Femoston: instructions for use, reviews from doctors, price. Options 1/5, 1/10, 2/10

Compound

One Femoston 1/5 tablet contains estradiol and dydrogesterone in concentrations of 1 and 5 mg, respectively.
The auxiliary components used are: lactose in the form of monohydrate, methylhydroxypropylcellulose, anhydrous colloidal silicon dioxide, corn starch, macrogol 400, magnesium stearate, iron dyes (yellow oxide E172 and red E172), titanium dioxide (E171), Opadry orange. Femoston Conti 1/5 tablets have a similar composition.

Femoston 1/10 white tablets use estradiol . Substance concentration - 1 mg/tab. Each gray Femoston tablet contains estradiol and dydrogesterone estradiol per 10 mg dydrogesterone ).

Femoston 2/10 pink tablets contain estradiol at a concentration of 2 mg/tablet. Light yellow tablets contain estradiol and dydrogesterone estradiol per 10 mg dydrogesterone ). Auxiliary components: lactose in the form of monohydrate, hypromellose, magnesium stearate, corn starch, colloidal silicon dioxide, Opadry (white, gray, pink and yellow, respectively).

Femoston 1/10 film-coated tablets 28 pcs. in Moscow

Estradiol 1 mg tablets: round, biconvex, white film-coated, embossed “S” above the “6” on one side and embossed “379” on the other.

Tablets 1 mg estradiol / 10 mg dydrogesterone: round, biconvex, gray film-coated, embossed “S” above the “6” on one side and embossed “379” on the other.

The tablet core is white.

After oral administration, micronized estradiol is easily absorbed. Metabolized in the liver to estrone and estrone sulfate, which also undergoes hepatic biotransformation. Glucuronides of estrone and estradiol are excreted primarily in the urine.

Dydrogesterone after oral administration is quickly absorbed from the gastrointestinal tract. Metabolized completely. The main metabolite is 20-dihydrodydrogesterone, present in urine mainly in the form of a glucuronic acid conjugate. Complete elimination of dydrogesterone occurs after 72 hours.

Estradiol is an estrogen that is part of the drug Femoston®, identical to endogenous human estradiol. Estradiol replenishes the deficiency of estrogen in the female body after menopause and provides effective treatment of psycho-emotional and vegetative menopausal symptoms: hot flashes, increased sweating, sleep disturbances, increased nervous excitability, dizziness, headache, involution of the skin and mucous membranes, especially the mucous membranes of the genitourinary system (dryness and irritation of the vaginal mucosa, pain during sexual intercourse). Hormone replacement therapy (HRT) with Femoston® prevents bone loss in the postmenopausal period caused by estrogen deficiency. Taking Femoston® leads to a change in the lipid profile towards a decrease in the level of total cholesterol and LDL and an increase in HDL.

Dydrogesterone is a progestogen, effective when taken orally, which completely ensures the onset of the secretion phase in the endometrium, thereby reducing the risk of developing endometrial hyperplasia and/or carcinogenesis, which increases against the background of estrogens. Dydrogesterone does not have estrogenic, androgenic, anabolic or glucocorticosteroid activity.

The combination of 1 mg estradiol with dydrogesterone is a modern low-dose HRT regimen.

Before prescribing or restarting HRT, it is necessary to obtain a complete medical and family history and conduct a general and gynecological examination to identify possible contraindications and conditions requiring precautions. During treatment with the drug, it is recommended to periodically examine women (the frequency and nature of the studies are determined individually). In addition, it is advisable to conduct breast examination and/or mammography in accordance with accepted standards, taking into account clinical indications. The use of estrogens may affect the results of the following laboratory tests: glucose tolerance testing, thyroid and liver function tests.

Generally recognized risk factors for thrombosis and thromboembolism while taking HRT are a history of thromboembolic complications, severe forms of obesity (body mass index more than 30 kg/m2) and systemic lupus erythematosus. There is no generally accepted opinion regarding the role of varicose veins in the development of thromboembolism.

The risk of developing deep vein thrombosis of the lower extremities may temporarily increase with prolonged immobilization, major trauma, or surgery. In cases where prolonged immobilization is necessary after surgery, temporary cessation of HRT should be considered 4–6 weeks before surgery.

When deciding on HRT in patients with recurrent deep vein thrombosis or thromboembolism receiving anticoagulant treatment, the benefits and risks of HRT must be carefully assessed.

If thrombosis develops after starting HRT, the drug should be discontinued. The patient should be informed of the need to consult a doctor if the following symptoms occur: painful swelling of the lower extremities, sudden loss of consciousness, dyspnea, blurred vision.

There is data demonstrating a slight increase in the detection rate of breast cancer in women who received HRT for a long time (more than 10 years). The likelihood of being diagnosed with breast cancer increases with the duration of treatment and returns to normal 5 years after stopping HRT.

Patients who have previously received HRT using only estrogen drugs should be especially carefully examined before starting treatment in order to identify possible endometrial hyperstimulation. Breakthrough uterine bleeding and mild menstrual-like bleeding may occur in the first months of treatment with the drug. If, despite dose adjustment, such bleeding does not stop, the drug should be discontinued until the cause of the bleeding is determined. If bleeding recurs after a period of amenorrhea or continues after discontinuation of treatment, its etiology should be determined. This may require an endometrial biopsy.

Femoston® is not a contraceptive. Perimenopausal patients are advised to use non-hormonal contraceptives.

It does not affect the ability to drive a car or use other mechanisms.

Release form

The dosage form of the drug is film-coated, round, biconvex tablets with a diameter of 0.7 cm. The tablets differ in color depending on the concentration of the active substance/substances; each of them is marked “379” on one side.

Femoston 1/5 tablets have the letter “S” engraved on the other side. Tablets are available in calendar packs of 28 pieces.

Tablets with a higher concentration of active substances are packaged in calendar packs as follows:

14 white tablets 1 mg + 14 gray tablets 1 mg + 10 mg (Femoston 1/10);
14 pink tablets 2 mg + 14 light yellow tablets 2 mg + 10 mg (Femoston 2/10).

Pharmacodynamics and pharmacokinetics

Femoston is a combined hormonal drug used to eliminate the symptoms of estrogen deficiency and treat DUB - dysfunctional uterine bleeding .

The estradiol contained in the drug is identical to endogenous estradiol . The drug is used to replenish estrogen after the onset of menopause and effectively treats vegetative and psychoemotional disorders associated with menopause , accompanied by:

hyperhidrosis;
tides;
involution of the mucous membranes and skin, and especially the mucous membranes of the urogenital tract (in particular, the vaginal mucosa, due to which a woman begins to experience discomfort during sexual intercourse);
increased nervous excitability;
headaches and dizziness;
sleep disorders;
loss of bone mass or osteoporosis (especially if certain risk factors are noted - long-term treatment with glucocorticosteroids in the recent past, early onset of menopause , asthenic type of build, smoking, etc.).

Estradiol also helps reduce the concentration of total cholesterol and low-density lipoproteins, while simultaneously increasing the concentration of high-density lipoproteins.

