Why is femoston prescribed and how to take it. The medicine Femoston is an effective means of hormone replacement therapy. Use during pregnancy and lactation.

Femoston 1/10: instructions for use and reviews

Latin name: Femoston

ATX code: G03FB08

Active substance: dydrogesterone (dydrogesteronum), estradiol (oestradiolum)

Manufacturer: Solvay Pharmaceuticals (Netherlands), Abbott Laboratories S.A. (USA)

Updating the description and photo: 26.10.2018

Femoston 1/10 is a combined estrogen-progestogen antimenopausal drug.

Release form and composition

Femoston 1/10 is available in the form of film-coated tablets: round, biconvex, engraved “379” on one side, white tablet core with a rough structure; in one blister there are two types of tablets - white and gray (28 tablets in a blister - 14 pieces of white and gray; in a cardboard pack there are 1, 3 or 10 blisters).

  • white tablet: estradiol hemihydrate – 1.03 mg, which is equivalent to the content of 1 mg estradiol;
  • gray tablet: estradiol hemihydrate – 1.03 mg, which is equivalent to the content of 1 mg estradiol; dydrogesterone – 10 mg.

Auxiliary components: lactose monohydrate, hypromellose, starch, colloidal silicon dioxide, magnesium stearate.

Shell composition:

  • white tablet: opadry Y-1-7000 white [macrogol 400, titanium dioxide (E171), hypromellose];
  • gray tablet: opadry II 85F27664 gray [macrogol 3350, polyvinyl alcohol, titanium dioxide (E171), iron (II) oxide black (E172), talc].

Pharmacological properties

Pharmacodynamics

Femoston 1/10 is a combination drug intended for hormone replacement therapy (HRT) to prevent bone loss in the postmenopausal period and after oophorectomy. The identity of estradiol hemihydrate to endogenous human estradiol, which is the most active estrogen, makes it possible to compensate for the deficiency of estrogen in the body of a woman at menopausal age and reduces the symptoms of menopause during the first weeks of using the drug. The therapeutic effectiveness of dydrogesterone (progestogen) is similar in activity to the action of progesterone for parenteral administration. Dydrogesterone during HRT ensures complete secretory transformation of the endometrium. Its presence in the drug reduces the risk of developing endometrial hyperplasia, which is increased by the action of estrogens.

Pharmacokinetics

After taking Femoston 1/10 orally, micronized estradiol and dydrogesterone are rapidly and completely absorbed from the gastrointestinal tract. The bioavailability of dydrogesterone is 28%, the maximum concentration in the blood plasma occurs after 0.5–2.5 hours.

Binding to blood plasma proteins: estradiol - approximately 98-99% (with albumin - 30-52%, with globulin - up to 69%), dydrogesterone - more than 90% of the dose taken.

In the liver, estradiol is metabolized to estrone and estrone sulfate, which have estrogenic activity. Estrone sulfate also has the ability of enterohepatic recirculation.

Dydrogesterone is completely metabolized, its main metabolite is 20-a-dihydrodydrogesterone (DHD), the maximum concentration in the blood plasma is reached approximately 1.5 hours after taking Femoston 1/10. The plasma concentration of DHD significantly exceeds the initial level of dydrogesterone concentration.

The lack of estrogenic and androgenic activity is determined by the characteristic feature of all dydrogesterone metabolites to retain the 4,6-dien-3-one configuration of the original substance and the absence of 17alpha-hydroxylation.

The half-life for dydrogesterone is 5–7 hours (DGD is 14–17 hours), estrone and estradiol is 10–16 hours.

Estrogens pass into breast milk.

Estrone and estradiol in a state conjugated with glucuronic acid are excreted primarily through the kidneys.

Approximately 63% of the dose of dydrogesterone is excreted by the kidneys; its complete elimination occurs only after 72 hours. Its total plasma clearance is 6.4 l/min. DHD is detected in urine primarily as a glucuronic acid conjugate.

With daily intake of Femoston 1/10, the equilibrium concentration of estradiol occurs after 5 days, dydrogesterone - after 3 days.

The pharmacokinetic properties of dydrogesterone and DHD do not change with repeated administration.

Indications for use

According to the instructions, Femoston 1/10 is indicated for women in perimenopause (only 6 months after the last menstruation) or postmenopause, as hormone replacement therapy for conditions that are caused by estrogen deficiency in the body.

In addition, the drug is prescribed for the prevention of postmenopausal osteoporosis at a high risk of fractures in women with intolerance or contraindications to other drugs.

Contraindications

Absolute:

  • bleeding from the vagina of unknown etiology;
  • breast cancer, including suspected;
  • endometrial cancer and other estrogen-dependent malignant neoplasms, including if they are suspected;
  • meningioma and other progestogen-dependent neoplasms, including if they are suspected;
  • untreated endometrial hyperplasia;
  • arterial and venous thrombosis, including deep vein thrombosis (including medical history);
  • thromboembolism, including hemorrhagic or ischemic cerebrovascular disorders, pulmonary embolism, myocardial infarction (including medical history);
  • pronounced or multiple risk factors for the development of venous or arterial thrombosis in patients with an acquired or hereditary predisposition, such as angina pectoris, cerebrovascular disease, transient ischemic attacks, atrial fibrillation, coronary artery disease, complicated lesions of the heart valve apparatus, antithrombin III deficiency, the presence of antibodies to phospholipids (lupus anticoagulant, antibodies to cardiolipin), protein C or S deficiency, prolonged immobilization, severe obesity (body weight index more than 30 kg per 1 m2);
  • malignant liver tumors;
  • acute or chronic liver disease (including medical history);
  • porphyria;
  • lactase deficiency, galactose intolerance, glucose-galactose malabsorption syndrome;
  • pregnancy period;
  • breast-feeding;
  • hypersensitivity to the components of the drug.

It is recommended to be careful when prescribing Femoston 1/10 as HRT if you have or have a history of the following diseases and conditions: arterial hypertension, endometriosis, uterine leiomyoma, the presence of risk factors for the occurrence of estrogen-dependent tumors (including first-degree relatives with breast cancer) , bronchial asthma, diabetes mellitus (with and without vascular complications), benign liver tumors, cholelithiasis, severe headache, migraine, systemic lupus erythematosus, epilepsy, otosclerosis, history of endometrial hyperplasia.

Immediate discontinuation of Femoston 1/10 is required if liver dysfunction, jaundice, uncontrolled arterial hypertension, or migraine-like headaches appear during treatment.

Instructions for use of Femoston 1/10: method and dosage

Femoston 1/10 tablets are taken orally, regardless of meals, at a time convenient for the woman, but always at the same time of day.

Recommended dosage: 1 pc. 1 per day. The package is designed for 28 days; you should start taking tablets from the blister with white tablets (marked with the number 1), which contain 1 mg of estradiol. After 14 days, therapy is continued with gray tablets (marked with the number 2 in the blister), they contain 1 mg of estradiol and 10 mg of dydrogesterone. After finishing taking the tablets from the current blister, therapy is continued by taking white tablets from the new package. HRT involves regular, continuous use of the drug.

