Гестаген, гормон желтого тела. Связываясь с рецепторами на поверхности клеток органов-мишеней, проникает в ядро, где, активируя ДНК, стимулирует синтез РНК. Способствует переходу слизистой оболочки матки из фазы пролиферации, вызываемой фолликулярным гормоном, в секреторную фазу, а после оплодотворения - в состояние, необходимое для развития оплодотворенной яйцеклетки. Уменьшает возбудимость и сократимость мускулатуры матки и маточных труб, стимулирует развитие концевых элементов молочной железы.; Стимулируя протеинлипазу, увеличивает запасы жира, повышает утилизацию глюкозы, увеличивая концентрацию базального и стимулированного инсулина, способствует накоплению в печени гликогена, повышает выработку альдостерона: в малых дозах ускоряет, а в больших - подавляет продукцию гонадотропных гормонов гипофиза; уменьшает азотемию, увеличивает выведение азота с мочой. Активирует рост секреторного отдела ацинусов молочных желез и индуцирует лактацию. Способствует развитию нормального эндометрия.
Показания к применению
Нарушения, связанные с дефицитом прогестерона.
Пероральный путь введения:
Бесплодие вследствие лютеиновой недостаточности
Предменструальный синдром
Нарушения менструального цикла вследствие нарушения овуляции или ановуляции
Фиброзно-кистозная мастопатия
Пременопауза
Заместительная гормонотерапия пери- и постменопаузы (в сочетании с эстрогенсодержащими препаратами)
Вагинальный путь введения:
Заместительная гормонотерапия в случае дефицита прогестерона при нефункционирующих (отсутствующих) яичниках (донорство яйцеклеток)
Поддержка лютеиновой фазы во время подготовки к экстракорпоральному оплодотворению
Поддержка лютеиновой фазы в спонтанном или индуцированном менструальном цикле
Преждевременная менопауза
Заместительная гормонотерапия (в сочетании с эстрогенными препаратами)
Бесплодие вследствие лютеиновой недостаточности
Профилактика привычного и угрожающего аборта вследствие прогестиновой недостаточности
Профилактика миомы матки
Профилактика эндометриоза
Противопоказания
Для перорального и вагинального применения;
Тромбофлебит, тромбоэмболические нарушения, внутричерепное кровоизлияние или наличие данных состояний в анамнезе
Кровотечения из половых путей неясного генеза
Неполный аборт
Порфирия
Установленные или подозреваемые злокачественные новообразования молочных желез или половых органов
Повышенная чувствительность к компонентам препарата , в т.ч. к арахисовому маслу, сое
Для перорального применения (дополнительно); — тяжелые заболевания печени в настоящее время (в т.ч. холестатическая желтуха, гепатит, печеночно-клеточный рак, синдромы Дубина-Джонсона, Ротора) или в анамнезе, если показатели функции печени не вернулись к нормальным значениям.
С осторожностью следует назначать препарат при заболеваниях сердечно-сосудистой системы, артериальной гипертензии, хронической почечной недостаточности, сахарном диабете, бронхиальной астме, эпилепсии, мигрени, депрессии, гиперлипопротеинемии.
Применение при беременности и в период грудного вскармливания
Применение препарата при беременности не противопоказано. Тем не менее, существует потенциальный риск для плода (особенного мужского пола) при применении прогестерона в первые 4 месяца беременности. Применение микронизированного прогестерона во II-III триместрах беременности может приводить к развитию заболеваний печени у беременных. Многочисленные эпидемиологические исследования не выявили случаев аномалии развития плода при применении прогестерона при беременности.; Прогестерон проникает в грудное молоко. Данных по применению препарата в период лактации недостаточно для того, чтобы оценить потенциальный риск для младенца.
