ethnoscience

Ovestin - cheap analogues. Cheap analogues of Ovestin: by composition Method of application and dosage

There are contraindications. Consult your doctor.

Preparations containing Estriol (Estriol, ATC code G03CA04):

Commercial names abroad (abroad) - Aacifemine, Evalon, Hormomed, Klimadoral, Klimax-E, OeKolp, Orgestriol, Orgastyptin, Ortho-Gynest, Pausanol, Physiogine, Styptanon, Synapause, Triovex, Trophicreme, Xapro.

Ovestin in candles - official instructions for use:

Clinical and pharmacological group:

Estrogen drug.

pharmachologic effect

Estrogen drug. An analogue of a natural female hormone. Replenishes estrogen deficiency in postmenopausal women and reduces postmenopausal symptoms. Most effective in the treatment of genitourinary disorders. With atrophy of the mucous membrane of the lower genitourinary tract, estriol helps normalize the epithelium of the genitourinary tract and helps restore normal microflora and physiological pH in the vagina. Increases the resistance of epithelial cells of the genitourinary tract to infections and inflammation, reducing complaints such as pain during sexual intercourse, dryness, itching in the vagina, reduces the likelihood of vaginal infections and urinary tract infections, helps normalize urination, and prevents urinary incontinence.

Unlike other estrogens, estriol has a short period of action, since it is retained in the nuclei of endometrial cells for a short period of time. It is assumed that a single daily dose does not cause endometrial proliferation. Therefore, cyclic administration of progestogen is not required and withdrawal bleeding does not occur. In addition, estriol has not been shown to increase mammographic density.

Pharmacokinetics

Suction

When the drug is used orally or topically, estriol is quickly and almost completely absorbed.

Cmax of estriol in plasma is achieved 1-2 hours after intravaginal administration.

Distribution

In plasma, almost all (90%) estriol is associated with albumin and, unlike other estrogens, is practically not associated with sex hormone binding globulin (SHBG).

Removal

Excretion of estriol (in bound form) is carried out mainly by the kidneys; about 2% is excreted unchanged through the intestines. Excretion of metabolites in the urine begins within a few hours after administration of the drug and continues for 18 hours.

Indications for use of the drug OVESTIN®

hormone replacement therapy (HRT) for the treatment of atrophy of the mucous membrane of the lower genitourinary tract associated with estrogen deficiency;
pre- and postoperative treatment of postmenopausal women during operations via vaginal access;
for diagnostic purposes in case of unclear results of a cytological examination of the cervix (suspicion of a tumor process) against the background of atrophic changes.

Directions for use and dosage

Suppositories should be inserted into the vagina at night before bed.

When treating atrophy of the mucous membrane of the lower genitourinary tract, 1 suppository per day is prescribed for the first weeks, followed by a gradual reduction in the dose, based on symptom relief, until a maintenance dose is reached (i.e., 1 suppository 2 times a week).

For pre- and postoperative therapy of postmenopausal women, during surgical interventions via vaginal access, 1 suppository per day is prescribed for 2 weeks before surgery; 1 suppository 2 times a week for 2 weeks after surgery.

For diagnostic purposes, if the results of a cytological examination of the cervix are unclear, 1 suppository is prescribed every other day for a week before taking the next smear.

When initiating or continuing treatment for postmenopausal symptoms, use the lowest effective dose for the shortest possible duration.

In women not receiving HRT, or women who are switching from continuous use of an oral combination drug for HRT, treatment with Ovestin® can be started on any day. Women who are switching from a cyclic regimen of HRT medications should begin treatment with Ovestin® 1 week after stopping HRT medications.

Side effect

As with any other drug that is applied to the surface of the mucous membranes, Ovestin® suppositories can sometimes cause local irritation or itching.

Sometimes there may be sensitivity, tension, soreness, and an increase in the size of the mammary glands. These undesirable reactions are usually short-lived and passing, but at the same time may indicate the use of too high a dose.

Acyclic spotting, breakthrough bleeding, and metrorrhagia are also noted.

When HRT using estrogen-progestagen-containing drugs, the following side effects were also observed, the connection of which with the use of Ovestin has not been proven:

benign and malignant estrogen-dependent neoplasia (endometrial and breast cancer);
venous thromboembolism (deep vein thrombosis of the legs or pelvis, pulmonary embolism) occurs more often with the use of HRT than without therapy;
myocardial infarction, stroke;
cholelithiasis;
skin and subcutaneous diseases (chloasma, erythema multiforme, erythema nodosum, hemorrhagic purpura);
dementia;
increased libido.

Contraindications to the use of the drug OVESTIN®

known, known or suspected breast cancer;
diagnosed or suspected estrogen-dependent tumors (for example, endometrial cancer);
bleeding from the vagina of unknown etiology;
untreated endometrial hyperplasia;
the presence of venous thrombosis at present and in history;
active or recent thromboembolic arterial disease (eg, angina, myocardial infarction);
acute liver disease or a history of liver disease after which liver function tests have not returned to normal;
porphyria;
established hypersensitivity to the active substance or to any of the excipients of the drug.

Carefully

If any of the following conditions are present or have been previously noted and/or worsened during previous pregnancies or previous hormonal treatment, the patient should be under the direct supervision of a physician. It must be taken into account that these conditions may recur or worsen during treatment with Ovestin®, especially if:

leiomyoma (uterine fibroids) or endometriosis;
previous thromboembolic disorders or existing risk factors for such disorders;
risk factors for estrogen-dependent tumors, for example, 1st degree of heredity for breast cancer;
arterial hypertension;
benign liver tumors (for example, liver adenoma);
diabetes mellitus with or without a vascular component;
cholelithiasis;
jaundice (including a history during a previous pregnancy);
liver failure;
migraine or severe headache;
systemic lupus erythematosus;
history of endometrial hyperplasia;
epilepsy;
asthma;
otosclerosis;
familial hyperlipoproteinemia;
pancreatitis.

