Instructions for use FEMOSTON® 1/10 (FEMOSTON® 1/10)

Pharmacological properties of the drug Femoston

Pharmacodynamics. combined estrogen-progestin drug. Estradiol Estradiol is chemically and biologically identical to the natural human sex hormone estradiol. Among ovarian hormones, it has the highest activity. Estradiol causes cyclic changes in the uterus, cervix and vagina and ensures the maintenance of tone and elasticity of the genitourinary tract. Estradiol also plays an important role in the preservation of bone tissue, ensuring the prevention of osteoporosis and fractures. Oral intake of estrogens has a positive effect on lipid metabolism, has a beneficial effect on the autonomic nervous system and an indirect positive effect on the psycho-emotional sphere. Dydrogesterone Dydrogesterone is an orally effective progestogen whose effects are comparable to those of parenterally administered progesterone. In the context of hormone replacement therapy, dydrogesterone promotes complete secretory transformation of the uterine endometrium, thus preventing the risk of developing estrogen-induced endometrial hyperplasia and/or carcinoma, without excluding androgenic side effects. Due to the fact that estrogens stimulate endometrial growth, estrogen monotherapy increases the risk of developing endometrial hyperplasia and cancer. The use of progestogen in therapy reduces the estrogen-induced risk of developing endometrial hyperplasia in women with a preserved uterus. Clinical trial data Reduction of symptoms of estrogen deficiency and improvement of bleeding profile Reduction in the severity of menopausal symptoms was achieved during the first weeks of treatment. Regular menstrual-like reactions (average duration 5 days) when using Femoston, which contains 2 mg estradiol and 10 mg dydrogesterone, were observed in approximately 90% of women. Menstruation usually began on the day of taking the last tablet of the progestogen phase. Breakthrough uterine bleeding and/or spotting was reported in approximately 10% of women. During the first year of therapy, amenorrhea (absence of bleeding or spotting) was observed in 5–15% of women per cycle. Regular menstrual-like reactions when using the drug Femoston, which contains 1 mg of estradiol and 10 mg of dydrogesterone, were observed in 75–80% of women. The day of the onset of menstruation, its duration, as well as the number of women with periodic menstrual-like reactions were the same as with the use of the drug Femoston, which contains 2 mg estradiol and 10 mg dydrogesterone, but there were more women with no menstruation (10–25% per 1 cycle). Prevention of osteoporosis Estrogen deficiency during menopause is associated with increased bone turnover and decreased bone mass. The effect of estrogens on bone mineral density is dose-dependent. The protective effect of estrogens only occurs during their use. After stopping hormone replacement therapy (HRT), the rate of bone loss is the same as in women who did not receive this therapy. Data from the WHI (Women's Health Initiative) study and objective analysis of studies suggest that current HRT, primarily in healthy women, either as monotherapy or in combination with a progestogen, reduces the risk of hip, vertebral and other types of fractures that occur due to osteoporosis. HRT may also prevent fractures in women with low bone density and/or known osteoporosis, but data on this are limited. After two years of treatment with Femoston, which contains 2 mg estradiol and 10 mg dydrogesterone, bone mineral density (BMD) in the lumbar spine increased by 6.7% ± 3.9%. During treatment, BMD in the lumbar spine increased or remained unchanged in 94.4% of women. In women who took the drug Femoston, which contains 1 mg of estradiol and 10 mg of dydrogesterone, BMD in the lumbar spine increased by 5.2% + 3.8%. BMD in the lumbar spine increased or remained unchanged during treatment in 93.0% of women. Femoston affects BMD of the femur. After two years of therapy with 1 mg estradiol, BMD of the femoral neck increased by 2.7% ± 4.2%, by 3.5% ± 5.0% in the trochanteric area and by 2.7% ± 6.7% in the Ward triangle . After two years of treatment with estradiol at a dose of 2 mg, these figures were 2.6% ± 5.0%; 4.6% ± 5.0% and 4.1% ± 7.4%, respectively. BMD in three areas of the femur increased or remained unchanged after treatment with estradiol at a dose of 1 and 2 mg in 67–78% and 71–88% of women, respectively. Pharmacokinetics. Estradiol After oral administration, micronized estradiol is rapidly absorbed and extensively metabolized. The main unconjugated and conjugated metabolites are estrone and estrone sulfate. These metabolites have estrogenic activity both directly and after their conversion to estradiol. Estrone sulfate may be subject to enterohepatic metabolism. The main compounds found in urine are the glucuronides of estrone and estradiol. Estrogens pass into breast milk. Dydrogesterone After oral administration, approximately 63% of dydrogesterone is excreted in the urine. The drug is completely eliminated after 72 hours. Dydrogesterone is completely metabolized in the body. The main metabolite of dydrogesterone is 20-α-dihydrodydrogesterone (DHD), which is found primarily in urine as a glucuronic acid conjugate. A common feature of all metabolites is that they retain the 4,6-dien-3-one configuration and the absence of hydroxylation reaction under the action of 17α-hydroxylase. This explains the lack of estrogenic and androgenic effects of dydrogesterone. After oral administration of dydrogesterone, the concentration of DHD in the blood plasma significantly exceeds the level of the parent substance. Dydrogesterone is rapidly absorbed. The time to reach maximum concentration for dydrogesterone and DGD varies between 0.5–2.5 hours. The half-lives for dydrogesterone and DGD are 5–7 and 14–17 hours, respectively. Unlike progesterone, dydrogesterone is not excreted in the urine in the form of pregnanediol. Thus, it remains possible to analyze the formation of endogenous progesterone based on the measurement of pregnanediol excretion.

