Angelique micro tablets for menopause reviews

Release form and composition

Dosage form – film-coated tablets: yellow, round, biconvex in shape, engraved “EL” on one side in a regular hexagon; on the cross section there is a yellow shell, the core is almost white to white (28 pieces in a blister, in a cardboard pack 1 or 3 blisters complete with a pocket for carrying them).

Content of active substances in 1 tablet:

• estradiol hemihydrate (micronized) in terms of estradiol – 0.5 mg;
• drospirenone (micronized) – 0.25 mg.

Auxiliary components: lactose monohydrate, corn starch, pregelatinized corn starch, povidone, magnesium stearate.

Film shell composition: yellow varnish (macrogol 6000, hypromellose (5cP), yellow iron oxide dye, titanium dioxide, talc).

Contraindications

• vaginal bleeding of unknown etiology;
• hormone-dependent malignant tumor or hormone-dependent precancerous disease, or suspicion of them;
• breast cancer or suspicion of it (including medical history);
• benign or malignant liver tumors (including medical history);
• severe liver pathologies;
• adrenal insufficiency;
• acute renal failure, severe kidney disease (including medical history);
• exacerbation of deep vein thrombosis, venous thromboembolism, including pulmonary embolism (including history);
• angina pectoris, acute arterial thrombosis, thromboembolism (myocardial infarction, stroke);
• the presence of high risk factors for arterial and venous thrombosis: genetic predisposition (the presence of deep vein thrombosis or pulmonary embolism in close relatives (mother, father, sister) at a young age), obesity (body weight index more than 30 kg per m2), age of the patient;
• hyperhomocysteinemia, resistance to activated protein C, protein C deficiency, antithrombin III deficiency, antibodies to phospholipids (lupus anticoagulant, antibodies to cardiolipin), protein S deficiency and other signs of predisposition to arterial and venous thrombosis;
• untreated hyperplasia;
• porphyria;
• lactose intolerance, congenital lactase deficiency, glucose-galactose malabsorption syndrome;
• severe hypertriglyceridemia;
• period of pregnancy and breastfeeding;
• age under 18 years;
• hypersensitivity to the components of the drug.

If these diseases or conditions are detected during the use of Angeliq Micro, treatment must be discontinued immediately.

It is recommended to prescribe the drug with caution to women with uterine fibroids, congenital hyperbilirubinemia (Dubin-Johnson, Gilbert and Rotor syndromes), cholestatic itching during previous pregnancy, cholestatic jaundice, endometriosis, diabetes mellitus, in the presence of risk factors for the development of estrogen-dependent tumors (including breast cancer). glands in close relatives), a history of endometrial hyperplasia, the presence of risk factors for the development of thromboembolism and thrombosis in a family history (the presence of thromboembolic complications at a young age in close relatives), smoking, obesity, hypercholesterolemia, dementia, systemic lupus erythematosus, gallbladder diseases, epilepsy , moderate hypertriglyceridemia, retinal vascular thrombosis, severe hypocalcemia, edema due to chronic heart failure, endometriosis, bronchial asthma, liver hemangiomas, migraine, hyperkalemia and conditions predisposing to the development of hyperkalemia, when taking potassium supplements, potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors , heparin, angiotensin II receptor antagonists (drugs that cause hyperkalemia).

Directions for use and dosage

The tablets are taken orally, without chewing, with a sufficient amount of liquid, regardless of meals.

Taking Angeliq Micro can be started at any time in the absence of previous estrogen therapy and when switching from another combination drug for continuous use. If a woman has previously taken a combination hormone replacement therapy for a cyclic regimen, then use should begin after completion of the current cycle of therapy.

Dosage regimen: 1 tablet per day for 28 days, after finishing the tablets in the previous blister, the next day, start taking the first tablet from the new blister on the same day of the week on which the first tablet from the first blister was taken, without a break.

