Trioginal

Trioginal - combined drug for intravaginal use. The biocenosis of the vagina is determined by a number of factors, in particular the concentration of female sex hormones. The combination of progesterone and estriol in low doses with a vaginal route of administration has a moderate trophic effect on the vaginal epithelium, contributing to the accumulation of glycogen in it. The accumulation of glycogen contributes to the formation of the optimal acidic environment of the vagina (pH 3.8-4.2), which provides optimal conditions for the life of the Doderlein stick, which in turn prevents the colonization of the vagina by pathogenic bacteria.

The composition of the drug as one of the active substances includes estriol in the ultralow dose of 0.2 mg. Estriol is an estrogen synthesized in the human body. Once in the bloodstream, it forms a complex with specific receptors (in the uterus, vagina, urethra, mammary gland, liver, hypothalamus, pituitary gland), stimulates the synthesis of DNA and proteins. It has a selective effect, mainly on the cervix, vagina, vulva, causes an increase in the proliferation of the epithelium of the vagina and cervix, stimulates its blood supply, helps to restore the epithelium during its atrophic changes during the premenopause and menopause, normalizes the pH of the vaginal environment, the vaginal flora, and the vaginal changes, and the vagina, and the menopause, normalizes the pH of the vaginal environment, the vaginal flora, and the microflora of the vagina and menopause epithelium to infectious and inflammatory processes, affects the quality and quantity of cervical mucus.

The composition of the drug as the following of the active substances include progesterone in a small dose of 2 mg. Progesterone is a yellow body hormone. By binding to receptors on the surface of target organ cells, it penetrates into the nucleus, where, by activating DNA, it stimulates RNA synthesis. After the preparation of the epithelium with estriol, progesterone in the composition of the Trioginal preparation promotes the formation of intermediate layers of the epithelium and the synthesis of glycogen, the substrate necessary for the Doderleini stick to take root.

Local saturation with hormones provides colonization of the vagina with Doderlein live chopsticks - the third active ingredient of the preparation Lactobacillus casei rhamnosus Doderleini, belonging to a strain that is known for its resistance to a number of antimicrobials. This creates a similar physiological environment in the vagina.

Pharmacokinetics
Absorption estriol happens quickly: time to reach C_max in blood plasma with intravaginal use for 1-2 hours

The excretion is carried out mainly by the kidneys in the form of metabolites (several hours after ingestion and lasts up to 18 hours), 2% is excreted through the intestine in unchanged form.

C_max in blood plasma progesterone in blood plasma is achieved 2-6 hours after administration.

Progesterone is excreted in the urine as metabolites, 95% of which are glucuron-conjugated metabolites, mainly 3-alpha, 5-beta-pregnandiol (pregnandion). These metabolites, which are determined in the blood plasma and urine, are similar to substances formed during the physiological secretion of the corpus luteum.