If you accidentally miss taking the next dose of Femoston 1/10, the tablet should be taken as soon as you remember, if the period of delay does not exceed 12 hours (the period from taking the previous dose to 36 hours). If the delay is more than 12 hours, then you should not take the missed tablet, and the next day take the usual dose at the prescribed time. If you miss the next dose of the drug, the risk of spotting or breakthrough uterine bleeding increases.

When switching from the use of another hormonal drug (cyclic or continuous sequential regimen), you must end the current cycle and start taking Femoston 1/10. When switching from a continuous combination therapy regimen, you can start treatment with Femoston 1/10 on any day.

If the clinical effectiveness of the drug is insufficient due to estrogen deficiency, the dosage can be adjusted by prescribing Femoston 2/10.

Side effects

  • from the reproductive system and mammary glands: very often - tension or soreness of the mammary glands; often - metrorrhagia, impaired vaginal secretion, minor bleeding in postmenopause, pain in the lower abdomen, heavy menstrual-like bleeding, acyclic bleeding, absence or scant menstrual bleeding, painful menstrual-like bleeding, vaginal candidiasis; uncommon – enlarged mammary glands, increased size of leiomyoma, premenstrual-like syndrome;
  • from the nervous system: very often – headache; often – dizziness, migraine;
  • from the cardiovascular system: infrequently - increased blood pressure, venous thromboembolism; rarely - myocardial infarction;
  • mental disorders: often – nervousness, depression; infrequently – libido disturbance;
  • from the gastrointestinal tract: very often – abdominal pain; often – flatulence, nausea, vomiting;
  • from the hepatobiliary system: infrequently - impaired liver function, including in combination with abdominal pain, jaundice, malaise, asthenia; gallbladder pathology;
  • from the skeletal muscles and connective tissue: very often – back pain (lumbar pain);
  • on the part of the immune system: infrequently – hypersensitivity to the components of the drug;
  • dermatological reactions: often - allergic reactions, including urticaria, skin rash, itching; rarely – angioedema, vascular purpura;
  • general disorders: often - peripheral edema, asthenic conditions (malaise, weakness, fatigue);
  • infectious diseases: infrequently – cystitis;
  • other reactions: often - increase in body weight; infrequently – loss of body weight.

In addition, during combination therapy with estrogen and progestogen (including estradiol and dydrogesterone), the following undesirable effects may develop:

  • from the body as a whole: neoplasms of benign, malignant and unspecified etiology (including ovarian cancer, endometrial cancer, meningioma);
  • from the cardiovascular system: arterial thromboembolism;
  • from the hematopoietic system: hemolytic anemia;
  • from the nervous system: provoking attacks of epilepsy, chorea, risk of developing dementia against the background of hormone replacement therapy started over the age of 65 years;
  • from the immune system: systemic lupus erythematosus;
  • from the reproductive system and mammary glands: cervical erosion, fibrocystic mastopathy;
  • from the organs of vision: increased curvature of the cornea, intolerance to contact lenses;
  • from the skeletal muscles and connective tissue: cramps in the muscles of the lower extremities;
  • from the genitourinary system: urinary incontinence;
  • from the side of metabolism: hypertriglyceridemia;
  • from the gastrointestinal tract: with hypertriglyceridemia - pancreatitis;
  • diagnostic studies: increased levels of thyroid hormones;
  • dermatological reactions: erythema nodosum, erythema multiforme, chloasma and/or melasma;
  • other reactions: with porphyria – worsening of the disease.

Overdose

Symptoms: abdominal pain, nausea, vomiting, dizziness, drowsiness, weakness, withdrawal bleeding, breast tension.

Treatment: use of symptomatic therapy as indicated.

special instructions

The prescription of Femoston 1/10 is indicated only in the presence of symptoms that have an adverse effect on the quality of life. HRT is recommended until the risk of side effects exceeds the benefits of taking the drug. The limited clinical experience with the drug in women over 65 years of age should be taken into account.

In younger women, the absolute risk from using the drug is much lower than in older women.

To identify possible contraindications, the doctor should prescribe Femoston 1/10 based on a complete medical and family history and after a general gynecological examination of the patient, including mammography. The doctor should inform the woman about those changes in the mammary glands, the appearance of which requires consultation with a doctor. The use of the drug requires mandatory periodic examinations, at least once every 6 months. The doctor determines their nature and frequency individually.

The use of estrogens significantly increases the risk of developing endometrial cancer and hyperplasia, the degree of risk depends on the dose of the drug and the period of HRT. The combined composition of Femoston 1/10, namely cyclic administration of progestogen, reduces the risk of endometrial hyperplasia and cancer caused by estrogens. For timely diagnosis of these pathologies, it is advisable to conduct ultrasound screening, and, if necessary, histological examination. Bloody vaginal discharge, including breakthrough bleeding, may occur during the first months of therapy. If such bleeding occurs at later stages of treatment or occurs after discontinuation of the drug, it is necessary to diagnose their cause. To exclude malignancy, an endometrial biopsy is recommended.

The risk of developing deep vein thrombosis and pulmonary embolism during HRT increases several times, to a greater extent during the first 12 months of drug use. Patients whose first-degree relatives had thromboembolic complications at a young age, or with a history of spontaneous abortion, require a hemostasis study before prescribing the drug. With concomitant anticoagulant therapy, it is necessary to carefully evaluate the feasibility of prescribing Femoston 1/10. For planned surgery followed by long-term immobilization, it is recommended to discontinue HRT 1–1.5 months in advance and resume it only after the patient’s mobility has been completely restored. A woman should be informed about the symptoms of thromboembolism, such as shortness of breath, swelling or tenderness of the lower extremities, sudden chest pain, and the need to immediately consult a doctor if they occur.

The risk of developing breast cancer during combined estrogen-progestogen HRT, which lasts for more than 5 years, increases by 2 times. Breast engorgement caused by the drug may make it difficult to diagnose breast cancer in a timely manner.

There is a risk of developing ovarian cancer, but to a much lesser extent than breast cancer.

Combination therapy with estrogen and progestogen causes an increase in the relative risk of ischemic stroke, which is independent of the patient's age or duration of therapy. It should be borne in mind that the older the patient is at which she begins HRT, the higher the initial risk of ischemic stroke. Femoston 1/10 does not affect the occurrence of hemorrhagic stroke. The risk of developing coronary heart disease increases with age, but this can occur for objective and subjective reasons.

Femoston 1/10 is not a contraceptive.

In patients with impaired renal and cardiac function, their condition may be aggravated by the ability of estrogens to cause fluid retention.

In case of hypertriglyceridemia, HRT in very rare cases can contribute to the development of pancreatitis due to a significant increase in the level of triglyceride concentration in the blood plasma.

