Ovestinon

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Ovestinon uses



NADA 141-325, Approved by FDA

For Oral Use in Dogs Only

CAUTION

Federal law restricts this drug to use by or on the order of a licensed veterinarian.

DESCRIPTION

Ovestinon (estriol) Tablets contain 1 mg of Ovestinon per tablet.

USP Chemical Name: Estra-1,3,5(10)-triene-3,16,17-triol, (16α,17β)-.

USP Molecular Weight: 288.38

USP Solubility: Soluble in acetone, in chloroform, in dioxane, in ether, and in vegetable oils; sparingly soluble in alcohol; insoluble in water.

Chemical Structure

INDICATION

Ovestinon Tablets are indicated for the control of estrogen-responsive urinary incontinence in ovariohysterectomized female dogs.

DOSAGE AND ADMINISTRATION

The dose of Ovestinon Tablets is not dependent upon body weight. All dogs should receive an initial dose of 2 mg Ovestinon Tablets (2 tablets) orally once per day for a minimum of 14 days. After urinary incontinence is controlled, the lowest effective daily dose of Ovestinon Tablets should be determined by decreasing the dose in a step-wise manner from 2 mg once daily (2 tablets) to 1 mg once daily (1 tablet), then 0.5 mg once daily (1/2 tablet) depending upon the response of the individual dog. There should be a minimum of 7 days between each dose adjustment. After the lowest daily dose that controls urinary incontinence is identified, the dose may be decreased further by administering once every two days. Dogs should not receive more than 2 mg Ovestinon Tablets per day (2 tablets). If the dog does not respond to 2 mg of Ovestinon Tablets per day, the diagnosis should be re-assessed.

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WARNINGS

Human Warnings

Not for human use. Keep out of the reach of children. Women who are of child-bearing age or those who are breastfeeding should use caution when administering Ovestinon Tablets. Wash your hands with soap and water after administration to avoid exposure to the drug. Consult a physician in case of accidental ingestion by humans.

Animal Warnings

Some estrogens have been associated with bone marrow changes and an increased risk of mammary tumors. However, target animal safety study results and foreign post-market pharmacovigilance data for Ovestinon Tablets have shown that estriol-treated dogs are at low risk for developing these conditions.

PRECAUTIONS

Evaluation of factors contributing to urinary incontinence should be considered prior of administration of Ovestinon Tablets.

Do not use with other estrogens. The concomitant use of Ovestinon

Tablets with other estrogens has not been evaluated.

The concomitant use of Ovestinon Tablets with glucocorticoids has not been evaluated.

The use of Ovestinon Tablets in dogs with liver disease has not been evaluated.

The safe use of Ovestinon Tablets has not been evaluated in intact female dogs, pregnant or lactating dogs, male dogs, and dogs less than 1 year of age.

ADVERSE REACTIONS

In the initial phase of a placebo-controlled field study conducted to determine effectiveness, 115 of 226 dogs were dosed with Ovestinon Tablets orally at 2 mg per day for 14 days. Adverse reactions during the first study phase included primarily gastrointestinal and estrogenic effects, as summarized in Table 1.

Adverse Reaction Ovestinon Tablet Group % of dogs

Placebo Group % of dogs

(n = 111)

Anorexia 13.0% 3.6%
Emesis 9.6% 6.3%
Polydipsia 7.0% 7.2%
Swollen vulva 4.3% 0.0%
Anxiety 3.5% 2.7%
Sexual attractiveness 3.5% 1.8%
Somnolence 1.7% 0.0%
Hypersalivation 1.7% 0.0%
Estrous behavior 0.9% 0.0%
Mammary hyperplasia 0.9% 0.0%

In the second phase of the field study, all dogs received treatment with Ovestinon Tablets from Day 14 to Day 42; the drug dose was adjusted up or down (not to exceed 2 mg per day) at weekly intervals depending on whether urinary incontinence was controlled. Table 2 summarizes reported adverse reactions in dogs treated with Ovestinon Tablets during the second study phase. Adverse reactions tended to lessen when dogs received lower drug doses. One dog that received 10 doses of Ovestinon was removed due to suspected uterine stump pyometra. The relationship between this adverse reaction and Ovestinon Tablets could not be determined.