You should start taking the drug at a time convenient for the patient and strictly adhere to it throughout the entire treatment period. If you are accidentally late in taking the next dose, you should take it as soon as you remember. If the delay is more than 24 hours, you should not take an additional tablet. If a woman misses several tablets in a row, she may experience vaginal bleeding.

Dose adjustments are not made when treating elderly patients or patients with mild to moderate impairment of liver and kidney function.

Analogs

Only a doctor can replace Angeliq-Micro with another medication.

Silhouette

Gedeon Richter (Hungary)

Average price: (21 tables) – 642 rubles, (63 tables) – 1443 rubles.

A drug with a contraceptive effect based on ethinyl estradiol and dienogest. Also used for the treatment of acne, MC disorders caused by hormonal imbalance.

The product is available in tablets for 21 days. The pills are taken every day, without skipping, after the end of the course there is a week-long break for withdrawal bleeding, after which the pills are resumed.

Pros:

• Good effect
• Improves skin condition.

Flaws:

• Side effects
• High price.

Divina

Orion Corporation (Finland)

Average price: (21 tables) – 725 rubles.

The drug is used in replacement HT to eliminate severe manifestations of menopause and prevent the occurrence of osteoporosis in postmenopause.

The drug contains natural estradiol in the form of valerate and a derivative of natural progesterone - medroxyprogesterone in the form of acetate.

Divina is available in the form of a set of two types of 21 tablets. The course of treatment is designed for 21 days: first take 11 estrogen-containing pills, then switch to blue pills with estrogen and gestagen. After completion, take a week-long break and again begin taking the product from a new blister.

Pros:

• Eases the symptoms of menopause
• You can drink it for a long time.

Flaws:

• Possible weight gain.

Side effects

Adverse reactions identified during clinical and post-marketing studies of Angeliq Micro:

• mammary gland and genital organs: often – pain, including uterine bleeding, painful discomfort in the mammary glands; uncommon – breast cancer, cervical polyp;
• nervous system: infrequently – migraine;
• mental disorders: often – emotional lability;
• vascular system: uncommon - arterial and venous thromboembolic complications (embolism (occlusion) and thrombosis of pulmonary vessels, occlusion of peripheral deep veins, thrombosis, embolism, infarction (myocardial infarction or cerebral infarction), stroke (except hemorrhagic stroke));
• gastrointestinal tract: often – abdominal pain.

In addition, in isolated cases or after very long use of the tablets, the following side effects of the drug may occur:

• benign and malignant liver tumors;
• hormone-dependent malignant neoplasms or hormone-dependent precancerous pathologies;
• cholelithiasis;
• endometrial cancer;
• dementia;
• arterial hypertension;
• hypertriglyceridemia;
• liver dysfunction;
• chloasma;
• an increase in the size of uterine fibroids;
• exacerbation of symptoms of hereditary angioedema;
• changes in insulin resistance or glucose tolerance;
• prolactinoma;
• reactivation of endometriosis;
• itching and/or jaundice associated with cholestasis;
• benign pathologies of the mammary glands, epilepsy, systemic lupus erythematosus, bronchial asthma, minor chorea, otosclerosis, porphyria (development, worsening of conditions or diseases with taking Angeliq Micro tablets has not been proven);
• rash, hives and other symptoms of hypersensitivity.

Side effects and overdose

The most common undesirable effects are discomfort and pain in the chest and abdomen. In the first months of therapy, bleeding or discharge with blood from the genitals is possible, which disappear on their own with continued treatment. Other undesirable disorders of the internal organs that may occur in women during a course of pills:

• Hematopoietic system: anemia
• Metabolic processes and nutrition: increased or decreased appetite, weight gain or loss, dyslipidemia
• Psycho-emotional state: mood lability, depression, increased nervousness, insomnia, decreased sexual desire
• NS: migraine, headaches, absent-mindedness, vertigo, numbness of certain parts of the body
• CVS: rapid heartbeat, complication of existing pulmonary embolism, vein thrombosis, hypertension, varicose veins, thrombophlebitis
• Organs of vision and hearing: decreased visual acuity, eye irritation, tinnitus
• Respiratory system: dyspnea
• Gastrointestinal tract: abdominal pain, flatulence, bowel dysfunction (diarrhea or constipation), vomiting, dry mouth, distorted taste perception, liver dysfunction, cholelithiasis
• Skin: inflammation, acne, hair loss, itching, hair growth in uncharacteristic areas of the body
• Locomotor system: pain in the limbs, back, joints or muscles, muscle cramps
• Genitourinary system: infections
• Reproductive system: benign neoplasms of the breast and uterus, enlargement of the mammary glands or uterine fibroids, MC disorder, vaginal discharge, endometrial hyperplasia, dysfunction of the genital organs, salpingitis, vaginal dryness, vaginal candidiasis
• Other disorders: local swelling, fever, severe sweating.

Overdose symptoms

Studies and clinical observations have not revealed severe toxicity of the drug after unintentional overdoses. It is assumed that if a large number of tablets are consumed, possible intoxication will manifest itself in the form of greatly increased side effects. If nausea, vomiting or vaginal bleeding develops, treatment of symptoms is carried out, since a special agent that neutralizes the effect of the drug has not been developed.

special instructions

The doctor should prescribe the drug based on a detailed study of the patient’s medical history, data from general medical and gynecological examinations, including measurement of blood pressure (BP), the condition of the mammary glands, abdominal organs, and cytological examination of the cervical epithelium.

The drug is not a contraceptive.

If pregnancy is suspected, the woman should stop taking the drug until pregnancy is ruled out.

Before starting to use Angeliq Micro, it is necessary to compare the expected benefits and all individual risk factors from therapy, and take into account the effect of sex hormones on the growth of some hormone-dependent tumors and tissues.

The risk of deep vein thrombosis or pulmonary embolism increases with prolonged immobilization, extensive planned and post-traumatic surgical operations, and severe injuries. Therefore, the drug should be stopped 4-6 weeks before the planned surgery; combined continuous hormone replacement therapy can be resumed after the restoration of motor activity.

Suspicion of the development of thrombotic disorders or the appearance of their symptoms is grounds for immediate discontinuation of treatment.

Concomitant anticoagulant therapy requires an assessment of individual risk.

The presence of drospirenone in the drug prevents the risk of developing endometrial hyperplasia due to the use of estrogens. Patients with a history of endometrial hyperplasia should use estrogen-containing drugs with caution.

The increased risk of breast cancer decreases to normal levels after stopping therapy for several years.

With hormone replacement therapy, the mammographic density of the mammary glands increases, which may negatively affect the X-ray detection of breast cancer.

There is a risk of developing ovarian cancer with long-term use of combined hormone replacement therapy drugs.

In case of an enlarged liver, differential diagnosis of pain in the upper abdomen, or signs of intra-abdominal bleeding in women taking Angeliq Micro tablets, the possibility of a liver tumor should be taken into account, since the drug may contribute to the development of benign or malignant liver tumors.

Taking estrogen increases the risk of developing cholelithiasis by 2-4 times.

Taking sex hormones can affect the results of biochemical studies of the thyroid gland, liver, kidney and adrenal function, the level of concentration of transport proteins in the blood plasma, indicators of coagulation, fibrinolysis, and carbohydrate metabolism. The drug does not affect the patient's tolerance to glucose.

If severe, frequent headaches or newly manifested migraine-like pain or other symptoms that are precursors of a thrombotic stroke of the brain appear, taking the tablets should be stopped immediately.

While using the drug, a slight increase in blood pressure is possible; in case of clinically significant stable arterial hypertension, discontinuation of the drug should be considered.

Treatment of patients with impaired liver function should be accompanied by periodic liver function tests; if indicators worsen, hormonal therapy should be discontinued.

