home › It is interesting › Ginipral during pregnancy: reviews, instructions, dosage. Instructions for the use of ginipral during pregnancy, indications and contraindications, possible side effects and analogues

Ginipral during pregnancy: reviews, instructions, dosage. Instructions for the use of ginipral during pregnancy, indications and contraindications, possible side effects and analogues

Ginipral refers to drugs that reduce the tone and contractile activity of the uterus, that is, it has a relaxing effect on the uterus. Such drugs are called "tocolytics" - means to prevent premature birth.

The uterus is a muscular organ that can contract. During a normal pregnancy, muscle fibers are in a relaxed state, contractions begin with the arrival of the term of delivery. There are many factors that contribute to the development of increased uterine tone (hypertonicity). Hypertonicity is dangerous in that it can cause abortion, as well as intrauterine hypoxia and fetal developmental delay according to ultrasound results due to insufficient oxygen and nutrients for the child.

Under the influence of Ginipral, premature contractions in most cases stop, which allows you to extend the pregnancy until the normal term of delivery. Reducing the frequency and intensity of uterine contractions improves uteroplacental blood flow, resulting in an increase in the oxygen concentration in the blood of the fetus, which prevents fetal hypoxia. During childbirth, Ginipral normalizes excessively strong or irregular contractions.

The use of Ginipral during pregnancy

Ginipral is prescribed by an obstetrician-gynecologist with the threat of spontaneous miscarriage, placental insufficiency, uterine hypertonicity starting from the 20th week of pregnancy, and also to prevent premature birth (tocolytics can delay labor by at least 48 hours).

Ginipral is administered to pregnant women inside in the form of tablets, and in a hospital, Ginipral is administered by intravenous infusion.

Contraindications to the use of Ginipral

first trimester of pregnancy (up to 20 weeks);
bleeding from the vagina of any origin, premature detachment of the placenta; intrauterine infections;
diseases of the heart and blood vessels, especially cardiac arrhythmia, occurring with tachycardia, myocarditis, coronary heart disease (CHD);
individual intolerance (especially for patients suffering from bronchial asthma);
thyrotoxicosis (excess thyroid hormone);
severe liver and kidney disease;
lactation period (breastfeeding);
patients with lactose intolerance

Side effects and warnings when using Ginipral

Before starting treatment with Ginipral, it is necessary to conduct an ECG control of the pregnant woman. While taking Ginipral, a pregnant woman may experience dizziness, headache, heart palpitations (tachycardia), weakness, slight tremor (trembling) of the fingers, increased sweating. There may be a decrease in blood pressure.

Ginipral, like other tocolytics, can cause an increase in plasma glucose levels and a decrease in potassium levels. Ginipral is incompatible with preparations containing calcium and vitamin D. During treatment with hypipral, you should stop drinking tea and coffee, as these drinks can increase the side effects of the drug. Under the influence of Ginipral, diuresis (the amount of urine excreted) decreases, so it is very important to monitor symptoms that indicate fluid retention in the body, for example, swelling of the lower extremities (legs), especially if the pregnant woman has a concomitant kidney disease, preeclampsia, detection of protein in the urine (proteinuria ). Strictly limit excess fluid intake (no more than 2 liters per day) and reduce salt intake as much as possible.

Blood pressure, pulse and cardiac activity (HR) should be under constant medical supervision. With an increase in the heart rate of a pregnant woman (more than 130 beats / min) or with significant fluctuations in blood pressure, the dose of the drug must be reduced. With the appearance of compressive pain in the heart and difficulty breathing, you should immediately stop taking the drug and inform your doctor about it. When taking Ginipral, it is desirable to conduct CTG to clarify the condition of the fetus and the tone of the uterus.

Pregnant women with diabetes should regularly monitor their blood sugar levels. Due to the content of lactase, Ginipral is not recommended for pregnant women who have lactose intolerance.

How to use Ginipral during pregnancy

Ginipral in tablets of 0.5 mg is administered orally, without chewing and with a small amount of water. The doctor selects the dosage individually, taking into account the tolerability of the drug. Initially, 1 tablet is prescribed every 3 hours, and then every 4-6 hours (from 4 to 8 tablets per day). In case of poor tolerance, the drug is used in reduced doses prescribed individually (half or even a quarter) and under constant medical supervision.

Ginipral and Verapamil

The most common side effect that pregnant women experience when taking Ginipral is heart palpitations (feeling that the heart will jump out of the chest). To eliminate side effects to Ginipral, the doctor may prescribe Verapamil (a calcium antagonist), which not only relieves side effects, but also suppresses the contractile activity of the uterus.

Therefore, Verapamil and Ginipral during pregnancy are most often prescribed together - one drug inhibits the strong effect of the other. Verapamil is taken 20 minutes before taking Ginipral.

Verapamil is an international non-proprietary name with the active substance - verapamil hydrochloride. This category of medicines also includes: Finoptin, Isoptin.

The list of medicines is given for informational purposes and is not intended for self-treatment.

