Crinon release form. Crinon: instructions for use of vaginal gel
Latin name: Krinon
ATX code: G03DA04
Active substance:
Manufacturer: Fleet Laboratories
Limited, UK
Dispensing from the pharmacy: On prescription
Storage conditions: t up to 25 C
Best before date: 3 years
Krinon is a gestagen-containing drug that promotes the rapid transition of the uterine mucosa from the proliferation stage to the secretory phase. This reduces excitability, as well as the contractility of the fallopian tubes and uterine muscles.
Indications for use
The gel-like preparation is prescribed for use for:
- Supporting the full course of the luteal phase during assisted reproductive measures
- Treatment of secondary amenorrhea, as well as uterine bleeding associated with a lack of natural progesterone
- Carrying out HRT (hormone replacement therapy)
- Therapy of postmenopausal conditions (comprehensively).
Composition and release forms
Vaginal gel (1.125 g) includes a monocomponent, which is progesterone (0.09 g). The drug also contains:
- Liquid paraffin
- Sodium hydroxide
- Sorbic acid
- Polycarbophil
- Glycyrin
- Carbomer
- Glyceride derivative of palm oil.
Krinon is a gel-like whitish suspension of uniform consistency, characterized by a specific aroma. The drug is packaged in vaginal applicators made of polyethylene (1 dose). Inside the pack there can be 6 or 15 app. At the moment there is no production of candles.
Medicinal properties
Crinone is made on the basis of a synthetic hormonal substance - progesterone, which is identical to the hormone produced in the human body. Under the influence of the drug, the mucous membrane lining the uterus gradually enters the secretory phase. At the same time, the hormonal component of the gel thermosites the process of synthesis of gonadotropic hormones, reducing the contractility of the muscles of the uterus, as well as the tubes.
When using the drug intravaginally, progesterone comes into contact with the vaginal mucosa, penetrates the uterine cavity and is released over the next 3 days. Due to this, an increased concentration of the hormone accumulates in the endometrial layer, exceeding that observed with intramuscular administration.
During use of the drug, the highest concentration of the active substance is recorded after 6 hours from the moment of administration. The period of elimination of metabolites does not exceed 48 hours. Metabolic transformations of synthetic progesterone occur in the liver tissues and allow a rapid increase in its level in the endometrial layer of the uterus. Metabolic products are excreted by the renal system.
Crinon: instructions for use
Price: from 2132 to 3174 rubles.
The gel should be used during IVF to maintain the luteal phase on the day of embryo transfer. The standard daily dose of hormonal drugs is 0.09 g. The drug must be administered intravaginally. The duration of maintenance therapy is 4 months, if in vitro fertilization and embryo transfer with subsequent implantation were successful.
In case of secondary amenorrhea and uterine bleeding (due to hormonal imbalance), use Crinon once a day, 1 app. (preferably from 15 days to 25 days MC). The dose of the hormonal drug is adjusted by the attending physician.
To carry out HRT, a weekly dosage of 0.18 g of Crinone is prescribed, and the use of estrogen-containing drugs is assumed.
How to use hormonal gel
The drug should be used in a certain sequence:
- Place the applicator with the drug between your fingers (thumb and index)
- Squeeze the applicator and then shake it well to distribute the gel evenly
- Grasp the end of the container
- Remove the existing cap (turn it slightly to the side)
- Take a horizontal position, pull your knees to your chest
- Gently insert the end of the applicator into the vagina
- Squeeze the container so that the gel it contains penetrates into the vagina
- Remove applicator and discard.
Use during pregnancy and pregnancy
If indicated, hormonal gel can be used in the 1st trimester. Starting from the 2nd trimester, the drug is not prescribed. Crinon is not used during lactation.
