in the female body after menopause and provides effective treatment for psycho-emotional and autonomic menopausal symptoms (such as hot flashes, increased sweating, sleep disorders). , increased nervous irritability, irritability, palpitations, cardialgia, dizziness, headache, decreased libido, muscle and joint pain); involutions of the skin and mucous membranes, especially the mucous membranes of the urogenital system (urinary incontinence, vaginal mucosa dryness and irritation, pain during sexual intercourse). HRT with an adequate dose of estrogen, such as occurs in Progin, reduces bone resorption and delays or stops bone loss in postmenopausal disease. It has been shown that prolonged use of hormone replacement therapy (HRT) reduces the risk of peripheral bone fractures in women after menopause. With the abolition of HRT, the rate of decrease in bone mass is comparable to the indicators typical for the period immediately after menopause. It is not proven that using HRT can restore bone mass to the premenopausal level. HRT also has a beneficial effect on the collagen content in the skin, as well as on its density, and can also slow down the formation of wrinkles. HRT leads to a decrease in total cholesterol , low-density lipoprotein cholesterol (LDL) and to an increase in high-density lipoprotein cholesterol (HDL), as well as an increase in triglyceride levels. Adding progestogen may to some extent interfere with the effects of estradiol on metabolism. In general, the metabolic effects of HRT are considered to be positive and are considered to be involved in reducing the risk of cardiovascular diseases in postmenopausal women. For women with a uterus not removed, when using Progynova, an additional dose of gestagen is recommended for at least 10 days in each cycle.This reduces the risk of endometrial hyperplasia and the concomitant risk of adenocarcinoma in women of this group.

Pharmacokinetics

Absorption After ingestion of estradiol, valerate is rapidly and completely absorbed. During absorption and the first passage through the liver, the steroid ester is broken down into estradiol and valeric acid. At the same time, estradiol is largely subjected to further metabolization, for example, to estrone, estriol, and estrone sulfate. After oral administration, only about 3% of estradiol becomes bioavailable. The food taken does not have any effect on the bioavailability of estradiol. The Cmax distribution of estradiol in serum, which is approximately 30 pg / ml, is usually reached 4–9 hours after taking the pills. After 24 hours after administration, the level of estradiol in serum is reduced to a concentration of approximately 15 pg / ml. Estradiol binds to albumin and to the globulin that binds sex steroids (GSPS). The free fraction of estradiol in serum is about 1-1.5%, and the fraction of the substance bound by GPS, is in the range of 30-40%. The Vd estradiol, after a single IV, is about 1 l / kg. Metabolism After hydrolysis of estradiol valerate, the substance passes the same biotransformation paths as endogenous estradiol. Estradiol is metabolized primarily in the liver, and also partially in the intestine, kidneys, skeletal muscles and target organs. These processes are accompanied by the formation of estrone, estriol, catecholestrogens, and sulphate and glucuronide conjugates of these compounds, all of which have significantly less estrogenic activity or do not have estrogenic activity at all. from 10 to 30 ml / min / kg. A certain part of estradiol is excreted in the bile and undergoes enterohepatic recirculation. Estradiol metabolites are excreted mainly with urine in the form of sulfates and glucuronides. Equilibrium concentration The concentration of estradiol in the blood serum after repeated administration is approximately two times higher than after administration of a single dose. On average, serum estradiol concentration ranges from 30 pg / l (minimum level) to 60 pg / l (maximum level). The concentration of estrone (weaker estrogen) is about 8 times, and the concentration of estrone sulfate is about 150 times higher than the concentration of estradiol.After discontinuation of taking, Proginous concentrations of estradiol and estrone return to their original values ​​within 2-3 days.

Indications

Estrogen deficiency (postmenopausal period, oophorectomy, radiation castration), accompanied by vasomotor symptoms: hot flashes, sweating, sleep disturbances, depressions, irritability, headache, dizziness, hyperesthesia of the bladder, degenerative changes of the skin and mucous membranes; prevention of osteoporosis.

