Заместительная гормональная терапия (ЗГТ) для лечения атрофии слизистой оболочки нижних отделов мочеполового тракта, связанной с эстрогенной недостаточностью; пред- и послеоперационное лечение женщин в постменопаузном периоде при операциях влагалищным доступом; с диагностической целью при неясных результатах цитологического исследования шейки матки ...
Установленный, имеющийся в анамнезе или подозреваемый рак молочных желез; диагностированные эстрогенозависимые опухоли или подозрение на них (например, рак эндометрия); кровотечение из влагалища неясной этиологии; нелеченная гиперплазия эндометрия; наличие венозных тромбозов в настоящее время и в анамнезе; активное или недавно перенесенное тромбоэмболическое ...
В 1 г крема: Эстриол (estriol) 1 мг. Вспомогательные вещества: октилдодеканол, цетилпальмитат, глицерол, цетиловый спирт, стеариловый спирт, полисорбат, сорбитана стеарат, молочная кислота, хлоргексидина дигидрохлорид, натрия гидроксид, вода очищенная.
Фармакологические свойства
Эстрогенный препарат. Аналог естественного женского гормона. Восполняет дефицит эстрогенов у женщин в постменопаузном периоде и ослабляет симптомы постменопаузы. Наиболее эффективен при лечении мочеполовых расстройств. При атрофии слизистой оболочки нижних отделов мочеполовых путей эстриол способствует нормализации эпителия мочеполового тракта и способствует восстановлению нормальной микрофлоры и физиологического рН во влагалище. Повышает сопротивляемость эпителиальных клеток мочеполового тракта к инфекциям и воспалению, снижая такие жалобы как болезненность при половом акте, сухость, зуд во влагалище, уменьшает вероятность возникновения вагинальных инфекций и инфекций мочевыводящих путей, способствует нормализации мочеиспускания, предотвращает недержание мочи. В отличие от других эстрогенов, эстриол обладает коротким периодом действия, поскольку в ядрах клеток эндометрия он удерживается в течение короткого промежутка времени. Предполагается, что одноразовое введение суточной дозы не вызывает пролиферации эндометрия. Поэтому не требуется циклического введения прогестагена и не возникает кровотечений отмены. Кроме того, показано, что эстриол не увеличивает маммографической плотности.
Показания к применению
Заместительная гормональная терапия (ЗГТ) для лечения атрофии слизистой оболочки нижних отделов мочеполового тракта, связанной с эстрогенной недостаточностью; пред- и послеоперационное лечение женщин в постменопаузном периоде при операциях влагалищным доступом; с диагностической целью при неясных результатах цитологического исследования шейки матки (подозрение на опухолевый процесс) на фоне атрофических изменений.
Противопоказания
Установленный, имеющийся в анамнезе или подозреваемый рак молочных желез; диагностированные эстрогенозависимые опухоли или подозрение на них (например, рак эндометрия); кровотечение из влагалища неясной этиологии; нелеченная гиперплазия эндометрия; наличие венозных тромбозов в настоящее время и в анамнезе; активное или недавно перенесенное тромбоэмболическое заболевание артерий (например, стенокардия, инфаркт миокарда); заболевание печени в острой стадии или заболевание печени в анамнезе, после которого показатели функции печени не вернулись к норме; порфирия; установленная повышенная чувствительность к активному веществу или к любому из вспомогательных веществ препарата.
Применение при беременности и в период грудного вскармливания
Препарат Овестин; противопоказан при беременности. В случае возникновения беременности во время терапии препаратом Овестин;, лечение необходимо немедленно отменить. Результаты большинства эпидемиологических исследований, проведенных к настоящему времени относительно непреднамеренного воздействия эстрогенов на плод, свидетельствуют об отсутствии тератогенных или фетотоксических эффектов. Препарат Овестин; не рекомендуется назначать в период кормления грудью. Эстриол выводится с грудным молоком и может уменьшать образование молока.