Use of the drug OVESTIN® during pregnancy and breastfeeding

Ovestin® is contraindicated during pregnancy. If pregnancy occurs during therapy with Ovestin®, treatment should be discontinued immediately.

The majority of epidemiological studies conducted to date regarding unintentional fetal exposure to estrogens indicate no teratogenic or fetotoxic effects.

Use for liver dysfunction

The drug is contraindicated in patients with acute liver disease or a history of liver disease after which liver function tests have not returned to normal.

In case of liver failure, use the drug with caution.

Use for renal impairment

Estrogens can cause fluid retention, and therefore patients with impaired renal function should be closely monitored by a physician. In the terminal stage of chronic renal failure, there should be special monitoring due to a possible increase in the level of circulating active components of Ovestin.

special instructions

To treat postmenopausal symptoms, HRT should only be started for symptoms that adversely affect quality of life. In all cases, a thorough assessment of the risks and benefits of treatment should be carried out at least once a year. HRT should only be continued for a period of time when the benefit outweighs the risk.

Medical examination/observation

Before starting or resuming HRT, a detailed individual and family history should be established. Based on the medical history, contraindications and warnings for the use of the drug, it is necessary to conduct a clinical examination, including examination of the pelvic organs and mammary glands. During treatment, it is recommended to conduct periodic medical examinations, the frequency and nature of which vary from person to person, but at least once a year. Women should be informed about the need to report changes in the mammary glands to their doctor. Tests, including mammography, must be performed in accordance with generally accepted screening standards.

Therapy should be discontinued if a contraindication is identified and/or if the following conditions occur:

jaundice and/or deterioration of liver function;
significant increase in blood pressure;
resumption of migraine-type headaches;
pregnancy.

Endometrial hyperplasia

To prevent stimulation of the endometrium, the daily dose should not exceed 1 suppository (500 mcg estriol). This maximum dose should not be used for more than 4 weeks.

Breast cancer

Based on the results of the randomized, placebo-controlled Women's Health Initiative (WHI) trial and epidemiological studies including the Million Women Study (MWS), an increased risk of breast cancer was reported in women taking estrogens, estrogen-progestogen-containing combinations, or tibolone. for HRT for several years. For all HRT, the increased risk becomes noticeable after several years of use and increases with duration of use, but returns to baseline levels a few (maximum 5) years after stopping treatment.

In the MWS study, the relative risk of mammary cancer with conjugated equine estrogens (CEE) or estradiol (E2) was higher when a progestogen was added, both cyclically and continuously, regardless of the type of progestogen. There was no confirmation of changes in the degree of risk with different routes of administration.

In the WHI study, continuous use of a combination of conjugated equine estrogen and medroxyprogesterone acetate (CEE + MPA) was associated with mammary tumors that were slightly larger in size and more likely to have metastases to local lymph nodes compared with placebo.

No such risk is known for Ovestin. A recent population-based case-control study of 3,345 women with invasive breast cancer and 3,454 controls found that estriol, unlike other estrogens, was not associated with an increased risk of breast cancer. In this regard, it is important that the patient is aware of the risk of developing breast cancer in relation to the known benefits of HRT.

Venous thromboembolism

HRT is associated with a higher relative risk of developing venous thromboembolism (VTE), i.e. deep vein thrombosis or pulmonary embolism. One randomized controlled trial and epidemiological studies found that the risk for women receiving HRT was 2-3 times higher than for patients not receiving such treatment. For women not using HRT, the incidence of VTE that is likely to occur over a 5-year period is estimated to be about 3 in every 1,000 women aged 50-59 years and 8 in every 1,000 women aged 60-69. years. In healthy women using HRT for 5 years, the number of additional cases of VTE over a 5-year period should be 2-6 cases (average 4) for every 1000 women aged 50-59 years and 5-15 cases (average 9) for every 1000 women aged 60-69 years. VTE is more likely to occur during the first year of HRT than later in life. In relation to Ovestin, such a risk is unknown.

Generally accepted risk factors for VTE include a relevant personal or family history, high obesity (BMI >30 kg/m2) and systemic lupus erythematosus. There is no consensus regarding the role of varicose veins in the development of VTE.

Patients with a history of VTE or known thromboembolic conditions are at increased risk of VTE. HRT may increase this risk. In order to exclude a predisposition to blood clots, a careful individual and family history of thromboembolism or recurrent spontaneous miscarriage is necessary. Until a thorough assessment of thromboembolic factors has been carried out, anticoagulant treatment or HRT should not be started. For women already receiving anticoagulant treatment, careful consideration of the benefit/risk of HRT is required.

The risk of VTE may increase with prolonged immobilization of the patient, extensive trauma, or a large volume of surgical intervention. After surgery, special attention should be paid to preventive measures to prevent VTE. In cases where prolonged immobilization is unavoidable after elective surgery, particularly after abdominal surgery or orthopedic surgery on the lower extremities, temporary cessation of HRT should be considered 4-6 weeks before surgery if possible. If Ovestin® is used for the indication “pre- and postoperative treatment of postmenopausal women during operations with vaginal access,” it is necessary to provide prophylactic treatment to prevent thrombosis.

