progesterone (Progestasert, Prometrium, Pro-Gest, Prochieve)
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Introduction
Prepares the uterine endometrium for implantation & for maintenance of pregnancy. Synthesized endogenously from pregnenolone.
Pharmacology
Tradenames: Progestasert, Prometrium.
Indications
- endometrial carcinoma
- renal carcinoma
- secondary amenorrhea or abnormal uterine bleeding due to hormonal imbalance
- Progestasert: intrauterine contraceptive in women who
- have had at least one child
- are in a stable, mutually monogamous relationship
- have no history of pelvic inflammatory disease
- oral capsule may be used vaginally for infertility[4]
- premature labor[6]
- hot flashes
- endometrial dysplasia
- progesterone challenge test[6]
Contraindications
- does not prevent preterm birth or intrauterine death in twin pregnancy
Dosage
- amenorrhea: 5-10 mg IM QD for 6-8 consecutive days
- dysfunctional uterine bleeding: 5-10 mg IM QD for 6 days
- contraception: intrauterine device: insert single system into uterine cavity; contraception is effective for 1 year
- menopause: in conjunction with estrogen 200 mg PO QHS*
Injection: (in oil) 50 mg/mL (10 mL).
Intrauterine system: reservoir: 38 mg in silicone fluid.
* Prometrium: micronized progesterone capsule, 100, 200 mg (contains peanut oil) (safer alternative for menopause)[7]
Crinone: progesterone vaginal cream[2] (contains palm oil)
- can prevent endometrial hyperplasia
- alternative to oral progesterone for use in conjunction with estrogen therapy in postmenopausal women
Pro-Gest: topical progesterone used for hot flashes (OTC)[3]
Adverse effects
- common (> 10%)
- less common (1-10%)
- edema, depression, fever, melasma, chloasma, allergic rash with or without pruritus, cholestatic jaundice, changes in cervical erosions & secretions, weight gain or loss, insomnia, increased breast tenderness, thrombophlebitis, central thrombosis & embolism
More general terms
More specific terms
Additional terms
- progesterone in serum
- Progesterone receptor; PR; nuclear receptor subfamily 3 group C member 3 (PGR, NR3C3)
- steroid biosynthesis
Component of
References
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 2.0 2.1 Prescriber's Letter 8(7):41 2001
- ↑ 3.0 3.1 Prescriber's Letter 9(9):52 2002
- ↑ 4.0 4.1 Prescriber's Letter 13(10): 2006 Alternative or 'Off-label' Routes of Drug Administration Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=221012&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Norman JE et al Progesterone for the prevention of preterm birth in twin pregnancy (STOPPIT): a randomised, double-blind, placebo- controlled study and meta-analysis Lancet, Early Online Publication, 11 June 2009 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19523680 doi:10.1016/S0140-6736(09)60947-8
- ↑ 6.0 6.1 6.2 Deprecated Reference
- ↑ 7.0 7.1 Anello J, Feinberg B, Heinegg J et al Medscape: New Guidelines and Recommendations, August 2017. http://reference.medscape.com/viewarticle/884517
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5994
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=4920
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5320716
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=445033
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=657254