More info
Active ingredients
Medroxyprogesterone + Estradiol
Release form
Pills
Composition
1 tablet contains: Active ingredient: estradiol valerate 2 mg. Excipients: lactose monohydrate, corn starch, gelatin, magnesium stearate, talc, purified water .; 1 tablet contains: Active substance: estradiol valerate 2 mg, medroxyprogesterone acetate 10 mg. Excipients: lactose monohydrate, corn starch, gelatin, magnesium stearate, talc, kollidon 25, indigo carmine (E132), purified water .;
Pharmacological effect
Combined hormone-substituting drug of continuous action, which consists of natural estrogen - estradiol valerate and a derivative of natural progesterone - medroxyprogesterone acetate .; The introduction of the estradiol valerate / medroxyprogesterone acetate combination closely imitates the natural cycle of hormonal activity characteristic of the normal menstrual cycle, i.e. the estrogenic phase precedes the combined estrogen / progestogenic phase, followed by menstrual bleeding that occurs within 1 week after the last dose of the drug .; After 12 months of use, divines disappear hot flashes and increased sweating at night .; In women in menopause, while taking Divina, the mineral content and bone density are not reduced, i.e. development of osteoporosis is prevented .; The drug has a beneficial effect on the level of lipids in the blood: reduces the level of low-density lipoproteins and cholesterol, reduces the risk of atherosclerosis; increases the level of high-density lipoproteins that have an anti-atherogenic effect .; The use of Divina prevents the development of endometrial hyperplasia and malignancy.
Pharmacokinetics
Estradiol valerate; Absorption; When taking the drug inside estradiol valerate is well absorbed from the gastrointestinal tract .; Metabolism and excretion; Estradiol valerate is biotransformed mainly in the liver with the formation of less active estriol. Estradiol metabolites are excreted in the urine as water-soluble compounds with glucuronic and sulfuric acids .; Medroxyprogesterone Acetate; Absorption and Distribution; When taking 1 tablet of Divin inside Medroxyprogesterone Acetate is well absorbed from the gastrointestinal tract,Cmax in blood plasma is from 1 to 5 ng / ml and is reached in 2-4 hours. Medroxyprogesterone practically does not bind to plasma proteins .; Withdrawal; Medroxyprogesterone is excreted in the form of metabolites in urine and bile.
Indications
- Relief of symptoms resulting from estrogen and progesterone deficiency in menopausal women; - Prevention of osteoporosis in postmenopausal women.
Contraindications
- thromboembolic disorders or pathology of cerebral vessels in history (including family history); - sickle cell anemia; - pituitary tumors; - estrogen-dependent tumors (cancer of the breast, uterus); - acute and chronic liver diseases; - endometriosis; - arterial hypertension resistant to therapy; - pregnancy.
Use during pregnancy and lactation
Divina is contraindicated for use in pregnancy .; The drug can not be used as a contraceptive.
Dosage and administration
Inside 1 tab. / Day (preferably in the evening) for 21 days, followed by a 7-day break, during which menstrual-like bleeding occurs, after which the administration of pills is restarted (see the label on the packaging with a calendar scale) .; For the first 11 days, pills are taken that contain only estrogen (white) .; Then for the remaining 10 days - pills containing a combination of estrogen with progesterone (blue) .; The pill can be started at any time if the normal menstrual cycle has stopped or if it is irregular, as well as on the 5th day of menstruation .; If you miss a pill, you should take it no later than 12 hours and then take the drug in the usual way.
Side effects
From the reproductive system: rarely - violation of the regularity of bleeding (metrorrhagia), engorgement of the mammary glands .; From the side of the central nervous system: rarely - headache, fatigue .; On the part of the digestive system: rarely - nausea .; Other: rarely - a feeling of heaviness in the lower limbs.
Overdose
Symptoms: nausea, headache, breakthrough uterine bleeding .; Treatment: conduct symptomatic therapy.
Interaction with other drugs
With simultaneous use of Divin can reduce the effectiveness of antihypertensive agents, oral anticoagulants and oral hypoglycemic drugs .; Barbiturates, anticonvulsants, tetracyclines and rifampicin reduce the effect of Divina when they are used simultaneously.
special instructions
During menopause, there may be differences in the duration of the menstrual cycle, so in some women bleeding may begin even while taking blue pills of the drug Divin. In these cases, you must temporarily stop taking the drug, and after the bleeding ends, resume taking the white pills .; Influence on the ability to drive vehicles and control mechanisms; Divina does not affect the ability to drive a car and engage in other activities that require increased attention and speed of psychomotor reactions.