Contraindications and precautions
Treatment with a gestagen-containing drug is contraindicated in:
- Bleeding from the vagina of unknown etiology
- Thrombosis, thrombophlebitis, thromboembolic pathologies
- Hormone-dependent gynecological pathologies
- Excessive sensitivity to synthetic progesterone or other gel components
- Porphyria
- Incomplete miscarriage or abortion
- Deterioration of cerebral circulation.
The use of progesterone-containing gel is prescribed with extreme caution when:
- Increased blood pressure
- Disorders of the renal system
- Migraine-like headaches
- Bronchial asthma
- Diabetes mellitus
- Presence of epileptic seizures
- Hyperlipoproteinemia
- Depression
- Serious liver disorders
- Cardiovascular failure.
Cross-drug interactions
Side effects and overdose
When using a progesterone-based drug, the following symptoms may occur:
- Epigastric pain
- Changes in glucose tolerance
- Severe headaches
- Local rashes accompanied by itching and burning
- Dysfunctional bleeding from the genital tract
- Breast engorgement
- Drowsiness.
Analogs
Dalkhimfarm, Russia
Price from 271 to 729 rub.
The drug contains a steroid hormone that supports the second phase of the cycle. The use of the drug is indicated in the treatment of a number of gynecological ailments, during IVF and maintaining pregnancy (1st trimester). The drug is produced in the form of a 1% and 2% solution.
Pros:
- Low price
- Reduces swelling caused by hormonal imbalances
- Regulates the menstrual cycle.
Minuses:
- Contraindicated in case of hormone-dependent oncological pathologies occurring in the internal genital organs and mammary glands
- May provoke the development of dysphoria
- Dispensed by prescription.
Sun Pharmaceutical Industries, India
Price from 223 to 434 rub.
Prajisan is a progestogenic drug that promotes the transition of the uterine mucosa into the proliferative phase. Used for PMS, fibrocystic changes in the mammary gland, MC disorders, and infertility. It is produced in two dosage forms: capsules and gel.
Pros:
- Can be used for early menopause
- Treats endometriosis
- Promotes successful implantation of a fertilized egg.
Minuses:
- Allergic reactions are possible during use
- Contraindicated in persons with porphyria
- Not recommended for use with enterosorbents (capsules).
Release form, composition and pack
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, light liquid paraffin, hydrogenated palm oil glyceride, carbomer 974P, sorbic acid, polycarbophil, sodium hydroxide, purified water.
Clinical and pharmacological group: Gestagen.
pharmachologic effect
Progesterone. Causes secretory transformation of the endometrium, preparing it for implantation of the embryo/embryos. 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.
In the vaginal gel, progesterone is included in a polymer delivery system that binds to the vaginal mucosa and provides continuous release of progesterone for at least 3 days.
Pharmacokinetics
Distribution
When using vaginal gel in doses corresponding to 90 mg of progesterone, Cmax is achieved after 6 hours and is 11 ng/ml.
Metabolism and excretion
Progesterone is metabolized primarily in the liver. Vaginal use significantly reduces the first-pass effect through the liver. The main metabolite, 3-α, 5-β-pregnanediol, is excreted in the urine. T1/2 - 34-48 hours.
Indications
maintaining the luteal phase, incl. as a result of the use of assisted reproductive technologies;
secondary or dysfunctional uterine bleeding caused by progesterone deficiency;
hormone replacement therapy.
Dosage regimen
To maintain the luteal phase during the use of assisted reproductive techniques, 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 every day from the day of embryo transfer.
For 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 15 to 25 days of the cycle.
If necessary, the dose can be reduced or increased.
When carrying out hormone replacement therapy, 90-180 mg of progesterone (1-2 applicators) is administered 1-2 times a day.
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; not often - intermenstrual bleeding, irritation of the vaginal mucosa at the site of application.
Contraindications
vaginal bleeding of unknown etiology;
malignant tumors of the genital organs or mammary glands;
acute thrombosis or thrombophlebitis, thromboembolic diseases;
acute cerebrovascular accident (including history);
non-developing pregnancy;
lactation;
high sensitivity to progesterone or other components of the product.
