Dosage regimen

  Oral route of administration

The drug is taken orally, in the evening before bedtime, with water.

In most cases, with progesterone deficiency, the daily dose of Utrozhestan® is 200-300 mg, divided into 2 doses (200 mg in the evening before bedtime and 100 mg in the morning, if necessary).

  In case of threatened abortion or to prevent habitual abortion due to progesterone deficiency, 200-600 mg / day are prescribed daily in the I and II trimesters of pregnancy. Further use of the drug Utrozhestan® is possible as prescribed by the attending physician based on an assessment of the clinical data of a pregnant woman.

  In case of insufficiency of the luteal phase (premenstrual syndrome, fibrocystic breast disease, dysmenorrhea, menopausal transition period), the daily dose of the drug is 200 or 400 mg for 10 days (usually from the 17th to the 26th day of the cycle).

  With MHT in perimenopause while taking estrogens, Utrozhestan® is prescribed at 200 mg / day for 12 days.

  With MHT in postmenopausal women in a continuous mode, the drug Utrozhestan® is used at a dose of 100-200 mg from the first day of estrogen intake. Dose selection is carried out individually.

  Vaginal route of administration

The capsules are inserted deep into the vagina.

Prevention (prophylaxis) of premature birth in women at risk (with shortening of the cervix and / or the presence of anamnestic data of preterm labor and / or premature rupture of membranes): the usual dose is 200 mg at bedtime, from 22 to 34 weeks pregnancy.

  The complete absence of progesterone in women with non-functioning (absent) ovaries (egg donation): against the background of estrogen therapy, 100 mg / day on the 13th and 14th days of the cycle, then 100 mg 2 times / day from the 15th to On the 25th day of the cycle, from the 26th day and if pregnancy is determined, the dose increases by 100 mg / day every week, reaching a maximum of 600 mg / day, divided into 3 doses. The indicated dose is usually applied for 60 days.

Support of the luteal phase during the cycle of in vitro fertilization: it is recommended to use from 200 to 600 mg / day, starting from the day of injection of chorionic gonadotropin during the I and II trimesters of pregnancy.

  Support of the luteal phase in a spontaneous or induced menstrual cycle, with infertility associated with dysfunction of the corpus luteum: it is recommended to use 200-300 mg / day, starting from the 17th day of the cycle for 10 days, in case of delayed menstruation and diagnosis of pregnancy, treatment should to be continued.

In cases of threatened abortion or in order to prevent habitual abortion arising against the background of progesterone deficiency: 200-400 mg / day in 2 doses daily in the first and second trimesters of pregnancy.

Hypersensitivity to the components of Utrozhestan;

vaginal bleeding of unknown etiology;

incomplete abortion;

porphyria;

malignant neoplasms of the mammary glands or genitals.

Additionally for oral administration:

tendency to thrombosis;

acute phlebitis or thromboembolism;

severe liver disease, liver failure.

Side effects are usually observed when taking Utrozhestan inside.

From the nervous system: drowsiness, transient dizziness, especially in the case of concomitant hypoestrogenism. Reducing the dose of Utrozhestan or increasing the dose of estrogen eliminates these phenomena without reducing the therapeutic effect.

From the reproductive system: shortening of the cycle, intermenstrual spotting.

For oral administration

Progesterone enhances the effect of diuretics, antihypertensive drugs, immunosuppressants, anticoagulants.

Reduces the lactogenic effect of oxytocin.

Simultaneous use with drugs-inducers of microsomal liver enzymes CYP3A4, such as barbiturates, antiepileptic drugs (phenytoin), rifampicin, phenylbutazone, spironolactone, griseofulvin, is accompanied by an acceleration of progesterone metabolism in the liver.

The simultaneous use of progesterone with some antibiotics (penicillins, tetracyclines) can lead to a decrease in its effectiveness due to a violation of the intestinal-hepatic recirculation of sex hormones due to changes in the intestinal microflora.

The severity of these interactions may vary in different patients, therefore, it is difficult to predict the clinical effects of these interactions.

Ketoconazole may increase the bioavailability of progesterone.

Progesterone can increase the concentration of ketoconazole and cyclosporine.

Progesterone can decrease the effectiveness of bromocriptine.

Progesterone can cause a decrease in glucose tolerance, as a result of which - an increase in the need for insulin or other hypoglycemic drugs in patients with diabetes mellitus.

The bioavailability of progesterone can be reduced in patients who smoke and with excessive alcohol consumption.

With intravaginal use

The interaction of progesterone with other drugs for intravaginal use has not been evaluated. The simultaneous use of other drugs used intravaginally should be avoided in order to avoid impaired release and absorption of progesterone.

Symptoms: drowsiness, transient dizziness, euphoria, shortening of the menstrual cycle, dysmenorrhea.

In some patients, the average therapeutic dose may be excessive due to the existing or emerging unstable endogenous secretion of progesterone, special sensitivity to the drug, or too low a concentration of estradiol.

Treatment:

in case of drowsiness or dizziness, it is necessary to reduce the daily dose or to prescribe the drug before bedtime for 10 days of the menstrual cycle;

in the case of a shortening of the menstrual cycle or spotting spotting, it is recommended to postpone the start of treatment to a later day of the cycle (for example, to the 19th instead of the 17th);

in perimenopause and in postmenopausal MHT, it is necessary to ensure that the concentration of estradiol is optimal.

In case of an overdose, symptomatic treatment is carried out if necessary.