Increased uterine tone during gestation is a threatening condition, which is accompanied by pathological contractions of the uterine muscles. Without adequate treatment, this can result in miscarriage or early birth. Unfortunately, it is difficult to predict and even more so to prevent the development of this pathology. But if you seek medical help in time, you can avoid complications. In obstetric practice, Ginipral is used with great success. During pregnancy, many women are forced to take it in order to maintain their pregnancy or delay unplanned labor that has begun. This drug is completely allowed during pregnancy, but it has its own rules for taking and, of course, contraindications and various side effects. Therefore, let's take a closer look at the features of the use of Ginipral during pregnancy.

Features of the drug Ginipral for pregnant women: composition, therapeutic properties, dosage forms

Ginipral is a tocolytic agent that, due to the additional synthesis of norepinephrine, relaxes all smooth muscles, including the uterus. This inhibits the contractile activity of the uterus, reduces the manifestations of hypertonicity, helps the uterus to relax, which in combination prevents miscarriage or early birth.

Ginipral also suppresses pathological spontaneous contractions off schedule, which gives time to stimulate the accelerated development of the lungs in a child if a woman has a premature birth. Most often, a woman, against the background of the begun treatment, manages to convey the baby before the specified period.

The active component of the drug is hexoprynaline sulfate, which, at a stable concentration in the blood, provides a long-term therapeutic effect. At first, when hypertonicity appears, Ginipral concentrate is used to prepare liquid for infusion. After the woman's condition improves, Ginipral tablets are prescribed during pregnancy to keep the uterus relaxed.

Ginipral has high absorption properties. The tocolytic effect is manifested within 3-7 minutes after intravenous administration and lasts at least 30 minutes. The maximum effect is observed between 12 and 18 minutes after ingestion. The drug is excreted gradually over 7 days with urine and bile.

Ginipral is produced in three pharmaceutical forms with the same active substance, but different auxiliary elements.

Tablets Ginipral have a rounded shape, a white tint and are sold 10 pieces in a blister. In a tablet, in addition to 0.5 mg of hexoprynaline, there are:

lactose;
copovidone;
starch;
trilon B;
magnesium stearate;
glycerol;
talc.

Ginipral solution(for injections) goes on sale in hermetic ampoules of 2 ml. Each individual ampoule contains hexoprynaline at a concentration of 10 μg. They are already ready for use. Sold in a cardboard box of 5 pcs. Additionally, the drug contains:

purified water;
sodium sulfate;
disodium edetate.

Ginipral concentrate(for droppers) is a clear liquid with a high content of hexoprynaline (25 mcg). It must be diluted in liquid for injection and added to the solution for infusion. Among the excipients are:

sodium chloride;
sulfuric acid;
sodium pyrosulfate;
purified water.

The effect of Ginipral during pregnancy on the condition of the fetus

The drug is allowed during the gestation period, but it is not among the safe drugs. But in the event of hypertonicity, the use of Ginipral remains the only way to delay childbirth until a safe period and save the fetus.

Since Ginipral is actively absorbed in the intestines and instantly enters the bloodstream, it easily overcomes the placental barrier and enters the baby's blood. If you believe the data of the studies, long-term use of hexoprenaline negatively affects the baby's cardiovascular system. This can cause the following consequences:

pathological heart contractions;
difficulty breathing after delivery;
heart muscle defects;
anaphylactic shock on the first day after birth;
acidosis;
bronchospasm;
reduced glucose levels.

Important! Given the possible complications, Ginipral should be taken under the supervision of a doctor in a hospital setting and with constant monitoring of the child's condition.

Ginipral during pregnancy: what is the drug prescribed for

Tocolytic therapy with Ginipral is carried out in women between 22 and 36 weeks of gestation and in the absence of gynecological or medical contraindications.

Since the degree of therapeutic effect in different forms of Ginipral is different, the spectrum of indications is different for them.

The tablet form of Ginipral is indicated for the threat of early labor and is mainly used as a continuation of injection therapy. Maintenance dosage tablets ensure the normal condition of the uterus after stabilization of the myometrium. In the presence of moderate hypertonicity, it is possible to take only the tablet form without infusions.

Ginipral in the form of a solution and concentrate is indicated for the following conditions:

Short-term treatment of preterm labor without complications.
At the stage of turning over the baby, which is in a transverse presentation.
As an emergency measure when transporting a woman in labor.

Ginipral is also used for intravenous administration in case of tocolysis in a pregnant woman:

Acute tocolysis is a decrease in the frequency of contractions between 1 and 2 contractions in the presence of severe hypoxia in the fetus. By reducing the contractions of the uterus, the vessels dilate, and the fetus receives more oxygen.
Massive tocolysis - the cessation of intense contractions with the absolute opening of the neck.
Long-term tocolysis - stopping early labor at 20-34 weeks, as well as for immobilizing the uterus with cervical cerclage (suturing the uterine cervix to preserve pregnancy).

