Estradiol/progesterone
Pharmaceutical combination
Pharmaceutical compound
Estradiol/progesterone (E2/P4 ), sold under the brand name Bijuva among others, is a combined estrogen and progestogen medication which is used in the treatment of menopausal symptoms in postmenopausal women .[ 3] It contains estradiol , an estrogen, and progesterone , a progestogen, and is available in both oral and intramuscular formulations .[ 3] E2/P4 differs from other estrogen–progestogen formulations in that the sex-hormonal agents used are bioidentical .[medical citation needed ]
Estradiol/progesterone is an oral combination of estradiol (E2), an estrogen , and progesterone (P4), a progestogen , which was developed by TherapeuticsMD and is approved in the United States for the treatment of menopausal symptoms in women.[ 4] [ 5] It is also under development for the treatment of endometrial hyperplasia in women.[ 4] The medication contains 2 mg solubilized E2 and 200 mg P4 in each gelatin capsule .[ 5] [ 3] It is the first combination of E2 and P4 in oral capsule form that has been developed for clinical use.[ 5] Bijuva is currently in phase III clinical trials for endometrial hyperplasia.[ 4] The medication was approved by the Food and Drug Administration for the treatment of menopausal symptoms in October 2018.[ 4] [ 6] [ 3] It is available as a generic medication .[ 7]
E2/P4 is available as an aqueous suspension of E2 and P4 encapsulated in microspheres for use by intramuscular injection under the brand name Juvenum in Mexico.[ 8] [ 9] [ 10] It was introduced for the treatment and prevention of menopausal symptoms like hot flashes , vulvovaginal symptoms, and osteoporosis in December 2014.[ 8] [ 9] The combination contains relatively low doses of E2 and P4 (1 mg and 20 mg, respectively) contained within microspheres that results in a slower release of the hormones.[ 8] [ 9] Studies of this formulation have been published.[ 11] [ 12]
E2/P4 with 5 mg E2 and 150 to 300 mg P4 encapsulated in microspheres in an aqueous suspension has been studied as a once-a-month combined injectable contraceptive but has not been further developed or introduced for medical use.[ 13] [ 14] [ 15] [ 16] [ 17] E2/P4 with 5 mg E2 and 100 mg P4 in a macrocrystalline aqueous suspension has also been studied as a once-a-month combined injectable contraceptive, but likewise was not further developed.[ 18] [ 19]
Research
As of April 2022, a vaginal ring containing E2/P4 (developmental code names DARE-HRT1 and JNP-0201 ) is under development for use in menopausal hormone therapy.[ 20]
References
^ "Bijuva (Theramex Australia Pty Ltd)" . Therapeutic Goods Administration (TGA) . 22 September 2022. Archived from the original on 12 March 2023. Retrieved 29 April 2023 .
^ "Bijuva Product information" . Health Canada . 25 April 2012. Archived from the original on 6 June 2022. Retrieved 5 June 2022 .
^ a b c d e "Bijuva- estradiol and progesterone capsule" . DailyMed . 30 June 2021. Archived from the original on 12 March 2023. Retrieved 12 March 2023 .
^ a b c d "Estradiol/Progesterone - TherapeuticsMD - AdisInsight" . Archived from the original on 22 October 2016. Retrieved 21 October 2016 .
^ a b c Pickar JH, Bon C, Amadio JM, Mirkin S, Bernick B (2015). "Pharmacokinetics of the first combination 17β-estradiol/progesterone capsule in clinical development for menopausal hormone therapy" . Menopause . 22 (12): 1308– 16. doi :10.1097/GME.0000000000000467 . PMC 4666011 . PMID 25944519 .
^ "Bijuva (Estradiol and progesterone) FDA Approval History" . Archived from the original on 3 November 2018. Retrieved 3 November 2018 .
^ "First Generic Drug Approvals" . U.S. Food and Drug Administration . 17 October 2022. Archived from the original on 26 January 2021. Retrieved 28 November 2022 .
^ a b c "Juvenum (estradiol/progesterone) - Medicamentos PLM" . Medicamentos PLM . Archived from the original on 18 September 2018. Retrieved 17 September 2018 .
^ a b c "Estradiol/Progesterone injection - Laboratorios Carnot - AdisInsight" . Archived from the original on 29 August 2021. Retrieved 23 December 2017 .
