Directory → Hormones and their antagonists → Estrogens, gestagena; Their homologues and antagonists → Mirena
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MirenaSee also LevonorgestrelRoman nameMirenaThe composition and the form ofT-obraznoe intrauterine device contains levonorgestrel 52 mg and provides controlled diffusion hormone to 20 µ g / day; Vacuum packing bumajno-plastikova 1 pc. , In one box packaging.PharmacokineticsDiffusion levonorgestrel from vertical rod twice device is continuously at the speed of 20 µ g / sut. A few weeks after the device concentration in the blood plasma of 150 to 200 pg / ml for women of child-bearing age, and about 300 pg / ml in women receiving substitution therapy estrogenom. After 12, 24 and 60 months of the device in the uterus cavity levonorgestrel concentration in the plasma of the young women was 180 ± 66 pg / ml, 192 ± 140 pg / ml, 159 ± 60 pg / ml, respectively; Among women postmenopause-276 ± 119 pg / ml, 196 ± 87 pg / ml, 152 ± 43 pg / J These concentrations are low, and consequently the system gestagena minimum.Clinical pharmacologyContraception is effective for a period of five years. Study contraceptive effectiveness revealed that the overall frequency of pregnancy is 0.16 per 100 women a year. Current use of the device has no effect on procreative function : the ability to bear children recovering from the removal of the Navy after 12 months 80% of women. When treating idiopathic menorragii shown that the three months from the date of installation of the Navy menstrual bleeding is reduced by 88%. In menorragii due podslizistoi fibromioma a less pronounced effect. Shown to reduce the severity dismenorrei and prevent hyperplasia of the endometrium during continuous therapy estrogenami. In the application of the 259 women in postmenopause over a five-year monitoring had no recorded cases of hyperplasia of endometrium (with monotherapies estrogenom frequency of hyperplasia of endometrium reached 20%).IndicationsContraception idiopathic menorragia, protection of the endometrium hyperplasia and гормонозаместительно й therapy.Pregnancy and lactationContraindicated in pregnancy.ContraindicationsHypersensitivity, inflammatory diseases of the small pelvis, the lower infection divisions urinary tract, Post Dysmenorrhea, septic abortion in the last three months, zerwitzit, disease, accompanied by increased susceptibility to infection, dysplasia cervix with signs atipii, malignant neoplasm of the uterus, including cervix and breast, breeding pathological bleeding unclear etiology, congenital or acquired anomalies of the uterus, including fibromioma leading to the deformation of the cavity of the uterus, acute disease, or liver cancer, pregnancy or suspicion on it.Patient interactionWhile regular admission fenitoina, barbiturates, benzodiazepines, rifampitina may reduce control of the Mirena.OverdosingThis method of overdose impossible.PrecautionsBefore installing the Navy needed publevrachebnogo and gynaecological examinations, which includes a study mammary glands, the small pelvis (including the definition of the cavity of the uterus), a study of tuberculosis cervix. It is not pregnancy, and sexually transmitted diseases, the existence of pathological processes in endometrii and fully cure infectious diseases of the small pelvis. It should be borne in mind that levonorgestrol may modify tolerance to glukoze (a control glucose levels in patients with diabetes). After the Navy to re-survey of the 12 weeks, then once a year or more often if there is clinical evidence. In the absence of menstruation for 6 weeks after the start of the last menstrual period should be deleted pregnancy. It used to postkoichalna contraception. It should be carefully applied to migraines, incl. with the focal asymmetric loss of vision or other symptoms indicating ishemiu brain unusually severe headache, jelthe, severe hypertension, confirmed or alleged diagnosis gormonzawisimogo neoplasms, congenital or acquired valve heart diseases (increased risk of septic endocardita), heavy Cardiovascular diseases (including stroke, myocardial infarction) ectopicescoy pregnancy in history. If you have symptoms of venous or arterial thrombosis should take appropriate diagnostic and curative measures. Navy to remove the retidiviruuschem endometrite, infection of the small pelvis, heavy or resistant to treatment for a few days of acute infections, expulsii and partial loss of the Navy, perforating the uterus. Women with congenital or acquired klapannami congenital heart defects in the installation or removal of the Navy, with the aim of preventing the development of septic endocardita should антибиотикопрофилакт ику. It should be borne in mind that the Navy is not to the methods of choice for women to the concerns muscle Matki.sistemu to remove five years after installation, followed by the replacement of the need for a new Navy. If unwanted pregnancy, women of child-bearing age are removed during menstruation and uncertain cycle. If removal is the Navy in mid-cycle, and a woman in the previous week had sexual intercourse increases the risk of pregnancy, except in cases where the new system is being implemented immediately after Stara.ustanovka removal and disposal of the Navy may have certain feelings bolewami and bleeding, Evolution passed (vazovagusnaya reaction) or convulsant epilepsy in patients with epilepsy.Dosing and AdministrationVnutrimatern establish aseptic conditions within 7 days of the menstrual cycle. Replacing the Navy can be done on any day during the cycle, immediately after abortion in the first trimester of pregnancy, no earlier than six weeks after giving birth. To protect the endometrium in estrogenna replacement therapy for women who do not have menstruation, installation can be at any time and in women with menstruatiami saved in the last days of menstrual bleeding or bleeding lifting.Storage conditionsList B. In a dry, protected from direct sunlight place at a temperature of 15-30 ° CShelf life3 yearsThe registration014834/01 |
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