The action of the gestagenic component of the drug - dydrogesterone - is aimed at stimulating the onset of the secretory phase of the endometrial cycle, and also reduces the risk of carcinogenesis and endometrial hyperplasia associated with the influence of estrogen .

Dydrogesterone does not have androgenic estrogenic , glucocorticosteroid or anabolic effects . To ensure the maximum preventive effect of hormone replacement therapy (HRT), treatment is recommended to begin as early as possible after the onset of menopause .

After taking p/os, estradiol is easily absorbed. Biotransformation of the substance occurs in the liver ; the metabolic are estrone and estrone in the form of sulfate . Estradiol and estrone glucuronides are eliminated from the body primarily in the urine.

Dydrogesterone is also rapidly absorbed from the digestive tract after oral administration. The substance is completely biotransformed, the main product of metabolism is 20-dihydrodydrogesterone. Metabolites excreted mainly through urine.

The half-life of dydrogesterone is from 5 to 7 hours, its main metabolite is from 14 to 17 hours, the substances are completely eliminated after 72 hours.

Pharmacological properties of the drug Femoston

Pharmacodynamics. combined estrogen-progestin drug. Estradiol Estradiol is chemically and biologically identical to the natural human sex hormone estradiol. Among ovarian hormones, it has the highest activity. Estradiol causes cyclic changes in the uterus, cervix and vagina and ensures the maintenance of tone and elasticity of the genitourinary tract. Estradiol also plays an important role in the preservation of bone tissue, ensuring the prevention of osteoporosis and fractures. Oral intake of estrogens has a positive effect on lipid metabolism, has a beneficial effect on the autonomic nervous system and an indirect positive effect on the psycho-emotional sphere. Dydrogesterone Dydrogesterone is an orally effective progestogen whose effects are comparable to those of parenterally administered progesterone. In the context of hormone replacement therapy, dydrogesterone promotes complete secretory transformation of the uterine endometrium, thus preventing the risk of developing estrogen-induced endometrial hyperplasia and/or carcinoma, without excluding androgenic side effects. Due to the fact that estrogens stimulate endometrial growth, estrogen monotherapy increases the risk of developing endometrial hyperplasia and cancer. The use of progestogen in therapy reduces the estrogen-induced risk of developing endometrial hyperplasia in women with a preserved uterus. Clinical trial data Reduction of symptoms of estrogen deficiency and improvement of bleeding profile Reduction in the severity of menopausal symptoms was achieved during the first weeks of treatment. Regular menstrual-like reactions (average duration 5 days) when using Femoston, which contains 2 mg estradiol and 10 mg dydrogesterone, were observed in approximately 90% of women. Menstruation usually began on the day of taking the last tablet of the progestogen phase. Breakthrough uterine bleeding and/or spotting was reported in approximately 10% of women. During the first year of therapy, amenorrhea (absence of bleeding or spotting) was observed in 5–15% of women per cycle. Regular menstrual-like reactions when using the drug Femoston, which contains 1 mg of estradiol and 10 mg of dydrogesterone, were observed in 75–80% of women. The day of the onset of menstruation, its duration, as well as the number of women with periodic menstrual-like reactions were the same as with the use of the drug Femoston, which contains 2 mg estradiol and 10 mg dydrogesterone, but there were more women with no menstruation (10–25% per 1 cycle). Prevention of osteoporosis Estrogen deficiency during menopause is associated with increased bone turnover and decreased bone mass. The effect of estrogens on bone mineral density is dose-dependent. The protective effect of estrogens only occurs during their use. After stopping hormone replacement therapy (HRT), the rate of bone loss is the same as in women who did not receive this therapy. Data from the WHI (Women's Health Initiative) study and objective analysis of studies suggest that current HRT, primarily in healthy women, either as monotherapy or in combination with a progestogen, reduces the risk of hip, vertebral and other types of fractures that occur due to osteoporosis. HRT may also prevent fractures in women with low bone density and/or known osteoporosis, but data on this are limited. After two years of treatment with Femoston, which contains 2 mg estradiol and 10 mg dydrogesterone, bone mineral density (BMD) in the lumbar spine increased by 6.7% ± 3.9%. During treatment, BMD in the lumbar spine increased or remained unchanged in 94.4% of women. In women who took the drug Femoston, which contains 1 mg of estradiol and 10 mg of dydrogesterone, BMD in the lumbar spine increased by 5.2% + 3.8%. BMD in the lumbar spine increased or remained unchanged during treatment in 93.0% of women. Femoston affects BMD of the femur. After two years of therapy with 1 mg estradiol, BMD of the femoral neck increased by 2.7% ± 4.2%, by 3.5% ± 5.0% in the trochanteric area and by 2.7% ± 6.7% in the Ward triangle . After two years of treatment with estradiol at a dose of 2 mg, these figures were 2.6% ± 5.0%; 4.6% ± 5.0% and 4.1% ± 7.4%, respectively. BMD in three areas of the femur increased or remained unchanged after treatment with estradiol at a dose of 1 and 2 mg in 67–78% and 71–88% of women, respectively. Pharmacokinetics. Estradiol After oral administration, micronized estradiol is rapidly absorbed and extensively metabolized. The main unconjugated and conjugated metabolites are estrone and estrone sulfate. These metabolites have estrogenic activity both directly and after their conversion to estradiol. Estrone sulfate may be subject to enterohepatic metabolism. The main compounds found in urine are the glucuronides of estrone and estradiol. Estrogens pass into breast milk. Dydrogesterone After oral administration, approximately 63% of dydrogesterone is excreted in the urine. The drug is completely eliminated after 72 hours. Dydrogesterone is completely metabolized in the body. The main metabolite of dydrogesterone is 20-α-dihydrodydrogesterone (DHD), which is found primarily in urine as a glucuronic acid conjugate. A common feature of all metabolites is that they retain the 4,6-dien-3-one configuration and the absence of hydroxylation reaction under the action of 17α-hydroxylase. This explains the lack of estrogenic and androgenic effects of dydrogesterone. After oral administration of dydrogesterone, the concentration of DHD in the blood plasma significantly exceeds the level of the parent substance. Dydrogesterone is rapidly absorbed. The time to reach maximum concentration for dydrogesterone and DGD varies between 0.5–2.5 hours. The half-lives for dydrogesterone and DGD are 5–7 and 14–17 hours, respectively. Unlike progesterone, dydrogesterone is not excreted in the urine in the form of pregnanediol. Thus, it remains possible to analyze the formation of endogenous progesterone based on the measurement of pregnanediol excretion.

Indications for use

The use of Femoston is indicated for hormone replacement therapy to eliminate phenomena caused by estrogen deficiency in postmenopausal .

The medicine is prescribed no earlier than six months after the last menstrual bleeding.

Prophylactic use of the drug is advisable to prevent the development of osteoporosis after the onset of menopause . The drug is prescribed to women who have an increased risk of fractures and who are contraindicated in the use of other medications intended to prevent bone loss.