Due to the high risk of developing acute pancreatitis, the drug should be stopped immediately in case of recurrence of cholestatic itching or cholestatic jaundice.

The incidence of irregular bleeding decreases as the duration of treatment increases and bleeding usually disappears with long-term therapy.

In case of frequent or persistent pathological uterine bleeding, an endometrial examination is required to exclude organic pathologies.

If uterine fibroids enlarge or endometriosis recurs while taking estrogen, further therapy should be discontinued.

If you are prone to chloasma, a woman should avoid prolonged exposure to direct sunlight and ultraviolet radiation.

The effect of tablets on the ability of patients to drive vehicles and machines has not been established.

Comparison of safety of Angelica and Angelica micra

The safety of a drug includes many factors.

At the same time, in Angelique it is quite similar to Angelique micron. It is important where the drug is metabolized: drugs are excreted from the body either unchanged or in the form of products of their biochemical transformations. Metabolism occurs spontaneously, but most often involves major organs such as the liver, kidneys, lungs, skin, brain and others. When assessing the metabolism of Angelique, as well as Angelique micra, we look at which organ is the metabolizing organ and how critical the effect on it is.

The risk-benefit ratio is when the prescription of a drug is undesirable, but justified under certain conditions and circumstances, with the obligatory observance of caution in use. At the same time, Angelica does not have any risks when used, just like Angelica micra.

Also, when calculating safety, it is taken into account whether only allergic reactions occur or possible dysfunction of the main organs. In other matters, as well as the reversibility of the consequences of using Angelica and Angelica micra.

Drug interactions

When using the drug Angelique Micro simultaneously with barbiturates, hydantoins, carbamazepine, primidone, rifampicin, topiramate, felbamate, oxcarbazepine, griseofulvin and other drugs that induce liver enzymes, it should be taken into account that with long-term treatment they can increase the clearance of sex hormones and reduce their clinical efficiency. This property of these drugs manifests itself in women as irregular bleeding. Maximum enzyme induction is achieved after 2-3 weeks of use and persists for 4 or more weeks after discontinuation.

Combination with penicillin and tetracycline antibiotics can cause a decrease in estradiol concentrations.

Ketoconazole, cimetidine and other CYP3A4 inhibitors may slow the metabolism of estradiol.

Concomitant use of the drug with non-steroidal anti-inflammatory and antihypertensive drugs may lead to a slight increase in potassium levels in the blood serum, which is more pronounced in patients with diabetes mellitus.

Drinking large doses of alcohol during hormone therapy may cause an increase in circulating estradiol concentrations.

Patient reviews

Among female representatives, the medicine Angelique for menopause is very popular, since the vast majority of those who used it felt its positive and effective results. Patients, first of all, note the normalization of their psycho-emotional state, which significantly improves the quality of life during this period. According to reviews of Angelique, women who start taking it lose irritability, apathy, drowsiness, bad mood and menopausal neuroses, life takes on new bright colors, performance returns and even increases.

The number of painful hot flashes decreases, and most often completely disappears, which are often replaced by chills, trembling or profuse sweating. After taking the drug, most women lost headaches, back pain, and pain in the pelvic organs. The joints stopped hurting and the musculoskeletal system returned to normal.

Almost all representatives of the fair sex enjoy noticeable skin rejuvenation and a decrease in the number of wrinkles, firmness and elasticity of the skin. For many, libido returned, the quality of sexual life improved, and dryness and irritability of the genitals disappeared.

We can say with confidence that, in the absence of contraindications, Angelique Micro will become an effective and useful remedy in the fight against the manifestations of menopause and will improve well-being during this period.

Today you can hear a lot of positive feedback from women who have entered the menopausal phase about Angeliq. According to patients, the drug really eliminates all unpleasant symptoms and prevents the development of age-related diseases. Let's look at how Angeliq works during menopause, what its composition is and what doctors think about this medicine.