Ovestin - instructions for use, analogs, reviews and release forms (0.5 mg suppositories, cream or vaginal ointment, 2 mg tablets) of a hormonal drug for the treatment of pruritus, infertility, hot flashes in adults, children and pregnancy

In this article you can get acquainted with the instructions for the use of a hormonal drug Ovestin. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of experts on the use of Ovestin 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 Ovestina in the presence of existing structural analogues. Use to treat itching, infertility,tides and other climacteric disorders in adults, children, as well as during pregnancy and lactation. Interaction of the drug with alcohol.

Ovestin - an estrogenic preparation. Estriol (active ingredient of Ovestin) is a natural estrogen. In the period preceding menopause, and in postmenopausal (natural or surgical), estriol is used to treat symptoms caused by estrogen deficiency. Estriol has a selective effect mainly on the cervix, vagina, vulva and is especially effective for the treatment of urogenital symptoms caused by estrogen deficiency. In cases of atrophy of the mucous membrane of the vagina, Ovestin causes an increase in the proliferation of the vaginal and cervical epithelium, stimulates its blood supply, promotes the recovery of the epithelium, normal microflora and physiological vaginal environment, influences the quality and quantity of cervical mucus. As a result, the resistance of epithelial cells to infection and inflammation increases.

Unlike other estrogens, estriol has a short-term effect, as it is briefly retained in the nuclei of endometrial cells,and if the recommended dosage regimen is followed, proliferation of the endometrium should not be expected. In this regard, cyclic use of progestogens is not necessary, postmenopausal bleeding cancellations do not occur.

Composition

Estriol + auxiliary substances.

Pharmacokinetics

When the drug is administered orally, as well as topically, estriol is rapidly and almost completely absorbed. The binding with albumin plasma is 90%. The excretion of estriol (in a bound form) is carried out mainly by the kidneys; about 2% is excreted through the intestine in an unchanged form.

Indications

• hormone replacement therapy (HRT) for the treatment of mucosal atrophy of the lower genito-urinary tract associated with estrogen deficiency, in particular for the treatment of symptoms such as dyspareunia, dryness and itching of the vagina, to prevent recurrent vaginal and lower genital tract infections; for the treatment of urinary disorders (eg, frequency, dysuria) and moderate incontinence;
• pre- and postoperative treatment of women in the postmenopausal period;
• menopausal disorders (hot flashes and night sweats);
• infertility caused by a cervical factor;
• with a diagnostic purpose for unclear results of cervical cervical examination (suspicion of a tumor process) against the background of atrophic changes.

Forms of release

Vaginal Candles 0.5 mg.

The cream is vaginal (sometimes mistakenly called ointment).

Tablets 2 mg.

Instructions for use and dosage

Candles

Candles should be injected into the vagina at night before bedtime.

In the treatment of atrophy of the mucous membrane of the lower sections of the genito-urinary tract, 1 candle per day is administered during the first weeks, followed by a gradual dose reduction, based on alleviating the symptoms, until a maintenance dose is reached (i.e., 1 suppository 2 times a week).

In pre-and post-operative therapy of women in the postmenopausal period, with surgical interventions, vaginal access is prescribed 1 suppository per day for 2 weeks before the operation; 1 suppository 2 times a week for 2 weeks after the operation.

With a diagnostic purpose for unclear results of cytological examination of the cervix, 1 candle is prescribed every other day for a week before taking the next smear.

If a dose is missed, the missed dose should be entered on the same day,as soon as the patient remembers it (the dose should not be administered 2 times a day). In the future, the applications are carried out in accordance with the usual dosing scheme.

At the beginning or continuation of the treatment of postmenopausal symptoms, it is necessary to use the lowest effective dose for the shortest period of time.

In women who do not receive hormone replacement therapy (HRT), or women who are transferred from a continuous intake of an oral combination drug for HRT, treatment with Ovestin can begin any day. Women who switch from cyclic regimens for HRT should begin treatment with Ovestin 1 week after the withdrawal of HRT.

Cream

The cream should be injected into the vagina with a calibrated applicator at night (before bedtime).

1 application (applicator, filled to the ring mark) contains 500 mg of cream, which corresponds to 500 μg of estriol.

In the treatment of atrophy of the mucous membrane of the lower sections of the genito-urinary tract, 1 application per day for the first weeks (maximum 4 weeks), followed by a gradual dose reduction, based on relief of symptoms, until a maintenance dose is reached (i.e.1 application 2 times a week).

With pre-and postoperative therapy of women in the postmenopausal period, with surgical interventions with vaginal access - 1 application per day for 2 weeks before the operation; 1 application 2 times a week for 2 weeks after the operation.

With a diagnostic purpose for unclear results of cervical cervical examination - 1 application every other day for a week before taking the next smear.

Instructions for use for patients

1. The cream is injected into the vagina for the night (before bedtime).

2. Remove the cap from the tube, turn the cap over and use a sharp rod to open the tube.

3. Screw the applicator onto the tube.

4. Squeeze the tube to fill the applicator with cream until the piston stops.

5. Unscrew the applicator from the tube and close the tube with a cap.

6. In the prone position, the end of the applicator is inserted deep into the vagina and slowly pressed against the piston until it stops, injecting the cream.