Pregnancy and lactation
Crinon should not be used during pregnancy, except for use in early pregnancy during assisted reproduction methods. Crinon should not be used during lactation (breastfeeding).
Use for liver dysfunction
Prescribe the product with caution in cases of liver dysfunction.
special instructions
The Crinon product contains sorbic acid, which can cause a local skin reaction (contact). During long-term therapy, it is necessary to conduct regular gynecological examinations in order to exclude the possibility of developing endometrial hyperplasia. When using Crinon, the level of human chorionic gonadotropin should be determined or an ultrasound should be performed (to prevent the occurrence of a threatened abortion).
Prescribe the product with caution in cases of liver dysfunction. In case of sudden bleeding, as in the case of irregular vaginal bleeding, a non-functional cause must be excluded. If vaginal bleeding of unknown etiology occurs, an appropriate examination should be performed.
The product is prescribed with caution and under constant monitoring to patients with epilepsy, migraine, asthma, chronic heart failure, and impaired renal function (due to possible fluid retention in the body). Patients with a history of this should be closely monitored and the product should be discontinued if depression worsens.
During the use of estrogens and progestogens, some patients may experience a decrease in tolerance (the mechanism of this disorder is unknown). Patients should be closely monitored while using the product.
Effect of the product on the ability to drive a car and operate other mechanisms
Patients using Crinon should be careful when engaging in activities that require increased attention (as a feeling of fatigue may occur). Drinking alcohol may increase this effect.
Overdose
Currently, there are no cases of overdose of the Crinon product reported.
Drug interactions
The use of the Crinon product together with other intravaginal drugs is not recommended.
Storage conditions and periods
The drug should be stored out of reach of children at a temperature not exceeding 25°C; do not freeze. Shelf life – 3 years.
Attention!Before using the medication "Crinone" You should consult your doctor.
The instructions are provided for informational purposes only. Crinone"Did you like the article? Share with friends on social networks:
CRYNON IS A UNIQUE NEW GENERATION DRUG:
Contains natural progesterone, whose chemical structure is completely identical to that synthesized in the female body.
Micronization of progesterone significantly increases its surface area and maximizes the bioavailability of the drug.
Specially created for vaginal use: contains a bioadhesive polymer that provides stable connections with vaginal epithelial cells until they are rejected (up to 5 days).
Progesterone is contained in the form of an oil-in-water emulsion, which is in dynamic equilibrium.
WHAT IS PROGESTERONE?
Progesterone is a female hormone that prepares the endometrium, the inner lining of the uterine cavity, for implantation (attachment) of a fertilized egg (embryo).
Doctors prescribe bioadhesive vaginal gel Crinon in order to provide the woman’s body with a sufficient amount of progesterone. It is necessary to prepare the uterus (its inner layer - the endometrium) for a possible pregnancy. If there is a lack of progesterone, the attachment of a fertilized egg may become impossible or adequate nutrition of the embryo is not provided, which can lead to miscarriage.
Some women experience insufficient secretion of progesterone and, accordingly, incomplete transformation of the endometrium during the menstrual cycle. As a result, various menstrual cycle disorders can occur - from absence of menstruation to dysfunctional uterine bleeding.
The drug Crinon contains natural progesterone, absolutely identical to that synthesized in the female body. Progesterone is vital for maintaining a regular menstrual cycle, the onset and successful outcome of pregnancy.
Crinone (progesterone gel) is a bioadhesive vaginal gel containing micronized progesterone in an emulsion phase, commercially available as a one-component polyethylene applicator for single use. The matrix is an oil-in-water emulsion containing an aqueous-swellable but water-insoluble polycarbophil polymer. Progesterone is soluble in portions in both the oil and aqueous phases of the carrier, with most of the progesterone present in suspension. Physical properties of Crinon - a white or light beige gel with a characteristic consistency.
