Crinon suppositories and gel for IVF
One of the methods for increasing the effectiveness of the in vitro fertilization protocol is the administration of hormonal therapy. During this mandatory stage, thanks to the administration of medications, favorable conditions are created in the uterus for embryo transfer. Such medications include " Crinon
"(
gel
and suppositories).
"Сrinone": the effect of the drug
The successful course of pregnancy depends on progesterone. It is responsible for the readiness of the endometrium in the uterus for implantation and reduces the chances of embryo rejection during natural fertilization. When using the IVF method, such changes do not occur due to the continuation of menstruation, as a result of which on certain days there is a decrease in progesterone concentration and endometrial rejection. Therefore, in such cases, progesterone medications are prescribed for successful conception.
The drug "Crinone" is available in the form of suppositories and gel. If the first form is more familiar to most women, the second is popular due to its ease of use and speed of absorption. The hormone contained in Crinone thickens the endometrium, provokes the transition of the mucous membranes of the uterus into the secretion phase and weakens the contraction of the uterine muscles and tubes.
Thus, the drug brings the level of progesterone after IVF to a concentration characteristic of natural fertilization.
Dosage and methods of application
The drug is taken immediately after embryo transfer. One dose of the gel substrate or one Crinona suppository is inserted into the vagina. The gel is dosed in applicators containing 1.125 g (equal to 90 g of progesterone). The Krinona documentation (instructions for use) states that it should be administered once a day before bedtime for better absorption and active action.
During physical activity, the remains of the gel or suppository may come out in the form of discharge (brown, beige, pink)
– normal), which will weaken the effect.
In case of successful conception with IVF,
“
Crinon
” is taken until the 12th week of gestation.
Contraindications and side effects
Krinon should be taken only on the recommendation of a doctor. Contraindications include:
- diseases of the vascular system;
- porphyria;
- lactation period;
- uncompleted abortion and much more.
Certain side effects
, among which:
- stomach pain;
- depression;
- soreness of the mammary glands;
- spotting;
- allergic reactions;
- headache.
We can see that Crinon is a real panacea for those women whose infertility is caused by endocrine disorders or insufficient thickness of the endometrium.
Crinon gel vag 90 mg/dose x15
Crinon gel vag 90 mg/dose x15, ATX code: G03DA04 (Progesterone) Active substance: progesterone (progesterone) Rec.INN registered by WHO
Dosage form
KRYNON®
Vaginal gel 90 mg/1 dose: applicators 6 or 15 pcs.reg. No.: LS-000427 from 06/01/10 - Indefinitely
Release form, packaging and composition of Crinon®
Vaginal gel is homogeneous, white or almost white in color, soft consistency, with a specific odor.
1 applicator (1.125 g)
progesterone 90 mg
Excipients: glycerol, liquid light paraffin, hydrogenated palm oil glyceride, carbomer 974P, sorbic acid, polycarbophil, sodium hydroxide, purified water.
Clinical-pharmacological group: Gestagen Pharmaco-therapeutic group: Progestagen
pharmachologic effect
Gestagen. Progesterone is a hormone of the corpus luteum. Causes a transition of the uterine mucosa from the proliferation phase, caused by the action of FSH, to the secretory phase. Reduces the excitability and contractility of the muscles of the uterus and fallopian tubes.
Progesterone inhibits the secretion of hypothalamic release factors of FSH and LH, inhibits the formation of gonadotropic hormones in the pituitary gland and inhibits ovulation.
Crinon® Vaginal Gel incorporates progesterone into a polymer delivery system that binds to the vaginal mucosa and provides continuous release of progesterone for at least 3 days.
Pharmacokinetics
Suction
When using vaginal gel in a dose containing 90 mg of progesterone, the Cmax of the active substance in the blood is achieved after 6 hours and is 11 mg/ml.
Metabolism and excretion
T1/2 - 34-48 hours. Progesterone is metabolized mainly in the liver. Intravaginal use significantly reduces the “first pass” effect through the liver. The main metabolite, 3-α, 5-β-pregnanediol, is excreted in the urine.
