Luteal phase support as part of the infertility treatment program in women with assisted reproduction techniques.
Composition:
1 tabl vaginal contains 100 mg of progesterone.
Action:
Progesterone is a naturally occurring steroid secreted by the ovaries, placenta and adrenal glands. In the presence of an appropriate estrogen, it transforms the proliferative endometrium into secretion endometrium. It is necessary to increase the susceptibility of the endometrium to the implantation of the embryo. After implanting the embryo, he supports the pregnancy. At repeated dosing, steady-state concentrations were reached within about 1 day after starting treatment with the preparation. Approx. 96-99% of Progesterone is bound to plasma proteins, mainly with albumin and corticosteroid binding globulin. Progesterone is mainly metabolised in the liver, mostly pregnandiols and pregnanolones, which are then coupled with sulfuric and glucuronic acids. Progesterone metabolites, which are secreted in the bile, can deconjugate and further metabolize in the intestine by reduction, dehydroxylation and epimerisation. Progesterone is excreted through the kidneys and bile.
Contraindications:
Hypersensitivity to progesterone or to any of the excipients. Bleeding from genital tracts of unknown origin. Fixed abortion or ectopic pregnancy. Severe liver dysfunction or liver disease. Diagnosed or suspected breast cancer or genital tract. Active or previous thrombosis or severe thrombophlebitis. Porphyria.
Precautions:
Use with caution in patients with: mild to moderate hepatic impairment; depression in the interview; diseases that can be affected by fluid retention (eg epilepsy, migraine, asthma, cardiac or renal dysfunction); diabetes (doses of antidiabetic agents may need to be adjusted); risk factors for atherosclerosis, including patients aged> 35 years, smokers. Use of the drug should be discontinued if any of the following clinical conditions are suspected: arterial or venous thromboembolism, myocardial infarction, cerebrovascular disease, thrombophlebitis, retinal thrombosis, transient ischemia episodes, sudden severe headache, edema-related visual disturbances optic disc or retinal hemorrhage, as well as if symptoms of depression have increased in patients with a history of depression. Abrupt discontinuation of progesterone administration may cause increased anxiety, mood swings and increased susceptibility to convulsions. There are no indications for use in children or the elderly.
Pregnancy and lactation:
The drug is indicated only in the first trimester of pregnancy, as part of the program of treatment with assisted reproduction techniques. There are limited and inconclusive data on the risk of congenital malformations, including genital abnormalities in male and female children, following intrauterine progesterone exposure in pregnancy chat. Progesterone is excreted in human milk - not used during breastfeeding.
Side effects:
Common: headache, abdominal distension, abdominal pain, nausea, uterine contraction. Uncommon: dizziness, insomnia, diarrhea, constipation, rash, discomfort in the vulva and vagina, burning sensation in the vagina, vaginal discharge, dry vulva and vagina, vaginal bleeding, vaginal mycosis, breast pain, breast swelling, breast tenderness , genital pruritus, peripheral edema.
Dosage:
Vaginally. Adults: 100 mg 3 times a day, starting on the day of egg collection. If pregnancy is confirmed, the medication should be continued for 30 days. There is no experience regarding the use of the drug in patients with impaired liver or kidney function.
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