Adverse Reaction Ovestinon Tablets Group % of dogs

(n = 224)

Anorexia 12.9%
Emesis 7.6%
Licking vulva 4.5%
Swollen vulva 4.0%
Vulvovaginitis 4.0%
Lethargy 4.0%
Polydipsia 3.6%
Aggression 1.8%
Hyperactivity 1.8%
Cystitis 1.3%
Anxiety 0.9%
Mammary hyperplasia 0.9%
Somnolence 0.9%
Estrous behavior 0.9%
Sexual attractiveness 0.4%
Alopecia (local) 0.4%

Extended-use studies continued after the field studies involving more than 300 dogs. Additional adverse reactions to those seen in the field studies included hyperpigmentation and lichenification of the vulva. Also, 3 dogs receiving Ovestinon Tablets were euthanized due to aggressive behavior.

Foreign market experience

Foreign post-market pharmacovigilance data for Ovestinon Tablets were collected from the years 2000 through 2010 by Intervet, Inc. Approximately 20% of reported adverse events were for local or general alopecia. Vaginal hemorrhage, possible stump pyometra, an increase in epileptic seizures, and anemia, leukopenia, and thrombocytopenia were seen in 1 or more dogs. Other adverse events reported were similar to those seen during the US studies.

For technical assistance or to report suspected adverse reactions call Intervet at 1-800-224-5318. For a copy of the Material Safety Data Sheet (MSDS), call 1-800-770-8878.

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CLINICAL PHARMACOLOGY

Ovestinon is a natural estrogen. Estrogens increase the resting muscle tone of the urethra in females and can be used to treat female dogs with urinary incontinence due to estrogen depletion. Ovestinon is rapidly absorbed after oral administration. It has a high affinity for receptors in cells of the lower urogenital tract, but a short receptor occupancy time that limits the undesirable effects of endometrial proliferation, skeletal muscle growth, and bone marrow suppression associated with long-term estrogen-estrogen receptor binding.

As one of the three naturally occurring estrogens, Ovestinon is a lipophilic compound that can passively diffuse through cell membranes and bind to estrogen receptors in the nucleus to regulate gene expression. After an oral dose of 2 mg/dog/day in fed female dogs, Tmax occurred between 0.5-2 hrs (average 0.8 hrs) with corresponding Cmax values of 220-1150 pg/mL (average 650 pg/mL). Entero-hepatic recirculation and drug reabsorption may cause a second concentration peak in plasma around 4-12 hrs after dosing. Its elimination T½ ranges from 8 to 12 hours based on a multiple oral dose study in 6 adult female dogs.

However, the apparent Ovestinon recycling observed in most dogs produced multiple peaks that confound the accurate determination of T½. The effect of prandial state on oral Ovestinon bioavailability has not been evaluated. Repeated oral administration may result in elevated Ovestinon systemic exposure.

EFFECTIVENESS

A multi-site, masked, placebo-controlled field study was conducted to evaluate the effectiveness of Ovestinon Tablets. Two hundred and twenty-six client-owned, ovariohysterectomized female dogs 1 year of age or older with at least 3 episodes of urinary incontinence each week were randomly allocated to receive either Ovestinon Tablets or placebo. Two hundred and six dogs (106 treated with Ovestinon Tablets and 100 treated with placebo) from 22 sites were evaluated for effectiveness. Each dog was dosed orally with either two 1 mg tablets of Ovestinon Tablets or two tablets of placebo once per day for 14 days. During treatment, owners recorded the frequency of urinary incontinence episodes daily, and investigators rated response to treatment weekly (continent/improved or no change/worse). Treatment success was based upon response to treatment and a targeted reduction in the frequency of urinary incontinence episodes at Day 14 compared to Day 0. The proportion of dogs achieving treatment success was statistically significantly greater (p = 0.0038) in the group treated with Ovestinon Tablets (66%) than in the placebo-treated group (37%) at Day 14.