Contraindications

The drug is not prescribed:

women who have been diagnosed with malignant estrogen- or progestogen-dependent tumors , as well as if these diseases are suspected;
patients with diagnosed or suspected breast cancer ;
with vaginal bleeding of unspecified origin;
with untreated hyperplasia (pathological growth) of the endometrium ;
venous thromboembolism detected at the moment or noted in the anamnesis (including DVT and PE);
if the patient has certain thrombophilic disorders (including thrombophilia associated with deficiency of antithrombin , coagulation protein C or its cofactor - protein S );
for thromboembolic arterial diseases , including angina pectoris or myocardial infarction (both in the active stage and in cases where the disease was suffered in the recent past);
in case of active liver , and also if the patient’s liver biochemical parameters ;
with porphyrin disease ;
if you are aware of individual intolerance to estradiol , dydrogesterone or auxiliary components of Femoston;
children and adolescents under 18 years of age;
during pregnancy (both established and suspected pregnancy);
during lactation.

Contraindications to the use of Femoston

Hypersensitivity to the components of the drug; diagnosed or suspected breast cancer, endometrial carcinoma and other hormone-dependent tumors diagnosed or suspected; vaginal bleeding of unknown etiology; untreated endometrial hyperplasia; history of acute deep vein thrombosis, pulmonary embolism or idiopathic venous thromboembolism; arterial thromboembolism, including recent ones (for example, angina pectoris, myocardial infarction); acute and chronic liver diseases, as well as their history in the absence of normalization of functional state indicators; porphyria; established or suspected pregnancy.

Side effects

The category of side effects that often occur in connection with the use of Femoston includes: pain (headaches, in the abdomen, in the pelvic area), nausea, migraine attacks, flatulence, leg cramps, increased sensitivity and/or tenderness of the mammary glands, metrorrhagia, the appearance of bloody vaginal bleeding after menopause, asthenia, decrease/increase in body weight.

With a frequency of 1/1000-1/100 during clinical studies, the following phenomena occurred:

vaginal candidiasis;
depression;
an increase in the size of uterine fibroids ;
change in libido ;
increased nervousness;
DVT, PE;
dizziness;
gallbladder disease ;
backache;
allergic reactions on the skin, accompanied by itching, hives , rashes;
dysmenorrhea;
ulcerative defects on the cervix;
the appearance of cervical discharge;
peripheral edema.

In rare cases (with a frequency of 1/10000-1/1000), drug therapy was accompanied by:

intolerance to contact lenses;
functional liver , which often manifest themselves in the form of asthenia , malaise, abdominal pain, jaundice ;
increased curvature of the cornea;
enlargement of the mammary glands;
premenstrual tension syndrome.

In isolated cases, the drug can provoke the development of chorea , hemolytic anemia, stroke, myocardial infarction, vascular purpura, vomiting, erythema nodosum or multimorphic, melanopathy or chloasma (often persisting even after discontinuation of the drug), angioedema , hypersensitivity reactions, worsening of porphyrin disease .

In addition, in connection with treatment with estrogen-progestagen drugs, women sometimes develop neoplasms (benign, malignant or of unknown etiology), the size of progestogen-dependent tumors fibrocystic lesions of the mammary glands appear of triglycerides in the blood plasma and the concentration of thyroid hormones increase ; arterial hypertension , acute arterial , peripheral vascular disease, varicose , dyspepsia , pancreatitis (against the background of pre-existing hypertriglyceridermia), systemic lupus erythematosus , cystitis-like syndrome , urinary incontinence develop epilepsy worsens , signs of dementia .

Side effects of the drug Femoston

Common (1–10%): headache, migraine, nausea, abdominal pain, flatulence, leg cramps, breast pain, breakthrough bleeding, spotting, pelvic pain, asthenia, weight loss or gain. Uncommon (≤1%): vaginal candidiasis, increased size of uterine fibroids, depression, changes in libido, irritability, dizziness, venous thromboembolism, gallbladder disease, allergic skin reactions, rash, urticaria, itching, back pain, changes in cervical erosion and amount of cervical secretion, dysmenorrhea, peripheral edema. Rarely (≤0.1%): intolerance to contact lenses, increased corneal curvature, liver dysfunction, which may be accompanied by asthenia, malaise, jaundice and abdominal pain, breast enlargement, premenstrual-like syndrome. Very rare (≤0.01%): hemolytic anemia, hypersensitivity reactions, chorea, myocardial infarction, stroke, vomiting, chloasma and melasma, which may persist after drug discontinuation, erythema multiforme, erythema nodosum, vascular purpura, angioedema, deterioration with porphyria. Breast cancer According to the results of a large number of epidemiological studies and one randomized, placebo-controlled trial (Women Health Initiative - WHI), the overall risk of breast cancer increases with the duration of hormone replacement therapy (HRT) in women who receive this treatment, or who have undergone HRT in the recent past. For estrogen-only HRT, the relative risk (RR) estimate from a re-analysis of data from 51 epidemiological studies (in which estrogen-only HRT was given to more than 80% of all HRT cases) and the Million Women Study (MWS) epidemiological study is similar at 1.35 (95% confidence interval - CI: 1.21-1.49) and 1.30 (95% CI: 1.21-1.40), respectively. Regarding combined HRT (estrogen plus progestogen), several epidemiological studies have reported a higher overall risk of breast cancer than estrogen monotherapy. The MWS study demonstrated that, compared with patients who had never received HRT, use of different types of combined (progestogen plus estrogen) HRT was associated with a higher risk of breast cancer (RR = 2.00, 95% CI: 1 .88-2.12) than with estrogen alone (RR = 1.30, 95% CI: 1.21-1.40) or tibolone (RR = 1.45; 95% CI: 1.25-1. 68). In the WHI study, the risk in all patients was 1.24 (95% CI: 1.01-1.54) after 5.6 years of combined (progestogen plus estrogen) HRT (conjugated equine estrogens - CLE and methylprogesterone acetate - MPA) in comparison with placebo. The absolute risks calculated in the MWS and WHI studies are presented below: Based on the average incidence of breast cancer in developed countries, the MWS study found that approximately 32 out of 1000 women over 50 years of age can be expected to be diagnosed with breast cancer up to 64 who are not receiving HRT; per 1000 women who have recently received or are receiving HRT, the number of additional cases during the corresponding period would represent for those receiving estrogen replacement therapy only 0 to 3 (best estimate = 1.5) if used for 5 years; from 3 to 7 (best score = 5) when used for 10 years; for those receiving combined (estrogen plus progestogen) HRT 5 to 7 (best estimate = 6) when used for 5 years; 18 to 20 (best estimate = 19) when used for 10 years. The WHI study found that after 5.6 years of follow-up in women aged 50 to 79 years, combined estrogen-progestogen HRT (CPE and MPA) would result in an additional 8 cases of invasive breast cancer diagnosed per 10,000 woman-years. According to study statistics, it was found that: per 1000 women in the placebo group, approximately 16 cases of invasive breast cancer would be diagnosed after 5 years; per 1000 women who received combined estrogen + progestogen HRT (CLE and MPA), the number of additional cases will be from 0 to 9 (best estimate = 4) when used for 5 years. The number of additional cases of breast cancer in women who use HRT is similar to that of women who start HRT, regardless of their age at start of use (45 to 65 years). Other adverse reactions reported in association with estrogen/progestogen therapy:

estrogen-dependent neoplasms, both benign and malignant, for example, endometrial cancer, ovarian cancer;
venous thromboembolism, that is, deep vein thrombosis of the lower extremities or pelvis and pulmonary embolism, is more common among women who receive HRT than among those who do not;
arterial thromboembolism;
an increase in the size of neoplasms caused by progestogen (for example, meningioma);
dementia.