THE IMPORTANCE OF PROGESTERONE IN THE MENSTRUAL CYCLE
To better understand the mechanism of action of the drug Crinone, it is important to understand what the menstrual cycle is and what role progesterone plays in it.
During the menstrual cycle, maturation of the egg occurs in the ovaries, followed by ovulation (the release of a mature egg from the ovary into the abdominal cavity) simultaneously with the preparation of the uterus for implantation of the embryo. In typical cases, the duration of the menstrual cycle is from 28 to 32 days. It is customary to distinguish three successive stages of the menstrual cycle: the follicular phase, ovulation and the luteal phase.
The follicular phase (from the 1st to the 13th day of the standard menstrual cycle) is the period during which the growth and development of the follicle containing the egg occurs. Ovulation (around day 14 of the cycle) is the process of releasing a mature egg from the ovary into the abdominal cavity, from where it usually moves into the fallopian tube for subsequent fertilization by sperm.
The luteal phase is the period during which progesterone synthesis occurs. This hormone is necessary to prepare the endometrium for embryo implantation. If fertilization or embryo implantation does not occur, the menstrual cycle begins again.
HOW IS KRYNON DIFFERENT FROM OTHER DRUGS CONTAINING PROGESTERONE?
The drug Crinon is a unique drug specifically designed for the direct delivery of progesterone to the organ where it is vitally needed - the uterus. After administration, the bioadhesive gel attaches to the vaginal walls, and progesterone penetrates into the endometrium, bypassing the systemic bloodstream and primary breakdown in the liver. This allows you to create maximum concentration in the uterus and minimize the spread of progesterone to other organs and tissues where it is not needed.
Unlike other drugs containing progesterone, Crinon is designed exclusively for vaginal use. In addition to bioadhesive properties, its feature is the unique suspended state of the active compound - suspension. Progesterone penetrates into tissues from the aqueous phase (necessary for absorption), the expended amounts are compensated by the reserves of the oil solution. This provides a unique mechanism for continuous dosed release of the hormone from the bioadhesive gel. Due to its unique composition, the recommended dosages of Crinon are 5-10 times less than other vaginal preparations without continuous release of progesterone (capsules, suppositories) and tablet forms for oral administration. In addition, the fundamental advantage of Crinon is the prescription mode - ONE time per day.
A number of studies have examined the opinions of women receiving different progesterone preparations. When compared with intramuscular injections, 94% of patients believe that Crinon is more convenient to use. The obvious choice of patients in favor of Crinon was also confirmed when compared with natural progesterone capsules when used several times a day. The majority of study participants based their preference on the main practical factors - convenience, comfort and ease of use of Crinon gel.
HOW TO ADMINISTER KRYNON?
The drug Crinon is simple and easy to use. It is available in the form of disposable applicators. They are stored at room temperature, so you can use Crinon even when traveling.
To administer the drug Crinon, follow 4 steps in sequence:
For easy insertion into the vagina, the length of the applicator is about 7 cm, with only one third of the applicator filled with gel (since a small amount of gel provides the necessary effect of progesterone). After use, a certain amount of gel always remains in the applicator - this should not confuse the patient if she strictly followed the instructions for administering the drug.
Attention:
If you forget to administer the next dose of Crinone (progesterone gel), it is advisable to do this immediately, but you should not increase the recommended daily dosage. Crinone should not be used concomitantly with other vaginal medications.
QUESTIONS AND ANSWERS
Do I need to lie down after the injection of Crinon?
No. The uniqueness of the drug Crinon is that it is bioadhesive - a special progesterone carrier is attached to the walls of the vagina. Therefore, there is no need to maintain a horizontal position after administration of this drug, and Crinon is often used in the morning, since physical activity does not affect the effectiveness of the drug.
What to do if there is an unwanted accumulation of gel in the vagina?
