"Utrozhestan" during pregnancy: instructions for use

Some expectant mothers are faced with hormonal changes, which can lead to a threat of miscarriage or even termination of pregnancy. In many cases, they are due to a lack of progesterone, a substance that ensures the normal bearing of a baby. Such a hormone should be produced by the corpus luteum during the entire first trimester, and from the 16th obstetric week, its production becomes one of the functions of the placenta.

If for some reason the female body is unable to synthesize progesterone, doctors prescribe its substitutes, for example, "Utrozhestan". The main task of using this drug is replenishment of natural progesterone. It is thanks to this that the assigned course helps to maintain pregnancy.

Characteristics of the drug

The only dosage form of "Utrozhestan" is capsules. This medication is not available in the form of a gel, tablets or solutions. The main ingredient of the drug is micronized progesterone. Its dosage in each capsule is 100 or 200 mg. The amount of active ingredient affects both the capsule shape and the packaging.

Preparation with a dosage of 100 mg differs in a round shape and is sold 28 pieces per pack (14 capsules in one blister). The drug shell is made of glycerol and gelatin with the addition of titanium dioxide. It is shiny and yellowish, and inside is a homogeneous white oily liquid, which, in addition to progesterone, includes soy lecithin and sunflower oil.
Preparation with a dosage of 200 mg has the same composition and is also represented by pale yellow soft gelatin capsules, inside which is placed a whitish suspension. The difference between this medicine is the shape of the capsules - they are oval. In addition, the drug is packaged in 7 capsules in one blister and sold in 14 pieces in one carton box.

The medication belongs to prescription drugs, therefore it is sold in pharmacies only after presentation of a prescription, which excludes the use of the hormone for other purposes. The average price of one package, regardless of the dosage, is 400 rubles. Store "Utrozhestan" at home during the entire shelf life (3 years from the date of production) in a place hidden from small children. The manufacturer's recommended storage temperature is up to +25 degrees Celsius.

How does it work?

Since the main component of "Utrozhestan" is completely identical to natural progesterone, capsules can replace the natural hormone produced by the corpus luteum. Such a substance is needed in order to:

prepare the lining of the uterus for the adoption of the ovum;
reduce the excitability and activity of the muscular membrane of the uterus and fallopian tubes, thereby preventing the rejection of the egg;
support the development of the fetus until the placenta is fully formed;
influence the metabolic processes in the woman's body, contributing to the normal bearing of the fetus;
prepare the mammary glands for breastfeeding by activating the development of the milk ducts.

The bioavailability of the active substance "Utrozhestan" is equally high for any method of application, but after injection into the vagina, the hormone is absorbed faster and after 1 hour its concentration in plasma becomes maximum. An increase in the amount of progesterone in the blood after oral administration occurs within 1-3 hours. The drug is excreted almost completely in the urine.

Features of application at different times

"Utrozhestan" refers to drugs that are allowed to be used throughout the gestational period, so it is prescribed both in the 1st trimester and at a later date. Quite often, such a medication is prescribed even during preparation for conception, if pregnancy does not occur due to insufficient progesterone levels or any diseases of the uterus (endometriosis, fibroids).

At the same time, treatment with Utrozhestan must be under medical supervision. It is unacceptable to prescribe it yourself and apply it just in case. The specialist must make sure that the woman has a progesterone deficiency and the use of such a hormone is really justified, because the threat of miscarriage is not always caused by an imbalance of hormones. The cause may be genetic pathologies and then progesterone drugs do not help.

In the early stages, "Utrozhestan" is most often administered vaginally. This method reduces the burden on the digestive tract of the expectant mother and provides a faster action of the medicine. In addition, oral use in the first months of pregnancy is often impossible due to severe nausea or frequent vomiting. The use of capsules helps to eliminate hypertonicity and reduces the risk of possible miscarriage due to progesterone deficiency.

In this case, the drug does not have a negative effect on the fetus.

