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Prometrium
Prometrium, the brand name for progesterone, is a hormone replacement therapy used to manage menstrual disorders and symptoms associated with menopause. It is often prescribed for women who have not gone through menopause but do not have regular menstrual cycles or who need progesterone supplementation to prevent endometrial hyperplasia (thickening of the uterine lining) during estrogen therapy. Progesterone is important for regulating menstruation and supporting pregnancy, and Prometrium helps maintain hormonal balance when the body is not producing enough progesterone naturally.
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Frequently Asked Questions
Can Prometrium cause weight gain?
Some women may experience weight changes while taking Prometrium due to fluid retention and hormonal changes, though not all women report this effect.
Can Prometrium be used during pregnancy?
Prometrium should not be used during pregnancy unless specifically prescribed by a healthcare provider for progesterone supplementation in early pregnancy.
Does Prometrium affect mood?
Some women may experience mood swings, irritability, or changes in emotional state while taking Prometrium, particularly during the first few weeks of treatment.
What should I do if I miss a dose of Prometrium?
If you miss a dose, take it as soon as you remember. If it is close to your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not double the dose to make up for a missed one.
Can Prometrium be taken long-term?
Prometrium can be used long-term as part of hormone replacement therapy or for managing menstrual disorders, but regular monitoring by a healthcare provider is important to evaluate for potential risks such as blood clots or breast cancer.
Comprehensive Drug Guide
How Does Prometrium Work?
Prometrium contains bioidentical progesterone, which mimics the natural hormone produced by the body. It helps regulate the menstrual cycle by maintaining the uterine lining in preparation for pregnancy. In postmenopausal women taking estrogen therapy, Prometrium prevents endometrial hyperplasia, which can lead to endometrial cancer if untreated. By balancing estrogen and progesterone levels, Prometrium helps relieve menopause symptoms like hot flashes and vaginal dryness.
Common Dosages
- 100 mg capsules
- 200 mg capsules
Typical Dosing
- For prevention of endometrial hyperplasia: The typical dose is 200 mg once daily at bedtime for 12 consecutive days per 28-day cycle in women taking estrogen.
- For secondary amenorrhea: The usual dose is 400 mg once daily at bedtime for 10 days.
Prometrium should be taken with food to improve absorption and reduce the risk of side effects like dizziness.
Typical Dosing
FDA Approved Indications
- Prevention of endometrial hyperplasia in postmenopausal women receiving estrogen therapy.
- Treatment of secondary amenorrhea (absence of menstrual periods) in women of childbearing age who are not pregnant and are not menstruating due to low progesterone levels.
Who Shouldn't Take Prometrium?
- Undiagnosed abnormal vaginal bleeding.
- Breast cancer or suspected breast cancer.
- Liver disease.
- History of blood clots, stroke, or heart attack.
- Known hypersensitivity to progesterone, peanuts (capsules contain peanut oil), or any other ingredients in the formulation.
- Pregnancy: Prometrium should not be used during pregnancy unless specifically prescribed for progesterone supplementation during early pregnancy.
Advice From The Pharmacist
- Take Prometrium at bedtime, as it may cause dizziness or drowsiness.
- Take the capsules with food to improve absorption and reduce nausea.
- Prometrium contains peanut oil, so it should be avoided by individuals with a peanut allergy.
- Report any abnormal vaginal bleeding to your healthcare provider, as this could be a sign of a more serious condition.
- If using Prometrium as part of hormone replacement therapy, make sure to follow the exact dosing schedule prescribed by your healthcare provider.
Side Effects of Prometrium
Common Side Effects
- Dizziness or drowsiness
- Headache
- Breast tenderness
- Bloating
- Mood swings
- Vaginal bleeding or spotting
Uncommon/Severe Side Effects
- Blood clots: Symptoms include swelling, pain, or redness in the legs, chest pain, or shortness of breath.
- Severe allergic reactions: Rash, itching, swelling of the face or throat, and difficulty breathing (especially in those with peanut allergies).
- Liver problems: Symptoms include yellowing of the skin or eyes, dark urine, or severe stomach pain.
Risks and Warnings of Prometrium
- Increased risk of blood clots: Prometrium, particularly when used in combination with estrogen, may increase the risk of blood clots, stroke, or heart attack. Individuals with a history of cardiovascular disease or clotting disorders should use this medication cautiously.
- Breast cancer risk: Long-term use of combined estrogen and progesterone therapy may increase the risk of breast cancer. Regular breast exams and mammograms are recommended while taking hormone replacement therapy.
- Liver impairment: Prometrium can cause liver problems, especially in individuals with pre-existing liver conditions. Liver function should be monitored during treatment.
- Peanut allergy: Prometrium capsules contain peanut oil and should not be used by individuals with a peanut allergy.
Interactions with Prometrium
Common Drug Interactions
- CYP450 inducers: Medications like rifampin, carbamazepine, or phenytoin can reduce the effectiveness of Prometrium by increasing its metabolism.
- Anticoagulants (blood thinners): Progesterone may interfere with blood thinners like warfarin, increasing the risk of bleeding.
- Other hormone replacement therapies: The combination of estrogen and progesterone therapy should be carefully managed to prevent an increased risk of side effects.
Alternatives to Prometrium
- Micronized progesterone: Other bioidentical progesterone products used to manage menstrual disorders or endometrial protection.
- Provera (medroxyprogesterone acetate): A synthetic progestin used for hormone replacement therapy and menstrual disorders.
- Estrogen-only therapy: For women without a uterus, estrogen-only therapy may be sufficient to manage menopause symptoms without the need for progesterone.