The use of the drug does not improve the patient's cognitive functions. When starting HRT after the age of 65, women have an increased risk of developing dementia.

Impact on the ability to drive vehicles and complex mechanisms

Due to the risk of unwanted reactions from the nervous system, it is recommended to exercise caution when operating complex machinery and vehicles.

Use during pregnancy and lactation

The use of a combined hormonal drug during pregnancy and breastfeeding is contraindicated.

For liver dysfunction

The use of Femoston 1/10 is contraindicated in case of malignant liver tumors, acute or chronic forms of liver dysfunction (including medical history) and porphyria.

Use in old age

Women over 65 years of age have limited experience with the drug.

Drug interactions

When used simultaneously with Femoston 1/10:

  • carbamazepine, phenobarbital, phenytoin (anticonvulsants), rifabutin, nevirapine, rifampicin, efavirenz (antimicrobials), St. John's wort, ritonavir, nelfinavir: increase the metabolism of the active components of the drug, which may result in a decrease in its therapeutic effect and a change in the intensity of vaginal bleeding ;
  • tacrolimus, cyclosporine, theophylline, fentanyl: can significantly increase their plasma concentration levels.

Analogs

Analogues of Femoston 1/10 are: Femoston Mini, Femoston 1/5 Conti, Femoston 2/10, Klimonorm, Kliogest, Trisequens, Divina.

Terms and conditions of storage

Store at temperatures up to 30 °C. Keep away from children.

Shelf life – 3 years.

Composition and release form

blister 28 pcs. (14 white and 14 gray); in a cardboard pack there are 1, 3 or 10 blisters.

blister 28 pcs. (14 pink and 14 light yellow); in a cardboard pack there are 1, 3 or 10 blisters.

Description of the dosage form

Estradiol tablets 1 mg: round, biconvex, covered with a white shell, embossed “S” above the “6” icon on one side and embossed “379” on the other.

Tablets 1 mg estradiol/10 mg dydrogesterone: round, biconvex, covered with a gray shell, embossed "S" above the "6" icon on one side and embossed "379" on the other.

The tablet core is white.

Estradiol tablets 2 mg: round, biconvex, covered with a pink shell, embossed “S” above the “6” icon on one side and embossed “379” on the other.

The tablet core is white.

Tablets 2 mg estradiol/10 mg dydrogesterone: round, biconvex, covered with a light yellow shell, embossed with an "S" above the "6" on one side and "379" on the other side.

The tablet core is white.

Characteristic

A drug for hormone replacement therapy with normal (2/10) and low-dose (1/10) content of estradiol as an estrogenic component and dydrogesterone as a gestagenic component.

pharmachologic effect

pharmachologic effect- estrogen-progestogen.

Pharmacodynamics

Estradiol is an estrogen that is part of the drug Femoston ®, identical to endogenous human estradiol. Estradiol replenishes the deficiency of estrogen in the female body after menopause and provides effective treatment of psycho-emotional and vegetative menopausal symptoms: hot flashes, increased sweating, sleep disturbances, increased nervous excitability, dizziness, headache, involution of the skin and mucous membranes, especially the mucous membranes of the genitourinary system (dryness and irritation of the vaginal mucosa, pain during sexual intercourse). Hormone replacement therapy (HRT) with Femoston ® prevents bone loss in the postmenopausal period caused by estrogen deficiency. Taking Femoston ® leads to a change in the lipid profile towards a decrease in the level of total cholesterol and LDL and an increase in HDL.

Dydrogesterone is a progestogen, effective when taken orally, which completely ensures the onset of the secretion phase in the endometrium, thereby reducing the risk of developing endometrial hyperplasia and/or carcinogenesis, which increases against the background of estrogens. Dydrogesterone does not have estrogenic, androgenic, anabolic or glucocorticosteroid activity.

The combination of 1 mg estradiol with dydrogesterone is a modern low-dose HRT regimen.

Pharmacokinetics

After oral administration, micronized estradiol is easily absorbed. Metabolized in the liver to estrone and estrone sulfate, which also undergoes hepatic biotransformation. Glucuronides of estrone and estradiol are excreted primarily in the urine.

Dydrogesterone after oral administration is quickly absorbed from the gastrointestinal tract. Metabolized completely. The main metabolite is 20-dihydrodydrogesterone, present in urine mainly in the form of a glucuronic acid conjugate. Complete elimination of dydrogesterone occurs after 72 hours.

Indications of the drug Femoston ®

HRT for disorders caused by natural or surgical menopause;

prevention of postmenopausal osteoporosis.

Contraindications

established or suspected pregnancy;

breastfeeding period;

diagnosed or suspected breast cancer, history of breast cancer;

diagnosed or suspected estrogen-dependent malignancies;

vaginal bleeding of unknown etiology;

previous idiopathic or confirmed venous thromboembolism (deep vein thrombosis, pulmonary embolism);

active or recent arterial thromboembolism;

acute liver diseases, as well as a history of liver diseases (until normalization of laboratory parameters of liver function);

untreated endometrial hyperplasia;

hypersensitivity to any of the components of the drug;

porphyria.

Carefully- Patients receiving HRT and having the following conditions (currently or in the past) should be under close medical supervision:

uterine leiomyoma, endometriosis;

history of thrombosis or its risk factors;

risk factors for estrogen-dependent tumors (for example, breast cancer in the patient’s mother);

arterial hypertension;

benign liver tumor;

diabetes;

cholelithiasis;

epilepsy;

migraine or intense headache;

history of endometrial hyperplasia;

systemic lupus erythematosus;

bronchial asthma;

renal failure;

otosclerosis.

After consultation with your doctor, the drug should be discontinued in the following cases:

the appearance of jaundice or deterioration of liver function;

strong rise in blood pressure;

newly diagnosed migraine-like attack;

pregnancy;

manifestation of any contraindication.

Use during pregnancy and breastfeeding

Contraindicated during pregnancy and breastfeeding.

Side effects

From the blood and lymphatic system: very rarely (<0,01%) — гемолитическая анемия.

From the nervous system: headache, migraine (in 1-10%); sometimes (0.1-1%) - dizziness, nervousness, depression, changes in libido; very rarely - chorea.

From the cardiovascular system: sometimes - venous thromboembolism; very rarely - myocardial infarction.

From the gastrointestinal tract: nausea, abdominal pain, flatulence; very rarely - vomiting.

From the liver and biliary tract: sometimes - cholecystitis; rarely (in 0.01-0.1%) - impaired liver function, sometimes accompanied by asthenia, malaise, jaundice or abdominal pain.

For the skin and subcutaneous fat: sometimes - allergic reactions, rash, urticaria, itching, peripheral edema; very rarely - chloasma, melasma, erythema multiforme, erythema nodosum, hemorrhagic purpura, angioedema.

From the reproductive system and mammary glands: breast tenderness, breakthrough bleeding, pain in the pelvic area; sometimes - changes in cervical erosion, changes in secretion, dysmenorrhea; rarely - breast enlargement, premenstrual-like syndrome.

