Trioginal
Trioginal: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Trioginal
ATX code: G02CX
Active ingredient: Eubiotic, estriol, progesterone
Manufacturer: Laboratoires Lyocentre (France)
Description and photo update: 2018-22-10
Prices in pharmacies: from 709 rubles.
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Trioginal is a combined preparation with gestagenic and estrogenic components for intravaginal use, which regulates the balance of the vaginal microflora.
Release form and composition
Dosage form Trioginal - vaginal capsules (14 pcs. In colorless glass bottles, in a cardboard box 1 bottle).
Active ingredients in 1 capsule:
- lyophilized culture of lactobacilli Lactobacillus casei rhamnosus Doderleini (corresponds to the content of viable lactobacilli - 1 × 10 8 - 2 × 10 9 CFU; auxiliary components added before lyophilization: lactose monohydrate ~ 20.6%; potato starch ~ 41%; sodium thiosulfate 8%; monosodium glutamate ~ 4.5%) - 341 mg;
- progesterone - 2 mg;
- estriol - 0.2 mg.
Auxiliary components:
- capsule contents: lactose monohydrate - 6.8 mg;
- capsule shell: titanium dioxide - 3 mg; gelatin - up to 100 mg.
Pharmacological properties
Pharmacodynamics
Trioginal is a combined preparation for intravaginal use.
The biocenosis of the vagina determines a number of factors, in particular, the concentration of female sex hormones. The combination of low doses of estriol and progesterone with the vaginal route of administration has a moderate trophic effect on the vaginal epithelium, which contributes to the accumulation of glycogen in it. This, in turn, leads to the formation of an optimal acidic vaginal environment (pH from 3.8 to 4.2), which provides optimal conditions for the vital activity of Doderlein's bacillus, which prevents the colonization of the vagina by pathogenic bacteria.
One of the active components of Trioginal vaginal capsules - estriol is present in an ultra-low dose (0.2 mg). It is an estrogen synthesized in the human body. After entering the bloodstream, it forms a complex with specific receptors (in the vagina, uterus, mammary gland, urethra, liver, pituitary gland, hypothalamus), stimulates the synthesis of proteins and DNA. It has a selective effect, mainly on the vulva, vagina, cervix, causes an increase in the proliferation of the epithelium of the vagina and cervix, stimulates blood supply, normalizes the vaginal microflora, the pH of the vaginal environment, increases the resistance of the epithelium to inflammatory and infectious processes, affects the amount / quality of cervical mucus, in the presence of atrophic changes during menopause and premenopause, it helps to restore the epithelium.
Another active ingredient in Trioginal is progesterone in a small dose (2 mg). It is a hormone of the corpus luteum. It binds to receptors on the surface of cells of target organs and penetrates into the nucleus, where, after DNA activation, it stimulates RNA synthesis. After the preparation of the epithelium with estriol occurs, progesterone promotes the formation of intermediate layers of the epithelium and the synthesis of glycogen, the substrate that is necessary for the Doderlein bacillus to take root.
Thus, local saturation with hormones allows for the colonization of the vagina with living Doderlein sticks (the third active component), while a physiological environment is created in the vagina.
Pharmacokinetics
- progesterone: Cmax (maximum concentration of a substance) in blood plasma after administration is reached after 2–6 hours. It is excreted in the form of metabolites in the urine, 95% of them are glucuron-conjugated metabolites, mainly 3-alpha, 5-beta-pregnandiol (pregnandion). These metabolites are analogous to substances that are formed during the physiological secretion of the corpus luteum;
- estriol: absorption occurs quickly, with intravaginal use, the time to reach Cmax in blood plasma is 1–2 hours. It is excreted mainly in the form of metabolites by the kidneys, 2% - unchanged through the intestines.
Indications for use
- atrophic vulvovaginitis, which is caused by estrogen deficiency;
- preparation for planned gynecological operations of postmenopausal patients (along with other drugs for the prevention of postoperative infectious complications).