Typically, a special progesterone carrier in the bioadhesive gel Crinon attaches to the cells of the vagina and remains on them until all the progesterone from the drug has completely entered the uterus. With prolonged use, gel accumulation may occur. This phenomenon is expected and does not cause harm. If this worries you (or your healthcare provider), you can mechanically clean the vagina with a tampon before inserting the next applicator.
What happens if some Crinone leaks from the vagina?
With daily administration and gradual accumulation of the gel in the vagina (sometimes even several days after the end of the drug), the patient may notice vaginal discharge (usually white). This phenomenon does not indicate leakage of the drug - this is how a special progesterone carrier (polycarbophil) can be released after the hormone has moved from the drug to the uterus. However, if in doubt, you should consult your doctor.
Is sex acceptable during therapy with Crinon?
Yes. Sexual activity does not impair the flow of progesterone from the Crinon drug into the uterus, and Crinon gel does not interfere with sexual intercourse.
What side effects are known for the drug Crinon?
Since progesterone from the drug Crinon enters directly into the uterus, there is minimal presence of the drug in the general bloodstream. Crinon is characterized by good tolerability. Side effects include breast enlargement and tenderness, constipation, drowsiness, nausea and headache. If these symptoms occur, you should consult your doctor.
BEFORE USE, PLEASE READ THE FULL TEXT OF INSTRUCTIONS FOR THE DRUG.
IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT YOUR DOCTOR.
"Krinon" is a gestagenic agent used in gynecology. This medicine is actively used in relation to those women who have decided to undergo IVF. It is also used for uterine bleeding and postmenopause. Today we will find out what the price of “Krinon” is, a drug that is a real salvation for many women, as well as how to use it correctly. We’ll also find out what women themselves think about him.
In what cases can it be prescribed?
The medicine "Krinon", instructions for use of which must be included in the packaging, can be used in the following cases:
- Hormone therapy in postmenopause.
- Secondary
- Uterine bleeding associated with a lack of the hormone progesterone.
- Maintaining the luteal phase - the period that begins after ovulation and lasts until the next menstruation appears, while using additional methods of reproduction.
In what form is it produced?
The medicine "Krinon", the instructions for use of which are quite clear, is a vaginal gel. Its composition is as follows:
- The main substance is progesterone.
- Auxiliary components - glycerol, carbomer, liquid paraffin, sorbic acid, palm oil glyceride, sodium hydroxide, polycarbophil, water.
The gel is packaged in special disposable plastic containers.
Dosage
"Krinon" (gel) is prescribed to girls and women in the following quantities as prescribed:
- As a substitute for hormone therapy in postmenopause - 1 dose (90 mg) 2 times a week.
- To maintain the luteal phase - 1 applicator daily, starting from day A, when the long-awaited pregnancy occurs, you need to continue administering the medicine intravaginally for up to 12 weeks.
- For uterine bleeding resulting from progesterone deficiency, with secondary amenorrhea, 1 dose is prescribed every other day, from the 15th to the 25th day of the menstrual cycle. If necessary, the gynecologist can either reduce or increase the dose of this drug.
Rules for using the drug
The use of Krinon, a medicine that solves serious problems, is not difficult. For ease of use and compliance with hygiene rules, this drug is packaged in disposable containers, which must be used as follows:
- Take the plastic device with the medicine and shake it.
- Holding the applicator by the upper end of the container, remove the cap by turning it sharply.
- The product can be administered in two positions: sitting or lying down with bent legs.
- The applicator should be inserted slowly.
- In order for the medicine to completely enter the vagina, it is necessary to squeeze the container.
Undesirable manifestations
The following negative effects may occur when using this medication:
- Stomach ache.
- Drowsiness.
- Headache.
- Irritation in the vagina.
- Pain in the mammary glands.
- Rash all over the body.
Restrictions
Krinon gel, the instructions for use of which clearly indicate the situations in which the drug can be prescribed, has the following contraindications:
- Malignant formations in the breast, uterus, vagina.