Pharmacodynamics and pharmacokinetics

Femoston is a combined hormonal drug used to eliminate the symptoms of estrogen deficiency and treat DUB - dysfunctional uterine bleeding .

The estradiol contained in the drug is identical to endogenous estradiol . The drug is used to replenish estrogen after the onset of menopause and effectively treats vegetative and psychoemotional disorders associated with menopause , accompanied by:

• 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 osteoporosis (especially if certain risk factors are noted - long-term treatment with glucocorticosteroids in the recent past, early onset of menopause , asthenic type of build, smoking, etc.).

Estradiol also helps reduce the concentration of total cholesterol and low-density lipoproteins, while simultaneously increasing the concentration of high-density lipoproteins.

The action of the gestagenic component of the drug - dydrogesterone - is aimed at stimulating the onset of the secretory phase of the endometrial cycle, and also reduces the risk of carcinogenesis and endometrial hyperplasia associated with the influence of estrogen .

Dydrogesterone does not have androgenic estrogenic , glucocorticosteroid or anabolic effects . To ensure the maximum preventive effect of hormone replacement therapy (HRT), treatment is recommended to begin as early as possible after the onset of menopause .

After taking p/os, estradiol is easily absorbed. Biotransformation of the substance occurs in the liver ; the metabolic are estrone and estrone in the form of sulfate . Estradiol and estrone glucuronides are eliminated from the body primarily in the urine.

Dydrogesterone is also rapidly absorbed from the digestive tract after oral administration. The substance is completely biotransformed, the main product of metabolism is 20-dihydrodydrogesterone. Metabolites excreted mainly through urine.

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

Use of the drug Femoston

To initiate and maintain treatment of postmenopausal symptoms, the minimum effective dose should be prescribed for the minimum period of time. Femoston is taken daily in the first 14 days of a 28-day cycle, 1 tablet containing 1 or 2 mg of estradiol, and in the remaining 14 days - daily, 1 tablet containing 1 mg of estradiol and 10 mg of dydrogesterone or 2 mg of estradiol and 10 mg of dydrogesterone. After the end of the 28-day cycle, a new cycle should begin. Treatment must be continuous. The tablets should be taken in the order indicated on the package. Treatment of postmenopausal symptoms Usually begins with taking the drug Femoston, containing 1 mg of estradiol and 10 mg of dydrogesterone. Depending on the clinical effect, the dose is then selected individually. If the severity of symptoms associated with estrogen deficiency does not decrease, the dose can be increased by prescribing a drug that contains 2 mg of estradiol and 10 mg of dydrogesterone. Prevention of osteoporosis When hormone replacement therapy is used, it is necessary to take into account individual tolerance to treatment and that the expected effect of the drug on bone tissue is dose-dependent. Femoston Conti 1 tablet 1 time per day daily, without breaks, regardless of meals. Prevention of osteoporosis When hormone replacement therapy is used, it is necessary to take into account individual tolerance to treatment and that the expected effect of the drug on bone tissue is dose-dependent.