A second phase of the study evaluated decreasing doses of Ovestinon Tablets to control urinary incontinence. After Day 14, all dogs (224) received 2 tablets of Ovestinon Tablets (2 mg) orally once per day. Starting at Day 21, investigators were permitted to adjust the dose of Ovestinon Tablets up or down (not to exceed 2 mg per day) at weekly intervals until Day 42 if urinary continence was controlled. Dose information and urinary incontinence scoring was available for 191 dogs at the end of the study; ninety four dogs were receiving 2 mg of Ovestinon Tablets per day, and the other 96 dogs had dose reductions below 2 mg per day. Of the 94 dogs receiving 2 mg of Ovestinon Tablets per day during the last week of the study, 81 dogs (86%) had either reduced urinary incontinence (n = 57) or no urinary incontinence (n = 24) compared to Day 0. Of the ninety-seven dogs with dose reductions below 2 mg per day, all dogs receiving 1 mg of Ovestinon Tablets once daily (n = 41), 1 mg every other day (n = 5), or 0.5 mg every other day (n = 24) had either reduced or no incontinence compared to Day 0. Twenty-five of 26 dogs receiving 0.5 mg once daily had reduced or no incontinence, and one dog dosed with 2 mg of Ovestinon Tablets every other day had reduced incontinence.

There were no clinically significant changes in hematology or serum chemistry during either phase of the study.

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ANIMAL SAFETY

In a 26-week safety study, 24 healthy, ovariohysterectomized female Beagle dogs approximately 1 year of age, weighing 7.3 to 10.5 kg, were randomly divided into 4 groups of 6 animals each. Ovestinon Tablets were administered orally at doses of 0 (placebo), 1× (2 mg), 3× (6 mg) and 5× (10 mg) the maximum proposed label dose of 2 mg per dog per day. Estrogenic effects such as swollen vulva, mammary hyperplasia, and vulvar discharge occurred frequently in all dogs that received Ovestinon Tablets and increased in a dose-dependent manner. On gross necropsy, all dogs treated with Ovestinon Tablets had enlarged vulvas except 1 dog that received 2 mg per day. Microscopically, the vulvas and vaginas of treated dogs had a proestrus-like appearance, with or without a lymphoplasmacytic infiltrate. In addition, approximately one-third of the dogs in each group treated with Ovestinon Tablets had lymphoplasmacytic infiltrate and urothelium hyperplasia of the renal pelvis. One dog treated with 10 mg per day had urinary bladder inflammation. Dogs that received 6 mg and 10 mg of Ovestinon Tablets per day had increased white blood cell counts, absolute neutrophil counts and platelet counts compared to dogs in the other 2 groups. There were no changes related to Ovestinon Tablet administration noted in the microscopic evaluation of bone marrow smears. The myeloid:erythroid (M:E) cell ratios were comparable between dogs that received 10 mg of Ovestinon Tablets per day and those treated with placebo.

STORAGE INFORMATION

Store at or below 25°C (77°F) with excursions permitted to 40°C (104°F)

HOW SUPPLIED

Ovestinon Tablets contain 1 mg of Ovestinon in each tablet and are supplied in foil-sealed blister packs of 30 single-scored tablets. Two carton sizes containing either 30 tablets (one blister pack) or 90 tablets (three blister packs) are available.

Made in the Netherlands,

May, 2011

Ovestinon is the property of Intervet International B.V. or affiliated companies or licensors and is protected by copyrights, trademark and other intellectual property laws.

Copyright © 2011

Intervet International B.V.

All rights reserved.

117967 R10

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Ovestinon pharmaceutical active ingredients containing related brand and generic drugs:

Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.


Ovestinon available forms, composition, doses:

Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.


Ovestinon destination | category:

Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.


Ovestinon Anatomical Therapeutic Chemical codes:

A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.


Ovestinon pharmaceutical companies:

Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.


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References

  1. Dailymed."INCURIN (ESTRIOL) TABLET [MERCK SHARP & DOHME CORP.]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
  2. "estriol". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).
  3. "estriol". http://www.drugbank.ca/drugs/DB0457... (accessed August 28, 2018).

Frequently asked Questions

Can i drive or operate heavy machine after consuming Ovestinon?

Depending on the reaction of the Ovestinon after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Ovestinon not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.

Is Ovestinon addictive or habit forming?

Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.

Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.

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Review

sdrugs.com conducted a study on Ovestinon, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Ovestinon consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.

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The information was verified by Dr. Rachana Salvi, MD Pharmacology

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