It should be noted that the use of Ginipral in the first trimester in obstetric practice does not occur. The fact is that the receptors that the drug affects are formed closer to the 20th gestational week, so taking Ginipral in the first three months does not give the desired result and can greatly harm the fetus. Therefore, other drugs are selected to eliminate hypertonicity in the 1st trimester.

Ginipral: instructions for use during pregnancy

Ginipral is a serious drug with many contraindications and side effects. Its reception occurs according to a certain scheme under the supervision of an obstetrician-gynecologist. Therefore, self-administration of the drug, a decrease / increase in the indicated dosage, or replacement of the drug with another analogue is strictly prohibited.

Dosage of Ginipral during pregnancy: dropper and tablets

Ginipral solution is administered intravenously. It is diluted in a solution of sodium chloride to obtain 10 mg of the agent, and then slowly administered by intravenous injection. The daily dose is 2 ampoules. To stabilize the condition after the jet injection of the solution, a concentrate for infusion is prescribed at a rate of 0.3 or 0.07 mcg / min.

After the hypertonicity and the frequency of contractions return to normal, the infusions are replaced by tablets. The intake of Ginipril in tablets should correspond to the following scheme: one hour before the end of the infusion of Ginipral, 1 tablet is drunk every 3 hours for 2 days. Then every 4-6 hours, but not more than 8 tablets per day. After stabilization of the condition, the daily dose is reduced to 2 tablets. The drug is taken orally as a whole, washed down with plain water.

Ginipral during pregnancy: instructions for drug withdrawal

Abrupt discontinuation of Ginipral tablets may have the opposite effect. Therefore, the reduction or cancellation of the drug is carried out gradually.

If you need to reduce the dose, 1 tablet is removed every two days. The remaining amount is taken at regular intervals. When the dose becomes equal to 2 tablets, you need to stop reducing it. On average, the drug should be taken up to 33 weeks of pregnancy and longer. If the condition worsens, the dose of the drug is also gradually increased.

The cancellation of Ginipral occurs in this way. If the daily dose was more than 6 tablets, you need to take one tablet less after two days. When 2-3 tablets remain, you need to reduce half a tablet every two days and so on until the drug is completely discontinued.

Contraindications to the use of Ginipral

The drug is not prescribed to patients with individual intolerance to hexoprenaline. Also, a complete contraindication is a negative reaction to beta-mimetics in the form of hypertension of the lung tissue, abnormalities in the work of the heart.

Ginepral is contraindicated in the following diseases and conditions:

The transfer of any disease up to 22 gestational weeks.
The use of the drug for tocolysis in the presence of coronary heart disease.
Threatened miscarriage in the 1st and 2nd trimester.
Cervical dilatation more than 4 cm.
Rupture of the amniotic membrane.
Any dangerous disease of the mother and fetus, in which it is dangerous to maintain pregnancy (vaginal bleeding, intrauterine infection, preeclampsia, placental abruption, renal failure).
The presence in the anamnesis of intrauterine death of the child, genetic abnormalities, diseases that led to the death of the fetus in the perinatal period.
Pathology of the cardiovascular system (tachycardia, myocarditis, etc.).
Exacerbation of bronchial asthma.
Hyperthyroidism.
Glaucoma.
Damage to the kidneys and liver.

Ginipral is used with extreme caution in parturient women with sulfate intolerance.

Features of the use of Ginipral

The drug in gynecology is prescribed only after assessing the ratio of benefits / harm to the fetus and woman. Moreover, treatment takes place only in medical institutions in order to constantly monitor the well-being of a woman and her baby.

During treatment, especially if tocolysis is prescribed, it is necessary to monitor the condition of the woman and the fetus. To do this, the following activities are carried out:

Control of heart rate and blood pressure. The entire period of taking Ginipral in a woman is accompanied by an increase in heart rate by 35-50 bpm. In order for the woman's condition to be stable, Ginipral is taken during pregnancy at a dosage that allows you to keep the contraction rate up to 120 bpm. at rest. With the intravenous administration of Ginipral, a woman's blood pressure can drop significantly, so at the time of the dropper, blood pressure indicators must be monitored.
Study of water-electrolyte balance and control of the respiratory system. Treatment with Ginipral can lead to extensive pulmonary edema. If a woman has a multiple pregnancy or is diagnosed with preeclampsia, then the risk of edema increases several times.
Measurement of glucose and lactose in the blood. Tocolytics cause an increase in glucose levels. If a woman is diabetic, the dose of stroke should be adjusted.
Prevention of hypokalemia. Ginipral affects the concentration of potassium in the blood serum. If there are clinical prerequisites for hypokalemia, therapy with potassium preparations is prescribed.

At the first symptoms of myocardial ischemia, treatment should be stopped.

Possible side effects after taking Ginipral

Widespread adverse reactions occur due to the pharmacological features of tocolytics. To prevent their occurrence, strict control of hemodynamic parameters (blood pressure, heart rate, dosage) is needed. After the end of treatment, all side effects disappear.

