Divigel gel for external use teabags 0.1% 1000mg №28

Mechanism of action

Estrogenic preparation for external use, is an alcohol-based gel containing 17b-estradiol. During treatment with Divigel, the severity of menopausal syndrome (including hot flashes, sweating, vaginal dryness, depressed mood) is significantly reduced. Divigel's clinical efficacy in treating menopause symptoms is comparable to that when taking estrogen orally.
The use of the drug helps reduce total cholesterol without changing the ratio of cholesterol / HDL. The use of the drug inhibits the decrease in bone density during menopause. The effectiveness of Divigel for the prevention of postmenopausal osteoporosis is the same as when taking estrogen drugs orally.

Indications and usage

- relief of symptoms of menopausal syndrome (including in case of artificial menopause);
- prevention of postmenopausal osteoporosis.

Divigel prescribed continuously or in cycles. Dose and duration of therapy set individually.
The gel is prescribed in the initial dose of 1 g (1 mg of estradiol) per day. In the future, if necessary, the dose can be adjusted. The average dose of the gel is 0.5-1.5 g / day, which corresponds to 0.5-1.5 mg of estradiol per day.
In postmenopausal patients, the duration of continuous use of Divigel can be up to 3 months.
In patients with an intact uterus, it is recommended to combine the use of Divigel with the sequential administration of gestagens in an adequate dose for 12-14 days, starting from the 12th day of taking Divigel.
The drug is applied 1 time / day on the skin of the lower part of the anterior abdominal wall or alternately on the right or left buttocks.The area of ​​application is equal to 1-2 palms.
If the patient has forgotten to apply the gel, this should be done as soon as possible, but no later than within 12 hours. If more than 12 hours have passed, then application of Divigel should be postponed until the next time.

Adverse reactions

From the side of the central nervous system: headache, migraine, mood swings.
From the reproductive system: breast engorgement, irregular menstruation, changes in libido.
Gastrointestinal: phenomena of dyspepsia, nausea, vomiting, spasms of smooth muscles of the gastrointestinal tract.
Other: swelling, weight gain, increased blood pressure, skin reactions.
Side effects, as a rule, are mild, occur predominantly in the first months of therapy, and very rarely lead to drug withdrawal.

Contraindications

- thromboembolism or acute thrombophlebitis;
- uterine bleeding of unknown etiology;
- estrogen-dependent cancer of the breast, ovary or uterus;
- severe liver disease;
- Dubin-Johnson syndrome;
- Rotor syndrome;
- pregnancy;
- lactation;
- Hypersensitivity to the drug.

Pregnancy and breastfeeding

Divigel is contraindicated for use during pregnancy and lactation.

Special notes

Before starting treatment, a thorough medical examination should be carried out and in the process of treatment you should visit a gynecologist at least once a year.
Precautions should be prescribed to patients with endometriosis,endometrial hyperplasia, diseases of the cardiovascular system, as well as cerebrovascular disorders, arterial hypertension, indications of a history of thromboembolism, impaired lipid metabolism, marked impaired renal function, breast cancer (including in the family history). If such therapy is necessary, these categories of patients should be under constant medical supervision.
Prolonged use of estradiol without the addition of progestin drugs can cause endometrial hyperplasia. After the course application of progestogen, menstrual bleeding should occur.
With the occasional use of the drug may be breakthrough uterine bleeding.
During treatment with estrogen, the following diseases and conditions can be exacerbated: migraine and severe headaches, benign breast tumors, liver dysfunction, cholestasis, cholelithiasis, porphyria, uterine myoma, diabetes, epilepsy, asthma, otosclerosis, multiple sclerosis. If necessary, treatment with Divigel in predisposed patients should be carefully monitored.
With prolonged uterine bleeding should definitely determine the cause of their occurrence.
Divigel should not be applied on the mammary glands, face, genital area, as well as on damaged skin.After applying the drug should wait a few minutes until the gel dries.
Divigel's accidental eye contact should be avoided. It is necessary to wash your hands immediately after applying the gel.
Influence on ability to drive motor transport and control mechanisms
Divigel therapy does not affect the ability to engage in potentially hazardous activities that require increased attention and psychomotor speed.

Overdosage

Symptoms: may increase the manifestations of the described side effects.
Treatment: conduct symptomatic therapy.

Drug interactions

Data on the clinically significant interaction of the drug Divigel with other drugs are not available.
It should be borne in mind that when used together, estrogens may reduce the effect of anticoagulants, antihypertensives and hypoglycemic drugs.
With the simultaneous use of estrogen and drugs that induce hepatic enzymes (barbiturates, Carbamazepine, Griseofulvin and rifampicin), it is possible to reduce the level of estradiol in blood plasma.

Storage conditions

The drug should be stored at room temperature. Shelf life - 3 years.