Indications for the drug Crinon®
maintaining the luteal phase during the use of assisted reproduction methods, secondary amenorrhea, dysfunctional uterine bleeding caused by progesterone deficiency, hormone replacement therapy in postmenopause (in combination with estrogen drugs). ICD-10 codes
Dosage regimen
Maintaining the luteal phase during the use of assisted reproduction methods
Starting from the day of embryo transfer, the gel is used in a dose of 1.125 g (90 mg of progesterone - 1 applicator) and is administered intravaginally daily. If pregnancy occurs, therapy is continued until 12 weeks or for 10-12 weeks from the moment of confirmed pregnancy.
Secondary amenorrhea, dysfunctional uterine bleeding caused by progesterone deficiency
1.125 g of gel (90 mg of progesterone) is administered intravaginally every other day from day 15 to day 25 of the cycle. If necessary, the dose can be reduced or increased.
Hormone replacement therapy in postmenopause (in combination with estrogen drugs)
90 mg (1 applicator) is administered 2 times a week.
Rules for using the drug
The patient should be informed about the need to strictly follow the recommendations for use of the drug.
To ensure hygienic conditions and ease of use, Krynon® is packaged in a disposable applicator, which should be thrown away after use.
1. Take the applicator, holding it tightly at the top between your thumb and forefinger. Shake the applicator like a medical thermometer so that the gel moves to the lower end of the applicator.
2. Hold the applicator by the top flat end of the air container. Remove the break-off cap from the opposite end by turning it. Do not press on the air container.
3. The applicator can be inserted either in a sitting position or in a lying position with slightly bent knees. Carefully insert the lower end of the applicator into the vagina.
4. Squeeze the air container firmly so that the gel from the applicator enters the vagina. Although some gel remains in the applicator, the dose is fully administered. Now you can throw away the applicator with the remaining gel. Crinone® coats the vaginal mucosa, providing prolonged release of progesterone.
Side effect
From the side of the central nervous system: headache, drowsiness.
From the digestive system: abdominal pain.
From the reproductive system: soreness of the mammary glands, intermenstrual bleeding, irritation of the vaginal mucosa and other local reactions of moderate severity in the area of application.
Allergic reactions: hypersensitivity reactions are possible, usually manifested in the form of a skin rash.
Contraindications for use
vaginal bleeding of unknown etiology, acute porphyria, malignant tumors of the genital organs or mammary glands or suspicion of their presence, acute thrombosis or thrombophlebitis, thromboembolic diseases, acute cerebrovascular accident (including history), incomplete abortion, period of breastfeeding, hypersensitivity to the components of the drug.
The drug should be used with caution in case of arterial hypertension, chronic renal failure, cardiovascular failure, diabetes mellitus, bronchial asthma, epilepsy, migraine, depression, hyperlipoproteinemia.
Use during pregnancy and breastfeeding
Crinon® can be used in the first trimester of pregnancy if there is insufficient function of the corpus luteum. The use of Crinon® in later stages of pregnancy is not recommended.
Use is contraindicated during breastfeeding.
Use for liver dysfunction
Prescribe the drug with caution in case of liver dysfunction.
Use for impaired renal function The drug is prescribed with caution and under constant monitoring to patients with impaired renal function (due to possible fluid retention in the body).
special instructions
Particular attention should be paid to the possible appearance of early symptoms of thrombotic disorders (thrombophlebitis, cerebrovascular accidents, pulmonary embolism and retinal thrombosis). If a symptom is detected that indicates these disorders or even suggests their presence, you should immediately stop taking the drug.
Patients with any risk factors for thrombotic disorders should be closely monitored.
During long-term treatment, regular gynecological examinations are necessary to exclude the possibility of developing endometrial hyperplasia.
Physical examination before starting therapy should include assessment of the condition and development of the mammary glands and pelvic organs, as well as a cervical smear (Papanicolaou test).
In order to prevent the possibility of incomplete abortion when using the drug Krinon®, the level of human chorionic gonadotropin should be determined or an ultrasound examination should be performed.