If VTE develops after starting treatment with Ovestin®, then treatment with the drug must be discontinued. Patients should be advised to seek immediate medical attention if they experience a symptom of a potential thromboembolism (eg, painful leg swelling, sudden chest pain, shortness of breath).

Randomized controlled trials have not confirmed the positive effect of continuous use of a combination of conjugated estrogens and medroxyprogesterone acetate (MPA) on the state of the cardiovascular system. Two large clinical trials, the WHI and the HERS (Heart and Estrogen-Progestin Replacement Therapy Study), confirmed the possibility of a possible increased risk of cardiovascular disease during the first year of use and a lack of overall benefit.

There are only limited data available for other HRT medications, so it is not certain that these results also apply to other HRT medications.

A large randomized trial (WHI) found that an increased risk of ischemic stroke may be considered as a side effect in healthy women during treatment with continuous use of a combination of conjugated estrogens and MPA. For women who do not use HRT, the number of strokes that may occur over a 5-year period is about 3 in every 1000 women aged 50-59 years and 11 in every 1000 women aged 60-69 years. It has been found that for women who use conjugated estrogens and MRAs for 5 years, the number of additional cases increases by 0-3 cases (average 1) for every 1000 patients aged 50-59 years and 1-9 cases (average 4 ) for every 1000 patients aged 60-69 years. It is unknown whether the increased risk also applies to other HRT drugs.

Ovarian cancer

Long-term (at least 5-10 years) estrogen monotherapy (as HRT) in women who have undergone uterine surgery is associated with an increased risk of ovarian cancer, which has been found in several epidemiological studies. It has not been proven that long-term combined HRT or monotherapy with low-active estrogens (for example, Ovestin®) has any other risk.

Other states

Estrogens can cause fluid retention, and therefore patients with impaired renal function and cardiovascular insufficiency should be closely monitored by a physician. In the terminal stage of chronic renal failure, there should be special monitoring due to a possible increase in the level of circulating active components of Ovestin.

Estriol is a weak gonadotropin inhibitor and has no other significant effects on the endocrine system.

There was no convincing evidence of improvement in cognitive function. The WHI trial provided evidence of an increased risk of eventual dementia in women who started using the combination of conjugated estrogens and MPA continuously after age 65 years. It is unknown whether these results apply to younger postmenopausal women using other HRT medications.

Overdose

The acute toxicity of estriol in animals is very low. An overdose of Ovestin® when administered vaginally is unlikely. However, if large quantities of the drug enter the gastrointestinal tract, nausea, vomiting and cessation of bleeding in women may develop.

Treatment: there is no specific antidote. If necessary, symptomatic treatment should be carried out.

Drug interactions

In clinical practice, no interaction has been observed between the drug Ovestin® and other drugs.

The metabolism of estrogens may be enhanced when used in combination with compounds that induce enzymes involved in drug metabolism, particularly cytochrome P450 isoenzymes, such as anticonvulsants (phenobarbital, phenytoin, carbamazepine) and antimicrobial agents (rifampicin, rifabutin, nevirapine, efavirenz).

Ritonavir and nelfinavir exhibit inducing properties when used in combination with steroid hormones.

Herbal preparations containing St. John's wort (Hypericum perforatum) may induce estrogen metabolism.

Increased metabolism of estrogens may lead to a decrease in their clinical effect.

Estriol enhances the effect of lipid-lowering drugs.

Weakens the effects of male sex hormones, anticoagulants, antidepressants, diuretics, antihypertensives, hypoglycemic agents.

General anesthesia, opioid analgesics, anxiolytics, some antihypertensive drugs, and ethanol reduce the effectiveness of the drug.

Folic acid and thyroid medications enhance the effects of estriol.

Conditions for dispensing from pharmacies

The drug is approved for use as a means of OTC.

Storage conditions and periods

The drug should be stored in a dry place, protected from light and out of reach of children, at a temperature of 2° to 25°C. Shelf life - 3 years.

The instructions are quoted from the Vidal pharmaceutical website.

Ovestin cream - method of application and dosage:

Dosage regimen

The cream should be inserted into the vagina using a calibrated applicator at night (before going to bed).

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

When treating atrophy of the mucous membrane of the lower genitourinary tract - 1 application per day for the first weeks (maximum 4 weeks), followed by a gradual reduction in dose, based on symptom relief, until a maintenance dose is reached (i.e. 1 application 2 times a week) .

For pre- and postoperative therapy of postmenopausal women, for surgical interventions via vaginal access - 1 application per day for 2 weeks before surgery; 1 application 2 times a week for 2 weeks after surgery.

For diagnostic purposes in case of unclear results of cytological examination of the cervix - 1 application every other day for a week before taking the next smear.

If a dose is missed, the missed dose must be administered on the same day as soon as the patient remembers (the dose should not be administered 2 times a day). Subsequent applications are carried out in accordance with the usual dosage regimen.

When initiating or continuing treatment of postmenopausal symptoms, use the lowest effective dose for the shortest possible duration.

In women not receiving HRT, or women who are switching from continuous use of an oral combination drug for HRT, treatment with Ovestin can be started on any day. Women who are switching from a cyclic regimen of HRT medications should begin treatment with Ovestin® cream 1 week after stopping HRT medications.

Instructions for use for patients

The cream is inserted into the vagina at night (before bedtime).
Remove the cap, turn the cap over and use a sharp rod to open it.
Screw the applicator onto the tube.
Squeeze the tube to fill the applicator with cream until the piston stops.
Unscrew the applicator and close the tube with the cap.
In a lying position, the end of the applicator is inserted deep into the vagina and slowly press the piston all the way, introducing the cream.