Against the background of taking Ginipral, the following undesirable reactions may occur:

Lipolysis (impaired fat metabolism).
Potassium deficiency.
Hyperkalemia (in patients with diabetes mellitus).
Violation of the central nervous system (tremor, headache, dizziness).
Problems with the work of the heart (tachycardia, hypotension, increased heart rate, angina pectoris).
Pulmonary edema.
Bronchospasm.
Problems in the gastrointestinal tract (nausea, constipation, impaired intestinal motility, vomiting).
Inflammation of the skin (rash, sweating, itching, redness).
Decreased daily diuresis.
Swelling of the extremities.

Pregnant women with asthma may become severely ill and may experience symptoms such as:

Protracted asthmatic attack.
Whistling during inhalation/exhalation.
Confused mind, shock.
Nausea, diarrhea.

Important! If Ginipral was used on the eve of childbirth, the newborn should be examined for hypokalemia and acidosis (ketone bodies).

What can replace Ginipral during pregnancy?

The pharmaceutical industry produces several analogues of Ginipral. Some of them have the same composition. These include Ipradol and Hexoprenaline. And there are also drugs with a different composition, but similar therapeutic properties - Magnesia, Salbutamol and Partusitsen.

Ginipral during pregnancy - reviews

Feedback on the drug Ginipral is mostly positive, because for pregnant women who were treated, he helped save the baby, postponing early birth. All positive reviews relate specifically to its rapid therapeutic effect and the ability to instantly eliminate intense uterine contractions, removing the threat of premature delivery.

However, among the positive qualities of the drug, women distinguish a number of disadvantages. Ginipral provoked side effects in almost all patients. But severe discomfort was noted only during the first 45 minutes after ingestion, and then passed without a trace. But such disadvantages of Ginipral are acceptable, especially against the background of the high efficiency of the remedy.

Thus, Ginipral is considered an active drug that allows a woman to bring her baby to a safe line.

How is childbirth going after taking Ginipral?

In women taking Ginipral, the process of delivery is different. The vast majority of women in labor successfully wait for contractions, and then give birth to babies calmly and without complications. This situation is typical for women who have been treated for severe uterine hypertension. As a rule, labor activity intensified, 3 weeks after the abolition of Ginipral.

A smaller number of women reach the 42nd gestational week, and without waiting for contractions, they are hospitalized. There, they stimulate the birth process in suitable ways. Often, against the background of full disclosure of the cervix and the absence of contractions, an emergency caesarean section is performed.

Despite the large list of contraindications and the risk of weak labor activity, Ginipral is considered one of the most effective tocolytic agents. Sometimes this drug is the only way to keep the pregnancy going. Therefore, if you are prescribed it, it is better to heed the advice of a doctor.

Ginipral and pregnancy. Video

Ginipral: instructions for use and reviews

Latin name: Gynipral

ATX Code: R03CC05

Active substance: hexoprenaline (hexoprenaline)

Manufacturer: MbH GLOBOPHARM Pharmazeutische Produktions- und Handelsgesellschaft (Austria), Takeda (Germany), GmbH Nycomed Austria (Austria)

Description and photo update: 10.07.2018

Ginipral is a drug that helps to reduce the tone and contractile activity of the myometrium.

Release form and composition

Ginipral is produced in the following dosage forms:

Tablets: white, biconvex, round (10 pieces in blisters, 2 blisters in a carton box);
Solution for intravenous administration: colorless, transparent (in ampoules of 2 ml, 5 ampoules in plastic trays, 1 or 5 trays in a cardboard box).

The composition of 1 tablet includes:

Active substance: hexoprenaline sulfate - 0.5 mg;
Auxiliary components: talc, corn starch, copovidone, lactose hydrate, disodium edetate dihydrate, magnesium stearate, glycerol palmitate stearate.

The composition of 1 ml includes:

Active substance: hexoprenaline sulfate - 0.005 mg;
Auxiliary components: disodium edetate dihydrate, sulfuric acid 2N (to maintain the pH level), sodium pyrosulfite, sodium chloride, water for injection.

Pharmacological properties

Pharmacodynamics

The action of the drug is based on the mechanisms of selective stimulation of β 2 -adrenergic receptors and activation of adenylate cyclase, followed by an increase in the production of cyclic adenosine monophosphate, which stimulates the calcium pump, which redistributes calcium ions (Ca 2+) in myocytes and reduces its concentration in myofibrils. Expands blood vessels, bronchi, reduces the tone and contractile activity of the myometrium, resulting in improved uteroplacental blood flow. Stimulates glycogenolysis.

Due to β 2 -selectivity, Ginipral slightly affects the blood flow and cardiac activity of the pregnant woman and the fetus. When it is taken, the tone decreases, the intensity and frequency of uterine contractions decreases, including their complete cessation, which allows you to prolong pregnancy until the onset of timely delivery.

When administered intravenously, hexoprenaline inhibits oxytocin-induced and spontaneous labor pains, and normalizes irregular and excessively strong contractions during childbirth.