Способ применения и дозы
Крем следует вводить во влагалище с помощью калиброванного аппликатора на ночь (перед сном).1 аппликация (аппликатор, заполненный до кольцевой отметки) содержит 500 мг крема, что соответствует 500 мкг эстриола. При лечении атрофии слизистой оболочки нижних отделов мочеполового тракта - 1 аппликация/сут в течение первых недель (максимум 4 недель) с последующим постепенным снижением дозы, основываясь на облегчении симптомов, до достижения поддерживающей дозы (т.е. 1 аппликация 2 раза в неделю). При пред- и послеоперационной терапии женщин в постменопаузном периоде, при хирургических вмешательствах влагалищным доступом - 1 аппликация/сут в течение 2 недель перед операцией; 1 аппликация 2 раза в неделю в течение 2 недель после операции. С диагностической целью при неясных результатах цитологического исследования шейки матки - 1 аппликация через день в течение недели перед взятием следующего мазка. При пропуске дозы пропущенную дозу необходимо ввести в тот же день, как только больная вспомнит об этом (доза не должна вводиться 2 раза/сут). В дальнейшем аппликации проводят в соответствии с обычной схемой дозирования. В начале или при продолжении лечения постменопаузных симптомов необходимо применять наименьшую эффективную дозу в течение наиболее короткого промежутка времени. У женщин, не получающих ЗГТ, или женщин, которые переводятся с непрерывного приема перорального комбинированного препарата для ЗГТ, лечение Овестином можно начинать в любой день. Женщины, которые переходят с циклического режима приема препаратов для ЗГТ, должны начинать лечение кремом Овестин; через 1 неделю после отмены препаратов ЗГТ. Инструкция по применению для пациентов1. Крем вводят во влагалище на ночь (перед сном).2. Снимают колпачок с тубы, переворачивают колпачок и используют острый стержень для вскрытия тубы.3. Наворачивают аппликатор на тубу.4. Сжимают тубу для заполнения аппликатора кремом до тех пор, пока не остановится поршень.5. Отворачивают аппликатор с тубы и закрывают тубу колпачком.6. В положении лежа, конец аппликатора вводят глубоко во влагалище и медленно надавливают на поршень до упора, вводя крем. После введения препарата из цилиндра вынимают поршень и промывают цилиндр и поршень теплой водой с мылом. Не следует применять детергенты. После этого цилиндр и поршень обильно ополаскивают чистой водой. Не следует опускать аппликатор в горячую или кипящую воду.
Побочное действие
Как и в случае применения любого другого препарата, который наносится на поверхность слизистых оболочек, крем Овестин; может иногда вызывать местное раздражение или зуд. Иногда может отмечаться чувствительность, напряженность, болезненность, увеличение размеров молочных желез. Эти нежелательные реакции обычно бывают непродолжительными и проходящими, но в тоже время могут свидетельствовать о применении слишком высокой дозы. Также отмечаются ациклические кровянистые выделения, прорывные кровотечения, метроррагия. При ЗГТ с использованием эстроген-прогестаген-содержащих препаратов наблюдались так же следующие побочные эффекты, связь которых с использованием Овестина не доказана: доброкачественные и злокачественные эстрогенозависимые неоплазии (рак эндометрия и молочных желез); венозная тромбоэмболия (тромбоз глубоких вен ног или таза, эмболия сосудов легких) чаще возникает при применении ЗГТ, чем при отсутствии терапии; инфаркт миокарда, инсульт; желчнокаменная болезнь; кожные и подкожные заболевания (хлоазма, многоформная эритема, узловатая эритема, геморрагическая пурпура); деменция; повышение либидо.
Передозировка
Острая токсичность эстриола у животных очень низкая. Передозировка препаратом Овестин; при вагинальном введении маловероятна. Однако в случае попадания больших количеств препарата в ЖКТ может развиться тошнота, рвота и прекращение кровотечений у женщин. Лечение: специфического антидота нет. При необходимости следует проводить симптоматическое лечение.
Особые указания
Терапию следует прекратить в случае выявления противопоказания и/или при возникновении следующих состояний: желтуха и/или ухудшение функции печени; значительное повышение АД; возобновление головной боли по типу мигрени; беременность. При наличии вагинальных инфекций рекомендовано сопутствующее специфическое лечение.