After administering the drug, remove the piston from the cylinder and wash the cylinder and piston with warm water and soap. Detergents should not be used. After this, the cylinder and piston are rinsed generously with clean water.

Do not immerse the applicator in hot or boiling water

This page provides a list of all Ovestin analogues by composition and indication for use. A list of cheap analogues, and you can also compare prices in pharmacies.

The cheapest analogue of Ovestin:
The most popular analogue of Ovestin:
ATX classification: Estriol
Active ingredients/composition: estriol

Cheap analogs of Ovestin

#	Name	Price in Russia	Price in Ukraine
1	estradiol	412 RUR	100 UAH
2	estriol	450 rub.	600 UAH
3	estradiol Similar in indication and method of use	489 RUR	10 UAH
4	estriol Analogue in composition and indication	498 RUR	490 UAH
5	estradiol Similar in indication and method of use	684 RUR	242 UAH

When calculating the cost cheap analogs of Ovestin the minimum price was taken into account, which was found in the price lists provided by pharmacies

Popular analogues of Ovestin

#	Name	Price in Russia	Price in Ukraine
1	estradiol Similar in indication and method of use	489 RUR	10 UAH
2	estriol Analogue in composition and indication	450 rub.	600 UAH
3	estradiol Similar in indication and method of use	412 RUR	100 UAH
4	cyproterone, estradiol valerate Similar in indication and method of use	1055 RUR	197 UAH
5	estradiol Similar in indication and method of use	684 RUR	242 UAH

The list of drug analogues based on statistics of the most requested drugs

All analogs of Ovestin

The above list of drug analogues, which indicates Ovestin substitutes, is the most suitable because they have the same composition of active ingredients and coincide in indications for use

Analogues by indication and method of use

To compile a list of cheap analogues of expensive drugs, we use prices that are provided to us by more than 10,000 pharmacies throughout Russia. The database of drugs and their analogues is updated daily, so the information provided on our website is always up to date as of the current day. If you have not found the analogue you are interested in, please use the search above and select the medicine you are interested in from the list. On the page of each of them you will find all possible analogues of the drug you are looking for, as well as prices and addresses of pharmacies where it is available.

How to find a cheap analogue of an expensive medicine?

To find an inexpensive analogue of a medicine, a generic or a synonym, first of all we recommend paying attention to the composition, namely the same active ingredients and indications for use. The same active ingredients of a drug will indicate that the drug is a synonym for the drug, pharmaceutically equivalent or a pharmaceutical alternative. However, we should not forget about the inactive components of similar drugs, which may affect safety and effectiveness. Do not forget about the instructions of doctors; self-medication can harm your health, so always consult a doctor before using any medication.

Ovestin price

On the sites below you can find prices for Ovestin and find out about availability at a pharmacy near you

Ovestin instructions

INSTRUCTIONS
on the use of the drug
OVESTIN

Compound
Pills:
Active substance: estriol - 1 or 2 mg.
Additional substances: potato starch, amylopectin, magnesium stearate, lactose monohydrate, povidone, silicon dioxide.

Candles:
Active substance: estriol - 0.5 mg
Additional substances: vitepsol S 58.

Cream:
Active substance: estriol - 1 mg/g.
Additional substances: octyldodecanol, cetyl palmitate, glycerin, cetyl alcohol, stearyl alcohol, polysorbate, sorbitan stearate, lactic acid, chlorhexidine hydrochloride, sodium hydroxide, prepared water.

pharmachologic effect
The drug contains the natural female hormone estriol, which is a short-acting hormone, which means it does not stimulate proliferative processes in the endometrium. The drug promotes the regeneration of the epithelium of the vaginal mucosa, restoration of the pH environment and natural microflora of the vagina, all this improves local immunity and prevents the development of pathological flora.

Indications for use
- age-related atrophic changes in the vaginal mucosa associated with estrogen deficiency (including dryness, itching and discomfort in the vagina, pain during sexual intercourse);
-increased urination, pain when urinating;
-prevention of inflammatory diseases of the urogenital area;
-urinary incontinence;
- for diagnosis, with unclear results of a vaginal smear for cytology;
- infertility associated with cervical factor;
- prevention of complications during operations with transvaginal access.

Mode of application
It can be used both internally, in the form of tablets, and topically, in the form of suppositories and cream. The effectiveness of the drug does not change. Regardless of the method of administration, the drug is used once a day. The cream is usually administered before bedtime using an applicator.
For atrophic changes in the vaginal mucosa, the following method of use is recommended: 2-4 tablets (4-8 mg), for a month, with a further transition to a maintenance dosage of 1-2 tablets (1-2 mg). For urinary incontinence, it is possible to prescribe in higher dosages. Suppositories are administered once a day, and when symptoms improve, they switch to more rare administration - 2 times a week. The cream is administered using an applicator, at the beginning of treatment every day, when the condition improves, they switch to administering the drug 2 times a week. The course of therapy depends on the severity of the symptoms of the disease.
Preparation for surgery with transvaginal access, women of menopausal age: 1 suppository daily, starting 2 weeks before surgery and one suppository 2 times a week, for 14 days after surgery. Tablets are used according to the following scheme: 4-8 mg 14 days before surgery and 1-2 mg 14 days in the postoperative period. The cream is administered according to the same scheme: 14 days before surgery once a day, in the postoperative period - 2 times a week.
For pathological menopause: 4-8 mg, with a gradual reduction in dose as the condition improves.
For diagnosis, if the results of a vaginal smear for cytology are unclear: 1 suppository every other day for 1 week before taking the next smear. Cream, according to the same scheme as the candles.
For infertility associated with the cervical factor: 1–2 mg per day from the 6th to the 15th day of the menstrual cycle, sometimes the dose is increased to 8 mg per day.
If you miss the next dose of the drug, if the interval between doses is no more than 36 hours, you must take the missed dose and then continue taking the drug according to the regimen. If more than 36 hours have passed, you just need to continue taking the drug according to the regimen.

