Suppositories "Ovestin" are an estrogenic drug intended for the treatment of diseases of urogenital organs. The medicine is released in the form of vaginal suppositories. They are suitable for local use. Next, consider the instructions for candles "Ovestin."
The composition of the drug
The active substance is estriol, and Witepsol is an auxiliary substance. Suppositories are available in the form of a torpedo and have a cream color. This drug belongs to the pharmacotherapeutic group of estrogens.
Indications for use
According to the instructions, Ovestin suppositories are prescribed to patients in the following cases:
- Conducting hormonal therapy for the treatment of atrophy of the mucosa of the lower genitourinary system, which are associated with estrogen deficiency in women during postmenopausal women.
- Postoperative treatment of women during postmenopause.
- As an aid to diagnosis.
Contraindications
Candles "Ovestin" have many different contraindications, including the following:
- An identified or suspected breast cancer.
- Diagnosed tumors that are estrogen dependent or suspected, such as endometrial cancer.
- The appearance of bleeding from the vagina, which have an unclear etiology.
- Untreated endometrial hyperplasia.
- Venous thrombosis.
- Protein C deficiency.
- The presence of thromboembolism or cerebrovascular disorders
- The presence of transient ischemic attacks, angina pectoris.
- The presence of liver disease in the acute stage.
- The presence of hypersensitivity to the active component or to the excipient of the drug.
The use of Ovestin candles should be very careful.
When should the medicine be taken with caution?
With caution, the drug should be used if there are any of the following diseases or conditions, as well as if these pathologies have been noted previously:
- The presence of uterine fibroids.
- Risk of thromboembolism.
- The presence of the first degree of heredity of breast cancer.
- The presence of arterial hypertension.
- The presence of benign liver tumors, for example adenomas.
- The presence of diabetes with and without angiopathy.
- The appearance of cholelithiasis.
- The presence of familial hyperlipoproteinemia or pancreatitis.
- The appearance of jaundice.
- The development of liver failure.
- The presence of migraine or severe headache.
- Systemic lupus erythematosus.
- The presence of endometrial hyperplasia in the anamnesis.
- The presence of epilepsy, bronchial asthma, or otosclerosis.
Can I take candles on a background of pregnancy?
Candles "Ovestin" are absolutely contraindicated during gestation. If pregnancy is established during the treatment with this drug, the therapeutic course should be immediately canceled. This product is also not recommended for breastfeeding. The active substance estriol is excreted in mother's milk and can reduce its formation.
Method of administration and dosage of medication
Suppositories "Ovestin" is injected into the vagina before bedtime. As part of the treatment of atrophy of the mucosa of the lower regions of the genitourinary system, one suppository is used per day for the first two weeks, followed by a gradual decrease in dosage. The dose begins to reduce, based on the relief of symptoms. Thus, when the symptoms subside, take one suppository twice a week.
During postoperative therapy in the postmenopausal periods, one suppository is used every seven days for two weeks after surgery. For diagnostic purposes, in the absence of the results of cytological examination of the uterus, the use of Ovestin suppositories is as follows: one suppository every other day for a week before taking the next smear.
The missed rate of the drug must be entered on the same day when the woman remembers this. The dose should not be administered twice a day. In the subsequent applications are carried out according to the usual dosing schedule. In the case of continued treatment of postmenopausal symptoms, it is necessary to use the lowest effective dosage for the shortest possible time interval.
In women who are not receiving hormone therapy, treatment with this drug can be started any day. Women who switch to other hormonal medications should begin treatment with Ovestin a week after the cancellation of the previous similar medication.
Side effects
As indicated by the instructions for use, suppositories "Ovestin" can cause irritation and itching in women. Sensitivity is sometimes noted along with tension, soreness and an increase in the size of the mammary glands. Such reactions are usually short-lived, but may indicate taking too high a dosage.
Bloody discharge, as well as metrorrhagia, can be observed. In addition, there are many other side effects. For example, the liver and bile ducts can respond by the following adverse reactions:
- The development of cholelithiasis.