Contraindications

Hypersensitivity, pregnancy, breastfeeding, severe liver dysfunction, Dubin-Johnson and Rotor syndromes, liver tumors and thromboembolic processes (including history), breast cancer, existing or suspected tumors that are sensitive to sex steroid hormones, severe hypertriglyceridemia, vaginal bleeding of unknown origin.

Precautionary measures

Do not exceed recommended doses.

Use during pregnancy and lactation

HRT is not prescribed during pregnancy or lactation. If pregnancy is detected while taking Progynova, the drug should be stopped.

Dosage and administration

Inside, after eating, without chewing and drinking a small amount of liquid, 1 tablet daily for 21 days, then a break of 7 days. If you have menstruation, Progynova should be taken on the 5th day of the menstrual bleeding. In any other case, immediate treatment can be taken. recommended by the doctor. If the uterus is preserved, it is possible to add another hormone, progesterone. And the doctor's recommendation is necessary: ​​should the dragee be taken continuously (without interruptions) or intermittently. The time of the day of Proginov's intake does not matter. However, if the first dragee is taken at a specific time of the day, you should adhere to this time and when taking all subsequent pills.

Side effects

In rare cases - headache, nausea, dysfunction of the stomach, engorgement of the mammary glands, changes in body weight, uterine bleeding, chloasma.

Overdose

There is no risk of serious risk of acute side effects if you accidentally take the drug in an amount that exceeds many times the daily therapeutic dose.Symptoms that may occur with an overdose: nausea, vomiting, vaginal bleeding. There is no specific antidote, the treatment is symptomatic.

Interaction with other drugs

At the beginning of HRT it is necessary to stop the use of hormonal contraceptives. If necessary, the patient should be recommended non-hormonal contraceptives. Long-term treatment with drugs that induce liver enzymes (for example, some anti-convulsants and antimicrobial drugs) can increase the clearance of sex hormones and reduce their clinical efficacy. A similar property to induce liver enzymes has been found in hydantoins, barbiturates, primidone, carbamazepine and rifampicin, the presence of this feature is also expected in oxcarbazepine, topiramate, felbamate and griseofulvin. The maximum induction of enzymes is usually observed not earlier than in 2-3 weeks, but then it may persist for at least 4 weeks after stopping the drug. In rare cases, against the background of concomitant use of certain types of antibiotics (for example, penicillin and tetracycline groups) a decrease in estradiol was observed. Substances that are largely subject to conjugation (for example, paracetamol) may increase the bioavailability of estradiol due to competitive inhibition of the conjugate system uu during vsasyvaniya.Vsledstvie effect of HRT on glucose tolerance in some cases may need to change in oral antidiabetic agent or insuline.Chrezmernoe alcohol consumption during HRT may lead to an increase in circulating levels of estradiol.