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.

Femoston 1/5 tablets have the letter “S” engraved on the other side. 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).

Contraindications to the use of Femoston

Hypersensitivity to the components of the drug; diagnosed or suspected breast cancer, endometrial carcinoma and other hormone-dependent tumors diagnosed or suspected; vaginal bleeding of unknown etiology; untreated endometrial hyperplasia; history of acute deep vein thrombosis, pulmonary embolism or idiopathic venous thromboembolism; arterial thromboembolism, including recent ones (for example, angina pectoris, myocardial infarction); acute and chronic liver diseases, as well as their history in the absence of normalization of functional state indicators; porphyria; established or suspected pregnancy.

Overdose

Cases of overdose with Femoston have not been recorded.

Both estrogen and progestogen 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).

Side effects of the drug Femoston

Common (1–10%): headache, migraine, nausea, abdominal pain, flatulence, leg cramps, breast pain, breakthrough bleeding, spotting, pelvic pain, asthenia, weight loss or gain. Uncommon (≤1%): vaginal candidiasis, increased size of uterine fibroids, depression, changes in libido, irritability, dizziness, venous thromboembolism, gallbladder disease, allergic skin reactions, rash, urticaria, itching, back pain, changes in cervical erosion and amount of cervical secretion, dysmenorrhea, peripheral edema. Rarely (≤0.1%): intolerance to contact lenses, increased corneal curvature, liver dysfunction, which may be accompanied by asthenia, malaise, jaundice and abdominal pain, breast enlargement, premenstrual-like syndrome. Very rare (≤0.01%): hemolytic anemia, hypersensitivity reactions, chorea, myocardial infarction, stroke, vomiting, chloasma and melasma, which may persist after drug discontinuation, erythema multiforme, erythema nodosum, vascular purpura, angioedema, deterioration with porphyria. Breast cancer According to the results of a large number of epidemiological studies and one randomized, placebo-controlled trial (Women Health Initiative - WHI), the overall risk of breast cancer increases with the duration of hormone replacement therapy (HRT) in women who receive this treatment, or who have undergone HRT in the recent past. For estrogen-only HRT, the relative risk (RR) estimate from a re-analysis of data from 51 epidemiological studies (in which estrogen-only HRT was given to more than 80% of all HRT cases) and the Million Women Study (MWS) epidemiological study is similar at 1.35 (95% confidence interval - CI: 1.21-1.49) and 1.30 (95% CI: 1.21-1.40), respectively. Regarding combined HRT (estrogen plus progestogen), several epidemiological studies have reported a higher overall risk of breast cancer than estrogen monotherapy. The MWS study demonstrated that, compared with patients who had never received HRT, use of different types of combined (progestogen plus estrogen) HRT was associated with a higher risk of breast cancer (RR = 2.00, 95% CI: 1 .88-2.12) than with estrogen alone (RR = 1.30, 95% CI: 1.21-1.40) or tibolone (RR = 1.45; 95% CI: 1.25-1. 68). In the WHI study, the risk in all patients was 1.24 (95% CI: 1.01-1.54) after 5.6 years of combined (progestogen plus estrogen) HRT (conjugated equine estrogens - CLE and methylprogesterone acetate - MPA) in comparison with placebo. The absolute risks calculated in the MWS and WHI studies are presented below: Based on the average incidence of breast cancer in developed countries, the MWS study found that approximately 32 out of 1000 women over 50 years of age can be expected to be diagnosed with breast cancer up to 64 who are not receiving HRT; per 1000 women who have recently received or are receiving HRT, the number of additional cases during the corresponding period would represent for those receiving estrogen replacement therapy only 0 to 3 (best estimate = 1.5) if used for 5 years; from 3 to 7 (best score = 5) when used for 10 years; for those receiving combined (estrogen plus progestogen) HRT 5 to 7 (best estimate = 6) when used for 5 years; 18 to 20 (best estimate = 19) when used for 10 years. The WHI study found that after 5.6 years of follow-up in women aged 50 to 79 years, combined estrogen-progestogen HRT (CPE and MPA) would result in an additional 8 cases of invasive breast cancer diagnosed per 10,000 woman-years. According to study statistics, it was found that: per 1000 women in the placebo group, approximately 16 cases of invasive breast cancer would be diagnosed after 5 years; per 1000 women who received combined estrogen + progestogen HRT (CLE and MPA), the number of additional cases will be from 0 to 9 (best estimate = 4) when used for 5 years. The number of additional cases of breast cancer in women who use HRT is similar to that of women who start HRT, regardless of their age at start of use (45 to 65 years). Other adverse reactions reported in association with estrogen/progestogen therapy:

• estrogen-dependent neoplasms, both benign and malignant, for example, endometrial cancer, ovarian cancer;
• venous thromboembolism, that is, deep vein thrombosis of the lower extremities or pelvis and pulmonary embolism, is more common among women who receive HRT than among those who do not;
• arterial thromboembolism;
• an increase in the size of neoplasms caused by progestogen (for example, meningioma);
• dementia.

Endometrial cancer In women with an intact uterus, the risk of endometrial hyperplasia and cancer increases with the duration of estrogen monotherapy. According to epidemiological studies, the best estimate of risk is that in women who do not take HRT, endometrial cancer can be expected to be diagnosed in approximately 5 in 1000 cases at ages 50 and 65 years. Depending on the duration of treatment and dose of estrogen, the risk of developing endometrial cancer among those taking estrogen alone is 2 to 12 times greater than among those not taking it. Adding a progestogen to estrogen monotherapy significantly reduces this increased risk.

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 estrogen and manifested by insufficiency of the first phase (that is, conditions in which by the end of the first (follicular) phase of the 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.

Most often, at the planning stage, doctors recommend taking Femoston 2/10.

The concentration of 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 simulating the first phase of the menstrual cycle and stimulating the division and growth of endometrial .

Taking tablets containing estradiol supplemented with dydrogesterone, in turn, ensures secretory transformation of the inner layer of the uterus , which is necessary for normal implantation of the egg in the event of its fertilization and pregnancy. Thus, Femoston 2/10 allows you to normalize the disrupted 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 Duphaston (or its analogue).

Dydrogesterone is present as gestagenic component in Duphaston , and this makes it possible to enhance the positive effect of therapy on the female body and the condition of the endometrium .

Duphaston is taken one tablet twice a day 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 endometrial . However, such a decision can only be made by a qualified specialist.

