Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
АТХ:G.02.A.D.02 Dinoprostone
Pharmacodynamics:The drug has uterotonizing effect.
Refers to prostaglandins - PGE2. Has a stimulating effect on the contractile activity and tone of the myometrium, modulates the reaction of internal organs to various hormonal effects, causes rhythmic contractions of the pregnant uterus at any period of pregnancy (sensitivity is higher in the last trimester of pregnancy). With topical application it reduces the smooth muscles of the uterus and increases its blood supply, promotes softening, smoothing and opening of the cervix and stimulates contractions of smooth muscles.
Pharmacokinetics:Rapidly metabolized in various tissues, especially in the lungs, as well as in the liver and kidneys. It is excreted mainly by the kidneys in the form of metabolites.
Indications:Stimulation of cervical ripening, induction of labor in women with term or almost full pregnancy.
XV.O80-O84.O83.9 Obstetrics allowance for single-childbirth, unspecified
Contraindications:Hypersensitivity, 6 or more preterm pregnancies in history, caesarean section or large surgical interventions on the uterus (in the anamnesis), difficult and / or traumatic births (in the anamnesis), previous fetal distress, mismatch of the pelvis of the mother and fetal head, spotting from the genital ways of unspecified nature during pregnancy, infection of the lower genital tract, abnormal position of the fetus, revealed fetal bladder.
Carefully:Dinoprostone is intended for use only in hospital settings. Before using for induction of labor, it is necessary to carefully evaluate the compliance of the pelvis and fetal head dimensions; during labor, it is necessary to carefully monitor the uterine activity, the course of maturation and opening of the cervix, the fetus. In the presence of an anamnesis of hypertensive or tetanic uterine contractions, control the activity of the uterus and the status of the fetus during the entire period of induced labor. If the patient retains high-grade contractions, the possibility of rupture of the uterus should be considered.
Pregnancy and lactation:In experimental animal studies, prostaglandin E2 causes an increase in skeletal anomalies in the offspring of rats and rabbits. The embryotoxicity of dinoprostone in rats and rabbits is shown. Any dose of the drug that causes a prolonged increase in the tone of the uterus represents a certain risk for the embryo or fetus.
The action category for fetus by FDA is C.
Prostaglandins are excreted in breast milk in very small amounts.
Dosing and Administration:Intravaginal, endocervical. Dosage regimen is individual, it is established by the doctor an obstetrician-gynecologist.
Side effects:From the genitourinary system: hypertension of the uterus, tetanic contractions of the uterus (increase in frequency, tone of the uterus or duration of contractions), rupture of the uterus.
On the part of the digestive system: nausea, vomiting, diarrhea.
Other: flushes to the face, trembling, fever, leukocytosis, back pain. Influence on the fetus - distress syndrome of the fetus / change in the frequency of fetal heartbeats, fetal compression, asphyxia.
Overdose:Symptoms: significant increase and increase in uterine contractions, fetal distress.
Treatment: intravenous administration of beta-adrenomimetics; with inefficiency - rapid delivery.
In case of an overdose of gel: the drug must be removed from the vagina, placing the patient in a position reclining on its side; shows the use of oxygen.
Interaction:Strengthens the effect of oxytocin.
Special instructions:In women over 35 years with complications that occurred during pregnancy, as well as with a gestation period of more than 40 weeks, there is an increased risk of postpartum disseminated intravascular coagulation, so apply
dinoprostone these patients should be treated with caution. Immediately after childbirth (as soon as possible), it is necessary to determine whether the patient does not have a risk of developing fibrinolysis.
When used in the form of a gel, care should be taken not to introduce the gel above the level of the internal throat in the extraamniosic space (possible hyperstimulation of the uterus).