Others: changes in body weight; sometimes - vaginal candidiasis, breast carcinoma, increase in leiomyoma size; rarely - intolerance to contact lenses, increased corneal curvature; very rarely - exacerbation of porphyria (<0,01%).

Interaction

Drugs that are inducers of microsomal liver enzymes (barbiturates, phenytoin, rifampicin, rifabutin, carbamazepine) can weaken the estrogenic effect of Femoston ®. Ritonavir and nelfinavir, although known as inhibitors of microsomal metabolism, may act as inducers when taken concomitantly with steroid hormones. Herbal preparations containing St. John's wort can stimulate the exchange of estrogens and progestogens.

The interactions of dydrogesterone with other drugs are unknown.

The patient should inform the doctor about the medications she is currently taking or was taking before prescribing Femoston ®.

Directions for use and doses

Inside, preferably at the same time of day, regardless of food intake - 1 table. per day without a break. Femoston ® 1/10 is taken according to the following scheme: in the first 14 days of a 28-day cycle, take 1 white tablet daily (from half the package with an arrow marked with the number “1”) containing 1 mg of estradiol, in the remaining 14 days - daily 1 gray tablet (from half the package with the arrow marked "2") containing 1 mg estradiol and 10 mg dydrogesterone.

Femoston ® 2/10 is taken according to the following regimen: in the first 14 days of a 28-day cycle, take 1 tablet daily. pink (from half of the package with an arrow marked with the number “1”) containing 2 mg estradiol, and in the remaining 14 days - 1 light yellow tablet daily (from half of the package with an arrow marked with the number “2”) containing 2 mg estradiol and 10 mg dydrogesterone.

For patients whose menstruation has not stopped, it is recommended to begin treatment on the first day of the menstrual cycle (1st day of the onset of menstruation). For patients with irregular menstrual cycles, it is advisable to begin treatment after 10-14 days of monotherapy with progestogen. Patients whose last menstruation was observed more than 1 year ago can begin treatment at any time.

Overdose

Symptoms: nausea, vomiting, drowsiness, dizziness.

Treatment: symptomatic.

special instructions

Before prescribing or restarting HRT, it is necessary to obtain a complete medical and family history and conduct a general and gynecological examination to identify possible contraindications and conditions requiring precautions. During treatment with the drug, it is recommended to periodically examine women (the frequency and nature of the studies are determined individually). In addition, it is advisable to conduct breast examination and/or mammography in accordance with accepted standards, taking into account clinical indications. The use of estrogens may affect the results of the following laboratory tests: glucose tolerance testing, thyroid and liver function tests.

Generally recognized risk factors for thrombosis and thromboembolism while taking HRT are a history of thromboembolic complications, severe forms of obesity (body mass index more than 30 kg/m2) and systemic lupus erythematosus. There is no generally accepted opinion regarding the role of varicose veins in the development of thromboembolism.

The risk of developing deep vein thrombosis of the lower extremities may temporarily increase with prolonged immobilization, major trauma, or surgery. In cases where prolonged immobilization is necessary after surgery, temporary cessation of HRT should be considered 4-6 weeks before surgery.

When deciding on HRT in patients with recurrent deep vein thrombosis or thromboembolism receiving anticoagulant treatment, the benefits and risks of HRT must be carefully assessed.

If thrombosis develops after starting HRT, the drug should be discontinued. The patient should be informed of the need to consult a doctor if the following symptoms occur: painful swelling of the lower extremities, sudden loss of consciousness, dyspnea, blurred vision.

There is data demonstrating a slight increase in the detection rate of breast cancer in women who received HRT for a long time (more than 10 years). The likelihood of being diagnosed with breast cancer increases with the duration of treatment and returns to normal 5 years after stopping HRT.

Patients who have previously received HRT using only estrogen drugs should be especially carefully examined before starting treatment in order to identify possible endometrial hyperstimulation. Breakthrough uterine bleeding and mild menstrual-like bleeding may occur in the first months of treatment with the drug. If, despite dose adjustment, such bleeding does not stop, the drug should be discontinued until the cause of the bleeding is determined. If bleeding recurs after a period of amenorrhea or continues after discontinuation of treatment, its etiology should be determined. This may require an endometrial biopsy.

Femoston ® is not a contraceptive. Perimenopausal patients are advised to use non-hormonal contraceptives.

It does not affect the ability to drive a car or use other mechanisms.

Manufacturer

Solvay Pharmaceuticals B.V., The Netherlands.

Storage conditions for the drug Femoston ®

At a temperature not exceeding 30 °C.

Keep out of the reach of children.

Shelf life of the drug Femoston ®

3 years.

Do not use after the expiration date stated on the package.

Synonyms of nosological groups

Category ICD-10Synonyms of diseases according to ICD-10
M81.0 Postmenopausal osteoporosisMenopausal osteoporosis
Osteoporosis in menopause
Osteoporosis in menopause
Osteoporosis in postmenopause
Osteoporosis in the postmenopausal period
Postmenopausal osteoporosis
Osteoporosis due to estrogen deficiency
Osteoporosis in postmenopausal women
Osteoporosis in postmenopausal women
Osteoporosis in postmenopausal women and after hysterectomy
Perimenopausal osteoporosis
Postmenopausal osteoporosis
Postmenopausal osteoporosis
Postmenopausal osteoporosis
Postmenopausal bone demineralization
N95.1 Menopausal and menopausal conditions in womenAtrophy of the mucous membrane of the lower genitourinary tract caused by estrogen deficiency
Vaginal dryness
Autonomic disorders in women
Hypoestrogenic conditions
Estrogen deficiency in menopausal women
Dystrophic change in the mucous membrane during menopause
Natural menopause
Intact uterus
Climax
Female menopause
Menopause in women
Menopausal depression
Menopausal ovarian dysfunction
Menopause
Menopausal neurosis
Menopause
Menopause complicated by psychovegetative symptoms
Menopausal symptom complex
Menopausal autonomic disorder
Menopausal psychosomatic disorder
Menopausal disorder
Menopausal disorder in women
Menopausal condition
Menopausal vascular disorder
Menopause
Menopause premature
Menopausal vasomotor symptoms
Menopause period
Estrogen deficiency
Feeling hot
Pathological menopause
Perimenopause
Menopause period
Postmenopausal period
Postmenopausal period
Postmenopausal period
Postmenopausal period
Premature menopause
Premenopause
Premenopausal period
Tides
Hot flashes
Flushing to the face in menopause and postmenopause
Hot flashes/feelings of heat during menopause
Palpitations during menopause
Early menopause in women
Disorders during menopause
Menopausal syndrome
Vascular complications of menopause
Physiological menopause
Estrogen deficiency conditions

In concentrations of 1 and 5 mg, respectively. The auxiliary components used are: lactose in the form of monohydrate, methylhydroxypropylcellulose, anhydrous colloidal silicon dioxide, corn starch, macrogol 400, magnesium stearate, iron dyes (yellow oxide E172 and red E172), titanium dioxide (E171), Opadry orange.