With intravenous administration, the tocolytic effect of the drug begins immediately after the injection and lasts about 20 minutes. The effect of the drug is maintained by subsequent long-term intravenous infusion.

Pharmacokinetics

absorption: after oral administration, from 5 to 11% of hexoprenaline is absorbed from the gastrointestinal tract. The time to reach maximum concentration is approximately 2 hours;
distribution: data on the distribution of the active substance in the human body are not available. When conducting animal studies in the case of intravenous administration, significant concentrations of hexoprenaline were found in skeletal muscles, kidneys, liver, and to a lesser extent in the myocardium and brain;
metabolism: hexoprenaline is metabolized by catechol-O-methyltransferase to mono-3-O-methyl-hexoprenaline and to di-3-O-methyl-hexoprenaline;
elimination: when taken orally, the elimination half-life is about 50 minutes. Up to 90% of the drug is excreted through the intestines, up to 5% - by the kidneys in the form of glucuronides. With intravenous administration, the elimination half-life is about 25 minutes. For 1 day, approximately 44% of the dose of hexoprenaline is excreted by the kidneys, and about 5% through the intestines. Over the next 8 days, these figures are respectively 54% and 15.5%. At the initial stage, both free hexoprenaline and methylated metabolites, sulfates and conjugates of both metabolites with glucuronic acid are excreted by the kidneys. In the urine after 2 days, only di-3-O-methyl-hexoprenaline is detected. Approximately 10% of the dose is excreted in the bile, mainly conjugates of O-methylated metabolites. Some reabsorption takes place in the intestines, since less of the substance is excreted in the feces than is found in the bile.

Indications for use

According to the instructions, Ginipral in the form of a solution for injection is prescribed in the following cases:

Massive tocolysis: for inhibition of premature labor pains in the opening of the cervix of the uterus and / or the presence of a flattened cervix;
Acute tocolysis: as an emergency measure for preterm labor before delivery of the pregnant woman to the hospital; to inhibit labor pains during childbirth during immobilization of the uterus before caesarean section, acute intrauterine asphyxia, complicated labor, prolapse of the umbilical cord, and also before turning the fetus from a transverse position;
Prolonged tocolysis: for the prevention of preterm labor with frequent or intensified contractions without opening the cervix or smoothing the cervix; with immobilization of the uterus before, during and after cervical cerclage.

Ginipral in the form of tablets is used for the threat of premature birth (most often as a continuation of infusion therapy).

Contraindications

tachyarrhythmias;
thyrotoxicosis;
Aortic stenosis and mitral valve disease;
Myocarditis;
Severe kidney and liver diseases;
Arterial hypertension;
Coronary heart disease;
Premature placental abruption, uterine bleeding;
Intrauterine infections;
Angle-closure glaucoma;
lactation period (breastfeeding);
Hypersensitivity to the components of the drug (especially in patients with bronchial asthma and a history of hypersensitivity to sulfites).

During pregnancy, Ginipral is contraindicated in the first trimester.

Instructions for use Ginipral: method and dosage

The solution is administered intravenously slowly over 5-10 minutes. The doctor selects the dose individually. A dropper of Ginipral is placed after dilution to 10 ml with isotonic sodium chloride solution using automatic dosing infusion pumps or conventional infusion systems.

The scheme of application of Ginipral droppers is determined by the indications:

Massive tocolysis: the introduction of Ginipral begins with 0.01 mg (1 ampoule of 2 ml) followed by infusion at a rate of 0.0003 mg per minute. It is also possible to use the drug infusion without prior bolus administration;
Acute tocolysis: the drug is used at a dose of 0.01 mg. If necessary, further therapy can be continued with the help of infusions;
Long-term tocolysis: Ginipral is prescribed as a long-term drip infusion at a rate of 0.000075 mg per minute.

If the resumption of contractions does not occur within 48 hours, treatment is continued with Ginipral tablets.

Ginipral tablets are taken orally with a small amount of water.

With the threat of premature birth, Ginipral is prescribed at a dose of 0.5 mg (1 tablet) 1-2 hours before the end of the infusion.

First take 1 tablet every 3 hours, then every 4-6 hours. The daily dose is from 4 to 8 tablets (2-4 mg).

Side effects

Central and peripheral nervous system: dizziness, headache, slight tremor of the fingers, anxiety;
Digestive system: rarely - vomiting, nausea, inhibition of intestinal motility, a temporary increase in the level of transaminases, intestinal obstruction (it is recommended to control the regularity of the stool);
Cardiovascular system: tachycardia in the mother (in most cases, the heart rate of the fetus remains unchanged), arterial hypotension (usually diastolic); rarely - cardialgia (usually after discontinuation of the drug quickly disappear), rhythm disturbances (ventricular extrasystole);
Laboratory indicators: hypocalcemia at the beginning of treatment, hypokalemia, increased blood glucose levels;
Allergic reactions: bronchospasm, difficulty breathing, impaired consciousness up to coma, anaphylactic shock (in patients with bronchial asthma or hypersensitivity to sulfites);
Other: oliguria, increased sweating, edema (especially in patients with kidney disease).