Side effects
Local: irritation and itching in the vagina.
General: discomfort and pain in the mammary glands, nausea. Very rare: headache, increased blood pressure.

Contraindications
Pregnancy.
Intolerance to any of the components of the drug.
Current, history or suspected breast cancer.
An estrogen-dependent malignant tumor, most often endometrial cancer, or a suspicion of this type of tumor.
Vaginal bleeding of unknown etiology.
A history of an episode of arterial or venous thromboembolism.
Acute liver disease or changes in liver tests.
Porphyria.

Pregnancy
The drug is contraindicated during pregnancy.

Drug interactions
Cases of adverse interactions with other drugs have not been reported, but given the pharmacological properties of Ovestin, interaction with: anticonvulsants (barbiturates, carbamazepine), antibiotics (for example, rifampicin), antiretroviral drugs, and drugs based on St. John's wort is possible.
It is possible that estriol may enhance the pharmacological effects of some corticosteroids and theophylline.

Overdose
Symptoms of Ovestin overdose: nausea, vomiting, vaginal bleeding. There is no specific antidote; treatment is symptomatic.

Release form
Tablets 1 mg, 2 mg No. 30;
Vaginal cream in tube 15 g;
Vaginal suppositories 0.5 mg No. 15.

Storage conditions
Store in a dry place, protected from sunlight.
Store cream and suppositories at temperatures from 2 to 25 °C; tablets at temperatures from 2 to 30 °C.

All information is presented for informational purposes and is not a reason for independent prescription or replacement of medication.

Ovestin cream is a medicine to eliminate the symptoms of menopause. During natural menopause, women suffer from dry vaginal mucosa and pain during sexual intercourse. The use of Ovestin helps to replenish the reserves of estrogens - hormones necessary for the coordinated functioning of the body. The ingredients of the cream also act at the systemic level, preventing the formation of wrinkles and the appearance of psycho-emotional instability.

Ovestin is a hormonal drug with a wide list of contraindications. It is prescribed to women only after a series of biochemical studies. Uncontrolled use of the drug will cause various and dangerous side effects.

Ovestin is a thick, white cream without foreign inclusions with a specific odor. The Dutch manufacturer produces it packaged in 15.0 g in aluminum tubes with a screw cap. Secondary packaging is a cardboard box, inside of which there are instructions for use and an applicator for intravaginal administration. The medicinal properties of the drug are due to its active component estriol.

One of the release forms The auxiliary composition is represented by the following ingredients:

cetyl palmitate;
octyldodecanol;
cetyl and stearyl alcohols;
glycerin;
polysorbate;
sorbitan stearate;
chlorhexidine;
lactic acid;
purified water;
sodium hydroxide.

Some additional components not only improve the absorption of estriol into the vaginal mucosa. Chlorhexidine suppresses the activity of pathogenic microorganisms and prevents the development of vaginal infections. And lactic acid stimulates an increase in the number of beneficial lactobacilli.

Ovestin in three different forms

The therapeutic line also includes suppositories and tablets for intravaginal administration. Often, with pronounced symptoms of menopause, gynecologists prescribe women a combination of several dosage forms of Ovestin.

pharmachologic effect

Often the pathological course of menopause is characterized by urogenital and sexual disorders. The reason for their development is a decrease in the production of estrogen in the body, which provokes increased dryness of the vaginal mucosa.

In such cases, local remedies with female sex hormones are used, the most effective of which is Ovestin. Its therapeutic effectiveness is due to the properties of the active substance estriol. This is a synthetic analogue of the hormone produced by the follicular apparatus of the ovaries in women.

Differences between natural estrogen and synthetic estriol Additional intake of estriol into the body helps improve the well-being of patients:

the optimal pH level in the vagina is restored;
the number of lactobacilli producing beneficial lactic acid increases;
painful sensations, itching, burning - characteristic symptoms of dry mucous membranes - disappear;
local immunity increases;
inflammatory processes caused by excessive activity of pathogenic fungi are stopped.

Many women during menopause have a delicate problem - urinary incontinence when the urge to urinate appears. Because of this, they are forced to constantly use urological pads, which is not always useful. Course use of Ovestin helps eliminate all urinary disorders. Its use also stimulates epithelial healing by accelerating regeneration processes.

Urological pads are not a solution for imbalances.

Pronounced cosmetic effects of the therapy are also noted. The complexion improves, the depth of wrinkles decreases, hair growth accelerates, and the nail plates become stronger.

Indications for use of Ovestin cream

Ovestin ointment is prescribed to patients for hormone replacement therapy. This is the name of a treatment method aimed at eliminating the deficiency of substances produced in the body in insufficient quantities. The cream is used to reduce the severity of urogenital symptoms and discomfort during sexual intercourse. Indications for its use are the following pathological conditions:

atrophic colpitis - inflammation of the mucous membrane with subsequent damage;
destructive changes in the mucous membrane against the background of natural aging of the body;
frequent urge to urinate with the release of a small amount of urine, accompanied by pain;
involuntary leakage of urine, which cannot be controlled by volitional effort;
inability to conceive due to damage to the lower reproductive tract by various pathologies.