In the 2nd trimester, "Utrozhestan" is used in cases where the production of progesterone by the placenta is insufficient. At this time, expectant mothers who carry the baby after IVF, as well as patients with cervical insufficiency, receive the drug. Indications for taking capsules at a later date are also various problems with a previous pregnancy, for example, if a woman has suffered a miscarriage, she underwent surgical manipulations on the cervix, or she had a premature birth.

For some pregnant women, the drug is prescribed in the 3rd trimester. The use of "Utrozhestan" for such a period is necessary, if the cervix is shortened and softened ahead of time, and the child is too low. These signs of a high risk of premature birth are the main reason to prescribe capsules in the third trimester, however, due to the risk of side effects, the medication is used only in situations that are dangerous for the woman and baby, when the benefits of treatment outweigh the possible harm.

Contraindications

The reasons for refusing to take "Utrozhestan" are the following problems:

the woman has a tendency to blood clots, thrombophlebitis or thromboembolic pathologies (including in the past) have been identified;
revealed vaginal bleeding, but its cause has not yet been established;
an incomplete abortion has occurred;
there is a suspicion of tumors of the genitals, mammary glands, or a malignant neoplasm has already been diagnosed;
the patient developed porphyria;
a woman's liver is damaged due to hepatitis or other serious illness;
revealed hypersensitivity to progesterone or any inactive ingredient in the capsules.

In addition to these contraindications, there are also many diseases and pathological conditions in which capsules are used with caution. These include diabetes mellitus, heart disease, bronchial asthma, epilepsy, renal failure, high blood pressure, and many other ailments.

If the expectant mother has any concomitant diseases, then this must be taken into account when prescribing hormonal treatment.

Instructions for use

Capsules can be used in two ways:

swallow with water;
injected into the vagina as suppositories.

Ingestion is carried out at about the same time, and the dosage is selected individually. As a rule, a woman should drink most of the daily dose before bedtime, and a smaller part in the morning after waking up. For example, if a patient is prescribed 300 mg of progesterone per day, then she takes 100 mg in the morning, and 200 mg at night. Taking with food is not recommended, so the capsules are drunk either before meals or after meals.

Insert the capsule into the vagina simple and painless... After washing the hands, the drug is removed from the blister, and then injected in a position convenient for the patient. In order for Utrozhestan to dissolve better and quickly penetrate into the tissues of the vagina, after the procedure, you need to lie down for a while or sit quietly.

The dose of the drug, as well as for oral administration, is determined individually.

Duration of oral or vaginal use of "Utrozhestan" depends on the clinical situation and the portability of the agent... For example, with a habitual or threatening abortion, the medication should be drunk for only 1 trimester, canceling from 16-20 weeks. If the capsules are prescribed for the prevention of premature birth, then they are inserted into the vagina at 30-37 weeks of gestation.

Cancellation of "Utrozhestan", like other hormonal agents, should be smooth. It is carried out according to the scheme prescribed by the doctor, reducing the dosage every few days and observing the woman's condition. If any alarming changes appear, revert to previous doses and postpone cancellation for a while. How to properly stop taking capsules, be sure to check with your obstetrician-gynecologist.

Side effects

During treatment with Utrozhestan, the following negative reactions may appear:

drowsiness;
discomfort in the mammary glands;
dizziness;
increased body temperature;
headaches;
depression;
vomiting;
nausea;
bloating;
itchy skin;
acne;
allergy in the form of urticaria;
diarrhea;
change in weight;
hair loss;
painful sensations in the joints;
increased sweating at night;
insomnia and others.

The occurrence of dizziness and drowsiness is often noted after taking "Utrozhestan" inside. Often, an overdose of the drug manifests itself in this way, therefore, a decrease in dosage usually helps to eliminate these unpleasant symptoms. In addition, you can get rid of them by switching to vaginal use. This method of treatment is also recommended for patients who may feel sick after swallowing capsules.

