Progesterone

Progesterone is a prescription medication used to promote normal menstrual periods in women who are premenopausal but have stopped having periods due to low progesterone levels. Progesterone is also used in combination with estrogen-containing medications in postmenopausal women with a uterus to reduce the risk of developing cancer of the uterus and to prevent abnormal thickening of the lining of the uterus in women taking estrogen. Progesterone is also used to promote embryo implantation and pregnancy in conjunction with fertility treatments in women. 

Progesterone belongs to a group of drugs called progestins. These work to acheive various effects in the body by mimicking the effects of naturally occuring hormones.

This medication comes in a capsule form and is typically taken once a day, at bedtime, for 10 or 12 continuous days, depending on the condition being treated.

This medication is also available in a vaginal insert form that is typically inserted into the vagina 2 to 3 times daily for up to 10 weeks of treatment.

This medication is also available in a gel form that is typically applied to the vagina once or twice a day. The frequency of application depends on the condition being treated. 

This medication is also available in an injectable form to be given directly into a muscle by a healthcare provider, typically daily, for 6 to 8 days.

Common side effects of progesterone include headaches, breast pain, and irregular vaginal bleeding or spotting.

Progesterone can also cause dizziness and/or drowsiness. Do not drive or operate heavy machinery until you know how progesterone affects you.

Progesterone is a prescription medication used to promote normal menstrual periods in women who are premenopausal but have stopped having periods due to low progesterone levels. Progesterone is also used in combination with estrogen-containing medications in postmenopausal women with a uterus to reduce the risk of developing cancer of the uterus and to prevent abnormal thickening of the lining of the uterus in women taking estrogen. Progesterone is also used to promote embryo implantation and pregnancy in conjunction with fertility treatments in women. 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Progesterone may be found in some form under the following brand names:

• Crinone

• Cyclogest

• Eazi-Breed CIDR

• Endometrin

• Prochieve

• Progest

• Prometrium

Serious side effects have been reported with progesterone. See the “Progesterone Precautions” section.

Common side effects of progesterone include the following:

• Headaches
• Breast pain
• Irregular vaginal bleeding or spotting
• Abdominal cramps 
• Bloating
• Nausea and vomiting
• Hair loss
• Swelling of extremities
• Vaginal yeast infections

This is not a complete list of progesterone side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• acarbose
• acetaminophen
• acetohexamide
• albiglutide
• alogliptin
• aminoglutethimide
• aminophylline
• amlodipine
• amobarbital
• amoxicillin
• apixaban
• aprepitant
• armodafinil
• aspirin
• atorvastatin
• atropine
• bazedoxifene
• belladonna
• bexarotene
• boceprevir
• bosentan
• brentuximab
• butabarbital
• butalbital
• canagliflozin
• carbamazepine
• chlorpropamide
• clarithromycin
• clotrimazole
• cobicistat
• conivaptan
• cyclosporine
• dabrafenib
• dalfopristin
• dapagliflozin
• darunavir
• dasatinib
• daunorubicin
• deferasirox
• delavirdine
• diltiazem
• divalproex sodium
• doxorubicin
• dronedarone
• dulaglutide
• dyphylline
• edoxaban
• efavirenz
• empagliflozin
• enzalutamide
• ephedrine
• erythromycin
• eslicarbazepine
• etravirine
• exenatide
• felbamate
• fidaxomicin
• fluconazole
• fluvoxamine
• fosaprepitant
• fosphenytoin
• glimepiride
• glipizide
• glyburide
• grepafloxacin
• griseofulvin
• hyoscyamine
• idarubicin
• imatinib
• indinavir
• insulin products
• isavuconazonium
• isoniazid
• itraconazole
• ivacaftor
• ketoconazole
• lamotrigine
• lapatinib
• linagliptin
• liraglutide
• mephobarbital
• metformin
• mibefradil
• miconazole
• mifepristone
• miglitol
• mitotane
• mitoxantrone
• modafinil
• nafcillin
• nateglinide
• nefazodone
• netupitant
• nevirapine
• nilotinib
• oxcarbazepine
• pentobarbital
• phenobarbital
• phenylbutazone
• phenytoin
• pioglitazone
• posaconazole
• pramlintide
• primidone
• ranolazine
• repaglinide
• rifabutin
• rifampin
• rifapentine
• riociguat
• rosiglitazone
• rufinamide
• saquinavir
• saxagliptin
• secobarbital
• simvastatin
• sirolimus
• sitagliptin
• st. john's wort
• sulfinpyrazone
• tacrolimus
• telaprevir
• telithromycin
• tolazamide
• tolbutamide
• troglitazone
• valproic acid
• vemurafenib
• vismodegib
• voriconazole

 This is not a complete list of progesterone] drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with progesterone including the following:

• Heart attacks. Discontinue use and get medical attention immediately if you experience severe pains in your chest or legs with or without shortness of breath, weakness and/or fatigue.
• Strokes. Discontinue use and get medical attention immediately if you experience changes in vision or speech, sudden new severe headaches, and/or vision changes.
• Blood clots. Discontinue use and get medical attention immediately if you experience extremity pain, tenderness, and/or a warm sensation, pain in your calf when you stretch your toes upward, and/or a pale or bluish skin discoloration.
• Depression. Consult with your physician if you have a history of depression or any other psychiatric disorders.

