Cliogest - instructions for use, reviews, analogs and formulations (tablets) of drugs for hormone replacement therapy and estrogen deficiency in women with menopause and the prevention of postmenopausal osteoporosis. Composition and side effect

In this article, you can read the instructions for using the drugCleiGest. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Cliogest in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Kliogest in the presence of existing structural analogs.Use for hormone replacement therapy and estrogen deficiency in women with menopause and prevention of postmenopausal osteoporosis in women. Composition and side effect of the drug.

Cliogest - a combined preparation containing estrogen and progestogen. It is intended for continuous hormone replacement therapy (HRT).

Estradiol (the first active substance of the Cleiopest preparation) is a synthetic 17 Β-estradiol, chemically and biologically identical to human endogenous estradiol. Eliminates estrogen deficiency in postmenopausal women and alleviates menopause symptoms, and also prevents bone loss during menopause or oophorectomy (ovarian surgery).

Since estrogens stimulate the growth of the endometrium, the use of exclusively estrogens increases the risk of endometrial hyperplasia and endometrial cancer. The addition of progestogen (norethisterone, the second active ingredient in Cleigoest) significantly reduces the estrogen-induced risk of endometrial hyperplasia in women who have not undergone hysterectomy (uterine surgery).

Attenuation of the symptoms of menopause occurs within the first few weeks of treatment.The termination of regular menstrual bleeding occurs in 93% of women with an average duration of 3-4 days.

Deficiency of estrogen during the menopause is associated with an increase in the rate of bone tissue renewal and a decrease in bone mineral density. The effect of estrogens on the mineral density of bones depends on the dose. It is believed that this effect persists as long as the treatment continues. After the termination of HRT, the decrease in bone mass occurs in the same degree as in women who have not undergone treatment. Various studies and their meta-analyzes show that the widespread use of HRT alone estrogen or in combination with progestogen, prescribed mainly to healthy women, reduces the risk of fractures of the hip joint, spine and other fractures due to osteoporosis. HRT can also prevent fractures in women with low bone mineral density and / or with diagnosed cases of osteoporosis, but the evidence supporting this assumption is limited.

Studies based on the measurement of bone mineral density indicate that Cleiogest is effective as a drug that prevents osteoporosis in postmenopausal women.After 2 years of treatment, the mineral density of the bone mass of the spinal column increases by 5.14%, and the hip joint by 3.12%.

Composition

Estradiol (in the form of estradiol hemihydrate) 2 mg + Norethisterone 1 mg + excipients.

Pharmacokinetics

After oral administration of Cliogest 17, Β-estradiol is rapidly absorbed in the gastrointestinal tract. It circulates in the blood as a complex with globulin (37%), binding sex hormones (SHGG), and albumin (61%), and only 1-2% remains unbound. Metabolism 17 Β-estradiol occurs mainly in the liver and intestines. Norethisterone quickly enters the bloodstream, where 36% of it binds to SHBG, and 61% to albumin. Norethisterone undergoes presystemic metabolism in the liver and intestines. In elderly people, pharmacokinetic studies have not been conducted.

Indications

• estrogen insufficiency in menopause;
• relief of menopausal symptoms;
• prevention of osteoporosis in menopause.

Forms of release

Tablets coated with a film sheath of 28 pieces in a plastic calendar disk.

Instructions for use and dosing regimen

Cliogest is a drug for permanent, consistent use in HRT in women with intact (intact, not involved in any process) uterus.Take 1 tablet orally 1 time per day without interruption, preferably at the same time each day.

Side effect

• tenderness of the mammary glands;
• sporadically occurring menstrual bleeding;
• nausea;
• swelling;
• headache.

Contraindications

• hormone-dependent tumors (mammary carcinoma or endometrium);
• acute or chronic liver disease, including history;
• deep vein thrombosis, thromboembolism;
• disturbances of cerebral circulation, including in the anamnesis;
• uterine bleeding of unclear etiology;
• hemoglobinopathy (hereditary or congenital change, or a breakdown in the structure of the hemoglobin protein);
• porphyria (almost always a hereditary impairment of pigment metabolism with an increased content of porphyrins in the blood and tissues and enhanced excretion in urine and feces).