Estriol - drug replacement of estrogen

Another area of application of Ovestin is carrying out diagnostic measures to study a cervical smear. The cream is also used after surgical interventions in which access to the surgical field was provided through the vagina. It is prescribed to prevent mucosal atrophy when taking drugs of certain groups.

In some cases, Ovestin is used in the treatment of synechia in girls. This is a disease in which not only the labia, but also the entrance to the vagina are welded together. The tissue adhesion can later cause serious urinary problems.

Contraindications

Contraindications to therapy with Ovestin are common to all its dosage forms - cream, vaginal suppositories and tablets. They are not prescribed to patients if they have an individual intolerance to estriol and auxiliary ingredients.

The use of Ovestin is strictly prohibited in the following cases:

period of bearing a child;
a history of malignant neoplasm in the mammary gland or suspicion of its development;
formation of an estrogen-dependent tumor of any location;
vaginal bleeding of unknown origin;
history of acute blockage (embolism) of a blood vessel by a thrombus;
porphyria - metabolic disease;
severe course of liver pathologies.

Remember what contraindications the drug has.

Relative contraindications include diseases of the venous system, including thrombophlebitis and varicose veins. The product should be used with caution in case of high blood pressure, diabetes mellitus, and endocrine disorders.

During lactation, treatment with Ovestin is possible. But it should be borne in mind that the intake of estriol will lead to a deterioration in the production of breast milk.

Instructions for use

If your doctor has not determined an individual dosage regimen, then you should follow the instructions for using Ovestin cream. The drug is intended for use once a day. Its intravaginal administration before bedtime is most therapeutically effective.

The medicine should be used as follows:

Open the aluminum tube, attach the applicator, fill it with cream.
Remove the applicator and close the tube by screwing on the cap.
While lying on your back, insert the applicator into the vagina and remove the cream by pressing on the piston.

All parts of the applicator must be washed with warm water and hygiene products after each procedure.

The instructions for the drug are very detailed.

The duration of treatment depends on the purpose of using Ovestin and the severity of the diagnosed pathology. It begins to be administered daily 2 weeks before surgery and twice a week after surgery. To increase the diagnostic information, the cream is applied 7 days before the upcoming examination.

As hormone replacement therapy, the drug is administered daily at first. After a woman feels better, it is enough to use it 2 times a week. This dosage regimen helps maintain optimal estrogen concentrations in the body.

If after 2 weeks of treatment the severity of menopause symptoms does not decrease, you should inform your doctor. He will clarify the diagnosis, adjust dosages or prescribe a more effective remedy.

Overdose

If the dosage regimen is violated, bleeding from the vagina may occur. They are often accompanied by gastrointestinal disorders - lack of appetite, attacks of nausea and vomiting, excessive gas formation. In such cases, you should immediately seek medical help. Symptomatic treatment, including detoxification, will be carried out.

The presence of a hormonal component in Ovestin determines an increased risk of adverse reactions. There have been cases of uterine bleeding of varying severity, and the appearance of discharge mixed with blood. In the first days of treatment, the mammary glands may harden and become painful when pressed. If this effect persists for a long time, it is necessary to reduce the dose of the cream.

The drug may cause side effects

In case of hypersensitivity to the ingredients, local adverse reactions occur. Clinically, they are manifested by increased burning, itching, swelling and redness of the mucous membrane.

It should be taken into account that the use of a hormonal agent increases the likelihood of the formation of malignant and benign neoplasms. People with a predisposition to blood clots have an increased risk of developing thrombophlebitis.

special instructions

Ovestin is one of the most effective local drugs for eliminating discomfort in the vagina. But its use can cause complications and deterioration in general health. Therefore, the cream is prescribed to patients only if the use of safer means is unsuccessful.

During therapy, constant monitoring of the condition of the liver, kidneys, and organs of the reproductive system is carried out. If the results of general clinical and biochemical studies worsen, the drug is discontinued.

Drug interactions

There have been no cases of negative chemical interactions between the components of Ovestin and the ingredients of other drugs. But it is possible that the pharmacological properties of the products may be distorted when used together with cream. Gynecologists must adjust dosages in such cases. This is relevant when Ovestin is combined with anticonvulsant, antimicrobial, antiviral, and lipid-lowering drugs.

When the cream is used simultaneously with anesthetics, narcotic analgesics, and antihypertensive drugs, its effectiveness is reduced.

Terms and conditions of storage

Ovestin should be stored in a dark place at room temperature. Freezing of the drug is unacceptable. The shelf life of the cream is 36 months, after opening the initial packaging - several weeks. If it has exfoliated, acquired a foreign odor or a yellowish tint, it cannot be used for treatment. Small children should not have access to the place where the hormonal drug is stored.

Analogues

There are several analogues of Ovestin cream in the pharmacy assortment. The most commonly prescribed local remedies include Orniona, Mikrofollin-forte, Dimestrol. All of these drugs contain estriol, but the composition of the auxiliary ingredients may vary. Orniona, produced by a domestic manufacturer, is considered an equivalent cheap analogue.

Among all analogues, the closest is Orniona

In this article you can read the instructions for using hormonal drugs Ovestin. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Ovestin in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Ovestin analogues in the presence of existing structural analogues. Use for the treatment of itching, infertility, hot flashes and other menopausal disorders in adults, children, as well as during pregnancy and lactation. Interaction of the drug with alcohol.

