Wonder

Divina is a hormone replacement medication.

Indications Wonder

It is used as HRT with a lack of progesterone with estrogen during menopause.

Release form

The release of the substance is implemented in a tablet set number 21.

[1]

Pharmacodynamics

The hormone replacement drug Divin contains a complex of estradiol with medroxyprogesterone.

Used to eliminate climacteric disorders and prevent the development of osteoporosis. It helps to improve the activity of estrogen, preventing the negative impact of progestins on lipid metabolism. The combination of 2 hormones mimics the course of the hormonal period that develops during normal menstruation.

Valerate estradiol is an ester of natural estrogen estradiol. Synthesized with endings, estrogens promote endometrial growth and increase the likelihood of endometrial hyperplasia and carcinoma. To prevent such an effect, medroxyprogesterone acetate, synthesized with progestin endings, is added to the drug. It changes the activity of the endometrium from the proliferative stage to the excretory.

A month after the start of the use of drugs in 50% of women passes hyperhidrosis and hot flashes, and after the 1st year these symptoms disappear in 94% of patients. The drug does not reduce bone mineral density. The drug reduces the likelihood of developing atherosclerosis by positively affecting cholesterol levels with low density lipoproteins.

[2], [3], [4]

Pharmacokinetics

After oral use, estradiol is well absorbed inside the gastrointestinal tract, after which it undergoes hydrolysis inside the intestinal walls with the liver. Cmax values are recorded after 4-5 hours. Synthesis is carried out with proteins. Metabolic products are excreted in the urine; small volume - with feces.

Cmax indices of medroxyprogesterone are observed after 1-2 hours from the moment of using the drug. Synthesis with albumin is equal to 90%. The medroxyprogesterone component is excreted in the urine as well as in the bile. Half-life is in the range of 24-48 hours.

[5], [6], [7], [8], [9], [10],

Dosing and administration

It is necessary to take medicine orally, on the 1st tablet in a day (it is recommended to do it in the evening). Initially, white tablets (estrogen-containing) are consumed for 11 days, and then blue for a further 10 days (they contain progesterone in addition to estrogen). After that, it is necessary to withstand a 7-day period, for which menstrual-like bleeding passes. Next begins the use of drugs from the new pack.

Reception of drugs begin on any day with an irregular cycle of menstruation or on the 5th day after the onset of menstruation.

During menopause, the duration of the cycle is different, so the onset of bleeding may occur on the use of blue tablets. In such a situation, it is necessary to discontinue use of Divina, and after the end of the bleeding, start using white tablets.

When you skip the use of the drug to resume its use is necessary for the next 12 hours from the time elapsed and then continue to receive at the standard rate.

[16], [17], [18]

Use Wonder during pregnancy

The use of Divina is prohibited during lactation or pregnancy. In estradiol valerate and medroxyprogesterone acetate, the proportions of milk and plasma are 0.5.

The use of the drug during breastfeeding can cause gynecomastia and vaginal bleeding in an infant, and in addition to prolonging the jaundice of newborns that develops after delivery.

Contraindications

Main contraindications:

• the presence of intolerance;
• thromboembolic disorders;
• severe liver disease;
• assumption of breast cancer;
• congenital forms of hyperbilirubinemia;
• having an unknown etiology of bleeding from the uterus;
• endometriosis;
• pituitary neoplasms;
• suspicion of pregnancy.

Caution is required for such violations:

• multiple sclerosis;
• epileptic seizures;
• lupus erythematosus;
• diabetes mellitus with complications on the vascular system;
• elevated blood pressure;
• SN or CKD;
• porphyria or BA;
• estrogen-dependent neoplasms;
• IAB;
• severe obesity;
• infections with herpetic origin.

[11], [12], [13]

Side effects Wonder

The use of medication can lead to the following side effects:

• depression, headaches, moodiness, marked dizziness, sleep disturbances and anxiety;
• flatulence, nausea, obstipation, dyspepsia, and in addition vomiting and cholecystitis;
• thrombosis and increased blood pressure;
• alopecia or hirsutism;
• breast engorgement;
• itching, rash, or erythema nodosum;
• thrush or bleeding from the uterus;
• weight gain, swelling;
• cramps affecting the calf muscles;
• visual disturbances.

[14], [15]

Overdose

In case of poisoning, headaches, nausea and bleeding from the uterus occur.

The drug does not have an antidote, so you need to perform symptomatic procedures.

[19], [20]

Interactions with other drugs

Estrogenic effect of the drug is weakened when combined with antihypertensive or antidiabetic agents, barbiturates, indirect effect anticoagulants, ampicillin and rifampicin, and in addition with tetracycline and drugs that induce microsome oxidation (anticonvulsants and phenytoin with griseofulvin.

The activity of the drug increases with its use in combination with cyclosporine and ketoconazole, which inhibit the oxidation of microsomes.

[21], [22], [23], [24]

Storage conditions

Divina should be maintained at temperature indices of 15-25 ° C.

Shelf life

Divina can be used within a 5-year period from the moment the pharmaceutical product is manufactured.

[25]

Analogs

Analogues of the drug are substances such as Trisequens, Femoston and Indivina with Kliminorm.

[26]

Reviews

Divina is commonly used in women during perimenopause (from 45 years of age), as well as in the early phase of postmenopause (up to 55 years). To get the best effect, it is necessary to use the medication for 5-8 years (this period guarantees the greatest efficacy and safety in preventing breast carcinoma).

Reviews show that the medicine prevents malignancy and endometrial hyperplasia. Started in time HRT reduces the likelihood of developing cardiovascular disease and metabolic disorders.