After the drug is injected from the cylinder, remove the piston and rinse the cylinder and the piston with warm water and soap. Do not use detergents. After that, the cylinder and the piston are abundantly rinsed with clean water.

Do not lower the applicator into hot or boiling water.

Pills

The drug is administered orally. The daily dose should not exceed 8 mg.

When atrophy of the lower urinary tract due to estrogen deficiency is prescribed 4-8 mg per day for the first 4 weeks, followed by a gradual decrease in dose in accordance with the symptoms until a maintenance dose of 1-2 mg per day.

In pre-and post-operative treatment for operations on the vagina in the postmenopausal period - 4-8 mg per day for 2 weeks before the operation, 1-2 mg per day - within 2 weeks after the operation.

In the treatment of climacteric disorders (hot flashes, night sweats) - 4-8 mg during the week with a gradual decrease in dose. For maintenance therapy, the minimum effective dose should be used.

Infertility, due to the cervical factor, usually prescribed 1-2 mg per day from the 6th to the 15th day of the menstrual cycle. However, in different patients, the daily dose can vary from 1 mg to 8 mg. The dose should be increased every month until the optimal effect is achieved on the mucous membrane of the cervix.

If the woman missed taking the next dose, and the delay was no more than 12 hours, it is necessary to take the pill as soon as possible.If the delay was more than 12 hours, you should skip one dose and continue taking the drug at the usual time.

Tablets are taken with water, preferably at the same time of day.

The daily dose should be taken in 1 dose.

Side effect

• intermenstrual bleeding spotting from the vagina;
• cervical hypersecretion;
• tenderness and tension of the mammary glands;
• jaundice;
• nausea;
• skin rash;
• increased blood pressure;
• headache.

Contraindications

• identified or suspected estrogen-dependent tumors (breast cancer, endometrial cancer);
• vaginal bleeding of unclear etiology;
• confirmed venous thromboembolism (deep vein thrombosis, pulmonary thromboembolism) during the last 2 years;
• venous thromboembolism in history or thrombosis if anticoagulant therapy is not performed;
• diabetes mellitus with angiopathy;
• sickle-cell anemia;
• the Dubin-Johnson syndrome;
• Rotor syndrome;
• impaired cerebral circulation;
• pregnancy;
• lactation period (breastfeeding);
• hypersensitivity to the active and / or excipients of the drug.

Caution should be given to the drug under the following conditions:

• familial hyperlipoproteinemia;
• increased risk of thromboembolic complications;
• systemic lupus erythematosus;
• prolonged immobilization, serious surgical interventions;
• severe liver disease;
• gallbladder disease in history (especially cholelithiasis);
• hepatic porphyria;
• severe itching or cholestatic jaundice (including anamnesis during previous pregnancy);
• pancreatitis;
• endometriosis;
• leiomyoma;
• bronchial asthma;
• arterial hypertension;
• hypercalcemia due to bone metastases of breast cancer;
• herpes pregnant;
• epilepsy;
• otosclerosis.

Application in pregnancy and lactation

Ovestin is contraindicated for use in pregnancy and lactation (breastfeeding).

special instructions

Before starting hormone replacement therapy, a full medical examination is necessary.

During treatment every 6 months, regular examinations (including mammary examinations, mammography) should be performed according to accepted medical practice.

It is necessary to exclude the presence in the anamnesis of thromboembolism, repeated spontaneous abortions, which indicates thrombophilia.The risk of thromboembolism increases with prolonged immobilization, severe injuries and surgical interventions. In these cases, it is necessary to temporarily interrupt hormone replacement therapy (4-6 weeks before surgery)

The use of estriol does not lead to an increase in the density of the breast. And perhaps the use of estriol does not lead to an increased risk of developing breast cancer.

Cases of venous thromboembolism (deep vein thrombosis of the lower leg, thrombosis of pelvic veins and pulmonary thromboembolism) are more common in women receiving hormone replacement therapy.

Drug Interactions

No cases of interaction of Ovestin with other drugs were noted.

The data on the enhancement of the pharmacological effect of glucocorticosteroids (GCS), hypolipidemic agents when combined with estrogens are known. If necessary, the dose of GCS can be reduced.

Possible weakening effects of drugs male sex hormones, anticoagulants, antidepressants, diuretic, hypotensive and hypoglycemic agents.

Barbiturates, antiepileptic drugs (carbamazepine, phenytoin) increase the metabolism of steroid hormones.

Antibiotics (ampicillin, rifampicin), general anesthetics, opioid analgesics, anxiolytics, antiepileptics, some antihypertensives, ethanol (alcohol) reduce the effectiveness of estrogens.

Folic acid and preparations of thyroid hormones increase the effect of estriol.

Ovestin can change the effectiveness of oral anticoagulants.

Estriol can increase the pharmacological effect of succinicholine, theophylline, and foleandomicin.

Analogues of the drug Ovestin

Structural analogs for the active substance:

• Ovipol Clio;
• Elvagin;
• Estriol;
• Estrovagin;
• Estrokad.

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