In the article, we will consider why Ginipral is prescribed. The drug is used in obstetrics and is a medicine whose therapeutic effect is aimed at suppressing the contractile properties of the smooth muscles of the uterine walls.
The composition of the medication and the form of release
According to the instructions for use, Ginipral is made in the form of tablets for oral use. They are white in color, convex on both sides. The drug is packaged in 10 pieces in blisters, two of which are in cardboard packaging.
The main active element of this medication is hexoprenaline sulfate. In one tablet, its content is 500 mcg. In this case, magnesium stearate, glycerol, talc, corn starch, copovidone, lactose are used as additional components.
Also, the drug is produced in the form of a colorless solution for iv administration. 1 ml contains 0.005 mg of the active substance hexoprenaline sulfate, and in addition, auxiliary substances. Pregnant women with the threat of premature birth are often given droppers with Ginipral.
Pharmacological action of the drug
"Ginipral" refers to the category of selective beta-adrenergic agonists. The main active substance of these tablets is able to suppress the contractile activity of smooth muscles in the uterus and act on it relaxing. The drug inhibits both real contractions and any other contractions of the uterus that are caused by exposure to oxytocin during childbirth.
During treatment with this medication, an increase in heart rate in a woman and fetus may be observed.
Indications for appointment
According to the instructions for use, "Ginipral" is prescribed to women during pregnancy, in particular in its second and third trimesters, in the presence of the following pathological phenomena:
- High probability of premature birth.
- Increased uterine tone.
- In the prevention of preterm labor with the use of a pessary and insignificant disclosure of uterine throat.
- Periodic and painful contractions that occur earlier than the estimated date of delivery.
Indications for Ginipral should be strictly observed.
Contraindications
A drug during pregnancy is allowed to be used only after the appointment of a specialist. Before starting treatment with this medication, the expectant mother is recommended to carefully study the annotation, since the tablets have several limitations. Contraindications in this case include:
- impaired thyroid function;
- changes in heart rate;
- severe tachycardia;
- myocarditis;
- coronary heart disease;
- congenital defects of the mitral valve in the heart or aortic stenosis;
- increase in blood pressure;
- placental abruption;
- increased intraocular pressure;
- severe degree of impaired liver and kidney function;
- spotting from the genital tract of unknown etiology;
- first trimester of pregnancy and lactation;
- cases of individual intolerance to the elements of the drug.
What else can you learn from the instructions for use with Ginipral?
Mode of application
The daily dosage of this medication and the duration of the therapeutic course are determined by the doctor depending on the severity of the threat of spontaneous abortion. If this factor occurs, as well as in the presence of increased uterine tone, it is advisable to prescribe intravenous injections of the Ginipral medication, and after normalizing the condition, it is necessary to switch to maintenance treatment with tablets.
According to the instructions for use, pregnant women are prescribed one tablet 4 times a day. With a pronounced threat of miscarriage, as well as with an increased uterine tone, the daily dosage of Ginipral should be increased exactly twice, that is, two tablets 4 times a day or 1 tablet every three hours. After stabilization and elimination of the threat, the dose should be gradually reduced.
The drug is taken regardless of food intake, it is not crushed and chewed, washed down with a sufficient volume of liquid.
Ginipral tablets are not prescribed for women to maintain pregnancy in the first trimester. In the subsequent periods of bearing a child, the drug is used strictly according to indications with the determination of an individual dosage.
During lactation, when a new pregnancy occurs, breastfeeding must be interrupted and only after that treatment with this medication should be started. If there is no pregnancy, then during lactation, the use of a medication is not advisable.
Droppers with Ginipral may also be prescribed. The drug is used for infusion or iv administration.
The ampoule is diluted to a volume of 10 ml with 0.9% isotonic sodium chloride solution. The resulting solution is administered iv slowly (5-10 minutes) using automatically dispensing infusomats or simple infusion systems. Dosage is selected individually.
Side effects of Ginipral
During therapy with this medication in pregnant women, the development of the following side effects is often observed:
- nervous system: severe cephalgia, increased irritability, sleep disturbance, tremor of the extremities, dizziness, excessive anxiety and a feeling of fear;
- heart and vascular system: lowering blood pressure, palpitations at constant rates in the unborn child, pain in the heart, the development of heart rhythm disturbances;
- digestive organs: pain in the stomach, excessive salivation, dyspepsia, diarrhea or constipation;
- in the biochemical parameters of blood, an increase in the functionality of liver transaminases may be observed;
- the clinical picture of blood - a decrease in the level of calcium and potassium, anemia, an increase in glucose;
- respiratory system: respiratory failure, the occurrence of bronchospasm;
- violation or loss of consciousness;
- allergic manifestations - skin itching and flushing of the skin, the development of Quincke's edema, anaphylactic shock, urticaria;
- with prolonged use of this medication, swelling may occur, which is a consequence of impaired renal function;
- increased sweating.
Overdose symptoms
In accordance with the instructions for use with Ginipral, with uncontrolled and prolonged use of this medication during pregnancy, the development of symptoms of overdose is observed, which can be expressed in the following clinical manifestations and increase the adverse reactions from the drug:
- panic attacks, increased anxiety and anxiety;
- sleep disturbances - insomnia;
- a pronounced decrease in blood pressure, up to a coma or collapse;
- chest pain in the heart;
- severe tachycardia, violation of heart rhythms;
- dizziness and cephalalgia.
Against the background of an overdose of this medication, the birth of children with acidosis and critically low blood glucose was often observed in patients.
If you experience symptoms caused by the drug, you must urgently seek medical help. Therapy in this case consists in the use of beta-blockers (Ginipral antagonists) - drugs that can inhibit its effect.