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Вспомогательные вещества: октилдодеканол, цетилпальмитат, глицерол, цетиловый спирт, стеариловый спирт, полисорбат, сорбитана стеарат, молочная кислота, хлоргексидина дигидрохлорид, натрия гидроксид, вода очищенная."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Эстрогенный препарат. Аналог естественного женского гормона. Восполняет дефицит эстрогенов у женщин в постменопаузном периоде и ослабляет симптомы постменопаузы. Наиболее эффективен при лечении мочеполовых расстройств. При атрофии слизистой оболочки нижних отделов мочеполовых путей эстриол способствует нормализации эпителия мочеполового тракта и способствует восстановлению нормальной микрофлоры и физиологического рН во влагалище. Повышает сопротивляемость эпителиальных клеток мочеполового тракта к инфекциям и воспалению, снижая такие жалобы как болезненность при половом акте, сухость, зуд во влагалище, уменьшает вероятность возникновения вагинальных инфекций и инфекций мочевыводящих путей, способствует нормализации мочеиспускания, предотвращает недержание мочи. В отличие от других эстрогенов, эстриол обладает коротким периодом действия, поскольку в ядрах клеток эндометрия он удерживается в течение короткого промежутка времени. Предполагается, что одноразовое введение суточной дозы не вызывает пролиферации эндометрия. Поэтому не требуется циклического введения прогестагена и не возникает кровотечений отмены. Кроме того, показано, что эстриол не увеличивает маммографической плотности."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Заместительная гормональная терапия (ЗГТ) для лечения атрофии слизистой оболочки нижних отделов мочеполового тракта, связанной с эстрогенной недостаточностью; пред- и послеоперационное лечение женщин в постменопаузном периоде при операциях влагалищным доступом; с диагностической целью при неясных результатах цитологического исследования шейки матки (подозрение на опухолевый процесс) на фоне атрофических изменений."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Установленный, имеющийся в анамнезе или подозреваемый рак молочных желез; диагностированные эстрогенозависимые опухоли или подозрение на них (например, рак эндометрия); кровотечение из влагалища неясной этиологии; нелеченная гиперплазия эндометрия; наличие венозных тромбозов в настоящее время и в анамнезе; активное или недавно перенесенное тромбоэмболическое заболевание артерий (например, стенокардия, инфаркт миокарда); заболевание печени в острой стадии или заболевание печени в анамнезе, после которого показатели функции печени не вернулись к норме; порфирия; установленная повышенная чувствительность к активному веществу или к любому из вспомогательных веществ препарата."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат Овестин; противопоказан при беременности. В случае возникновения беременности во время терапии препаратом Овестин;, лечение необходимо немедленно отменить. Результаты большинства эпидемиологических исследований, проведенных к настоящему времени относительно непреднамеренного воздействия эстрогенов на плод, свидетельствуют об отсутствии тератогенных или фетотоксических эффектов. Препарат Овестин; не рекомендуется назначать в период кормления грудью. Эстриол выводится с грудным молоком и может уменьшать образование молока."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Крем следует вводить во влагалище с помощью калиброванного аппликатора на ночь (перед сном).1 аппликация (аппликатор, заполненный до кольцевой отметки) содержит 500 мг крема, что соответствует 500 мкг эстриола. При лечении атрофии слизистой оболочки нижних отделов мочеполового тракта - 1 аппликация/сут в течение первых недель (максимум 4 недель) с последующим постепенным снижением дозы, основываясь на облегчении симптомов, до достижения поддерживающей дозы (т.