Tablets have a similar composition Femoston Conti 1/5.

IN Femoston tablets 1/10 white color is used as the active component estradiol . Substance concentration - 1 mg/tab. Each gray tablet contains 1/10 Femoston estradiol And dydrogesterone contained in a ratio of 1:10 (1 mg estradiol at 10 mg dydrogesterone ).

In pink Femoston tablets 2/10 contains as an active component estradiol at a concentration of 2 mg/tab. In light yellow tablets estradiol And dydrogesterone contained in a ratio of 2:10 (2 mg estradiol at 10 mg dydrogesterone ). Auxiliary components: lactose in the form of monohydrate, hypromellose, magnesium stearate, corn starch, colloidal silicon dioxide, Opadry (white, gray, pink and yellow, respectively).

Release form

The dosage form of the drug is film-coated, round, biconvex tablets with a diameter of 0.7 cm. The tablets differ in color depending on the concentration of the active substance/substances; each of them is marked “379” on one side.

On tablets Femoston 1/5 on the other side the letter “S” is engraved. Tablets are available in calendar packs of 28 pieces.

Tablets with a higher concentration of active substances are packaged in calendar packs as follows:

  • 14 white tablets 1 mg + 14 gray tablets 1 mg + 10 mg (Femoston 1/10);
  • 14 pink tablets 2 mg + 14 light yellow tablets 2 mg + 10 mg (Femoston 2/10).

pharmachologic effect

Antimenopausal estrogen-progestogen agent for “calendar” (sequential) reception.

Pharmacodynamics and pharmacokinetics

Femoston is combined hormonal agent , used to eliminate symptoms of estrogen deficiency and treatment of DUB - dysfunctional uterine bleeding .

  • hyperhidrosis;
  • tides;
  • involution of the mucous membranes and skin, and especially the mucous membranes of the urogenital tract (in particular, the vaginal mucosa, due to which a woman begins to experience discomfort during sexual intercourse);
  • increased nervous excitability;
  • headaches and dizziness;
  • sleep disorders;
  • loss of bone mass or (especially if certain risk factors are noted - long-term treatment glucocorticosteroids in the recent past, early onset menopause , asthenic type of build, smoking, etc.).

Also estradiol helps reduce concentration general and low-density drugs, while simultaneously increasing the concentration of high-density drugs.

Action progestational component of the drug - dydrogesterone - aimed at stimulating the onset of the secretory phase of the endometrial cycle, and also reduces the risk carcinogenesis And endometrial hyperplasia, associated with influence estrogen .

Dydrogesterone does not provide androgenic estrogenic , glucocorticosteroid or anabolic action . To ensure maximum preventive effect (HRT), treatment is recommended to begin as soon as possible after the onset of menopause .

After taking p/os, estradiol is easily absorbed. Biotransformation of the substance is carried out in liver , the products are estrone And estrone as sulfate . Estradiol And estrone glucuronides are eliminated from the body mainly through urine.

Dydrogesterone is also quickly absorbed from digestive tract after taking p/os. The substance is completely biotransformed, the main product metabolism - 20-dihydrodydrogesterone. Removal metabolites carried out mainly through urine.

Half-life dydrogesterone - from 5 to 7 hours, its main metabolite - from 14 to 17 hours, the substances are completely eliminated after 72 hours.

Indications for use

The use of Femoston is indicated for hormone replacement therapy to eliminate phenomena caused by estrogen deficiency in women in postmenopausal period .

The medicine is prescribed no earlier than six months after the last menstrual bleeding.

Prophylactic use of the drug is advisable to prevent the development osteoporosis after the offensive menopause . The drug is prescribed to women who have an increased risk of fractures and who are contraindicated in the use of other medications intended to prevent bone loss.

Contraindications

The drug is not prescribed:

  • women who have been diagnosed in the past malignant estrogen- or progestogen-dependent tumors , as well as if there are suspicions of these diseases;
  • patients diagnosed or suspected;
  • at vaginal bleeding unspecified nature of origin;
  • at untreated hyperplasia (pathological growth) endometrium ;
  • when detected at the moment or noted in the anamnesis venous thromboembolism (including but not limited to DVT and PE);
  • if the patient is found to have certain thrombophilic disorders (including when thrombophilia associated with deficiency antithrombin , coagulation protein C or its cofactor - protein S );
  • at thromboembolic arterial diseases , including including or (both in the active stage and in cases where the disease was suffered in the recent past);
  • for active diseases liver , and also if the patient has not recovered from the illness biochemical parameters of the liver ;
  • at porphyrin disease ;
  • if you are aware of individual intolerance estradiol , dydrogesterone or auxiliary components of Femoston;
  • children and adolescents under 18 years of age;
  • during pregnancy (both established and suspected pregnancy);
  • during lactation.

Side effects

The category of side effects that often occur in connection with the use of Femoston includes: pain (headaches, in the abdomen, in the pelvic area), nausea, migraine attacks, flatulence, leg cramps, increased sensitivity and/or tenderness of the mammary glands, metrorrhagia, the appearance of bloody vaginal bleeding after menopause, asthenia, loss/increase in body weight.

With a frequency of 1/1000-1/100 during clinical studies, the following phenomena occurred:

  • vaginal candidiasis ;
  • depression;
  • increase in size uterine fibroids ;
  • change libido ;
  • increased nervousness;
  • DVT, PE;
  • dizziness;
  • illnesses gallbladder ;
  • backache;
  • allergic reactions on the skin, accompanied by itching, rashes;
  • ulcerative defects on the cervix ;
  • the appearance of cervical discharge;
  • peripheral edema.

In rare cases (with a frequency of 1/10000-1/1000), drug therapy was accompanied by:

  • intolerance to contact lenses;
  • functional disorders liver , which often manifest themselves in the form asthenia , malaise, abdominal pain, jaundice ;
  • increased curvature of the cornea;
  • enlargement of the mammary glands;
  • premenstrual tension syndrome.

In isolated cases, the medicine can provoke the development chorea , hemolytic anemia, stroke, myocardial infarction, vascular purpura, vomiting, erythema nodosum or multiforme, melanopathy or chloasma(often persisting even after discontinuation of the drug), angioedema , hypersensitivity reactions, worsening porphyrin disease .

In addition, due to treatment estrogen-progestogen drugs women sometimes develop neoplasms (benign, malignant or of unknown etiology), increase in size progestogen-dependent tumors , appear fibrocystic lesions of the mammary glands , concentration increases triglycerides in and concentration thyroid hormones ; are developing arterial hypertension , acute blockage arteries , peripheral vascular disease (against the background of pre-existing hypertriglyceridermia), cystitis-like syndrome , urinary incontinence; worsens, symptoms appear.