In newborns, side effects can manifest as acidosis and hypoglycemia.

Overdose

Symptoms: anxiety, tremor, increased sweating, dizziness, headaches, arrhythmia, tachycardia, cardialgia, shortness of breath, lowering blood pressure.

Therapy: symptomatic treatment. As antidotes, non-selective beta-blockers are prescribed, which completely neutralize the effect of Ginipral. This should take into account the risk of developing bronchospasm in the treatment of patients suffering from bronchial asthma.

special instructions

Patients with hypersensitivity to sympathomimetics are recommended to prescribe small doses of Ginipral, which the doctor selects individually. Also, such patients need constant medical supervision.

With a significant increase in the heart rate in the mother (more than 130 beats per minute) or / and with a pronounced decrease in blood pressure, the dose of the drug should be reduced.

If there are signs of heart failure, pain in the region of the heart and shortness of breath, the use of Ginipral should be stopped immediately.

During therapy, especially in the initial period, an increase in plasma glucose is possible, and therefore, in mothers with diabetes, carbohydrate metabolism should be monitored. If childbirth occurs immediately after the course of treatment, the possibility of developing acidosis and hypoglycemia in the newborn should be considered, which is associated with transplacental penetration of ketone and lactic acids.

When using Ginipral, diuresis decreases, so you need to carefully monitor the signs of fluid retention in the body.

Sometimes the simultaneous use of glucocorticosteroids during Ginipral infusions can lead to pulmonary edema. Therefore, infusion therapy requires constant monitoring of the condition of patients. This is especially important in combined treatment with glucocorticosteroids in patients with kidney disease. It is necessary to strictly limit excess fluid intake. Due to the risk of possible development of pulmonary edema, the volume of infusions should be limited as far as possible. It is also recommended to limit salt intake in the diet.

During the period of use of the drug, you need to monitor the regularity of bowel activity.

Before starting tocolytic treatment, potassium preparations should be taken, since the effect of sympathomimetics on the myocardium during hypokalemia is enhanced.

Simultaneous use of sympathomimetics and general anesthesia agents (halothane) can cause cardiac arrhythmias. Therefore, before using halothane, therapy with Ginipral should be discontinued.

With prolonged tocolytic therapy, it is necessary to monitor the state of the fetoplacental complex. It is also necessary to make sure that there is no placental abruption, the clinical symptoms of which can be smoothed out against the background of tocolytic therapy. With the opening of the cervix by more than 2-3 cm and the rupture of the fetal bladder, the use of Ginipral is ineffective.

When carrying out tocolytic treatment with the use of beta-agonists, it is possible to increase the symptoms of concomitant dystrophic myotonia. In these cases, the use of diphenylhydantoin (phenytoin) preparations is recommended.

It is possible to increase the side effects of Ginipral when it is taken in the form of tablets with coffee or tea.

Use during pregnancy and lactation

Ginipral during pregnancy is contraindicated before the 20th week of pregnancy. From the 20th week of pregnancy, it is allowed to use the drug according to indications.

When breastfeeding, Ginipral is contraindicated.

For impaired renal function

In severe kidney disease, Ginipral is contraindicated.

For impaired liver function

In severe liver diseases, Ginipral is contraindicated.

drug interaction

With the simultaneous use of Ginipral with certain drugs, undesirable effects may occur:

Beta-blockers: weakening or neutralization of the action of Ginipral;
Oral hypoglycemic drugs: weakening their action;
Methylxanthines (including theophylline): increased effectiveness of Ginipral;
Glucocorticosteroids: decrease in the intensity of glycogen accumulation in the liver;
Other drugs with sympathomimetic activity (bronchodilators and cardiovascular drugs): the appearance of symptoms of an overdose and an increase in the effect of these drugs on the cardiovascular system;
Fluorotan and beta-adrenergic stimulants: increased side effects of Ginipral on the part of the cardiovascular system.

Ginipral is incompatible with tricyclic antidepressants, monoamine oxidase (MAO) inhibitors, ergot alkaloids, as well as with drugs containing vitamin D and calcium, mineralocorticoids and dihydrotachysterol.

Sulfite is a highly active component, so Ginipral should not be mixed with any other solutions, except for 5% glucose (dextrose) solution and isotonic sodium chloride solution.

Analogues

Analogues of Ginipral are: Ipradol, Metacin, Nifedipine, Magne B6, Hexoprenaline, Parusisten, Yutopar.

Terms and conditions of storage

Store at a temperature of 18-25 ° C, protected from light, out of the reach of children.

Best before date:

Solution for intravenous administration - 3 years;
Tablets - 5 years.

Even a properly planned pregnancy in absolutely healthy partners does not always proceed without any disturbances and problems, to say nothing of unprepared expectant mothers. The most common problem that occurs in every third pregnant woman is uterine hypertonicity. There are many factors that can cause this condition, and if you do not treat it, the consequences can be the most dangerous, up to abortion or premature birth. To avoid such threatening consequences, the doctor may prescribe droppers with Ginipral. Why is the drug prescribed during pregnancy, and how does it affect its preservation?