Endometrial cancer In women with an intact uterus, the risk of endometrial hyperplasia and cancer increases with the duration of estrogen monotherapy. According to epidemiological studies, the best estimate of risk is that in women who do not take HRT, endometrial cancer can be expected to be diagnosed in approximately 5 in 1000 cases at ages 50 and 65 years. Depending on the duration of treatment and dose of estrogen, the risk of developing endometrial cancer among those taking estrogen alone is 2 to 12 times greater than among those not taking it. Adding a progestogen to estrogen monotherapy significantly reduces this increased risk.

Femoston tablets, instructions for use

Most often, Femoston is taken on days strictly determined by the attending physician, taking into account the characteristics of a particular menstrual cycle . In the absence of menstrual bleeding, the tablets should be taken on the expected days when they should begin. With amenorrhea observed throughout the year, taking the drug can be started at any time.

Instructions for use Femoston 1/5

The drug is intended for continuous use: tablets are taken p/os, one per day (optimally at the same time), without reference to meal times. The duration of one cycle is 4 full weeks (1 package No. 28 is designed for one cycle). There is no need to take a break between cycles.

To relieve the symptoms of menopause, the drug is started with the minimum effective dose. Treatment begins with the appointment of Femoston 1/5. Taking into account the time of onset of menopause, the severity of the accompanying symptoms and the effectiveness of therapy, adjustments can be made to the dosage regimen.

If it is necessary to switch from another drug containing estrogen and progestogen components for sequential (or cyclic) use, the patient should complete the full four-week course and only after that switch to treatment with Femoston 1/5 (reception can be started on any day). There is no break between cycles.

The regimen for using Femoston 1/5 Conti is similar to that described above.

Instructions for use Femoston 1/10

Femoston 1/10 tablets should be taken regardless of meal time. The estrogen contained in the drug is intended for continuous daily use during the first two weeks of the cycle.

The progestogen component is added in the last 14 days of each four-week course.

Treatment begins with taking white tablets according to the following scheme: 1 tablet 1 time per day (at the same time) during the first 2 weeks of the cycle. Next, following the instructions on the package, they begin to take gray tablets (also, one per day).

There is no need to take breaks between 28-day cycles.

Sequential combined HRT begins with the prescription of Femoston 1/10, and then, if necessary, the dose is adjusted taking into account the clinical results of therapy.

To switch from a similar drug, you should complete the full cycle of treatment and only then start taking Femoston 1/10 tablets. You can do this any day.

Instructions for use Femoston 2/10

The estrogen component of the drug should be taken continuously, the progestogen component is administered from the 15th day of the 28-day cycle.

This means that in the first 2 weeks of the cycle the patient should take 1 pink tablet per day, and starting from the 15th day, following the instructions on the drug packaging, switch to taking yellow tablets.

Usually the starting dose of estradiol is 1 mg, so sequential combined HRT begins with Femoston 1/10 and, if necessary, moves to a higher dose over time.

Switching from other drugs to Femoston 2/10 is carried out only after completing a full four-week cycle (on any day).

How to take Femoston correctly if you miss the next dose?

If a woman misses the next dose of the drug, the tablet should be taken as quickly as possible. If more than 12 hours have passed since the missed dose, then the course is continued by taking the next tablet from the package (you do not need to drink the missed one).

Taking a double dose to compensate for a missed dose is not advisable, since it is associated with an increased risk of breakthrough bleeding and the appearance of spotting vaginal discharge.

How should patients of different age groups take the drug?

There is no sufficient experience with the use of Femoston for the treatment of patients over 65 years of age.

There are no indications for prescribing the drug to children and adolescents.

Use of the drug Femoston

To initiate and maintain treatment of postmenopausal symptoms, the minimum effective dose should be prescribed for the minimum period of time. Femoston is taken daily in the first 14 days of a 28-day cycle, 1 tablet containing 1 or 2 mg of estradiol, and in the remaining 14 days - daily, 1 tablet containing 1 mg of estradiol and 10 mg of dydrogesterone or 2 mg of estradiol and 10 mg of dydrogesterone. After the end of the 28-day cycle, a new cycle should begin. Treatment must be continuous. The tablets should be taken in the order indicated on the package. Treatment of postmenopausal symptoms Usually begins with taking the drug Femoston, containing 1 mg of estradiol and 10 mg of dydrogesterone. Depending on the clinical effect, the dose is then selected individually. If the severity of symptoms associated with estrogen deficiency does not decrease, the dose can be increased by prescribing a drug that contains 2 mg of estradiol and 10 mg of dydrogesterone. Prevention of osteoporosis When hormone replacement therapy is used, it is necessary to take into account individual tolerance to treatment and that the expected effect of the drug on bone tissue is dose-dependent. Femoston Conti 1 tablet 1 time per day daily, without breaks, regardless of meals. Prevention of osteoporosis When hormone replacement therapy is used, it is necessary to take into account individual tolerance to treatment and that the expected effect of the drug on bone tissue is dose-dependent.

Overdose

Cases of overdose with Femoston have not been recorded.

Both estrogen and progestogen components of the tablets belong to the category of low-toxic substances.

Theoretically, an overdose can provoke an increase in the severity of side effects such as nausea, vomiting, dizziness, drowsiness.

It is unlikely that an overdose may require any specific symptomatic treatment (including overdose in children).

Interaction

Drug interaction studies with Femoston have not been conducted.

However, it is known that some drugs may affect the effectiveness of estrogens and progesterones .

Thus, anticonvulsants (for example, phenytoin or phenobarbital ) and antimicrobial (including nevirapine , rifampicin or efavirenz enzymes of the cytochrome P450 system involved in drug metabolism .

Ritonavir and nelvinavir , which are potent inhibitors of CYP 3A4, A5 and A7 isoenzymes, in combination with steroid hormones , promote the activation of these cytochromes.

Herbal remedies based on St. John's wort (Hypericum perforatum) can stimulate the biotransformation of estrogens and progestogens due to the ability to influence the CYP 3A4 isoenzyme.

There is evidence that the more active metabolism of estrogens and progestogens provokes a decrease in the clinical effectiveness of these substances and affects the profile of uterine bleeding.

In turn, estrogens can disrupt the process of biotransformation of other substances due to competitive suppression of cytochromes of the P450 system , which take part in the processes of biotransformation of active drug substances.

