Progesterone

Progesterone Brand Names

Crinone | Endometrin | First – Progesterone MC 10 | First – Progesterone MC 5 | First – Progesterone VGS | Prochieve | Prometrium

What is Progesterone

Progesterone is a naturally occurring progestin. In the body, it is synthesized in the ovaries, testes, placenta, and adrenal cortex. Progesterone may be given orally, parenterally, or vaginally.

The hormone is primarily used to treat amenorrhea and abnormal uterine bleeding, and also to prevent endometrial hyperplasia in postmenopausal women taking estrogen therapy.

The drug is sometimes used off-label for premenstrual dysphoric disorder (PMDD), and has historically been used as a contraceptive. Progesterone is also used to prevent early pregnancy failure in women with corpus luteum insufficiency, including women undergoing assisted reproductive technology (ART).

Progesterone also helps reduce the risk for preterm birth in selected patients. In women with single gestation pregnancy and a history of spontaneous preterm delivery, antenatal progesterone therapy effectively decreases the risk of a recurrent preterm delivery.

Progesterone supplementation is beneficial in these women starting at 16 to 24 weeks gestation and continuing through 34 weeks gestation. It is not yet clear if the drug is beneficial at reducing risk for preterm birth in multiple gestation pregnancies.

Progesterone was first marketed medicinally in 1939, which was prior to the modern FDA drug approval process; the injection and various bulk products for extemporaneous compounding of vaginal suppositories and other dosage forms have long been available.

A progesterone-containing intrauterine device was available for contraception, but is no longer marketed.

In May 1998, oral micronized progesterone capsules were first FDA-approved. In May 1997, a progesterone vaginal gel was FDA-approved for use in an Assisted Reproductive Technology (ART) program; a progesterone vaginal insert used for this purpose was FDA-approved in June 2007.

Indications

1. amenorrhea
2. corpus luteum insufficiency
3. dysfunctional uterine bleeding
4. estrogen replacement therapy
5. infertility
6. premenstrual syndrome (PMS)
7. preterm delivery prophylaxis

For the treatment of amenorrhea

Side Effects

1. abdominal pain
2. acne vulgaris
3. alopecia
4. amenorrhea
5. anaphylactoid reactions
6. anorexia
7. anxiety
8. appetite stimulation
9. arthralgia
10. breakthrough bleeding
11. breast cancer
12. breast enlargement
13. cervicitis
14. cholestasis
15. constipation
16. dementia
17. depression
18. diarrhea
19. dizziness
20. drowsiness
21. dysarthria
22. dysmenorrhea
23. dyspareunia
24. dysphagia
25. edema
26. elevated hepatic enzymes
27. emotional lability
28. endometrial cancer
29. endometrial hyperplasia
30. eructation
31. erythema
32. fatigue
33. fever
34. fluid retention
35. galactorrhea
36. gastritis
37. glossitis
38. headache
39. hepatic failure
40. hepatic necrosis
41. hepatitis
42. hirsutism
43. hot flashes
44. hypertension
45. hypotension
46. impaired cognition
47. increased urinary frequency
48. infection
49. injection site reaction
50. insomnia
51. irritability
52. jaundice
53. leukorrhea
54. libido decrease
55. libido increase
56. mastalgia
57. melasma
58. menstrual irregularity
59. migraine
60. musculoskeletal pain
61. myocardial infarction
62. nausea
63. new primary malignancy
64. nocturia
65. ovarian cancer
66. pancreatitis
67. paresthesias
68. perineal pain
69. pruritus
70. pulmonary embolism
71. purpura
72. rash
73. retinal thrombosis
74. rhinitis
75. seborrhea
76. sinus tachycardia
77. sinusitis
78. skin discoloration
79. spontaneous fetal abortion
80. stroke
81. suicidal ideation
82. syncope
83. thromboembolism
84. thrombosis
85. tremor
86. urticaria
87. uterine pain
88. vaginal bleeding
89. vaginal discharge
90. vaginal irritation
91. vaginitis
92. vomiting
93. weakness
94. weight gain
95. weight loss
96. xerophthalmia

Monitoring Parameters

• pap smear
• pelvic exam
• pelvic ultrasound
• pregnancy testing
• serum progesterone concentrations

Contraindications

• asthma
• benzyl alcohol hypersensitivity
• breast cancer
• breast-feeding
• cardiac disease
• cerebrovascular disease
• cervical cancer
• children
• coronary artery disease
• dementia
• depression
• diabetes mellitus
• driving or operating machinery
• ectopic pregnancy
• endometrial cancer
• endometrial hyperplasia
• geriatric
• hepatic disease
• hypercholesterolemia
• hyperlipidemia
• hypertension
• incomplete abortion
• infants
• infection
• infertility
• inflammation
• intravenous administration
• migraine
• myocardial infarction
• neonates
• new primary malignancy
• obesity
• ovarian cancer
• peanut hypersensitivity
• pregnancy
• pulmonary oil microembolism
• renal disease
• seizure disorder
• sesame oil hypersensitivity
• stroke
• thromboembolic disease
• thromboembolism
• thrombophlebitis
• tobacco smoking
• uterine cancer
• vaginal cancer
• visual disturbance

Interactions

• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetohexamide
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-glucosidase Inhibitors
• Amobarbital
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amprenavir
• Apalutamide
• Aprepitant, Fosaprepitant
• Armodafinil
• Artemether; Lumefantrine
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Atazanavir; Cobicistat
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Barbiturates
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Betamethasone; Clotrimazole
• Bexarotene
• Bosentan
• Brigatinib
• Bromocriptine
• Butabarbital
• Canagliflozin; Metformin
• Carbamazepine
• Cenobamate
• Chlorpropamide
• Cimetidine
• Clarithromycin
• Clobazam
• Clotrimazole
• Cobicistat
• Danazol
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Diltiazem
• Doxorubicin
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enzalutamide
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Felbamate
• Fluconazole
• food
• Fosamprenavir
• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Griseofulvin
• Hydantoins
• Incretin Mimetics
• Indinavir
• Insulins
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Itraconazole
• Ketoconazole
• Lesinurad
• Lesinurad; Allopurinol
• Linagliptin
• Linagliptin; Metformin
• Lorlatinib
• Meglitinides
• Mephobarbital
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methohexital
• Miconazole
• Miconazole; Petrolatum; Zinc Oxide
• Modafinil
• Nelfinavir
• Nevirapine
• Omeprazole; Amoxicillin; Rifabutin
• Oxcarbazepine
• Pentobarbital
• Phenobarbital
• Phentermine; Topiramate
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Primidone
• Rifabutin
• Rifampin
• Rifamycins
• Rifapentine
• Saxagliptin
• Secobarbital
• Simvastatin; Sitagliptin
• Sincalide
• Sitagliptin
• Sodium Iodide
• St. John’s Wort, Hypericum perforatum
• Sulfonylureas
• Tazemetostat
• Thiopental
• Tipranavir
• Tolazamide
• Tolbutamide
• Topiramate
• Trandolapril; Verapamil
• Ulipristal
• Verapamil
• Voriconazole