Drug interaction
With concomitant treatment with Ginipral tablets with beta-blockers, the latter can slightly reduce the therapeutic effect of the drug.
Theophylline is able to enhance the therapeutic effect of this medication, therefore, these drugs are not recommended to be taken simultaneously during treatment of pregnant women.
The main active substance of the Ginipral preparation can significantly weaken the effect of drugs aimed at lowering blood glucose levels.
With the simultaneous use of this medication with drugs for general anesthesia, the risk of serious adverse reactions from the heart and vascular system is significantly increased.
The drug in question can also not be combined with vitamin D and calcium preparations.
An increase in adverse reactions to the cardiovascular system is noted with the simultaneous use of this medication with bronchodilators (Broncholitin, Secrol, etc.), Fluorotan, as well as beta-adrenergic agonists (Orciprenaline, Izadrin, “Alupent”).
The medicine “Ginipral” is absolutely incompatible and cannot be used together with MAO inhibitors (“Befol”, “Iproniazid”, “Fenelzin”, “Nialamide”, “Moclobemide”, etc.), ergot alkaloids (“Methylergometrine”, “Ergometrin” ”,“ Syncapton ”,“ Ergotamine ”,“ Dihydroergotamine ”,“ Dihydroergotoxin ”,“ Neomigran ”,“ Sinepress ”), tricyclic antidepressants (“ Desipramine ”,“ Nortriptyline ”,“ Imipramine ”,“ Doxepin ”,“ Ks ” “Dotiyepin”, “Midantan” and others), mineralocorticoid preparations (“Florinef”, “Cortineff”, “Fludrocortisone”, “Desoxicort” n ").
special instructions
During the treatment with the Ginipral medication, a pregnant woman needs to regularly monitor her blood pressure and monitor her heart function. An ECG should be performed several times during the treatment period.
For patients with a high sensitivity to drug substances, the daily dosage should be calculated separately in the minimum effective volumes. This category of women should be under the constant supervision of a doctor.
If there are symptoms of severe tachycardia in a pregnant woman (with a heart rate of more than 110 beats per minute), the daily dosage of the drug should be reduced to normalize the condition.
In case of severe pain in the heart, as well as difficulty breathing during treatment with Ginipral, the tablets should be stopped immediately and a specialist should be informed about this.
In future mothers, against the background of therapy with this drug, an increase in blood glucose level may be observed, as a result of which tablets are prescribed with caution to women with a hereditary predisposition to such a disease as diabetes mellitus.
In addition, during the treatment with the Ginipral drug, patients should systematically monitor the frequency of urination per day and monitor the regularity of the stool.
If it is necessary to perform surgical interventions or other manipulations in a pregnant woman under general anesthesia, therapy with this medication should be discontinued, since a combination of such medications can lead to impaired heart function.
During treatment, the future mother is not recommended to drink strong black tea and coffee, because these drinks can increase the likelihood of adverse reactions from the heart and vascular system.
Analogues of the drug
In the modern pharmaceutical market there are a number of drugs - analogues of Ginipral. Often they contain the same active substance in the composition, but may coincide in therapeutic effect. These medicines include:
- "Hexoprenaline";
- Partusisten
- Ipradol;
- "Fenoterol";
- "Magnesia";
- "Salbutamol."
Ginipral's analogs should be prescribed by a doctor.
Features of childbirth after drug therapy
Childbirth after using this medication can take place in different ways. Some patients safely wait for the onset of natural contractions and successfully give birth on their own. In most cases, a similar situation occurs in those who suffered from a pronounced uterine tone. Childbirth in this group of women begins, as a rule, in 2-3 weeks after drug withdrawal. Other patients after using the product can not give birth until 41-42 weeks, and labor activity does not begin with them.
In this case, they are hospitalized and carry out artificial stimulation of childbirth. Such births can also occur in different ways, but this does not depend on the drug, and any complications are caused by other factors.
So Ginipral works with premature birth.
The most common complication of the prolonged use of this medication is insufficient disclosure of the cervix during childbirth and weak labor, due to which obstetricians are forced to resort to cesarean section. However, in general, the percentage of complications during childbirth in women treated with Ginipral during pregnancy is not higher than in those who did not take this medication.
In order to reduce the risks of artificial stimulation of labor and increase the chances of an independent start of labor, Ginipral must be canceled 2-3 weeks before the birth, so that the uterus regains the desired tone, reduced by the use of such a drug. Since the medication is recommended to be canceled gradually, the dosage should be reduced 5 weeks before the birth, so that it can be completely abandoned by 2-3 weeks.
Consider the feedback on the action of Ginipral.
Patient opinions
In this case, there are reviews not only of pregnant patients who were prescribed this medication, but also reviews of specialists. They are very ambiguous and contain both positive information about the medicine, and negative.
Patients using “Ginipral” in most cases noted its good tolerance, however, some of them had unpleasant side effects in the form of various digestive disorders, reactions from the nervous system, etc. The remaining negative effects on the body were not noted and respond This medicine is a highly effective drug for preserving pregnancy. This category of women observed that the cramping sensations in them disappeared around the third or fourth day of taking the pills, and the general condition improved significantly.
Reviews about Ginipral from doctors
Doctors call the drug one of the main means of treating the symptoms of miscarriage and premature birth and universally prescribe it to their patients. However, the only thing they are unhappy with is the inability to use this medication in the early stages of pregnancy.
Delivery in most cases after using the Ginipral agent proceeded normally, only a few cases of delayed labor and artificial stimulation were noted. In general, no significant complications were noted.