Способ применения и дозы
Продолжительность лечения определяется характером и особенностями заболевания.; Пероральный путь введения; Препарат принимают внутрь, запивая водой.; В большинстве случаев при недостаточности прогестерона суточная доза препарата Праджисан составляет 200-300 мг, разделенных на 2 приема (утром и вечером).; При недостаточности лютеиновой фазы (предменструальный синдром, фиброзно-кистозная мастопатия, дисменорея, пременопауза) суточная доза составляет 200 или 400 мг, принимаемых в течение 10 дней (обычно с 17-го по 26-й день цикла).; При заместительной гормонотерапии в пери- и постменопаузе на фоне приема эстрогенов препарат Праджисан применяется по 200 мг/сут в течение 10-12 дней.; Вагинальный путь введения; Капсулы вводят глубоко во влагалище.; Абсолютный дефицит прогестерона у женщин с нефункционирующими (отсутствующими) яичниками (донорство яйцеклеток): на фоне эстрогенной терапии по 200 мг/сут на 13 и 14-й дни цикла, затем по 100 мг 2 раза/сут с 15-го по 25-й день цикла, с 26-го дня, и в случае установления беременности доза возрастает на 100 мг/сут каждую неделю, достигая максимума 600 мг/сут, разделенных на 3 приема. Такая доза может применяться на протяжении 60 дней.; Поддержка лютеиновой фазы во время подготовки к экстракорпоральному оплодотворению: рекомендуется принимать от 200 до 600 мг/сут, начиная со дня инъекции хорионического гонадотропина в течение I и II триместра беременности.; Поддержка лютеиновой фазы в спонтанном или индуцированном менструальном цикле, при бесплодии, связанном с нарушением функции желтого тела рекомендуется принимать 200-300 мг/сут, начиная с 17-го дня цикла на протяжении 10 дней, в случае задержки менструации и диагностики беременности лечение должно быть продолжено.; В случаях угрозы аборта или в целях профилактики привычных абортов, возникающих на фоне недостаточности прогестерона: 200-400 мг ежедневно в 2 приема в I и II триместрах беременности.
Побочное действие
При пероральном пути введения; Кровотечения "прорыва" или укорочение нормального менструального цикла, напряженность молочных желез (обычно в первый месяц лечения).; Сонливость, преходящее головокружение (как правило, через 1-3 ч после приема), тошнота. Данные побочные эффекты могут быть уменьшены путем снижения дозы, изменением режима приема препарата или переходом на вагинальный путь введения. Эти эффекты обычно являются первыми признаками передозировки.; Ощущение усталости, мигрень, головная боль, кожная сыпь, зуд, желтуха, задержка жидкости.; При пероральном и вагинальном пути введения; Аллергические реакции (крапивница, анафилактический шок).
Передозировка
Симптомы: сонливость, преходящее головокружение, укорочение нормального менструального цикла.; Лечение: снижение дозы или коррекция режим приема, например, в случае сонливости и головокружения - 200 мг принимают перед сном с 12-го по 14-й день цикла или переходят на вагинальный путь введения: в случае укорочения менструального цикла - начать лечение позже в цикле, например с 19-го дня, вместо 17-го. При необходимости проводят симптоматическое лечение.
Особые указания
Препарат нельзя применять с целью контрацепции.; При длительном лечении прогестероном необходимо периодически проводить медицинские осмотры (включая исследование функции печени); лечение необходимо отменить в случае наличия отклонений диагностических тестов функции печени или возникновения холестатической желтухи. При применении эстроген и/или прогестаген-содержащих препаратов отмечались случаи развития хлоазмы, особенно у пациенток с наличием в анамнезе хлоазмы во время предшествующей беременности. У женщин со склонностью к развитию хлоазмы, подвергание кожи естественному или искусственному УФ-облучению может вызывать или усугублять течение хлоазмы.; Необходимо наблюдать за пациентами с депрессией в анамнезе, и в случае развития депрессии тяжелой степени, необходимо отменить препарат. Пациенты с сопутствующими сердечно-сосудистыми заболеваниями или наличием их в анамнезе должны также наблюдаться периодически врачом.; При лечении прогестероном может наблюдаться задержка жидкости, что может повлиять на течение эпилепсии, мигрени, бронхиальной астмы, сердечной или почечной недостаточности; такие пациенты должны тщательно наблюдаться.; Влияние на способность к вождению автотранспорта и управлению механизмами; При пероральном приеме необходимо соблюдать осторожность при вождении автотранспорта и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
