Amenorrhea, anovulatory uterine bleeding, endocrine infertility, including due to insufficiency
Composition and form of release
Progesterone is given in injection ampoules. The active ingredient of the drug is progesterone.
Progesterone is a corpus luteum hormone; causes the transition of the mucous membrane of the uterus from the proliferation phase caused by the follicular hormone into the secretory phase, and after fertilization contributes to its transition to the state necessary for the development of a fertilized egg. It also reduces the excitability and contractility of the muscles of the uterus and fallopian tubes, stimulates the development of the terminal elements of the mammary gland. In small doses it stimulates, and in large doses it inhibits the secretion of gonadotropic hormones. It inhibits the action of aldosterone, which leads to increased secretion of sodium and chlorine in the urine. It has catabolic and immunosuppressive effects.
Amenorrhea, anovulatory uterine bleeding, endocrine infertility, including those caused by corpus luteum insufficiency, miscarriage, oligomenorrhea, algomenorrhea (due to hypogonadism).
Liver disease, liver dysfunction, hepatitis, hepatic and renal failure; cholestatic jaundice during pregnancy (in history), benign hyperbilirubinemia; neoplasms of the mammary gland and genitals; tachycardia, tendency to thrombosis, active venous or arterial thromboembolism, severe thrombophlebitis, or a history of these conditions; nervous disorders with the phenomenon of depression; porphyria; pregnancy after 36 weeks, ectopic pregnancy, or pregnancy that has frozen in history; vaginal bleeding of unknown origin, condition after abortion; hypersensitivity to drug components.
Method of administration and dosage
Before use, slightly warm the ampoule with the drug in a water bath (up to 30-40 ºС). In case of precipitation of crystals, heat the ampoule in a boiling water bath until they are completely dissolved. The drug is administered intramuscularly or subcutaneously.
- In case of anovulatory uterine bleeding, the drug should be prescribed 5-15 mg daily for 6-8 days. If the mucous membrane of the uterine cavity has been previously scraped, then injections should be started after 18-20 days. If curettage is impossible, the drug should be administered during bleeding. In this case, bleeding may temporarily (3-5 days) increase; patients with moderate and severe anemia are advised to pre-transfuse blood (200-250 ml). If after 6-8 days of treatment the bleeding has not stopped, further administration of progesterone is inappropriate. If bleeding has stopped, treatment should not be interrupted earlier than 6 days.
- In hypogonadism and amenorrhea, administer (immediately after the use of estrogenic drugs) 5 mg daily or 10 mg every other day for 6-8 days.
- For the prevention and treatment of threatened miscarriage caused by insufficient function of the corpus luteum – 10-25 mg daily or every other day until the risk of miscarriage is completely eliminated. With habitual miscarriage, the drug can be administered up to the 4th month of pregnancy.
- In case of algodismenorrhea, to reduce or eliminate pain, the drug should be started 6-8 days before menstruation, 5-10 mg daily for 6-8 days. The course of treatment can be repeated several times. The highest single and daily intramuscular dose is 25 mg (2.5 ml of 1% solution or 1 ml of 2.5% solution). Progesterone treatment for algodismenorrhea associated with underdevelopment of the uterus can be combined with the preliminary appointment of estrogen drugs.
The drug should not be used in pediatric practice.
When using higher doses of the drug, side effects are more common, described in the corresponding section. If side effects appear, treatment with the drug should be discontinued, and after their disappearance, continue in lower doses. If necessary, carry out symptomatic treatment.
Usually progesterone is well tolerated, in some cases, manifestations of such side reactions are possible:
- on the part of the cardiovascular system: tachycardia, circulatory disorders, increased blood pressure, venous thromboembolism;
- from the nervous system: headache, dizziness, drowsiness, insomnia, depression;
- from the reproductive system and mammary glands: swelling, increased sensitivity and pain of the mammary glands, disorders of the external genital organs, such as burning, dryness, genital itching, changes in vaginal discharge, bleeding, vaginal mycosis, premenstrual syndrome, menstrual irregularities, acyclic bloody discharge, amenorrhea, oligomenorrhea, hirsutism, decreased libido, uterine spasms;
- from the digestive tract: bloating, abdominal pain, nausea, vomiting, constipation, diarrhea, flatulence;
- endocrine disorders: poor glucose tolerance;
- from the respiratory system: shortness of breath;
- from the hepatobiliary system: liver dysfunction and changes in liver function tests; cholestatic jaundice;
- metabolic and alimentary disorders: changes in appetite, increase or decrease in body weight, edema, albuminuria;
- on the part of the skin and soft tissues: allergic manifestations on the skin, erythema multiforme, itching, urticaria, skin rash, acne, chloasma, alopecia, hirsutism;
- general disorders and changes at the injection site: increased fatigue, weakness, fever, hypersensitivity reactions, including anaphylactic reactions; fluid retention paresthesia; changes at the injection site, including pain and swelling;
- laboratory parameters: change in plasma lipid profile;
- effect on the fetus: an excessive amount of progesterone can cause virilization of the female fetus (up to the uncertainty of gender).
Store in the original packaging to protect from light at a temperature not exceeding 25 ºС. Keep out of the reach of children.
The drug should not be mixed with other medicines.