special instructions

When prescribing HRT to women with several risk factors for thrombosis or a high degree of severity of one of the risk factors, consider the possibility of mutual enhancement of the action of risk factors and prescribed treatment for the development of thrombosis. In such cases, the total value of the existing risk factors increases. If there is a high risk, the drug Progynova is contraindicated. Medical examination Before the start of the drug use, and then after a certain period of time during treatment (at least 1 time in 6 months), gynecological examinations should be carried out, an examination of the mammary glands,measurement of blood pressure and other necessary studies. A medical examination (including periodic determination of prolactin concentration) is necessary if the patient has prolactinomas. If hormone replacement therapy is performed in one of the diseases or conditions listed below, you may need careful medical observation. Therefore, if you have one of these conditions, tell your doctor before you start taking Progynova: - uterine fibroids; - Endometriosis now or in the past; - Liver or gall bladder disease. After suffering hepatitis, it is possible to administer the drug no earlier than 6 months (before normalization of liver function indicators), jaundice during a previous pregnancy or previous intake of sex hormones, diabetes mellitus, arterial hypertension (high blood pressure), chloasma (areas of discolored skin ) currently or in the past. If they are, avoid prolonged sun exposure or ultraviolet radiation; - epilepsy; - benign breast diseases (mastopathy); - bronchial asthma; - migraine; - elevated blood triglycerides; - porphyria; - otosclerosis; - systemic lupus erythematosus; - Small chorea; - Increased risk of venous thrombosis. The risk increases with age. It may also increase if you or your relatives have thrombosis, with varicose veins, overweight. The risk of deep vein thrombosis is temporarily increased as a result of surgery, serious injuries or prolonged immobility. If you are taking Progynova, tell your doctor about any planned hospitalization or surgery (4-6 weeks). You should not use hormone replacement therapy to prevent a heart attack or stroke. The following warnings related to the use of HRT should also be taken when using Progynova .GTH and tumors. Endometrial cancer. With prolonged use of estrogens in monotraphy, the likelihood of uterine cancer (endometrial cancer) increases. If you have a uterus, you will need additional reception of gestagens. Adding progestogens reduces the risk of endometrial cancer. Tell your doctor,if you have irregular or breakthrough bleeding while taking Proginovy. Breast cancer Several studies have shown that women who have used hormone replacement therapy (HRT) for several years, have breast cancer more often than their peers who have never used it. The relative risk increases with an increase in the duration of estrogen monotherapy, but may be absent or be reduced. This increase is comparable to the increased risk of breast cancer in women with a later onset of natural menopause, as well as obesity and alcohol abuse. Increased risk is gradually reduced to the usual level during the first few years after stopping HRT. HRT increases mammographic density of the mammary glands, which in some cases may have a negative effect on the x-ray detection of breast cancer. In this regard, your doctor may use other research methods to screen for breast cancer. Ovarian cancer. During the epidemiological study, there was a slight increase in the risk of ovarian cancer in women using estrogen replacement therapy (EST) for a long time (more than 10 years). At the same time, a meta-analysis of 15 studies did not reveal an increase in risk with the use of EST. However, these data are currently controversial. Liver tumors. In rare instances, when using sex hormones, the development of benign, and even more rarely, malignant liver tumors was observed. In some cases, bleeding from such tumors into the abdominal cavity posed a threat to life. Connection with ongoing HRT is not proven. Although such cases are extremely unlikely, you should tell your doctor if you have unusual sensations in the upper abdomen that do not go away for a short period of time. The reasons for the immediate cessation of Progynova you should immediately stop the treatment and consult a doctor if you have any of the following conditions manifest themselves: - a new onset of migraine (characterized by throbbing headache and nausea,which are preceded by visual disturbances); - exacerbation of existing migraine; any unusually frequent or unusually severe headaches; - sudden impairment of vision or hearing; - inflammation of the veins (phlebitis). If you have a thrombosis while taking the drug Progynova or you suspect that this could happen, you should immediately stop taking the drug and turn to the doctor. The warning signs of a possible thrombosis are: - coughing up blood; - unusual pain in the arms or legs or their swelling; - sudden lack of air; - loss of consciousness. Taking Progynova should also be stopped immediately in case of pregnancy or jaundice. Influence on laboratory test results Reception sex hormones can affect the results of some laboratory tests. Always inform the doctor if you are taking Progynova. Progynova is not used for contraception. If contraception is necessary, non-hormonal methods should be used (except for calendar and temperature methods). If you suspect a pregnancy, you should stop taking the drug until pregnancy is excluded. Additional informationNo data on the need for dose adjustment in women under 65 years of age. There are limited data showing an increase in the risk of dementia in women starting hormone replacement therapy at the age of 65 and older. Tell your doctor if you start taking Progynova over the age of 65. The use of Progynova in patients with impaired liver function has not been studied. The use of Progynova in patients with impaired renal function has not been studied. Available data indicate that there is no need to adjust the dose when using the drug in this category of patients. The effect on the ability to drive vehicles and control mechanisms is not affected.

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