- The appearance of benign, malignant and unspecified neoplasms, including polyps and cysts.
A mental disorder can be dementia. This is possible if hormone therapy is carried out continuously after sixty-five years. Against the background of the use of Ovestin suppositories, the activity of the genitals and mammary glands may be accompanied by an increase in libido. The skin and subcutaneous tissue can react with chloasma, erythema multiforme, or hemorrhagic purpura.
There is evidence of an increased risk of breast or ovarian cancer. In addition, there is a risk of venous thromboembolism, coronary disease and stroke.
Drug overdose
According to the instructions for use for suppositories "Ovestin", with vaginal administration, this is unlikely. However, in the event of a large amount of the drug entering the intestinal tract, nausea and vomiting may occur. There is no specific antidote. If necessary, symptomatic treatment is necessary.
Indications for the use of candles "Ovestin" should be strictly observed.
Interaction with other medicines
In clinical practice, there is no interaction between Ovestin and other drugs. Estrogen metabolism can increase if used in combination with drugs such as Phenobarbital and Carbamazepine.
The drug "Ritonavir" may exhibit an inducing property when used in combination with hormones. Herbal medicines that contain St. John's wort are able to induce estrogen metabolism. Excessive estrogen metabolism can lead to a decrease in the clinical effect.
The active substance of suppositories estriol can enhance the effect of lipid-lowering drugs and reduces the effect of anticoagulants, male sex hormones, antidepressants, and, in addition, diuretic and hypoglycemic drugs.
Medicines intended for general anesthesia along with narcotic analgesics, anxiolytics and some antihypertensive drugs reduce the effectiveness of Ovestin. Folic acid is able to enhance the effects of estriol.
Indications for the candles "Ovestin" and contraindications we examined. What else is said in the instructions?
special instructions
For the treatment of menopausal symptoms, suppositories should be taken only with regard to signs that adversely affect the overall quality of life. In other cases, it is necessary to conduct at least once a year an assessment of the risk and benefits of hormonal therapy. Such treatment can only last for a period until the benefit exceeds the risks.
Before starting hormonal treatment with Ovestin suppositories for women, you need to collect an individual history. Guided by the results and contraindications for use, a clinical examination is required. First of all, you should carefully examine the condition of the pelvic organs and mammary glands.
During the treatment period, it is recommended to conduct a periodic medical examination, the frequency of such is individual. Patients should be informed of the need to inform the doctor of information regarding any changes in the mammary glands. The study, including appropriate imaging techniques, such as mammography, should be carried out in accordance with currently accepted examination standards and, as the case may be, specific. This is confirmed by the instructions for use for candles "Ovestin" for women.
What could be the reasons for the immediate withdrawal of the drug?
Candlestick therapy should be discontinued if the patient has the following conditions:
- Onset of jaundice or impaired liver function.
- Pressure increase.
- The appearance of headaches by type of migraine.
- The onset of pregnancy.
The danger of developing endometrial hyperplasia and carcinoma during treatment
As part of the prevention of endometrial stimulation, the daily dosage of this medication should not exceed one suppository, which contains 0.5 milligrams of estriol. Do not use this maximum dosage for more than four weeks. It should be noted that one epidemiological study found that prolonged use of low-dose estriol when used orally increases the risk of endometrial cancer.
Such a risk increases in the course of increasing the duration of therapy and returns to its original value a year after the drug is discontinued. The risk of developing a minimally invasive and highly differentiated tumor is predominantly increased. The occurrence of vaginal bleeding in all cases requires a mandatory additional examination. Patients should be informed about the need to contact a doctor in case of vaginal bleeding. Instructions for candles "Ovestin" for women warns about this.
The danger of developing breast cancer during treatment
Hormone treatment can increase mammographic density, which complicates the radiological determination of breast cancer. Clinical studies have shown that the likelihood of an increase in mammography density in women who receive estriol therapy is lower compared to patients who are treated with other estrogens.