Use with caution in case of liver dysfunction.
In cases of breakthrough bleeding, as in all cases of irregular vaginal bleeding, organic pathology should be excluded.
In case of vaginal bleeding of unknown etiology, appropriate examination should be carried out.
Because progestogens have the ability to retain fluid in the body; patients with diseases such as epilepsy, migraine, bronchial asthma, cardiovascular failure, and renal impairment should be closely monitored.
Patients with a history of depression should be closely monitored and treatment should be interrupted if depression worsens.
A small number of patients receiving estrogen-progestogen therapy may experience decreased glucose tolerance. The mechanism of this disorder is not known. In this regard, patients suffering from diabetes mellitus should be closely monitored during treatment with progesterone.
Crinon® contains sorbic acid, which can cause a local skin reaction (contact dermatitis).
The effect of the drug on the ability to drive a car and control other mechanisms
Krinon® has a weak or moderate effect on the ability to drive a car and use machinery. Because When using the drug Crinon®, you may feel tired or drowsy; caution is required when driving a car and other mechanisms. The use of alcohol may enhance this effect.
Overdose Currently, no cases of overdose of Crinon® have been reported.
Drug interactions The use of Crinon® together with other intravaginal agents is not recommended.
Storage conditions for Krynon®
The drug should be stored out of the reach of children at a temperature not exceeding 25°C, and do not freeze.
Shelf life of Krinon® Shelf life – 3 years.
Terms of sale The drug is available with a prescription.
Crinon vaginal gel 90 mg/dose applique 1.125 g No. 15
Compound
1 applicator contains:
active ingredient:
progesterone 90.00 mg,
excipients
a: glycerol 145.10 mg, liquid paraffin 47.25 mg, hydrogenated palm oil glycerides 11.25 mg, carbomer 974P 11.25 mg, sorbic acid 0.90 mg, polycarbophil 22.50 mg, sodium hydroxide qs, water qs
Pharmacokinetics
Suction
When using vaginal gel in a dose containing 90 mg of progesterone, the time to reach the maximum concentration of the drug in the blood (11 ng/ml) is about 6 hours.
The half-life is 34-48 hours.
Metabolism
Progesterone is metabolized primarily in the liver. Vaginal administration significantly reduces the first-pass effect through the liver.
The main metabolite, 3-, 5-pregnanediol, is excreted in the urine.
Indications for use
— Maintaining the luteal phase during the use of assisted reproduction methods,
- secondary amenorrhea, dysfunctional uterine bleeding caused by progesterone deficiency,
- hormone replacement therapy in postmenopause (in combination with estrogen drugs).
Contraindications
No cases of overdose of the drug Crinon have been reported.
Directions for use and doses
Maintaining the luteal phase during the use of assisted reproduction methods
Starting from the day of embryo transfer, 1.125 g of gel (90 mg progesterone - 1 applicator) is administered intravaginally daily. If pregnancy occurs, therapy is continued until 12 weeks or for 10-12 weeks from the moment of confirmed pregnancy.
Secondary amenorrhea, dysfunctional uterine bleeding caused by
progesterone deficiency
1.125 g (90 mg of progesterone) gel is administered intravaginally every other day from 15 to 25 days of the cycle. If necessary, the dose can be reduced or increased.
Hormone replacement therapy in postmenopause (in combination with estrogen drugs)
90 mg of progesterone (1 applicator) 2 times a week.
Patient information for self- administration
Follow your doctor's recommendations exactly when using Crinon.
Crinone contains a corpus luteum hormone identical to the natural hormone progesterone.
Crinon is inserted into the vagina. For hygienic reasons and for ease of use, Crinon is packaged in a disposable applicator, which is discarded after use.
1 - Air container
2 - Flat end
3 - Upper end
4 - Lower end
5 — Break-off cap
Carry out the application in accordance with these instructions:
A) Grasp the applicator by grasping the top end firmly between your thumb and forefinger. Shake the applicator like a medical thermometer so that the gel moves to the lower end of the applicator.