Femoston tablets: instructions for use

Most often, Femoston is taken on days strictly determined by the attending physician, taking into account the characteristics of a particular menstrual cycle . In the absence of menstrual bleeding, the tablets should be taken on the expected days when they should begin. At amenorrhea observed throughout the year, the drug can be started at any time.

Instructions for use Femoston 1/5

The drug is intended for continuous use: tablets are taken p/os, one per day (optimally at the same time), without reference to meal times. The duration of one cycle is 4 full weeks (1 package No. 28 is designed for one cycle). There is no need to take a break between cycles.

To relieve symptoms menopause The drug is started with the minimum effective dose. Treatment begins with the appointment of Femoston 1/5. Considering the timing menopause, the severity of the accompanying symptoms and the effectiveness of therapy can be adjusted to the dosage regimen.

If it is necessary to switch from another containing estrogen And progestogenic components of the drug for sequential (or cyclic) use, the patient should complete the full four-week course and only after that switch to treatment with Femoston 1/5 (reception can be started on any day). There is no break between cycles.

The regimen for using Femoston 1/5 Conti is similar to that described above.

Instructions for use Femoston 1/10

Femoston 1/10 tablets should be taken regardless of meal time. Estrogen as part of the drug is intended for continuous daily use during the first two weeks of the cycle.

Progestogenic the component is added in the last 14 days of each four-week course.

Treatment begins with taking white tablets according to the following scheme: 1 tablet 1 time per day (at the same time) during the first 2 weeks of the cycle. Next, following the instructions on the package, they begin to take gray tablets (also, one per day).

There is no need to take breaks between 28-day cycles.

Sequential combined HRT begins with the prescription of Femoston 1/10, and then, if necessary, the dose is adjusted taking into account the clinical results of therapy.

To switch from a similar drug, you should complete the full cycle of treatment and only then start taking Femoston 1/10 tablets. You can do this any day.

Instructions for use Femoston 2/10

Estrogen the drug component should be taken continuously, progestogenic the component is administered from the 15th day of the 28-day cycle.

This means that in the first 2 weeks of the cycle the patient should take 1 pink tablet per day, and starting from the 15th day, following the instructions on the drug packaging, switch to taking yellow tablets.

Typically starting dose estradiol - 1 mg, so sequential combined HRT starts with Femoston 1/10 and, if necessary, moves on to a higher dose over time.

Switching from other drugs to Femoston 2/10 is carried out only after completing a full four-week cycle (on any day).

How to take Femoston correctly if you miss the next dose?

If a woman misses the next dose of the drug, the tablet should be taken as quickly as possible. If more than 12 hours have passed since the missed dose, then the course is continued by taking the next tablet from the package (you do not need to drink the missed one).

Taking a double dose to compensate for a missed dose is not advisable, since it is associated with an increased risk of breakthrough bleeding and the appearance of spotting vaginal discharge.

How should patients of different age groups take the drug?

There is no sufficient experience with the use of Femoston for the treatment of patients over 65 years of age.

There are no indications for prescribing the drug to children and adolescents.

Overdose

Cases of overdose with Femoston have not been recorded.

AND estrogenic , And progestogenic the components of the tablets belong to the category of low-toxic substances.

Theoretically, an overdose can provoke an increase in the severity of side effects such as nausea, vomiting, dizziness, drowsiness.

It is unlikely that an overdose may require any specific symptomatic treatment (including overdose in children).

Interaction

Drug interaction studies with Femoston have not been conducted.

However, it is known that some agents may affect the effectiveness estrogen And progesterones .

So, anticonvulsants (for example, phenytoin or ) and antimicrobial (including nevirapine , or efavirenz ) drugs enhance the biotransformation of these substances, which is associated with their ability to induce those involved in metabolism medicine enzymes of the cytochrome P450 system .

Ritonavir And nelvinavir , which are potent inhibitors of CYP isoenzymes 3A4, A5 and A7, in combination with steroid hormones , promote the activation of these cytochromes.

Herbal remedies , based on St. John's wort (Hypericum perforatum), can stimulate biotransformation estrogen And progestogens due to the ability to influence the CYP 3A4 isoenzyme.

There is evidence that more active estrogen metabolism And progestogens provokes a decrease in the clinical effectiveness of these substances and affects the profile of uterine bleeding.

In its turn estrogens can disrupt the process of biotransformation of other substances due to competitive inhibition cytochromes of the P450 system , which take part in the processes of biotransformation of active substances of drugs.

This should be kept in mind when prescribing estrogens in combination with drugs that have a narrow therapeutic index, including fentanyl , , theophylline , cyclosporine .

Such combinations can cause an increase in the plasma concentration of these substances to a toxic level. Therefore, it may be necessary to carefully monitor the drug over an extended period of time, as well as to reduce the dose. cyclosporine, tacrolimus, theophylline and fentanyl .

Terms of sale

On prescription.

Storage conditions

Optimal storage conditions for Femoston tablets are to maintain a temperature of no more than 30 degrees Celsius. The drug must be stored in its original packaging. Keep away from children.

Best before date

The drug is suitable for use for 36 months after the date of release.

special instructions

The drug is recommended to be used only in the presence of symptoms that have an adverse effect on the quality of life. Treatment is continued until the benefits of using the drug outweigh the risk of side effects.

Analogs

Level 4 ATX code matches:

The generic (structural analogue) of Femoston ⅕ is the drug Femoston Conti 1/5.

Drugs with a similar mechanism of action: , .

Klimonorm or Femoston - which is better?

The decision about which drug from the combination group estrogen-progestin agents you should choose whether the doctor accepts it based on the data received from the patient about the period of age-related hormonal changes.

It is believed that the drug Klimonorm progestational the component is present in the most optimal concentration, which allows you to effectively control the cycle and ensure the required level protecting the endometrium from the hyperplastic effect of estrogens .

At the same time, it is possible to maintain the beneficial effects due to the influence estrogen per condition cardiovascular system and lipid metabolism . In addition, contained in Klimonorme potentiates action estradiol aimed at treatment and prevention osteoporosis .

Another important feature levonorgestrel is its almost 100% bioavailability, thanks to which it is possible to maintain the stability of the effects of the drug.

Moreover, the severity of the effects remains unchanged regardless of the woman’s nutritional characteristics, whether she has digestive tract diseases , as well as activities hepatic system , which plays a key role in the processes presystemic metabolism of xenobiotics .

Bioavailability dydrogesterone , which is part of Femoston, is 28%, and therefore its effects are subject to fluctuations (both inter- and inter-individual).

Angelique or Femoston - which is better?

Experts believe that there is not much difference between these means. The main difference between the drug and Femoston is that, as progestational components it contains at a concentration of 2 mg/tab.

Use with alcohol

The manufacturer's instructions do not describe the interaction of Femoston with alcohol.

During pregnancy

The use of Femoston is contraindicated if it is known for sure that the woman is pregnant, as well as if there is reason to suspect pregnancy. The drug is also contraindicated for women who are breastfeeding.