This should be remembered when prescribing estrogens in combination with drugs that have a narrow therapeutic index, including fentanyl , tacrolimus , theophylline , cyclosporine .

Such combinations can cause an increase in the plasma concentration of these substances to a toxic level. Therefore, there may be a need for careful monitoring of the drug over an extended period of time, as well as a reduction in the dose of cyclosporine, tacrolimus, theophylline and fentanyl .

Femoston® conti

The drug is prescribed only in the presence of symptoms that adversely affect the quality of life. All patients receiving HRT at least once a year require an assessment of the benefit-risk ratio. Therapy should be continued until the benefits of taking the drug outweigh the risk of adverse reactions. Experience with the drug in women over 65 years of age is limited.

Information about the risks associated with HRT in cases of premature menopause is limited. Due to the lower absolute risk in younger women, their benefit-risk ratio may be more favorable than in older women.

Medical examination

During treatment with Femoston® conti, it is recommended to conduct periodic examinations, the frequency and nature of which are determined individually, but not less than once every 6 months. It is advisable to perform mammography for additional examination of the mammary glands. Women should be informed about those possible changes in the mammary glands that need to be reported to their doctor.

The use of estrogens may affect the results of the following laboratory tests: determination of glucose tolerance, study of thyroid and liver functions.

Endometrial hyperplasia

The risk of developing endometrial hyperplasia and cancer when patients use only estrogens depends on the dose and duration of treatment and increases from 2 to 12 times compared with patients not receiving therapy; the risk may remain elevated for 10 years after stopping therapy.

In women with a preserved uterus, HRT with estrogens alone is not recommended due to the increased risk of developing endometrial cancer.

Cyclic use of progestogen (at least 12 days of a 28-day cycle), or use of a continuous combined HRT regimen in women with a preserved uterus, may prevent the estrogen-increased risk of endometrial hyperplasia and cancer.

For the purpose of timely diagnosis, it is advisable to conduct ultrasound (US) screening and, if necessary, conduct a histological (cytological) examination.

Bloody vaginal discharge

In the first months of treatment with the drug, there may be bleeding and/or scanty spotting from the vagina. If such bleeding appears some time after the start of therapy or continues after cessation of treatment, its cause should be determined. An endometrial biopsy may be performed to rule out malignancy.

Venous thromboembolism

HRT is associated with a 1.3-3-fold risk of developing venous thromboembolism (VTE), i.e. deep vein thrombosis or pulmonary embolism. The development of this phenomenon is most likely during the first year of HRT.

If there is a family history of thrombosis/thromboembolism in first-degree relatives aged less than 50 years, as well as a history of recurrent miscarriage, it is necessary to conduct a hemostasis study (screening reveals only some of the disorders of the blood coagulation system). If the patient is taking anticoagulants, a careful assessment of the benefit-risk ratio should be carried out when using Femoston® conti. Until a thorough assessment of the factors for the possible development of thromboembolism or the initiation of anticoagulant therapy is completed, Femoston® conti is not prescribed.

If a thrombophilic condition is detected in a family member and/or in the case of the seriousness or severity of the defect (for example, antithrombin III deficiency, protein S or C deficiency, as well as a combination of defects), Femoston® conti is contraindicated.

Since patients with diagnosed thrombophilic conditions have an increased risk of developing venous thromboembolism, the use of Femoston® conti, which increases this risk, is contraindicated.

In most cases, risk factors for developing VTE include: estrogen use, older age, major surgery, prolonged immobilization, obesity (body mass index > 30 kg/m2), pregnancy or the postpartum period, systemic lupus erythematosus and cancer. There is no consensus on the possible role of varicose veins in the development of VTE.

To prevent VTE after surgery, prophylactic measures should be considered in all postoperative patients.

In case of prolonged immobilization after surgery, it is recommended to stop taking Femoston-conti 4-6 weeks before, and treatment should not be resumed until the woman’s mobility is completely restored.

If VTE develops after initiation of therapy, the drug should be discontinued and patients should be informed that they should contact their physician immediately if they experience any possible symptoms of thrombosis/thromboembolism (for example, tenderness or swelling of the lower extremities, sudden chest pain, shortness of breath).

Mammary cancer

In women receiving long-term HRT using estrogen alone or in combination with estrogen and progestogen, the incidence of breast cancer diagnosis increases, which returns to the original level within 5 years after cessation of therapy.

The increase in risk depends on the duration of HRT use. In women taking combined HRT for more than 5 years, the risk of developing breast cancer can increase up to 2 times.

Combination therapy with estrogen and progestogen

Results from a randomized, placebo-controlled trial (Women's Health Initiative (WHI)) and epidemiological studies have shown an increased risk of breast cancer in women taking combined estrogen and progestogen HRT. This increase becomes noticeable after approximately three years of therapy.

Estrogen-only therapy

According to the WHI study, there was no increased risk of breast cancer in women with a previous hysterectomy who received estrogen-only HRT.

Most observational studies showed a small increase in the risk of breast cancer, although this risk was markedly lower in women taking combined estrogen and progestogen therapy.

The increase in risk becomes noticeable after several years of using HRT drugs, and after stopping therapy it returns to the original level within several (maximum five) years.

While taking HRT medications, there may be an increase in the density of breast tissue during mammography, which can make it difficult to diagnose breast cancer.

Ovarian cancer

Ovarian cancer is much less common than breast cancer. Epidemiological data obtained from a large meta-analysis suggest a small increase in the risk of developing ovarian cancer for women receiving HRT as estrogen monotherapy or combination therapy with estrogens and progestogens.

These studies (increased risk) become more apparent when therapy lasts more than five years, and after discontinuation, the risk gradually decreases over time. Findings from a number of other studies, including the WHI, indicate that combined HRT is associated with a similar or slightly lower risk of ovarian cancer.

Risk of ischemic stroke

Combination therapy with estrogen and progestogen or therapy with estrogen alone is associated with a 1.5-fold increase in the relative risk of ischemic stroke. The risk of hemorrhagic stroke does not increase when receiving HRT.

The relative risk does not depend on age, time of menopause, or duration of therapy. However, the baseline risk is highly dependent on age, so the overall risk of stroke in women taking HRT will increase with age.

Coronary heart disease (CHD)

Randomized controlled clinical trials provided no evidence of a protective effect of HRT against myocardial infarction in women with or without CAD who received combined estrogen and progestogen HRT or estrogen monotherapy.

Combination therapy with estrogen and progestogen

The relative risk of coronary heart disease during the use of combined estrogen and progestogen HRT is slightly increased. Because the absolute risk of CAD is highly dependent on age, the number of additional cases of CAD due to combined HRT use in healthy premenopausal women is very small, but increases with age. The risk is slightly higher in women over 60 years of age.

Estrogen-only therapy

Based on data from randomized controlled trials, there was no increased risk of coronary artery disease in women with a previous hysterectomy who received estrogen monotherapy.