- Cerebrovascular accident.
- Breast-feeding.
- Vaginal bleeding that appears for unknown reasons.
- Acute porphyria (pigment metabolism disorder - a hereditary disease).
- Hypersensitivity to the drug.
- Acute thrombosis and thrombophlebitis.
With caution, this drug should be used for renal failure, heart failure, arterial hypertension, diabetes mellitus, epilepsy, migraine, depression, bronchial asthma.
The need to use medication for artificial conception
Gel "Krinon" for IVF (in vitro fertilization) is often prescribed by gynecologists. With such artificial conception, the woman’s body does not have time to quickly react to changes. And it turns out that the membrane that envelops the uterus cannot accept a fertilized egg. As a result, spontaneous miscarriages occur in the early stages. Doctors have solved this problem, and in order to reduce the risk of miscarriage, they prescribe Crinon gel. Progesterone, which is the active element of this drug, enters the mucous membranes and helps the endometrium prepare for this. And this is done quite successfully.
What to do if the gel leaks?
If a woman uses this remedy every day, then, of course, the medicine accumulates in the vagina. Some girls may experience clear or white discharge even after 5-6 days after use. This is not scary, because it indicates that a special progesterone carrier is coming out of the vagina. And it is transported because the hormone itself has already moved from the medication to the uterus. This is how the medicine “Krinon” works. Discharge may bother a woman, but in reality there is no need to worry. Although, to be more sure, it is still better to consult your doctor.
Doubts of the fair sex
Many women have a completely logical question: is it necessary to lie down for some time after Crinon, a drug that makes many girls’ dreams of becoming mothers come true? The answer will be simple and clear: no. The uniqueness of this medication is that its components quickly attach to the walls of the vagina, and therefore there is no need to lie down, even for half a minute, after inserting the gel.
Also, some women do not know, and therefore doubt the question of whether it is possible or not to have sexual intercourse during treatment with the drug "Krinon". Gynecologists clearly advise women to get closer to their partners. Sexual life will in no way interfere with the transport of progesterone to the uterus. Therefore, this gel should in no way interfere with your sex life.
Price
The price of Crinon, a medicine that reduces the risk of miscarriage, is quite high. Depending on the manufacturer of this drug, the cost of 15 applicators can range from 2.5 to 4 thousand rubles. It is expensive, but still many people buy this medicine.
Analogs
Popular substitutes for Crinon include such medications as Progestogel, Utrozhestan, and Progesterone. In terms of price, they are in the same category as the medicine to which the article is devoted.
Women's opinions
The medication "Krinon" receives only favorable reviews from girls who have used it. So, users of this medicine note that it is easy to use, there is nothing supernatural or complicated. This is a mobile tool that can be used in any situation, wherever the girl is: at work, visiting, on a train or on a plane. Women also note that the procedure for introducing this gel is absolutely painless, unlike those previously prescribed to people. And of course, the effect of this medication is amazing: those women who decided to undergo IVF note that an important factor in the onset of their pregnancy is the use of Crinon gel. Also, for many girls who previously had problems with menstruation, their periods became regular. Such positive reviews about this medication indicate only one thing: the medicine really brings an effect, because it is no coincidence that many gynecologists prescribe it.
Rules for storage and release. Manufacturer
The medicine should be stored at a temperature not exceeding 25 degrees. The drug should be kept away from children. The shelf life of the gel is 3 years. After this period has expired, the product must be disposed of.
The medicine is sold according to a doctor's prescription.
The country of origin of the drug is Great Britain.
Interaction with other tools
The drug "Krinon" should not be used simultaneously with medications that are also intended for intravaginal administration. This may lead to undesirable consequences.
special instructions
- Women should be aware of what it contains that can cause contact dermatitis. This happens extremely rarely, but patients should still be aware of it.