^ "Juvenum - Drugs.com" . Archived from the original on 23 December 2017. Retrieved 23 December 2017 .
^ Cortés-Bonilla M, Alonso-Campero R, Bernardo-Escudero R, Francisco-Doce MT, Chavarín-González J, Pérez-Cuevas R, Chedraui P (October 2016). "Improvement of quality of life and menopausal symptoms in climacteric women treated with low-dose monthly parenteral formulations of non-polymeric microspheres of 17β-estradiol/progesterone". Gynecol. Endocrinol . 32 (10): 831– 834. doi :10.1080/09513590.2016.1183628 . PMID 27187320 . S2CID 22688585 .
^ Cortés-Bonilla M, Bernardo-Escudero R, Alonso-Campero R, Francisco-Doce MT, Hernández-Valencia M, Celis-González C, Márquez-Oñate R, Chedraui P, Uribe JA (July 2015). "Treatment of menopausal symptoms with three low-dose continuous sequential 17β-estradiol/progesterone parenteral monthly formulations using novel non-polymeric microsphere technology" . Gynecol. Endocrinol . 31 (7): 552– 9. doi :10.3109/09513590.2015.1019853 . PMC 4776687 . PMID 26062108 .
^ Toppozada MK (April 1994). "Existing once-a-month combined injectable contraceptives". Contraception . 49 (4): 293– 301. doi :10.1016/0010-7824(94)90029-9 . PMID 8013216 .
^ Garza-Flores J (April 1994). "Pharmacokinetics of once-a-month injectable contraceptives". Contraception . 49 (4): 347– 59. doi :10.1016/0010-7824(94)90032-9 . PMID 8013219 .
^ Bagade O, Pawar V, Patel R, Patel B, Awasarkar V, Diwate S (2014). "Increasing use of long-acting reversible contraception: safe, reliable, and cost-effective birth control" (PDF) . World J Pharm Pharm Sci . 3 (10): 364– 392. ISSN 2278-4357 . Archived (PDF) from the original on 10 August 2017. Retrieved 18 September 2018 .
^ Newton JR, D'arcangues C, Hall PE (1994). "A review of "once-a-month" combined injectable contraceptives". J Obstet Gynaecol (Lahore) . 4 (Suppl 1): S1–34. doi :10.3109/01443619409027641 . PMID 12290848 .
^ Garza-Flores J, Hall PE, Perez-Palacios G (1991). "Long-acting hormonal contraceptives for women". J. Steroid Biochem. Mol. Biol . 40 (4– 6): 697– 704. doi :10.1016/0960-0760(91)90293-E . PMID 1958567 . S2CID 26021562 .
^ Alvarez-Sanchez F, Brache V, Faundes A (December 1993). "Recent experience with and future directions of contraceptive implants and injectable contraceptives". Current Opinion in Obstetrics & Gynecology . 5 (6): 805– 814. doi :10.1097/00001703-199312000-00016 . PMID 8286694 .
^ Garza-Flores J, Fatinikun T, Hernandez L, Ramos I, Cardenas M, Menjivar M (July 1991). "A pilot study on the assessment of a progesterone/estradiol sustained release as once-a-month-injectable contraceptive". Contraception . 44 (1): 45– 59. doi :10.1016/0010-7824(91)90105-O . PMID 1893701 .
^ "Estradiol/Progesterone intravaginal ring - Dare Bioscience" . AdisInsight . Springer Nature Switzerland AG. Archived from the original on 29 April 2023. Retrieved 29 April 2023 .
Estrogens
ER Tooltip Estrogen receptor agonists
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Certain androgens /anabolic steroids (e.g., testosterone , testosterone esters , methyltestosterone , metandienone , nandrolone esters ) (via estrogenic metabolites)
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Estradiol
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RU-16117
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Agonists Antagonists Unknown
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RU-2309
Tetrahydrogestrinone
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Trenbolone esters (e.g., trenbolone acetate , trenbolone enanthate )
Trendione
Trestolone
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Mixed (SPRMs Tooltip Selective progesterone receptor modulators ) Antagonists
mPR Tooltip Membrane progesterone receptor (PAQR Tooltip Progestin and adipoQ receptor )