е. 1 аппликация 2 раза в неделю). При пред- и послеоперационной терапии женщин в постменопаузном периоде, при хирургических вмешательствах влагалищным доступом - 1 аппликация/сут в течение 2 недель перед операцией; 1 аппликация 2 раза в неделю в течение 2 недель после операции. С диагностической целью при неясных результатах цитологического исследования шейки матки - 1 аппликация через день в течение недели перед взятием следующего мазка. При пропуске дозы пропущенную дозу необходимо ввести в тот же день, как только больная вспомнит об этом (доза не должна вводиться 2 раза/сут). В дальнейшем аппликации проводят в соответствии с обычной схемой дозирования. В начале или при продолжении лечения постменопаузных симптомов необходимо применять наименьшую эффективную дозу в течение наиболее короткого промежутка времени. У женщин, не получающих ЗГТ, или женщин, которые переводятся с непрерывного приема перорального комбинированного препарата для ЗГТ, лечение Овестином можно начинать в любой день. Женщины, которые переходят с циклического режима приема препаратов для ЗГТ, должны начинать лечение кремом Овестин; через 1 неделю после отмены препаратов ЗГТ. Инструкция по применению для пациентов1. Крем вводят во влагалище на ночь (перед сном).2. Снимают колпачок с тубы, переворачивают колпачок и используют острый стержень для вскрытия тубы.3. Наворачивают аппликатор на тубу.4. Сжимают тубу для заполнения аппликатора кремом до тех пор, пока не остановится поршень.5. Отворачивают аппликатор с тубы и закрывают тубу колпачком.6. В положении лежа, конец аппликатора вводят глубоко во влагалище и медленно надавливают на поршень до упора, вводя крем. После введения препарата из цилиндра вынимают поршень и промывают цилиндр и поршень теплой водой с мылом. Не следует применять детергенты. После этого цилиндр и поршень обильно ополаскивают чистой водой. Не следует опускать аппликатор в горячую или кипящую воду."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Как и в случае применения любого другого препарата, который наносится на поверхность слизистых оболочек, крем Овестин; может иногда вызывать местное раздражение или зуд. Иногда может отмечаться чувствительность, напряженность, болезненность, увеличение размеров молочных желез. Эти нежелательные реакции обычно бывают непродолжительными и проходящими, но в тоже время могут свидетельствовать о применении слишком высокой дозы. Также отмечаются ациклические кровянистые выделения, прорывные кровотечения, метроррагия. При ЗГТ с использованием эстроген-прогестаген-содержащих препаратов наблюдались так же следующие побочные эффекты, связь которых с использованием Овестина не доказана: доброкачественные и злокачественные эстрогенозависимые неоплазии (рак эндометрия и молочных желез); венозная тромбоэмболия (тромбоз глубоких вен ног или таза, эмболия сосудов легких) чаще возникает при применении ЗГТ, чем при отсутствии терапии; инфаркт миокарда, инсульт; желчнокаменная болезнь; кожные и подкожные заболевания (хлоазма, многоформная эритема, узловатая эритема, геморрагическая пурпура); деменция; повышение либидо."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Острая токсичность эстриола у животных очень низкая. Передозировка препаратом Овестин; при вагинальном введении маловероятна. Однако в случае попадания больших количеств препарата в ЖКТ может развиться тошнота, рвота и прекращение кровотечений у женщин. Лечение: специфического антидота нет. При необходимости следует проводить симптоматическое лечение."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Терапию следует прекратить в случае выявления противопоказания и/или при возникновении следующих состояний: желтуха и/или ухудшение функции печени; значительное повышение АД; возобновление головной боли по типу мигрени; беременность. При наличии вагинальных инфекций рекомендовано сопутствующее специфическое лечение."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Эстрогенный препарат. Аналог естественного женского гормона. Восполняет дефицит эстрогенов у женщин в постменопаузном периоде и ослабляет симптомы постменопаузы. Наиболее эффективен при лечении мочеполовых расстройств. При атрофии слизистой оболочки нижних отделов мочеполовых путей эстриол способствует нормализации эпителия мочеполового тракта и способствует восстановлению нормальной микрофлоры и физиологического рН во влагалище. Повышает сопротивляемость эпителиальных клеток мочеполового тракта к инфекциям и воспалению, снижая такие жалобы как болезненность при половом акте, сухость, зуд во влагалище, уменьшает вероятность возникновения вагинальных инфекций и инфекций мочевыводящих путей, способствует нормализации мочеиспускания, предотвращает недержание мочи. В отличие от других эстрогенов, эстриол обладает коротким периодом действия, поскольку в ядрах клеток эндометрия он удерживается в течение короткого промежутка времени. Предполагается, что одноразовое введение суточной дозы не вызывает пролиферации эндометрия. Поэтому не требуется циклического введения прогестагена и не возникает кровотечений отмены. 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