- If a girl uses this medication for a long time, then she must undergo gynecological examinations in order to exclude the possibility of endometrial hyperplasia.
- Women who experience depression while using Crinon gel should interrupt treatment if the blues and despondency increase.
- If a girl has diabetes, then treatment with this medication should be strictly under the supervision of a doctor. The fact is that the components of the drug can reduce glucose tolerance. It is for this reason that diabetic women using the gel need to be monitored.
conclusions
Now you know everything about Crinon gel. Instructions for use during treatment must be strictly followed. You understand that this drug helps women with various gynecological diseases. Although the price of this medication is high, no one spares money for its effectiveness. In addition, the Krinon gel has many advantages, including ease of use, painless administration, and high effectiveness.
Gel for vaginal use - 1 applicator:
- active substance: progesterone - 90 mg;
- excipients: glycerol - 145.1 mg, liquid paraffin - 47.25 mg, hydrogenated palm oil glycerides - 11.25 mg, carbomer 974P - 11.25 mg, sorbic acid - 0.9 mg, polycarbophil - 22.5 mg , sodium hydroxide - q.s., water - q.s.
Vaginal gel, 8%. 1.125 g of gel in white polypropylene applicators with a snap-off cap. One applicator in laminated foil bags. 6 or 15 packages are placed in a cardboard pack.
Description of the dosage form
A homogeneous gel of white or almost white color with a specific odor.
pharmachologic effect
Progestogen.
Pharmacokinetics
Suction. When using vaginal gel in a dose containing 90 mg of progesterone, Tmax of the drug in the blood (11 ng/ml) is about 6 hours. T1/2 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, 3α,5β-pregnanediol, is excreted in the urine.
Pharmacodynamics
Progesterone is a hormone of the corpus luteum. Causes a transition of the uterine mucosa from the proliferation phase caused by 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. 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.
Instructions
The application should be carried out in accordance with these instructions:
Take the applicator, holding its upper end tightly between your thumb and forefinger. Shake the applicator like a medical thermometer so that the gel moves to the lower end of the applicator.
Hold the applicator by the top flat end of the air container and remove the break-off cap from the opposite end by turning it. Do not press on the air container.
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.
Squeeze the air container firmly so that the gel from the applicator enters the vagina. Despite the fact that some amount of gel remains in the applicator, the patient receives the required dose in full. You can then throw away the applicator with any remaining gel in it. Crinone® coats the vaginal mucosa, providing prolonged release of progesterone.
Indications for use of 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).
Contraindications to the use of Crinon
- hypersensitivity to progesterone or other components of the drug;
- 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, thrombroembolic diseases, acute cerebrovascular accident (including a history);
- incomplete abortion;
- breastfeeding period.
With caution: arterial hypertension, chronic renal failure, cardiovascular failure, diabetes mellitus, bronchial asthma, epilepsy, migraine, depression, hyperlipoproteinemia.
Crainon Use during pregnancy and children
Crinon® can be used in the first trimester of pregnancy in case of insufficiency of the corpus luteum function. The use of Crinon® in later periods of pregnancy is not recommended.
Crinon® should not be used during breastfeeding.
Crinon 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 manifesting as a skin rash.
Drug interactions
There is no data on the interaction of the drug Crinon® with other drugs. The use of the drug together with other intravaginal agents is not recommended.
Dosage of Crinone
Intravaginally.
Maintaining the luteal phase during the use of assisted reproduction methods. Starting from the day of embryo transfer, gel in the amount of 1.125 g (90 mg of 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 the 15th to the 25th day 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.
Information for the patient for self-administration
It is necessary to strictly follow the doctor's recommendations when using the drug Crinon®. Crinon® 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.
The applicator includes an air container, a flat end, a top end, a bottom end, and a snap-off cap.
Overdose
There have been no cases of overdose of Crinon® reported.
Precautionary measures
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 hCG should be determined or an ultrasound scan 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-progestin 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. 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.