Special instructions for the use of Femoston

Hormone replacement therapy should only be started if there are symptoms that adversely affect quality of life. In all cases, a careful risk-benefit analysis should be carried out at least annually, and treatment should only be continued if the benefit outweighs the risk. Before prescribing hormone replacement therapy or its resumption, it is necessary to conduct a thorough general and gynecological examination of the patient, study her individual and family history to identify possible contraindications and risk factors. During the treatment period, regular examinations are recommended, the frequency and scope of which are determined individually, with mandatory examination of the mammary glands and/or mammography, modified if necessary. Diseases for which monitoring of the patient’s condition is necessary: ​​uterine fibroids or endometriosis; history of thromboembolic disease or the presence of risk factors for thromboembolism (see below); the presence of risk factors for the occurrence of estrogen-dependent tumors, for example, the first degree of hereditary predisposition to breast cancer; AH (arterial hypertension); liver diseases (for example, liver adenoma); diabetes mellitus with or without vascular complications; cholelithiasis; migraine or (severe) headache; systemic lupus erythematosus; history of endometrial hyperplasia (see below); epilepsy; BA; otosclerosis. You should stop using the drug : if a contraindication to use is identified, as well as if jaundice or liver dysfunction develops, a significant increase in blood pressure, the appearance (for the first time) of a migraine-type headache, or pregnancy. Endometrial hyperplasia. When treated only with estrogen drugs for a long time, the risk of developing endometrial hyperplasia and cancer increases. Adding a progestogen to treatment for at least 12 days of the cycle in women with a preserved uterus significantly reduces this risk. Bleeding. Sometimes, in the first months of treatment, breakthrough uterine bleeding or spotting may occur. If they occur after some time during treatment or are noted after discontinuation of the drug, it is necessary to find out their cause (endometrial biopsy to exclude malignant neoplasms). Venous thromboembolism. Hormone replacement therapy increases the risk of developing venous thromboembolism (VTE), that is, deep vein thrombosis or pulmonary embolism. The occurrence of this condition is most likely during the first year of treatment. Risk factors for the development of VTE are a history of thromboembolism in the patient or her family members, severe obesity (body mass index 30 kg/m2) and systemic lupus erythematosus. If there is a history of thromboembolism, as well as with repeated spontaneous abortions, it is necessary to conduct an examination to exclude a tendency to thrombus formation. Until a thorough evaluation of thrombophilia factors is completed or anticoagulant therapy is initiated, the use of hormone replacement therapy in such patients should be considered contraindicated. In women taking anticoagulants, it is necessary to conduct a careful analysis of the risk/benefit ratio of using hormone replacement therapy. The risk of thromboembolism increases with prolonged immobilization, significant trauma, or extensive surgery. As for all patients in the postoperative period, special attention should be paid to preventive measures to prevent thromboembolic complications after surgery. If prolonged immobilization is planned after surgery, such as abdominal surgery or lower extremity orthopedic surgery, temporary cessation of hormone replacement therapy should be considered 4–6 weeks before surgery. Treatment should not be resumed until the woman’s motor activity is completely restored. If VTE develops after initiation of therapy, the drug must be discontinued. Patients should be warned to seek immediate medical attention if potential symptoms of thromboembolism (eg, painful swelling of the leg, sudden chest pain, shortness of breath) occur. Disease of the coronary arteries of the heart. In randomized controlled trials, there was no evidence of a positive effect on the cardiovascular system with continuous combination therapy of conjugated estrogens and MPA. Two large clinical trials, WHI and HERS (Heart and Estrogen/progestin Replacement Study), demonstrated a possible increased risk of cardiovascular disease during the first year of treatment and a lack of overall benefit. For other drugs used for HRT, there is only limited data from randomized controlled trials examining effects on cardiovascular disease or mortality. Therefore, it is unknown whether these results also apply to other HRT drugs. Stroke. In a large randomized clinical trial (WHI study), the secondary outcome was that the risk of ischemic stroke increased in healthy women during continuous combination therapy with conjugated estrogens and MPA. For women who do not receive HRT, the incidence of stroke over a 5-year period is estimated to be approximately 3 per 1000 women aged 50–59 years and 11 per 1000 women aged 60–69 years. It is estimated that for women who take conjugated estrogens and MPA for 5 years, the number of additional cases will occur in the range of 0 to 3 (best estimate = 1) per 1000 patients aged 50–59 years and from 1 to 9 (best estimate = 4) per 1000 patients aged 60–69 years. It is not known whether the increased risk of stroke also applies to other HRT drugs. Ovarian cancer. Long-term (at least 5–10 years) use of estrogen-only hormone replacement therapy in women with a hysterectomy has been associated with an increased risk of ovarian cancer. It is not known whether the risk will differ between long-term use of combined HRT and drugs that contain only estrogens. Other states. Estrogens may cause fluid retention, and patients with cardiac or renal impairment should be closely monitored. The condition of patients with end-stage renal failure requires constant monitoring, since it is possible that the level of circulating active ingredients of Femoston may increase. Women with hypertriglyceridemia should be closely monitored during hormone replacement therapy, as isolated cases of significant increases in plasma TG levels have been observed during estrogen treatment, leading to the development of pancreatitis. Estrogens increase the level of thyroxine-binding globulin, resulting in an increase in the concentration of circulating total thyroid hormones, which is determined by the level of protein-bound iodine, thyroxine (by column analysis or radioimmunoassay), or triiodothyronine (by radioimmunoassay). Triiodironine uptake is reduced, indicating increased levels of thyroxine-binding globulin. The concentrations of free triiodothyronine and thyroxine do not change. Serum levels of other binding proteins, corticosteroid binding globulin and sex hormone binding globulin, may be increased, resulting in increased concentrations of circulating corticosteroids and sex hormones, respectively. The concentrations of free or biologically active hormones do not change. Concentrations of other plasma proteins (angiotensinogen/renin substrate, alpha-I antitrypsin, ceruloplasmin) may increase. There is no convincing evidence of improvement in cognitive function. The WHI study found evidence of an increased risk of dementia in women receiving continuous combination estrogen and progesterone therapy after the age of 65 years. It remains unknown whether this also applies to younger postmenopausal women or other hormone replacement therapy drugs. Patients with rare hereditary diseases - galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption syndrome - should not take this drug. Experience in treating women over 65 years of age is limited. Use during pregnancy and lactation. Femoston is not indicated for use during pregnancy. If pregnancy occurs during treatment with Femoston, the drug should be stopped immediately. Femoston is not recommended for use during breastfeeding. Children. Due to insufficient data on the safety and effectiveness of Femoston in children under 18 years of age, the drug is not recommended for this age group of patients. The drug Femoston does not affect the ability to drive vehicles or operate machines and mechanisms.