Other states

Estrogens can cause fluid retention, which may adversely affect patients with impaired renal or cardiac function. This group of patients should be under medical supervision. Patients with hypertriglyceridemia while taking HRT medications should also be under medical supervision, because There are reports of very rare cases of significant increases in the concentration of triglycerides in the blood plasma, which contributes to the development of pancreatitis.

Estrogens increase the concentration of thyroxine-binding globulin, which leads to an overall increase in the concentration of circulating thyroid hormones, as measured by determination of plasma protein-bound iodine, thyroxine (T4) concentration - chromatographic or radioimmunoassay, or triiodothyronine (T3) - radioimmunoassay. A labeled triiodothyronine uptake test shows elevated levels of thyroxine-binding globulin. The concentrations of free hormones T3 and T4 usually do not change. Plasma concentrations of other binding proteins (eg, transcortin and sex hormone-binding globulin) may also be increased, resulting in increased concentrations of circulating corticosteroids and sex hormones.

The concentrations of free or biologically active hormones do not change. It is possible to increase the concentration of other plasma proteins (angiotensinogen/renin system, α-1-antitrypsin, ceruloplasmin).

The use of HRT does not improve cognitive function. There are reports of an increased risk of developing dementia in women who start using HRT (combined or estrogen-containing only) after 65 years.

Femoston® conti is not a contraceptive.

Analogs

Level 4 ATX code matches:
Klimonorm

The generic (structural analogue) of Femoston ⅕ is the drug Femoston Conti 1/5.

Drugs with a similar mechanism of action: Divina , Klimonorm , Kliogest , Trisequence .

Klimonorm or Femoston - which is better?

The decision about which drug from the group of combined estrogen-gestagen agents should be chosen is made by the doctor based on the data received from the patient about the period of age-related hormonal changes.

It is believed that in the drug Klimonorm the progestin component is present in the most optimal concentration, which allows effective control of the cycle and provides the necessary level of protection of the endometrium from the hyperplastic effect of estrogens .

At the same time, it is possible to maintain the beneficial effects caused by the influence of estrogens on the state of the cardiovascular system and lipid metabolism . In addition, levonorgestrel Klimonorm potentiates the effect of estradiol , aimed at the treatment and prevention of osteoporosis .

Another important feature of levonorgestrel is its almost 100% bioavailability, thanks to which it is possible to maintain the stability of the drug’s effects.

Moreover, the severity of the effects remains unchanged regardless of the woman’s nutritional characteristics, the presence of diseases of the digestive tract , as well as the activity of the liver system , which plays a key role in the processes of first-pass metabolism of xenobiotics .

The bioavailability of dydrogesterone , which is part of Femoston, is 28%, and therefore its effects are subject to fluctuations (both inter- and inter-individual).

Angelique or Femoston - which is better?

Experts believe that there is not much difference between these means. The main difference between the drug Angelique and Femoston is that it contains drospirenone progestational .

During pregnancy

The use of Femoston is contraindicated if it is known for sure that the woman is pregnant, as well as if there is reason to suspect pregnancy. The drug is also contraindicated for women who are breastfeeding.

In some cases, the medicine is prescribed during pregnancy planning. The indications are:

conditions caused by estrogen and manifested by insufficiency of the first phase (that is, conditions in which by the end of the first (follicular) phase of the menstrual cycle the thickness of the endometrial layer does not exceed 7-8 mm);
infertility caused by hormonal imbalance.

Too thin an endometrium can cause disruption of the luteal phase and, as a result, a woman cannot become pregnant.

Most often, at the planning stage, doctors recommend taking Femoston 2/10.

The concentration of estradiol in tablets intended for use during the first 2 weeks of the cycle is such that the drug, unlike contraceptives, does not suppress ovulation , while simulating the first phase of the menstrual cycle and stimulating the division and growth of endometrial .

Taking tablets containing estradiol supplemented with dydrogesterone, in turn, ensures secretory transformation of the inner layer of the uterus , which is necessary for normal implantation of the egg in the event of its fertilization and pregnancy. Thus, Femoston 2/10 allows you to normalize the disrupted menstrual cycle .

When planning pregnancy, Femoston 2/10 is taken from the first day of the menstrual cycle, one tablet per day for 4 full weeks. You should not stop treatment before the entire package is completed, as this can provoke a hormonal imbalance, manifested by breakthrough bleeding of varying degrees of intensity and leaving no chance of pregnancy.

Women who take Femoston when planning a pregnancy should further strengthen the luteal (second) phase of the cycle, therefore, from the 14th day of treatment, the patient is prescribed to take the drug in combination with Duphaston (or its analogue).

Dydrogesterone is present as gestagenic component in Duphaston , and this makes it possible to enhance the positive effect of therapy on the female body and the condition of the endometrium .

Duphaston is taken one tablet twice a day for a full two weeks.

Is it possible to get pregnant while taking the drug?

Pregnancy that occurs during the use of Femoston is an exception. As a rule, the chances of becoming pregnant after taking the drug for several cycles are considered more realistic, and this usually occurs after stopping treatment.

In extremely rare cases, it is possible to use the product against the background of an already existing pregnancy, when a woman needs endometrial . However, such a decision can only be made by a qualified specialist.

special instructions

The drug is prescribed only in the presence of symptoms that adversely affect the quality of life.
All patients receiving HRT are required to assess the benefit/risk ratio at least once a year. Therapy should be continued until the benefits of taking the drug outweigh the risk of side effects.

Experience with the drug in women over 65 years of age is limited.

Information about the risks associated with HRT in cases of premature menopause is limited.

Due to the lower absolute risk in younger women, their benefit/risk ratio may favor HRT compared with older women.

Medical examination

Before prescribing or resuming therapy with Femoston® conti, it is necessary to collect a complete medical and family history and conduct a general and gynecological examination (including the mammary glands) of the patient in order to identify possible contraindications and conditions requiring precautions. During treatment with Femoston® conti, it is recommended to conduct periodic examinations, the frequency and nature of which are determined individually, but not less than once every 6 months. It is advisable to perform mammography for additional examination of the mammary glands. Women should be informed about those possible changes in the mammary glands that need to be reported to their doctor.

The use of estrogens may affect the results of the following laboratory tests: determination of glucose tolerance, study of thyroid and liver functions.

Endometrial hyperplasia

In women with a preserved uterus, HRT with estrogens alone is not recommended due to the increased risk of developing endometrial cancer. Cyclic use of progestogen (at least 12 days of a 28-day cycle), or use of a continuous combined HRT regimen in women with a preserved uterus, may prevent the estrogen-increased risk of endometrial hyperplasia and cancer.

In women, the use of combined HRT for 5 years did not lead to an increased risk of developing endometrial cancer.

For the purpose of timely diagnosis, it is advisable to conduct ultrasound (US) screening and, if necessary, conduct a histological (cytological) examination.

Bloody vaginal discharge

In the first months of treatment with the drug, breakthrough bleeding and/or scanty spotting from the vagina may occur. If such bleeding appears some time after the start of therapy or continues after cessation of treatment, its cause should be determined. An endometrial biopsy may be performed to rule out malignancy.