In contact with

Starting from the second trimester of pregnancy, Ginipral is used to reduce uterine hypertonicity. It affects not only the vessels of the uterus and placenta, but also the cells of the uterus, which leads to a decrease in the tone and amplitude of contractions, relaxation of blood vessels, blood supply to the fetus and placenta improves.

In acute cases, when there is an acute danger of premature birth, it is prescribed only intravenously, and a very large dose of Ginipral is immediately given - up to 10 mcg, the drug is administered within 8-9 minutes using a special invasive system. To do this, several ampoules of the drug are diluted with sterile saline - 8 ml of NaCl is taken for each ampoule. If several ampoules were administered at once for a single dose, then the time for which the drug should be administered is calculated as follows: number of ampoules * for 10 minutes. For drip administration, the content of two ampoules of 25 μg is diluted in a 5% glucose solution or in a NaCl solution (500 ml), the drug should be administered at a rate of:

1 ampoule - 120 drops per minute (k / min),
2 ampoules - 60 k / min,
3 ampoules - 40k / min,
4 ampoules -30 k / min.

Intravenously, if necessary, the drug can be administered every 4 hours, if within two days the hypertonicity of the uterus does not resume, then the woman begins to take Ginipral in the form of tablets. The drug is administered intravenously only for 48 hours, as a rule, if the contractions do not stop, the question is raised about the advisability of maintaining the pregnancy.

In the event that the doctor decides to transfer the woman from the intravenous administration of Ginipral to the tablet form, then the pregnant woman should take the first tablet no later than 2-3 hours before the end of intravenous therapy. Instructions for use of Ginipral tablets are as follows:

first dose - 1 piece,
after 3 hours - 1 piece,
after, every 4-6 hours, 1 piece.

Thus, a woman should take 4 to 8 tablets per day. In the event that their daily intake gives a good result, and the hypertonicity of the uterus stops, then the dosage is reduced to two pieces. The dose should be reduced carefully - every two days a woman reduces the intake by 1 tablet, and the rest should be taken at regular intervals, the minimum dosage is 2 pieces within 24 hours, as a rule, she will take them until 33-34 weeks. In the event that the threat of premature birth remains, then the dosage will be up to 6 tablets of Ginipral.

Attention. Cancellation of the drug should occur gradually, if you do it abruptly, you can provoke premature birth.

If initially a woman was prescribed to take 4 tablets per day, then their dosage should be reduced as follows: during every third day of administration, the dosage is reduced by ½ tablet, and the remaining dosage is divided into equal parts and taken at regular intervals. In any case, the complete abolition of the drug does not begin before 30 weeks. This is done so that the uterus can recover for the necessary generic tone. In the event that intravenous administration was not carried out, then Ginipral can be prescribed from any period of time, but not earlier than 20 weeks.

Important! While taking the tablets, you need to drink them with a small amount of water, the time of eating does not affect the effect of the drug.

If a woman follows the instructions while taking Ginipral and the dosage is not exceeded, then the possibility of adverse reactions is minimized. The effectiveness of the drug can be significantly reduced if it is used with drugs to lower blood sugar levels, but the effect of the drug will increase if it is used together with Theophylline. Ginipral should not be administered together with beta-blockers. In the event that bronchodilators are taken simultaneously with it, then the following side effects may occur:

headaches and dizziness;
violation of intestinal motility;
intestinal obstruction;
swelling;
heavy sweating;
insomnia;
hypoglycemia;
arrhythmia;
tachycardia;
bradycardia;
hand tremor.

Unfortunately, the drug can have a negative effect on the newborn, so he may experience bronchospasm, acidosis, heart rate fluctuations, hypoglycemia.

Important! If you sing the tablets with tea or coffee, then the likelihood of side effects increases.

Sometimes a side effect of Ginipral is a decrease in labor activity in the expectant mother, which leads either to stimulation or delivery by caesarean section, but such cases are extremely rare.

There are times when it becomes necessary to search for an analogue for Ginipral. Full analogues of the drug, that is, they also contain the active substance - hexoprenaline, are:

Hexoprenaline;
Ipradol.

The only differences between these medicines are the names and the pharmaceutical company.

Important! The decision to prescribe Ginipral, as well as its analogues, can only be taken by a gynecologist, it is forbidden to replace the drug even with its full analogue.

Preparations with hexoprenaline are not the only means that can be used to relieve uterine hypertonicity. The following tools can also be used to alleviate anxiety:

parsusisten;
Fenoterol;
Salbutamol;
Magnesium sulfate 25%.

In pregnant women with diseases of the cardiovascular system, Nifedipine can be used.

Find out also if the drug is allowed for gargling and rinsing the nose.

Why you can not take Tavegil tablets in an interesting position, we will tell in the next.

How to use Proctosan and is it possible during pregnancy:.