Do not take progesterone if you:

• Have unusual vaginal bleeding
• Have active cancer
• Have liver disease
• Are allergic to progesterone or any of its ingredients
• Are pregnant or think you may be pregnant

Do not take progesterone capsules if you are allergic to peanuts. 

Progesterone can also cause dizziness and/or drowsiness. Do not drive or operate heavy machinery until you know how progesterone affects you.

Grapefruit and grapefruit juice may interact with progesterone and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Before taking progesterone, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to progesterone or to any of its ingredients
• are pregnant or plan to become pregnant
• are breastfeeding or plan to breastfeed
• have a history of heart disease and/or blood clots
• have a history of depression or other psychiatric conditions
• have cancer of any kind
• have a history of abortions
• have epilepsy
• have asthma
• have diabetes
• are currently using other vaginal products
• have liver disease

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Progesterone falls into category B. There are no well-designed studies that have been done in humans with progesterone. In animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Progesterone has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from progesterone, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

Take progesterone exactly as prescribed.

Progesterone comes in a capsule form and is typically taken once a day, at bedtime, for 10 or 12 continuous days depending on the condition being treated.

Progesterone is also available in a vaginal insert form that is typically inserted into the vagina 2 to 3 times daily for up to 10 weeks of treatment.

Progesterone is also available in a gel form that is typically applied to the vagina once or twice a day. The frequency of application depends on the condition being treated. 

Progesterone is also available in an injectable form to be given directly into a muscle by a healthcare provider, typically daily, for 6 to 8 days.

Capsules

• Progesterone capsules are recommended to be taken at bedtime as some patients become very drowsy and/or dizzy after taking progesterone
• If you experience difficulty in swallowing progesterone capsules, it is recommended that you take your daily dose at bedtime with a glass of water while in the standing position

Vaginal Insert

To administer progesterone vaginal inserts:

• Unwrap the applicator
• Put one insert in the space provided at the end of the applicator. The insert should fit snugly and not fall out
• Place applicator with the insert into the vagina while you are standing, sitting, or when lying on your back with your knees bent. 
• Push the plunger to release the insert
• Remove the applicator and throw it away in the trash

Vaginal Gel

To administer progesterone gel:

• Remove the applicator from the sealed wrapper. Do not remove the twist-off tab at this time.
• Hold the applicator between the thumb and forefinger along the seam on the sides of the bulb. Shake down vigorously 3 to 4 times to ensure that the contents are at the thin end of the applicator
• Hold the applicator by the flat section of the bulb. Twist off the tab at the thin end and throw away. Do not squeeze the bulb while twisting the tab. This could force some gel to be released before it is inserted. Twist off completely – Do not pull off
• The applicator may be inserted into the vagina while you are in a sitting position or when lying on your back with your knees bent.
• Squeeze the bulb of the applicator to deposit the gel into the vagina. Remove the applicator and throw it away in a waste container. Do not be concerned if a small amount of gel is left in the applicator. You will still be receiving the appropriate, measured dosage

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of progesterone at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your age

Capsules:

• The recommended dose of progesterone for the prevention of endometrial hyperplasia in postmenopausal women with a uterus and taking estrogens is 200 mg at bedtime for 12 continuous days per 28-day cycle
• The recommended dose of progesterone for the treatment of secondary amenorrhea is 400 mg at bedtime for 10 days

Vaginal Insert:

The recommended dose of progesterone to promote embryo implantation and pregnancy in conjunction with fertility treatments in women is 100 mg administered two or three times daily for up to 10 weeks total duration

Vaginal Gel:

Injection:

• The recommended dose of progesterone for the treatment of amenorrhea is 5 mg to 10 mg given daily for six to eight consecutive days

If you take too much progesterone, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store progesterone vaginal inserts and vaginal gel at room temperature 20 - 25°C (68 - 77°F)
• Do not use progesterone vaginal inserts after the expiration date that is printed on the carton
• Protect progesterone capsules from excessive moisture
• Keep progesterone and all medicines out of the reach of children