Venous thromboembolism

If there are thromboembolic complications in first-degree relatives at a young age, as well as with a history of recurrent miscarriage, it is necessary to conduct a hemostasis study (during screening, only some disorders of the blood coagulation system are detected).

If the patient is taking anticoagulants, it is necessary to carefully consider the prescription of Femoston® conti from the point of view of the benefit/risk ratio. Until a thorough assessment of the factors for the possible development of thromboembolism or the initiation of anticoagulant therapy is completed, Femoston® conti is not prescribed.

If a thrombophilic condition is detected in a family member and/or in case of seriousness or severity of the defect (for example, deficiency of antithrombin III, protein S or C, as well as a combination of defects), Femoston® conti is contraindicated.

Since patients with diagnosed thrombophilic conditions have an increased risk of developing venous thromboembolism, the use of Femoston® conti, which increases this risk, is contraindicated.

To prevent VTE after surgery, prophylactic measures should be considered in all postoperative patients.

In case of prolonged immobilization after surgery, it is recommended to stop taking Femoston® conti 4-6 weeks before, and treatment should not be resumed until the woman has completely recovered mobility.

If VTE develops after initiation of therapy, the drug should be discontinued and patients should be informed that they should contact their physician immediately if they experience any potential thromboembolic symptoms (eg, tenderness or swelling of the lower extremities, sudden pain in the chest, shortness of breath).

Mammary cancer

The increase in risk depends on the duration of HRT use. In women taking combined HRT for more than 5 years, the risk of developing breast cancer can increase up to 2 times.

Combination therapy with estrogen and progestogen

Estrogen-only therapy

According to the WHI study, there was no increased risk of breast cancer in women with a previous hysterectomy who received estrogen-only HRT.

Most observational studies showed a small increase in the risk of breast cancer, but the risk was markedly lower in women taking combined estrogen and progestogen therapy.

The increase in risk becomes noticeable after several years of using HRT drugs, and after stopping therapy it returns to the original level within several (maximum five) years.

While taking HRT medications, there may be an increase in the density of breast tissue during mammography, which can make it difficult to diagnose breast cancer.

Ovarian cancer

Risk of ischemic stroke

Coronary heart disease (CHD)

Combination therapy with estrogen and progestogen

Estrogen-only therapy

Based on data from randomized controlled trials, there was no increased risk of coronary artery disease in women with a previous hysterectomy who received estrogen monotherapy.

Other states

Estrogens can cause fluid retention, which may adversely affect patients with impaired renal or cardiac function. This group of patients should be under medical supervision.

Patients with hypertriglyceridemia while taking HRT medications should also be under medical supervision, because There are reports of very rare cases of significant increases in the concentration of triglycerides in the blood plasma, which contributes to the development of pancreatitis.

Plasma concentrations of other binding proteins (eg, transcortin and sex hormone-binding globulin) may also be increased, resulting in increased concentrations of circulating corticosteroids and sex hormones.

The concentrations of free or biologically active hormones do not change.

It is possible to increase the concentration of other plasma proteins (angiotensinogen/renin system, α-1-antitrypsin, ceruloplasmin).

The use of HRT does not improve cognitive function. There are reports of an increased risk of developing dementia in women who start using HRT (combined or estrogen-containing only) after 65 years.

Femoston® conti is not a contraceptive.

Femoston reviews

A considerable number of reviews about Femoston 1/5 Conti have been left on the forums. Like reviews of Femoston 2/10 or 1/10, they are quite contradictory. As a rule, in reviews, women describe their experience of using the product during menopause or when planning pregnancy .

Those who were satisfied with the treatment note as the advantages of the drug that it is quite well tolerated and rarely causes side effects, quickly normalizes the condition, relieving the unpleasant symptoms of the onset of menopause , and improves overall well-being, has a positive effect on the condition of the skin, and restores the cycle in case of its violations, easy to use.

Negative reviews are associated with the occurrence of undesirable side effects (depression, rash, excess weight, swelling, decreased activity, joint pain, etc.), as well as the lack of the expected effect.

Turning to doctors' reviews of Femoston 1/10, 2/10 or 1/5, which are based on the results of clinical studies, we can conclude that the drug is a highly effective remedy for the treatment and prevention of conditions that have developed as a result of premature ovarian .

Moreover, all patients showed good tolerability of the tablets. Studies have made it possible to establish a pronounced positive effect of therapy on the general well-being of women and, in particular, on the blood lipid profile .

Against the background of the treatment, a significant increase in the rate of maximum oxygen consumption and an increase in the bone-protective effect of the estrogen component of Femoston by dydrogesterone were also established.

Thus, doctors confirm the need for early initiation and differentiated choice of hormone replacement therapy in women with “switched off” ovarian function .