Ovestin- estrogen drug. Estriol (the active ingredient of the drug Ovestin) is a natural estrogen. In the period preceding menopause and postmenopause (natural or surgical), estriol is used to treat symptoms caused by estrogen deficiency. Estriol has a selective effect primarily 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 vaginal mucosa, Ovestin causes increased proliferation of the epithelium of the vagina and cervix, stimulates its blood supply, helps restore the epithelium, normal microflora and physiological vaginal environment, and affects 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 because it is retained for a short time in the nuclei of endometrial cells, and endometrial proliferation should not be expected if the recommended dosing regimen is followed. In this regard, cyclic use of progestogens is not necessary; postmenopausal withdrawal bleeding does not occur.

Compound

Estriol + excipients.

Pharmacokinetics

When the drug is used orally or topically, estriol is quickly and almost completely absorbed. Binding to plasma albumin is 90%. Excretion of estriol (in bound form) is carried out mainly by the kidneys; about 2% is excreted unchanged through the intestines.

Indications

Hormone replacement therapy (HRT) to treat atrophy of the mucous membrane of the lower genitourinary tract associated with estrogen deficiency, in particular to treat symptoms such as dyspareunia, vaginal dryness and itching, to prevent recurrent infections of the vagina and lower genitourinary tract; for the treatment of urinary disorders (for example, frequency, dysuria) and moderate urinary incontinence;
pre- and postoperative treatment of postmenopausal women;
menopausal disorders (hot flashes and night sweats);
infertility caused by cervical factor;
for diagnostic purposes in case of unclear results of a cytological examination of the cervix (suspicion of a tumor process) against the background of atrophic changes.

Release forms

Vaginal suppositories 0.5 mg.

Vaginal cream (sometimes mistakenly called ointment).

Tablets 2 mg.

Instructions for use and dosage

Candles

The suppositories should be inserted into the vagina at night before bedtime.

For diagnostic purposes, if the results of a cytological examination of the cervix are unclear, 1 suppository is prescribed every other day for a week before taking the next smear.

When initiating or continuing treatment of postmenopausal symptoms, use the lowest effective dose for the shortest possible duration.

In women not receiving hormone replacement therapy (HRT), or women who are switching from continuous use of an oral combination drug for HRT, treatment with Ovestin can be started on any day. Women who are switching from a cyclic regimen of HRT should begin treatment with Ovestin 1 week after discontinuation of HRT.

Cream

The cream should be inserted into the vagina using a calibrated applicator at night (before going to bed).

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

For diagnostic purposes in case of unclear results of cytological examination of the cervix - 1 application every other day for a week before taking the next smear.

Instructions for use for patients

1. The cream is inserted into the vagina at 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 the cap.

6. In a lying position, the end of the applicator is inserted deep into the vagina and slowly press the piston all the way, introducing the cream.

Do not immerse the applicator in hot or boiling water.

Pills

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

For atrophy of the lower genitourinary tract caused by estrogen deficiency, 4-8 mg per day is prescribed for the first 4 weeks, followed by a gradual dose reduction in accordance with symptoms until a maintenance dose of 1-2 mg per day is achieved.

For pre- and postoperative treatment during vaginal surgery in the postmenopausal period - 4-8 mg per day for 2 weeks before surgery, 1-2 mg per day for 2 weeks after surgery.

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

For infertility caused by the cervical factor, as a rule, 1-2 mg per day is prescribed 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 on the cervical mucosa is achieved.

If a woman misses the next dose and the delay is no more than 12 hours, she must take the pill as soon as possible. If the delay is more than 12 hours, you should skip one dose and then take the drug at the usual time.

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

The daily dose should be taken in 1 dose.

Side effect

intermenstrual bloody spotting from the vagina;
cervical hypersecretion;
soreness 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 unknown etiology;
confirmed venous thromboembolism (deep vein thrombosis, pulmonary thromboembolism) within the last 2 years;
a history of venous thromboembolism or thrombosis, if anticoagulant therapy is not carried out;
diabetes mellitus with angiopathy;
sickle cell anemia;
Dubin-Johnson syndrome;
Rotor syndrome;
cerebrovascular accident;
pregnancy;
lactation period (breastfeeding);
hypersensitivity to the active and/or excipients of the drug.

The drug should be prescribed with caution in the following conditions:

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

Use during pregnancy and breastfeeding

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

special instructions

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

During treatment, regular examinations (including breast examination, mammography) should be carried out every 6 months in accordance with accepted medical practice.

It is necessary to exclude a history of thromboembolism or repeated spontaneous abortions, which indicates thrombophilia. The risk of thromboembolism increases with prolonged immobilization, severe trauma and surgery. 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 breast density. And it is possible that estriol use does not increase the risk of breast cancer.

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

Drug interactions

There have been no cases of interaction between the drug Ovestin and other drugs.

There is known evidence of an increase in the pharmacological effect of glucocorticosteroids (GCS) and lipid-lowering drugs when used together with estrogens. If necessary, the dose of GCS can be reduced.

The effects of male sex hormones, anticoagulants, antidepressants, diuretics, antihypertensive and hypoglycemic drugs may be weakened.

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

Antibiotics (ampicillin, rifampicin), general anesthesia, opioid analgesics, anxiolytics, antiepileptic drugs, some antihypertensive drugs, ethanol (alcohol) reduce the effectiveness of estrogens.

Folic acid and thyroid hormone preparations enhance the effect of estriol.

Ovestin may alter the effectiveness of oral anticoagulants.

Estriol can increase the pharmacological effect of succinlycholine, theophylline, foleandomycin.