The evidence confirms the increased risk of breast cancer in women who receive combination treatment with estrogens and progestogens. Women who have received combined treatment with estrogen and progestogen for more than five years have a doubled risk of breast cancer. Thus, the level of risk directly depends on the duration of hormonal treatment.
It is still not known exactly whether Ovestin poses the same risk to patients. But, nevertheless, it is important that the risk of developing breast cancer be mandatory discussed with the patient and correlated with the benefits of hormonal treatment. Side effects from Ovestin suppositories can be very serious.
Is ovarian cancer possible with drug treatment?
Ovarian cancer appears much less frequently than breast cancer. Long-term estrogen treatment, for example for five years, is associated with a slight increase in the risks of ovarian cancer. The results of a number of studies indicate that combined hormonal treatment increases the likelihood of ovarian cancer to a small extent. But, nevertheless, before prescribing these candles, it is worth informing the patient about the possible risks.
Venous thromboembolism
Ovestin suppositories may increase the risk of venous thromboembolism or pulmonary embolism by one and a half times. A similar risk is relevant when taking estrogen in old age, and in addition, in the case of extensive surgical interventions, with obesity or in the presence of lupus erythematosus.
In the event that Ovestin is prescribed as part of postoperative treatment, the advisability of preventing thrombosis should be considered. If the patient develops thromboembolism after starting Ovestin therapy, then treatment with this drug must be stopped immediately. She should be informed about the need to immediately consult a doctor if she suddenly feels signs of thromboembolism, for example, painful swelling of the legs may appear along with sudden chest pain, shortness of breath, and so on.
Features of the drug "Ovestin" and its effect on the body
Estrogens can cause fluid retention, and therefore, women suffering from impaired renal function, in the case of treatment with Ovestin suppositories, should be under the supervision of a doctor. Estriol acts as a weak antagonist of gonadotropin and cannot have a significant effect on the endocrine system.
Cognitive function on the background of hormonal treatment in patients does not improve. There is evidence of an increased risk of dementia in women who have begun to use combination therapy with this drug continuously after sixty-five years. This is indicated in the instructions.
Analogs of candles "Ovestin"
One of the analogues is a drug called Ovipol Clio. This substitute has the same release form and method of use as Ovestin. This medicine is prescribed to patients as part of hormonal treatment in the postoperative period against the background of postmenopause. This analogue has many contraindications, and, in addition, side effects.
The drug "Estrokad" is an analogue of German production. It is also produced in the form of vaginal suppositories. The active substance is estriol. One candle contains 500 micrograms of active ingredient. This analogue is strictly contraindicated during pregnancy.
An analogue of Ovestin candles Ostrozhel is available in the form of a gel intended for topical application. This drug, like Ovestin, belongs to the pharmacotherapeutic group of estrogens. In this case, a substance called estradiol is used in this case.
Reviews about the drug "Ovestin"
Despite the large list of various contraindications, there are many positive reviews about this drug. For example, some report that thanks to these candles, women in some cases manage to get pregnant. The fact is that doctors sometimes prescribe these suppositories to dilute various female secretions, as a result of which it becomes easier for male sperm to penetrate the uterus. In such situations, it is noted that pregnancy occurs after the second month of treatment with Ovestin suppositories.
Also, many write that these suppositories are very effective against the background of hormonal therapy for the treatment of atrophy of the mucosa of the lower genitourinary system, which are associated with estrogen deficiency in women during postmenopausal women. Women also write in their reviews that these candles are small in size, making them easy to use.
The disadvantages, first of all, are the fact that the candles "Ovestin" are hormonal and therefore have many different contraindications. For a long time, patients are afraid to use this remedy, since there are risks of a possible development of breast oncology. Does not add popularity to this drug and its cost, which is about one and a half thousand rubles.
Thus, based on the reviews, the following conclusions can be drawn. This drug is quite controversial: on the one hand, it effectively helps women cope with various gynecological problems, and on the other, it is a hormonal drug that cannot be safe for health.
We examined analogues of Ovestin for candles, instructions for use and reviews.