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Связываясь с рецепторами на поверхности клеток органов-мишеней, проникает в ядро, где, активируя ДНК, стимулирует синтез РНК. Способствует переходу слизистой оболочки матки из фазы пролиферации, вызываемой фолликулярным гормоном, в секреторную фазу, а после оплодотворения - в состояние, необходимое для развития оплодотворенной яйцеклетки. Уменьшает возбудимость и сократимость мускулатуры матки и маточных труб, стимулирует развитие концевых элементов молочной железы.; Стимулируя протеинлипазу, увеличивает запасы жира, повышает утилизацию глюкозы, увеличивая концентрацию базального и стимулированного инсулина, способствует накоплению в печени гликогена, повышает выработку альдостерона: в малых дозах ускоряет, а в больших - подавляет продукцию гонадотропных гормонов гипофиза; уменьшает азотемию, увеличивает выведение азота с мочой. Активирует рост секреторного отдела ацинусов молочных желез и индуцирует лактацию. Способствует развитию нормального эндометрия."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Нарушения, связанные с дефицитом прогестерона."}},{"type":"paragraph","data":{"text":"Пероральный путь введения:"}},{"type":"list","data":{"style":"unordered","items":["Бесплодие вследствие лютеиновой недостаточности","Предменструальный синдром","Нарушения менструального цикла вследствие нарушения овуляции или ановуляции","Фиброзно-кистозная мастопатия","Пременопауза","Заместительная гормонотерапия пери- и постменопаузы (в сочетании с эстрогенсодержащими препаратами)"]}},{"type":"paragraph","data":{"text":"Вагинальный путь введения:"}},{"type":"list","data":{"style":"unordered","items":["Заместительная гормонотерапия в случае дефицита прогестерона при нефункционирующих (отсутствующих) яичниках (донорство яйцеклеток)","Поддержка лютеиновой фазы во время подготовки к экстракорпоральному оплодотворению","Поддержка лютеиновой фазы в спонтанном или индуцированном менструальном цикле","Преждевременная менопауза","Заместительная гормонотерапия (в сочетании с эстрогенными препаратами)","Бесплодие вследствие лютеиновой недостаточности","Профилактика привычного и угрожающего аборта вследствие прогестиновой недостаточности","Профилактика миомы матки","Профилактика эндометриоза"]}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Для перорального и вагинального применения;"}},{"type":"list","data":{"style":"unordered","items":["Тромбофлебит, тромбоэмболические нарушения, внутричерепное кровоизлияние или наличие данных состояний в анамнезе","Кровотечения из половых путей неясного генеза","Неполный аборт","Порфирия","Установленные или подозреваемые злокачественные новообразования молочных желез или половых органов","Повышенная чувствительность к компонентам препарата , в т.ч. к арахисовому маслу, сое"]}},{"type":"paragraph","data":{"text":"Для перорального применения (дополнительно); — тяжелые заболевания печени в настоящее время (в т.ч. холестатическая желтуха, гепатит, печеночно-клеточный рак, синдромы Дубина-Джонсона, Ротора) или в анамнезе, если показатели функции печени не вернулись к нормальным значениям."}},{"type":"paragraph","data":{"text":"С осторожностью следует назначать препарат при заболеваниях сердечно-сосудистой системы, артериальной гипертензии, хронической почечной недостаточности, сахарном диабете, бронхиальной астме, эпилепсии, мигрени, депрессии, гиперлипопротеинемии."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Применение препарата при беременности не противопоказано. Тем не менее, существует потенциальный риск для плода (особенного мужского пола) при применении прогестерона в первые 4 месяца беременности. Применение микронизированного прогестерона во II-III триместрах беременности может приводить к развитию заболеваний печени у беременных. Многочисленные эпидемиологические исследования не выявили случаев аномалии развития плода при применении прогестерона при беременности.; Прогестерон проникает в грудное молоко. Данных по применению препарата в период лактации недостаточно для того, чтобы оценить потенциальный риск для младенца."