Contraindications
Absolute:
- pulmonary embolism;
- breast cancer (suspected or diagnosed);
- bleeding from the vagina of unknown origin;
- progesterone- or estrogen-dependent malignant neoplasms (suspected or diagnosed, including endometrial cancer);
- untreated endometrial hyperplasia;
- porphyria;
- liver disease in acute and chronic course (until the normalization of liver function tests);
- jaundice and / or impaired hepatic function;
- liver neoplasms (benign or malignant);
- myocardial infarction;
- uncontrolled arterial hypertension;
- thrombosis (arterial and venous) and thromboembolism, including thrombosis, deep vein thrombophlebitis (including a burdened history);
- acquired / congenital predisposition to arterial thrombosis (for example, lack of protein C and S, antithrombin III, the presence of antibodies to phospholipids);
- severe or multiple risk factors for thromboembolic complications, including transient ischemic attacks, angina pectoris, atrial fibrillation, complicated lesions of the valvular apparatus of the heart, obesity with a body mass index of more than 30 kg / m 2, extensive trauma, extended surgical interventions, which are accompanied by prolonged immobilization;
- hemorrhagic / ischemic cerebrovascular disorders;
- diabetes mellitus occurring with diabetic angiopathy;
- age up to 18 years;
- pregnancy and the period of breastfeeding;
- individual intolerance to the components of the drug.
Relative (diseases / conditions in the presence of which the appointment of Trioginal requires caution):
- arterial hypertension;
- a burdened history of thromboembolic complications in first-degree relatives at a relatively young age;
- risk factors for progesterone and estrogen-dependent tumors;
- liver disease, including adenoma;
- endometriosis;
- cholelithiasis;
- diabetes mellitus without diabetic angiopathy;
- systemic lupus erythematosus;
- severe headache / migraine;
- epilepsy;
- burdened history of endometrial hyperplasia;
- otosclerosis;
- bronchial asthma.
Instructions for the use of Trioginal: method and dosage
According to the instructions, Trioginal is used intravaginally. The capsule must be inserted deep into the vagina. To accelerate the dissolution, it should first be moistened with a small amount of water.
Recommended regimen of the drug: 2 times a day (morning and evening), 1 capsule for 14 days. With atrophic vulvovaginitis caused by estrogen deficiency, if necessary (if symptoms persist), on the recommendation of a doctor, treatment can be continued up to 21 days (maximum).
Side effects
- reproductive system: bleeding (spotting) from the vagina; very rarely - breast tension, mastodynia, increased vaginal discharge;
- allergic reactions: irritation / itching at the injection site;
- others: fluid retention, nausea.
Overdose
No information provided.
special instructions
Combined use with spermicidal agents is not recommended.
Do not use Trioginal for contraception.
Application during pregnancy and lactation
During pregnancy and lactation, the drug is contraindicated for use.
Pediatric use
In children / adolescents under 18 years of age, Trioginal vaginal capsules are not prescribed.
With impaired renal function
In the presence of impaired renal function, therapy should be carried out under close supervision.
For violations of liver function
- jaundice and / or abnormal liver function, including acute / chronic liver disease (until the normalization of liver function tests); benign and malignant neoplasms of the liver: the use of Trioginal is contraindicated;
- liver disease, including adenoma: therapy requires caution.
Drug interactions
Cases of clinically significant interactions with other drugs have not been reported.
With the combined use of Trioginal with certain drugs / substances, the following effects may develop:
- nevirapine, rifampicin, phenobarbital, phenytoin, carbamazepine, rifabutin, efavirenz and other inducers of liver microsomal enzymes: increased metabolism of sex hormones, which may cause a decrease in the effectiveness of Trioginal;
- St. John's wort preparations: induction of estrogen metabolism;
- nelfinavir, ritonavir and other inhibitors of liver microsomal enzymes: a significant decrease in metabolism with the participation of liver microsomal enzymes is possible, however, when combined with sex hormones, they can act as inducers.
Analogs
Analogs of Trioginal are: Femaflor, Ginoflor E, Klimadinon Uno, Mardil Zinc, Melsmon, Sagenit, TsI-KLIM, Cyclodinon and others.
Terms and conditions of storage
Store at temperatures up to 20 ° C. Keep out of the reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Trioginal
According to reviews, Trioginal is an effective drug for vaginal dryness and endometriosis. Many patients also note a general improvement in the condition of the reproductive system after a course of therapy.
Of the shortcomings, they indicate the possibility of developing adverse reactions.
Price for Trioginal in pharmacies
The approximate price for Trioginal (14 capsules per pack) is 590-700 rubles.
Trioginal: prices in online pharmacies
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Drug name Price Pharmacy |
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Trioginal vaginal capsules 14 pcs. 709 r Buy |
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Trioginal capsule vaginal. 14 pcs. 729 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