Analogues of the drug Ovestin

Structural analogues of the active substance:

Ovipol Clio;
Elvagin;
Estriol;
Estrovagin;
Estrocad.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

"Ovestin" is a drug containing a female sex hormone prescribed for various diseases. In this regard, ovestine, analogues of which are widely represented on the market, is in constant demand. The substances it contains help restore the vagina and its natural microflora. Often this drug is prescribed for identified estrogen deficiency or in order to increase the resistance of the genitourinary tract to various infections.

Often, “Ovestin” or its Russian substitutes, for example, “Ovipol Clio”, “Estriol”, “Estocad” and so on, are prescribed for infertility caused by the cervical factor. With this diagnosis, there is an extremely low percentage of sperm survival in the cervix. To normalize the situation, the doctor prescribes 1 to 2 milligrams of the drug. It should be used exclusively from 6 to 15 days of the menstrual cycle.

If necessary, the doctor can increase the dosage to 8 milligrams, but in this case it will be necessary to closely monitor the dynamics of the main indicators. Prescribe "Ovestin" or its cheap analogue when symptoms of menopause appear. The medicine allows the patient to be well prepared for surgical intervention in the vaginal area. Preparatory activities should begin 2 weeks before the scheduled operation. In such a situation, the recommended dose is 1 suppository 2 times a week.

If the operation is successfully completed, the patient is shown Ovestin or its cheap substitutes as maintenance therapy. The maximum dosage will be no more than 1 suppository once every 14 days. If the patient has an individual intolerance to the drug, the doctor may prescribe pills. The recommended dose will be 4 to 8 milligrams per week before surgery, and no more than 2 milligrams for 14 days after surgery.

If we are talking about a simple climatic disorder, then the doctor has the right to prescribe medicine in the form of tablets, the dosage of which will be about 4-8 milligrams. Here it is necessary to proceed from the characteristics of the organism. There are cases when a patient, having taken a smear, receives a result that the doctor cannot possibly interpret. In such a case, “Ovestin” or its cheaper substitute is used to clarify the diagnosis.

Regardless of the diagnosis, the patient must strictly follow the course of treatment prescribed by the doctor. Even a short break can reduce the effectiveness of the entire treatment. For example, if less than 36 hours have passed since the last use of a medicine released in the form of a gel, then you can continue treatment without any fear. If we are talking about a longer time period, the use of ointment is not advisable. It is necessary to go to an appointment with your doctor to adjust the entire course based on the examination.

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Application of medicine

Regardless of which drug the doctor prescribes, the technology for its use remains unchanged. Experienced doctors say that the form of release, for example, suppositories, cream or tablets, does not affect its effectiveness. If the patient is diagnosed with atrophic changes, then in this case we are talking about prescribing from 4 to 8 milligrams for 1 day. The duration of the course of treatment should not be more than 30 days.

After a month, the patient undergoes a mandatory examination. If positive dynamics were recorded as a result, then the dosage is reduced to 1-2 milligrams per day. The rest of the treatment is supportive in nature. A different sequence of actions is used when the therapeutic course is carried out using Ovestin suppositories or its analogues.

Patients need to administer a maximum of 1 vaginal suppository daily for 30 days. If test results indicate a positive reaction of the body to treatment, the dosage of the drug must be reduced - no more than 2 vaginal suppositories once every 14 days.

The drug in the form of a cream is recommended to be used in 1 dose. As a rule, the ointment is used more as a maintenance therapy. After 1-2 applications, patients note that the ointment helped reduce the clinical manifestations of the disease. While using the drug, you must regularly visit a doctor who will monitor the body’s reaction. If the course is unfavorable, the course of treatment is adjusted.

Before the actual use of the drug begins, the patient must undergo a complete examination. Increased attention should be paid to the mammary glands, as well as clarification of a number of important details:

performing abortions;
tendency to form blood clots, especially in the lower extremities;
results and regularity of examinations by a gynecologist;
presence of severe injuries with complications;
carrying out immobilization;
the proximity of surgical intervention - if the patient is facing this, then taking Ovestin should be postponed for at least 4 weeks.

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Contraindications and side effects

The most common of all contraindications is hypersensitivity or intolerance to certain components. If the patient has any doubts about this, a doctor should be consulted. If we talk about side effects, the most common of them is itching and irritation on the vaginal mucosa. There are also a number of other contraindications:

previous oncological diseases;
the presence of benign or malignant neoplasms;
vein thrombosis;
myocardial infarction;
stroke;
liver problems;
hypertension;
angina pectoris;
uterine fibroids;
diabetes mellitus of any stage;
jaundice;
asthma;
otosclerosis;
pancreatitis;
phlebeurysm.

The drug should be prescribed with extreme caution to patients taking medications that increase lipid levels. In this case, “Ovestin” will significantly enhance the actions of the latter. A diametrically opposite effect is observed when Ovestin is taken together with anticoagulants or diuretics. Those who are prescribed antidepressants should completely stop taking it.

If higher doses of the drug are prescribed, Ovestin or its analogues provoke increased sensitivity at the site of application or pain. Much less often we talk about chest tension. In such a case, it is necessary to reduce the dose until the situation normalizes. Other contraindications include:

malignant or benign neoplasms;
breakthrough bleeding;
oncological diseases at any stage;
pulmonary embolism;
Varicose veins;
cardiovascular pathologies of any etymology;
problems with the gastrointestinal tract;
heavy bleeding.

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In order to prevent the development of various kinds of complications or contraindications, it is necessary to strictly adhere to the dosage prescribed by the doctor.

If any unpleasant symptoms appear, you must immediately stop taking the medication and see your doctor.