In the second to third trimesters, the drug can cause bile stasis.

If the medicine is taken for a long time, it is necessary to monitor the performance of the liver in order to notice the negative effect of the medicine on this organ in time.

Also note that with the introduction of "Utrozhestan" into the vagina, in most cases, women notice a change in the nature of the discharge. They often become a little more plentiful and yellowish in color. This is not considered a side effect and is a normal reaction to the drug. If the intravaginal use of the capsule causes itching, burning, redness or other uncomfortable symptoms, it is recommended to consult a doctor.

Consultation is also required in case of pronounced changes in the color or consistency of vaginal secretions, for example, if the discharge flows out of water, becomes cheesy, bright red, greenish or yellow with an unpleasant odor.

Such signs may indicate a bacterial infection, bleeding, thrush and other phenomena that are dangerous for the child, therefore, require immediate examination by a specialist.

Compatibility with other medicines

If the expectant mother takes any medications, this must be taken into account when prescribing "Utrozhestan", because this hormonal agent can affect the action of other medications. For example, taking it will enhance the therapeutic effects of anticoagulants, diuretics, or immunosuppressants. Some antibacterial agents can reduce the effectiveness of "Utrozhestan", for example, tetracycline and penicillin antibiotics, which are taken into account when treating infections in expectant mothers.

Deserves special attention and joint use of drugs vaginally, if the capsules are also prescribed to be inserted into the vagina. It is undesirable to use the medication simultaneously with any other local remedies. Therefore, if the expectant mother is prescribed treatment with candles "Terzhinan" or "Pimafucin", "Fluomisin", "Hexicon", "Papaverine" and similar preparations in the form of vaginal tablets, suppositories or creams, then between their use and the introduction of "Utrozhestan" there should be break at least 2 hours.

Reviews

There are quite a few good reviews about the use of "Utrozhestan" while waiting for a child (more than 80%). In them, women confirm the effectiveness of the drug with hypertonia and the threat of miscarriage, as well as with the risk of premature birth of a baby, it is not light. In most cases, the tolerance to the drug is assessed as normal, but in some expectant mothers, the capsules still provoked adverse reactions, for example, dizziness, nausea or drowsiness.

The cost of the medication is also called high, because it often needs to be used for a long period.

Analogs

Instead of "Utrozhestan", the doctor may prescribe another medicine, which is also based on progesterone. You should read the list of such drugs.

"Iprozhin"... Such capsules are identical to "Utrozhestan", as they are also presented in two dosages, are used for the same indications, have the same medicinal properties and can provoke the same side effects. They are prescribed for women with endocrine infertility, threatened miscarriage, uterine myoma, endometriosis.

"Prajisan"... The drug is produced not only in capsules with an oily core (their dosage is also 100 and 200 mg), but also in the form of a gel, which is inserted into the vagina using a disposable applicator (one dose contains 90 mg of the hormone). The medication is used when there is a lack of progesterone, including to prevent habitual abortion or to eliminate the symptoms of a threat of miscarriage at an early stage.

"Krynon"... This drug is presented only as a vaginal gel and is most often used in the IVF protocol. The medicine is started on the day of embryo replanting and is used until the 12th obstetric week. One applicator contains 90 mg of progesterone.

In addition, Duphaston is often used as a replacement for Utrozhestan. This medicine is slightly more expensive and contains a synthetic analogue of a natural hormone called dydrogesterone. It can replace natural progesterone, but is devoid of many side effects, due to which, judging by the reviews, it is better tolerated by expectant mothers. The pluses of "Duphaston" also include a smaller list of contraindications.

Dufaston is available in white coated tablets. It is applied only internally according to an individually selected scheme, which depends on the reason for the appointment. Cancellation of such a drug is often carried out after the 16th obstetric week. She, as well as when stopping the reception of "Utrozhestan", must be careful and slow.