In some cases, the medicine is prescribed during pregnancy planning. The indications are:

  • conditions caused by deficiency estrogen and manifested by insufficiency of the first phase (that is, conditions in which by the end of the first (follicular) phase menstrual cycle the thickness of the endometrial layer does not exceed 7-8 mm);
  • infertility caused by hormonal imbalance.

Too thin an endometrium can cause disruption of the luteal phase and, as a result, a woman cannot become pregnant.

Concentration estradiol in tablets intended for use during the first 2 weeks of the cycle is such that the drug, unlike contraceptives, does not suppress ovulation , while modeling the first phase menstrual cycle and stimulates cell division and growth.

Taking pills that contain estradiol supplemented dydrogesterone, in turn, ensures secretory transformation inner layer of the uterus , which is necessary for normal implantation eggs in case of fertilization and pregnancy. Thus, Femoston 2/10 allows you to normalize the disturbed menstrual cycle .

When planning pregnancy, Femoston 2/10 is taken from the first day of the menstrual cycle, one tablet per day for 4 full weeks. You should not stop treatment before the entire package is completed, as this can provoke a hormonal imbalance, manifested by breakthrough bleeding of varying degrees of intensity and leaving no chance of pregnancy.

Women who take Femoston when planning a pregnancy should further strengthen the luteal (second) phase of the cycle, therefore, from the 14th day of treatment, the patient is prescribed to take the drug in combination with (or its equivalent).

As progestational component in Duphaston present dydrogesterone , and this allows us to enhance the positive effect of therapy on the female body and condition endometrium .

Duphaston Take one tablet twice daily for a full two weeks.

Is it possible to get pregnant while taking the drug?

Pregnancy that occurs during the use of Femoston is an exception. As a rule, the chances of becoming pregnant after taking the drug for several cycles are considered more realistic, and this usually occurs after stopping treatment.

In extremely rare cases, it is possible to use the product against the background of an already existing pregnancy, when a woman needs support endometrium . However, such a decision can only be made by a qualified specialist.

Femoston reviews

A considerable number of reviews about Femoston 1/5 Conti have been left on the forums. Like reviews of Femoston 2/10 or 1/10, they are quite contradictory. As a rule, in reviews women describe their experience of using the product for menopause or when planning pregnancy .

Those who were satisfied with the treatment note that the advantages of the drug are that it is quite well tolerated and rarely causes side effects, quickly normalizes the condition, relieving the unpleasant symptoms of the onset menopause , and improves overall well-being, has a positive effect on the condition of the skin, restores the cycle if it is disrupted, and is easy to use.

Negative reviews are associated with the occurrence of undesirable side effects (depression, rash, excess weight, swelling, decreased activity, joint pain, etc.), as well as the lack of the expected effect.

Turning to doctors' reviews of Femoston 1/10, 2/10 or 1/5, which are based on the results of clinical studies, we can conclude that the drug is a highly effective remedy for the treatment and prevention of conditions that have developed as a result of premature exhaustion ovaries .

Moreover, all patients showed good tolerability of the tablets. Research has made it possible to establish a pronounced positive effect of therapy on the general well-being of women and, in particular, on blood lipid profile .

Against the background of the treatment, a significant increase in the rate of maximum oxygen consumption and an increase in dydrogesterone bone-protective effect of estrogen component of Femoston.

Thus, doctors confirm the need for early initiation and differentiated choice of hormone replacement therapy in women with “off” ovarian function .


Femoston– a combined drug for hormone replacement therapy containing estradiol as an estrogenic component and dydrogesterone as a gestagenic component.
The estradiol contained in Femoston is biologically and chemically identical to the natural human sex hormone - estradiol. Estradiol in the female body replenishes the estrogen deficiency associated with the onset of menopause, and also provides adequate therapy for vegetative and psycho-emotional menopausal symptoms: increased sweating, hot flashes, dizziness, sleep disturbances, headaches, increased nervous excitability, involutional processes of the skin, involution of the mucous membranes , primarily the mucous membranes of the genitourinary system (pain during sexual intercourse, irritation and dryness of the mucous membranes of the vagina). Estradiol is capable of causing cyclic changes in the cervix, uterus and vagina, helping to maintain the elasticity and tone of the genitourinary tract. Estradiol provides prevention of fractures and osteoporosis, participating in the preservation of bone tissue.
Dydrogesterone is a progestogen that is effective when taken orally. Dydrogesterone ensures the onset of the secretion phase in the endometrium, thereby reducing the risk of endometrial hyperplasia and the development of carcinogenesis, which increases against the background of estrogens. Dydrogesterone does not have androgenic, estrogenic, glucocorticosteroid or anabolic activity.
The combination of estradiol and dydrogesterone in the drug Femoston is a modern low-dose regimen of hormone replacement therapy.
MH therapy with Femoston helps prevent bone loss in the postmenopausal period, which is caused by estrogen deficiency. Femoston provides a change in lipid metabolism, reducing the level of LDL and total cholesterol and increasing the level of HDL.
After oral administration, estradiol is rapidly absorbed and metabolized in the liver to form estrone sulfate and estrone. Estrone sulfate also undergoes biotransformation in the liver. Estradiol metabolites are characterized by the presence of estrogenic activity before and after their transformation into estradiol. Glucuronides of estradiol and estrone are excreted primarily by the kidneys. Estrogens can pass into breast milk.
Dydrogesterone after oral administration is rapidly absorbed from the digestive tract. Completely metabolized in the liver to 20-dihydrodydrogesterone (the main metabolite), which is present in the urine in the form of a glucuronic acid conjugate. All dydrogesterone metabolites retain their configuration and, under the influence of 17α-hydroxylase, do not produce a hydroxylation reaction. The maximum concentration of dydrogesterone and dihydrodydrogesterone is observed 0.5-2.5 hours after taking Femoston. The half-life of dehydrodydrogesterone is 14-17 hours, dydrogesterone - 5-7 hours. Dydrogesterone is completely excreted by the kidneys after 72 hours.

Indications for use

Femoston used: for hormone replacement therapy of disorders that are caused by physiological or surgical menopause; for the prevention of osteoporosis in postmenopausal women with a high risk of fractures in cases where there is intolerance or contraindications to the use of other drugs intended for the prevention of osteoporosis.

Mode of application

Femoston 1/10 prescribed to perimenopausal patients in a low-dose cyclic regimen: 1 tablet per day. It is recommended to take Femoston at one time of day.
During the first two weeks of a 28-day cycle, you should take 1 white tablet containing 1 mg estradiol daily (from half a blister with an arrow with the number “1”). In the remaining 2 weeks of the cycle, you should take (from half a blister with arrow “2”) every day 1 gray tablet containing 1 mg estradiol and 10 mg dydrogesterone.
Fe moston 2/10 is prescribed in a traditional cyclic regimen: 1 tablet per day without a break. It is recommended to take Femoston at one time of day.
During the first two weeks of the 28-day cycle, you should take 1 orange tablet daily, which contains 2 mg estradiol. For the remaining two weeks, you should take 1 yellow tablet daily, which contains 2 mg estradiol and 10 mg dydrogesterone.
Patients with continued menstruation should begin therapy with Femoston on the 1st day of the monthly cycle. Patients with irregular menstrual cycles should begin therapy with Femoston after 10-14 days of gestagen monotherapy.
Patients who had their last menstruation more than one year ago can begin Femoston therapy at any time.
Femoston 1/5 prescribed to patients who have been postmenopausal for at least a year.
Femoston 1/5 should be taken without interruption at one time of day, 1 tablet per day.