Application in pregnancy and lactation

Contraindicated use of Cliogest during pregnancy and lactation (breastfeeding).

PImplications in children

The drug Cleiopest in pediatric practice is not used.

Application in elderly patients

The experience of using Cliogest in women over the age of 65 is limited.

special instructions

The drug Cleiopest is not a contraceptive and does not protect against pregnancy.

Prescribe Cliogest with caution in hypertension, epilepsy, migraine, diabetes, bronchial asthma, heart failure (patients should be under the supervision of a doctor).

Apply only to women who have had the last menstrual cycle at least 1 year ago. With long-term treatment, it is recommended to conduct preventive examinations at least once a year. Estrogens better to appoint a course duration of not more than 1 year, if there is no regular gynecological examination and examination of the mammary glands.

Before starting treatment, it is necessary to collect a family medical history and conduct a thorough examination (gynecological, breast, blood pressure).

Admission should be stopped with deep vein thrombosis, thromboembolic disorders, with jaundice, increased migraine-like pain, sudden visual impairment, a significant increase in pressure, and also 4-6 weeks before the scheduled surgical operation.

Drug Interactions

Metabolism of estrogen and progestogen can be increased while using inducers drug metabolism isoenzymes, in particular isoenzymes of cytochrome P450, such as antiepileptic drugs (e.g., phenobarbital, phenytoin, carbamazepine) and antibiotics (e.g., rifampicin, rifabutin, nevirapine, efavirenz).

Antiviral drugs that are active against HIV (ritonavir and nelfinavir), when combined with steroid hormones, stimulate the metabolism of estrogens and progestogens.

Herbal preparations containing St. John's wort (Hypericum perforatum) can also stimulate the metabolism of estrogens and progestogens.

Ketoconazole may increase the concentration of the active substances of Cleigoest.

Analogues of Cleigoest

Structural analogs for the active substance:

• Evian.

Analogues of Cliogest Pharmacological Group (estrogens, gestagens, their homologs and antagonists in combinations):

• Anabella;
• Angeletta;
• Angelique;
• Antotevin;
• Belara;
• Benidette;
• Bonade;
• Vesantra;
• Vidor;
• Gestarella;
• Delsia;
• Demulen;
• Jess;
• Divina;
• Divertrain;
• Dicycylene;
• Dimia;
• Evra;
• Janine;
• Zoeli;
• The individual;
• Clira;
• Klimen;
• Klimodien;
• Clinonorm;
• Colposseptin;
• Lei;
• Logest;
• Marvelon;
• Melleva;
• Mersilon;
• Midian;
• Microinon;
• Modell;
• NovaRing;
• Novinet;
• Non Ovlon;
• Ovidon;
• Oralcon;
• Pausogest;
• Regulon;
• Rigevidone;
• Silestus;
• Silhouettes;
• Three Mercy;
• Three regol;
• Triaclim;
• Trigestrel;
• Trikwilar;
• Triogynal;
• Femoden;
• Femoston;
• Cyclo Proginova;
• Tzimycycle;
• Evian;
• Egestenol;
• Erica 35;
• Yamera;
• Yarina;
• Yarina Plus.

Response of a gynecologist

The combined hormonal drug Cleiogest is one of those medicines that I prescribe to my patients during menopause, when there is an acute shortage of estrogens in the body of a woman. The main goal of such substitution therapy is to improve overall health and prevent osteoporosis. And the Cleiopest preparation perfectly copes with these tasks. It happens that in the first months of taking the tablets, there are spontaneous, menstruating, uterine bleeding, the soreness of the mammary glands is noted. Over time, all these phenomena completely disappear. And in general, women tolerate substitution therapy with this drug.

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