B) Holding the applicator by the top flat end of the air container, remove the break-off cap from the opposite end by twisting it. Do not press on the air container.
C) The applicator can be inserted either in a sitting position or in a lying position with slightly bent knees. Carefully insert the lower end of the applicator into the vagina.
D) Squeeze the air container firmly to force the gel from the applicator into the vagina. Although some gel remains in the applicator, you will receive the required dose in full. You can now throw away the applicator with any remaining gel in it. Crinone coats the vaginal mucosa, providing prolonged release of progesterone.
Storage conditions
At a temperature not exceeding 25 C. Do not freeze.
Keep out of the reach of children.
Best before date
3 years.
Do not use after the expiration date stated on the packaging.
special instructions
The attending physician should pay special attention to the possible appearance of early symptoms of thrombotic disorders (thrombophlebitis, cerebrovascular accidents, pulmonary embolism and retinal thrombosis). If a symptom is detected that indicates these disorders or even suggests their presence, you should immediately stop taking the drug.
Patients with any risk factors for thrombotic disorders should be closely monitored.
During long-term treatment, regular gynecological examinations are necessary to exclude the possibility of developing endometrial hyperplasia.
Physical examination before starting therapy should include assessment of the condition and development of the mammary glands and pelvic organs, as well as a cervical smear (Papanicolaou test).
In order to prevent the possibility of incomplete abortion when using the drug Crinon, the level of human chorionic gonadotropin should be determined or an ultrasound examination should be performed.
Use with caution in case of liver dysfunction.
In cases of breakthrough bleeding, as in all cases of irregular vaginal bleeding, organic pathology should be excluded.
In case of vaginal bleeding of unknown etiology, appropriate examination should be carried out.
Since progestogens have the ability to retain fluid in the body, patients with diseases such as epilepsy, migraine, bronchial asthma, cardiovascular failure, and renal impairment should be closely monitored.
Patients with a history of depression should be closely monitored and treatment should be interrupted if depression worsens.
A small number of patients receiving estrogen-progestogen therapy may experience decreased glucose tolerance. The mechanism of this disorder is not known. In this regard, patients suffering from diabetes mellitus should be closely monitored during treatment with progesterone.
Crinon contains sorbic acid, which can cause a local skin reaction (contact dermatitis).
Description
A homogeneous gel of white or almost white color with a specific odor.
Conditions for dispensing from pharmacies
On prescription
Dosage form
vaginal gel
Pharmacodynamics
Progesterone is a hormone of the corpus luteum. Causes a transition of the uterine mucosa from the proliferation phase caused by follicle-stimulating hormone (FSH) to the secretory phase. Reduces the excitability and contractility of the muscles of the uterus and fallopian tubes.
Progesterone inhibits the secretion of hypothalamic factors that release FSH and luteinizing hormone, inhibits the formation of gonadotropic hormones in the pituitary gland and inhibits ovulation.
In Crinon, progesterone in the form of a vaginal gel is included in a polymer delivery system that binds to the vaginal mucosa and ensures continuous release of the drug for at least 3 days.
Side effects
Headache, drowsiness, abdominal pain, breast tenderness, intermenstrual bleeding, irritation of the vaginal mucosa and other local reactions of moderate severity in the area of application; hypersensitivity reactions are also possible, usually manifested in the form of a skin rash.
Use during pregnancy and breastfeeding
Crinon can be used in the first trimester of pregnancy if there is insufficient function of the corpus luteum.
The use of Crinon in later periods of pregnancy is not recommended.
Crinone should not be used during breastfeeding.
Interaction
There is no data on the interaction of Crinone with other drugs.
The use of the drug together with other intravaginal agents is not recommended.
Overdose
No cases of overdose of the drug Crinon have been reported.
Impact on the ability to drive vehicles and operate machinery
Crinone has a weak or moderate effect on the ability to drive a car and use machinery. Since when using the drug Crinon you may feel tired or drowsy, caution is required when driving a car and other mechanisms. The use of alcohol may enhance this effect.