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Продолжительность лечения определяется характером и особенностями заболевания.; Пероральный путь введения; Препарат принимают внутрь, запивая водой.; В большинстве случаев при недостаточности прогестерона суточная доза препарата Праджисан составляет 200-300 мг, разделенных на 2 приема (утром и вечером).; При недостаточности лютеиновой фазы (предменструальный синдром, фиброзно-кистозная мастопатия, дисменорея, пременопауза) суточная доза составляет 200 или 400 мг, принимаемых в течение 10 дней (обычно с 17-го по 26-й день цикла).; При заместительной гормонотерапии в пери- и постменопаузе на фоне приема эстрогенов препарат Праджисан применяется по 200 мг/сут в течение 10-12 дней.; Вагинальный путь введения; Капсулы вводят глубоко во влагалище.; Абсолютный дефицит прогестерона у женщин с нефункционирующими (отсутствующими) яичниками (донорство яйцеклеток): на фоне эстрогенной терапии по 200 мг/сут на 13 и 14-й дни цикла, затем по 100 мг 2 раза/сут с 15-го по 25-й день цикла, с 26-го дня, и в случае установления беременности доза возрастает на 100 мг/сут каждую неделю, достигая максимума 600 мг/сут, разделенных на 3 приема. Такая доза может применяться на протяжении 60 дней.; Поддержка лютеиновой фазы во время подготовки к экстракорпоральному оплодотворению: рекомендуется принимать от 200 до 600 мг/сут, начиная со дня инъекции хорионического гонадотропина в течение I и II триместра беременности.; Поддержка лютеиновой фазы в спонтанном или индуцированном менструальном цикле, при бесплодии, связанном с нарушением функции желтого тела рекомендуется принимать 200-300 мг/сут, начиная с 17-го дня цикла на протяжении 10 дней, в случае задержки менструации и диагностики беременности лечение должно быть продолжено.; В случаях угрозы аборта или в целях профилактики привычных абортов, возникающих на фоне недостаточности прогестерона: 200-400 мг ежедневно в 2 приема в I и II триместрах беременности."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При пероральном пути введения; Кровотечения \"прорыва\" или укорочение нормального менструального цикла, напряженность молочных желез (обычно в первый месяц лечения).; Сонливость, преходящее головокружение (как правило, через 1-3 ч после приема), тошнота. Данные побочные эффекты могут быть уменьшены путем снижения дозы, изменением режима приема препарата или переходом на вагинальный путь введения. Эти эффекты обычно являются первыми признаками передозировки.; Ощущение усталости, мигрень, головная боль, кожная сыпь, зуд, желтуха, задержка жидкости.; При пероральном и вагинальном пути введения; Аллергические реакции (крапивница, анафилактический шок)."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: сонливость, преходящее головокружение, укорочение нормального менструального цикла.; Лечение: снижение дозы или коррекция режим приема, например, в случае сонливости и головокружения - 200 мг принимают перед сном с 12-го по 14-й день цикла или переходят на вагинальный путь введения: в случае укорочения менструального цикла - начать лечение позже в цикле, например с 19-го дня, вместо 17-го. При необходимости проводят симптоматическое лечение."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат нельзя применять с целью контрацепции.; При длительном лечении прогестероном необходимо периодически проводить медицинские осмотры (включая исследование функции печени); лечение необходимо отменить в случае наличия отклонений диагностических тестов функции печени или возникновения холестатической желтухи. При применении эстроген и/или прогестаген-содержащих препаратов отмечались случаи развития хлоазмы, особенно у пациенток с наличием в анамнезе хлоазмы во время предшествующей беременности. У женщин со склонностью к развитию хлоазмы, подвергание кожи естественному или искусственному УФ-облучению может вызывать или усугублять течение хлоазмы.; Необходимо наблюдать за пациентами с депрессией в анамнезе, и в случае развития депрессии тяжелой степени, необходимо отменить препарат. Пациенты с сопутствующими сердечно-сосудистыми заболеваниями или наличием их в анамнезе должны также наблюдаться периодически врачом.; При лечении прогестероном может наблюдаться задержка жидкости, что может повлиять на течение эпилепсии, мигрени, бронхиальной астмы, сердечной или почечной недостаточности; такие пациенты должны тщательно наблюдаться.; Влияние на способность к вождению автотранспорта и управлению механизмами; При пероральном приеме необходимо соблюдать осторожность при вождении автотранспорта и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Гестаген, гормон желтого тела. Связываясь с рецепторами на поверхности клеток органов-мишеней, проникает в ядро, где, активируя ДНК, стимулирует синтез РНК. 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