Side effects

When using Femostona the following side effects may occur: migraine, headache, nausea, flatulence, abdominal pain, cramps of the lower extremities, breakthrough bleeding, spotting, pain in the mammary glands, pain in the pelvic area, weight gain or loss, asthenia;
vaginal candidiasis, depression, increased size of fibroids, changes in libido, dizziness, irritability, venous thromboembolism, allergic skin reactions, gallbladder diseases, urticaria, skin rashes, itchy skin, back pain, dysmenorrhea, changes in cervical erosion, peripheral edema, changes amount of cervical secretion; increased curvature of the cornea, intolerance to contact lenses, enlarged mammary glands, liver dysfunction accompanied by malaise, asthenia, abdominal pain and jaundice; hemolytic jaundice, chorea, hypersensitivity reactions, myocardial infarction, vomiting, stroke, erythema nodosum, erythema multiforme, angioedema, vascular purpura, chloasma and melasma, which may remain after stopping the drug.

Contraindications

Femoston contraindicated: in case of known or suspected pregnancy; during lactation; with vaginal bleeding of unknown etiology; with diagnosed or suspected breast cancer; if you have a history of breast cancer; with diagnosed or suspected estrogen-dependent malignant neoplasms; with active or recent arterial thromboembolism; in case of acute liver diseases and a history of liver diseases (until the condition is stabilized and normal liver function indicators are restored); with hypersensitivity to the components of the drug; with porphyria; with previous idiopathic or confirmed venous thromboembolism (pulmonary embolism, deep vein thrombosis); with untreated endometrial hyperplasia.
Femoston should be prescribed with caution to patients receiving hormone replacement therapy and suffering from: endometriosis, uterine leiomyoma; thrombosis (or having risk factors for the development of thrombosis in history); arterial hypertension; diabetes mellitus; benign liver tumors; cholelithiasis; epilepsy; endometrial hyperplasia (history); migraine or intense headaches; systemic lupus erythematosus; renal failure; bronchial asthma; otosclerosis.
This category of patients should be under constant supervision of the attending physician.
Taking Femoston should be stopped after consultation with the doctor in the following cases: jaundice appears; deterioration of liver function; pregnancy; newly diagnosed migraine-like attack; strong rise in blood pressure; manifestation of any of the contraindications.

Pregnancy

A drug Femoston Contraindicated during pregnancy.

Interaction with other drugs

When taking the drug simultaneously Femoston with drugs that are inducers of microsomal liver enzymes (phenytoin, rifabutin, barbiturates, carbamazepine, rifampicin), the estrogenic effect of Femoston may be weakened. Nelfinavit and ritonavir, being inhibitors of microsomal metabolism, can act as inducers when taken simultaneously with steroids. When taken simultaneously with the drug, herbal medicines that contain St. John's wort can stimulate the exchange of progestogens and estrogens.

Overdose

In case of drug overdose Femoston Drowsiness, nausea, vomiting, and dizziness may develop. Treatment of overdose: symptomatic therapy.

Storage conditions

Storage temperature Femostona should not exceed 25 degrees Celsius. Keep away from moisture. Keep away from light. Keep away from children.

Release form

Femoston 1/5; 1/10; 2/10 tablets in a calendar pack of 28 tablets.

Compound

In 1 tablet Femostona 1/5 contains: 1 mg estradiol, 5 mg dydrogesterone.
Excipients: lactose monohydrate, corn starch, methylhydroxypropylcellulose, anhydrous colloidal silicon dioxide, macrogol 400, magnesium stearate, iron oxide red and yellow, titanium dioxide, Opadry orange.

1 white tablet Femostona 1/10 contains: 1 mg estradiol.
1 gray tablet of Flemoston 1/10 contains: 1 mg estradiol, 10 mg dydrogesterone.
Excipients: hypromellose, lactose monohydrate, corn starch, magnesium stearate, colloidal silicon dioxide, Opadry gray and white.

1 pink tablet Femostona 2/10 contains: 2 mg estradiol.
1 light yellow tablet of Flemoston 2/10 contains: 2 mg of estradiol, 10 mg of dydrogesterone.
Excipients: lactose monohydrate, corn starch, hypromellose, colloidal silicon dioxide, magnesium stearate, Opadry pink and yellow.

Additionally

Before starting or resuming a course of hormone replacement therapy, it is advisable to collect a complete family and medical history, as well as conduct a general examination and gynecological examination to identify the presence of contraindications or conditions that require constant medical supervision and precautions. During therapy Femoston Patients should be periodically examined, determining the nature of the study and frequency individually. Mammography and breast examination are recommended. Taking estrogen may affect the results of studies of liver and thyroid function and determination of glucose tolerance. While taking hormone replacement therapy, risk factors for thromboembolism and thrombosis include severe forms of obesity (with a body mass index > 30 kg/m2), a history of thromboembolic complications, and systemic lupus erythematosus. With extensive injuries, prolonged immobilization, and surgical interventions, the risk of developing deep vein thrombosis of the lower extremities may temporarily increase. If prolonged immobilization is necessary after surgery, it is advisable to consider temporarily stopping hormone replacement therapy 4-5 weeks before surgery. Before prescribing hormone replacement therapy to women with thromboembolism or recurrent deep vein thrombosis who are being treated with anticoagulants, the risks and benefits of HRT should be assessed. The development of thrombosis after starting a course of hormone replacement therapy requires discontinuation of the drug. Patients should be informed of the need to visit a doctor if painful swelling of the lower extremities, dyspnea, sudden loss of consciousness, or visual impairment occurs. Patients who have previously received hormone replacement therapy with estrogen-only drugs should be especially carefully examined before starting therapy to identify endometrial hyperstimulation. In the first months of Femoston therapy, moderate menstrual-like bleeding and breakthrough uterine bleeding may be observed. If dose adjustment does not lead to the cessation of such bleeding, Femoston should be discontinued until the cause of the bleeding is determined. In cases where bleeding continues after stopping treatment with the drug or recurs after a period of amenorrhea, its etiology should be clarified. This may require an endometrial biopsy. Femoston is not a contraceptive drug, and therefore perimenopausal patients should use non-hormonal contraceptives.
A drug Femoston does not affect the speed of reactions and the ability to drive vehicles.

Main settings

Name: FEMOSTON
ATX code: G03FB08 -