Special instructions for the use of Femoston

Hormone replacement therapy should only be started if there are symptoms that adversely affect quality of life. In all cases, a careful risk-benefit analysis should be carried out at least annually, and treatment should only be continued if the benefit outweighs the risk. Before prescribing hormone replacement therapy or its resumption, it is necessary to conduct a thorough general and gynecological examination of the patient, study her individual and family history to identify possible contraindications and risk factors. During the treatment period, regular examinations are recommended, the frequency and scope of which are determined individually, with mandatory examination of the mammary glands and/or mammography, modified if necessary. Diseases for which monitoring of the patient’s condition is necessary: uterine fibroids or endometriosis; history of thromboembolic disease or the presence of risk factors for thromboembolism (see below); the presence of risk factors for the occurrence of estrogen-dependent tumors, for example, the first degree of hereditary predisposition to breast cancer; AH (arterial hypertension); liver diseases (for example, liver adenoma); diabetes mellitus with or without vascular complications; cholelithiasis; migraine or (severe) headache; systemic lupus erythematosus; history of endometrial hyperplasia (see below); epilepsy; BA; otosclerosis. You should stop using the drug : if a contraindication to use is identified, as well as if jaundice or liver dysfunction develops, a significant increase in blood pressure, the appearance (for the first time) of a migraine-type headache, or pregnancy. Endometrial hyperplasia. When treated only with estrogen drugs for a long time, the risk of developing endometrial hyperplasia and cancer increases. Adding a progestogen to treatment for at least 12 days of the cycle in women with a preserved uterus significantly reduces this risk. Bleeding. Sometimes, in the first months of treatment, breakthrough uterine bleeding or spotting may occur. If they occur after some time during treatment or are noted after discontinuation of the drug, it is necessary to find out their cause (endometrial biopsy to exclude malignant neoplasms). Venous thromboembolism. Hormone replacement therapy increases the risk of developing venous thromboembolism (VTE), that is, deep vein thrombosis or pulmonary embolism. The occurrence of this condition is most likely during the first year of treatment. Risk factors for the development of VTE are a history of thromboembolism in the patient or her family members, severe obesity (body mass index 30 kg/m2) and systemic lupus erythematosus. If there is a history of thromboembolism, as well as with repeated spontaneous abortions, it is necessary to conduct an examination to exclude a tendency to thrombus formation. Until a thorough evaluation of thrombophilia factors is completed or anticoagulant therapy is initiated, the use of hormone replacement therapy in such patients should be considered contraindicated. In women taking anticoagulants, it is necessary to conduct a careful analysis of the risk/benefit ratio of using hormone replacement therapy. The risk of thromboembolism increases with prolonged immobilization, significant trauma, or extensive surgery. As for all patients in the postoperative period, special attention should be paid to preventive measures to prevent thromboembolic complications after surgery. If prolonged immobilization is planned after surgery, such as abdominal surgery or lower extremity orthopedic surgery, temporary cessation of hormone replacement therapy should be considered 4–6 weeks before surgery. Treatment should not be resumed until the woman’s motor activity is completely restored. If VTE develops after initiation of therapy, the drug must be discontinued. Patients should be warned to seek immediate medical attention if potential symptoms of thromboembolism (eg, painful swelling of the leg, sudden chest pain, shortness of breath) occur. Disease of the coronary arteries of the heart. In randomized controlled trials, there was no evidence of a positive effect on the cardiovascular system with continuous combination therapy of conjugated estrogens and MPA. Two large clinical trials, WHI and HERS (Heart and Estrogen/progestin Replacement Study), demonstrated a possible increased risk of cardiovascular disease during the first year of treatment and a lack of overall benefit. For other drugs used for HRT, there is only limited data from randomized controlled trials examining effects on cardiovascular disease or mortality. Therefore, it is unknown whether these results also apply to other HRT drugs. Stroke. In a large randomized clinical trial (WHI study), the secondary outcome was that the risk of ischemic stroke increased in healthy women during continuous combination therapy with conjugated estrogens and MPA. For women who do not receive HRT, the incidence of stroke over a 5-year period is estimated to be approximately 3 per 1000 women aged 50–59 years and 11 per 1000 women aged 60–69 years. It is estimated that for women who take conjugated estrogens and MPA for 5 years, the number of additional cases will occur in the range of 0 to 3 (best estimate = 1) per 1000 patients aged 50–59 years and from 1 to 9 (best estimate = 4) per 1000 patients aged 60–69 years. It is not known whether the increased risk of stroke also applies to other HRT drugs. Ovarian cancer. Long-term (at least 5–10 years) use of estrogen-only hormone replacement therapy in women with a hysterectomy has been associated with an increased risk of ovarian cancer. It is not known whether the risk will differ between long-term use of combined HRT and drugs that contain only estrogens. Other states. Estrogens may cause fluid retention, and patients with cardiac or renal impairment should be closely monitored. The condition of patients with end-stage renal failure requires constant monitoring, since it is possible that the level of circulating active ingredients of Femoston may increase. Women with hypertriglyceridemia should be closely monitored during hormone replacement therapy, as isolated cases of significant increases in plasma TG levels have been observed during estrogen treatment, leading to the development of pancreatitis. Estrogens increase the level of thyroxine-binding globulin, resulting in an increase in the concentration of circulating total thyroid hormones, which is determined by the level of protein-bound iodine, thyroxine (by column analysis or radioimmunoassay), or triiodothyronine (by radioimmunoassay). Triiodironine uptake is reduced, indicating increased levels of thyroxine-binding globulin. The concentrations of free triiodothyronine and thyroxine do not change. Serum levels of other binding proteins, corticosteroid binding globulin and sex hormone binding globulin, may be increased, resulting in increased concentrations of circulating corticosteroids and sex hormones, respectively. The concentrations of free or biologically active hormones do not change. Concentrations of other plasma proteins (angiotensinogen/renin substrate, alpha-I antitrypsin, ceruloplasmin) may increase. There is no convincing evidence of improvement in cognitive function. The WHI study found evidence of an increased risk of dementia in women receiving continuous combination estrogen and progesterone therapy after the age of 65 years. It remains unknown whether this also applies to younger postmenopausal women or other hormone replacement therapy drugs. Patients with rare hereditary diseases - galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption syndrome - should not take this drug. Experience in treating women over 65 years of age is limited. Use during pregnancy and lactation. Femoston is not indicated for use during pregnancy. If pregnancy occurs during treatment with Femoston, the drug should be stopped immediately. Femoston is not recommended for use during breastfeeding. Children. Due to insufficient data on the safety and effectiveness of Femoston in children under 18 years of age, the drug is not recommended for this age group of patients. The drug Femoston does not affect the ability to drive vehicles or operate machines and mechanisms.

Femoston price, where to buy

Price Femoston 1/5 in Russian pharmacies from 870 rubles. You can buy Femoston Conti 1/5 for an average of 900 rubles. Price Femoston 2/10 - from 790, Femoston 1/10 - from 795 rubles.

In Ukraine, the price of Femoston 1/10 is from 438 UAH, the price of Femoston 2/10 is from 520 UAH. The cost of the drug with a dosage of 1 mg + 5 mg is from 445 UAH.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

ZdravCity

Femoston 1/5 conti tablets p.p.o.
28 pcs. Abbott Biologicals B.V. 1160 rub. order
Femoston 2 tab. p/o captivity. 2mg+10mg No. 28 Abbott Biologicals B.V. NL
RUR 1,138 order
Femoston Mini tablets p.p.o. 2.5 mg+0.5 mg 28 pcs. Abbott Biologicals B.V.
RUB 1,159 order
Femoston 1 tab. p/o captivity. 1mg+10mg No. 28 Abbott Biologicals B.V. NL
RUB 1,169 order

Pharmacy Dialogue

Femoston conti tablets 1mg/5mg No. 28Abbot Biologicals
1130 rub. order
Femoston 2 tablets No. 28Abbot
1109 rub. order
Femoston 1 tablet No. 28Abbot
RUB 1,417 order
Femoston mini tablets 2.5mg+0.5mg No. 28Abbot
RUB 1,062 order

Pharmacy24

Femoston Conti 1mg+5 mg No. 28 tablets Abbott Biologicals B.V., Netherlands
444 UAH.order
Femoston 1 mg/10 mg No. 56 tablets Abbott Biologicals B.V., Netherlands
816 UAH order
Femoston Conti Mini 0.5 mg/2.5 mg No. 28 tablets Abbott Biologicals B.V., Netherlands
428 UAH. order
Femoston 1mg+10mg No. 28 tablets Abbott Biologicals B.V., Netherlands
439 UAH. order
Femoston 2 mg+10 mg No. 28 tablets Abbott Biologicals B.V., Netherlands
448 UAH order

PaniPharmacy

Femoston tablets Femoston tablets 2mg+10mg No. 28 Netherlands, Solvay Biologicals
470 UAH. order
Femoston conti tablets Femoston conti tablets 1mg+5mg No. 28 Netherlands, Solvay Biologicals
534 UAH. order
Femoston tablets Femoston tablets 1mg+10mg No. 28 Netherlands, Abbott Biologicals
433 UAH order
Femoston tablets Femoston tablets 1mg+10mg No. 56 Netherlands, Abbott Biologicals
795 UAH. order