Complications during pregnancy are unpredictable. One of the dangerous conditions is uterine hypertonicity, in which there is a threat of miscarriage or premature birth. In a similar situation, women are prescribed the drug ginipral - intravenously or in the form of tablets.

Uterine tone

The uterus during gestation should be in a relaxed state, however, its functioning may be impaired. What is uterine hypertonicity? In this condition, the muscles contract either continuously or intermittently. Why is this happening? Hypertonicity of the uterus may be due to psychological reasons:

inactive lifestyle;
bad habits of the expectant mother;
stress and excessive hassle;
other reasons.

A pregnant woman should get enough sleep and not overexert herself. Chronic sleep deprivation can cause unplanned uterine muscle contractions. Harmful influences on the tone of the uterus include unfriendly relationships in the family, early abortions and early pregnancy (up to 18 years). Also, hypertonicity can occur in women after 35 years of age during their first pregnancy. Unfavorable factors include influenza, SARS during gestation, and a history of inflammatory processes.

Also, hypertonicity can be caused by physiological reasons:

malformations;
multiple pregnancy;
endometriosis of the uterus;
uterine myoma;
somatic diseases;
genetic feature;
immune deficiency;
endocrine diseases.

Until the four-week gestation period, this pathology is treated with hormonal drugs. At a later date, ginipral is prescribed - intravenously or in tablets. Also, the drug is prescribed during labor with uneven and too intense contractions.

Survey

Untimely contraction of muscle fibers is fraught not only with miscarriage, but also with oxygen starvation of the fetus. Such a pathology affects the normal development of the fetus, prevents the intake of nutrients and can cause irreversible changes.

For a woman, muscle contraction can cause pain, cause spotting, and make you feel unwell. How to independently determine hypertonicity? Symptoms of this pathology are:

cramping abdominal pain;
drawing pains in the base of the back;
a characteristic feeling of tension in the abdomen;
"petrification" of the abdomen.

If these signs are accompanied by bloody or brown discharge, the pathology is obvious. An urgent examination is needed, after which the doctor will prescribe ginipral tablets / intravenously.

Medical diagnostic methods include:

vaginal examination;
hardware research.

Important! Drawing pain in the abdomen is not a symptom of a complication. Pathology is accompanied by other signs of disease or abnormality. Pain in the first half of pregnancy may be due to the growth of the uterus.

Prescribing the drug

Ginipral is prescribed after the 20th week of pregnancy in case of pathology. Tablets are drunk to prevent uterine contractions, a dropper is placed in case of emergency assistance with the threat of miscarriage. The drug in the form of tablets is taken for a long course of up to two months. In case of improvement in muscle condition, the dosage of the drug is adjusted.

Important! It is forbidden to use the drug ginipral alone during pregnancy without consulting a gynecologist.

The course of therapy is calculated individually. Sometimes the uterus returns to normal after a month of taking the drug, sometimes treatment is required for the entire second half of pregnancy. It depends on the individual state of the woman's organ and the characteristics of the course of pregnancy. With the normalization of the tone of the uterus, the drug is gradually reduced in dosage.

Important! It is forbidden to abruptly stop the use of ginipral in order to avoid recurrence of the complication.

During the course of treatment with Ginipral, the state of the pulse and blood pressure of the woman and fetus should be checked. The doctor prescribes an electrocardiogram to check the mother's cardiac activity, and CTG is performed to monitor the condition of the fetus. With an increase in the woman's pulse, the dosage of the drug is reduced.

Important! The drug ginipral increases blood glucose, so chronic diabetics should measure their sugar levels regularly.

The introduction of the drug during pregnancy reduces the amount of urine excreted. This is normal. You should not get carried away with liquids to increase the rate of excreted urine: you need to consume liquid in a volume of 2.5 liters in essence.

With the appearance of shortness of breath and disruption of the heart, the drug is immediately canceled. This may be an indicator of a drug overdose. Overdose symptoms are:

arrhythmia and tachycardia;
intense sweating;
trembling of the fingers;
pressure drop;
heartache;
headaches.

To eliminate an overdose, antagonists are used - drugs that eliminate the effect of ginipral. These funds are prescribed by the attending gynecologist.

The action of the drug and side effects

The effectiveness of the drug ginipral decreases when interacting with certain medical agents. Ginipral is not prescribed simultaneously with beta-blockers. An increase in the effect of this drug was also noted when taken together with Theophylline.

The drug reduces the effectiveness of drugs against high blood sugar. When combined with bronchodilators, it produces side effects. Side effects include:

dizziness and pain in the head;
decreased bowel tone (constipation);
intestinal obstruction;
swelling and decreased urine;
active sweating;
anxiety and sleep disturbance;
disruption of the heart;
trembling of the fingers.

Also, side effects can be noted in the newborn: bronchospasm, acidosis, etc. Sometimes there is a decrease in labor activity in women in labor who took this drug: they are prescribed stimulation or caesarean section. However, complications in labor activity are also found in women who did not take ginipral.