Analogs

Level 4 ATX code matches:
Klimonorm

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

Drugs with a similar mechanism of action: Divina , Klimonorm , Kliogest , Trisequence .

Klimonorm or Femoston - which is better?

The decision about which drug from the group of combined estrogen-gestagen agents should be chosen is made by the doctor based on the data received from the patient about the period of age-related hormonal changes.

It is believed that in the drug Klimonorm the progestin component is present in the most optimal concentration, which allows effective control of the cycle and provides the necessary level of protection of the endometrium from the hyperplastic effect of estrogens .

At the same time, it is possible to maintain the beneficial effects caused by the influence of estrogens on the state of the cardiovascular system and lipid metabolism . In addition, levonorgestrel Klimonorm potentiates the effect of estradiol , aimed at the treatment and prevention of osteoporosis .

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

Moreover, the severity of the effects remains unchanged regardless of the woman’s nutritional characteristics, the presence of diseases of the digestive tract , as well as the activity of the liver system , which plays a key role in the processes of first-pass metabolism of xenobiotics .

The bioavailability of 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 Angelique and Femoston is that it contains drospirenone progestational .

Interactions of the drug Femoston

The metabolism of estrogens can be enhanced when used simultaneously with substances that activate enzymes (cytochrome P450 systems) that are involved in the metabolism of drugs. These substances include anticonvulsants (eg, phenobarbital, carbamazepine, phenytoin) and antimicrobials (eg, rifampicin, rifabutin, nevirapine, efavirens). Ritonavir and nelvinavir, when used simultaneously with steroid hormones, activate the above enzymes. Herbal preparations, the component of which is St. John's wort (Hypericum perforatum), increase the metabolism of estrogens and progestogens, which can lead to a weakening of their effect and a change in the profile of uterine bleeding. There is no information on the interaction of dydrogesterone with other drugs.

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 during menopause or when planning pregnancy .

Those who were satisfied with the treatment note as the advantages of the drug that it is quite well tolerated and rarely causes side effects, quickly normalizes the condition, relieving the unpleasant symptoms of the onset of menopause , and improves overall well-being, has a positive effect on the condition of the skin, and restores the cycle in case of its violations, 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 ovarian .

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

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

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

Femoston price, where to buy

Price Femoston 1/5 in Russian pharmacies from 870 rubles. You can buy Femoston Conti 1/5 for an average of 900 rubles. Price Femoston 2/10 - from 790, Femoston 1/10 - from 795 rubles.

In Ukraine, the price of Femoston 1/10 is from 438 UAH, the price of Femoston 2/10 is from 520 UAH. The cost of the drug with a dosage of 1 mg + 5 mg is from 445 UAH.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
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