Progesterone

Why is this medicine prescribed?

Progesterone is used to prevent changes to the uterus lining that can happen with estrogen when used for hormone replacement in women during menopause. Combination of estrogen and progesterone used during menopause is called menopausal hormone therapy (MHT). Progesterone is also used to produce a period in women who have amenorrhea (absence of a period). Progesterone is in a class of medications called progestins (female hormones). It works as part of hormone replacement therapy by decreasing the amount of estrogen in the uterus. It works to bring on menstruation by replacing the natural progesterone that some women are missing.

Are there other uses for this medicine?

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

How should this medicine be used?

Progesterone comes as a capsule to take by mouth. Take once a day in the evening or at bedtime. You will probably take progesterone on a rotating schedule that alternates 10 to 12 days when you take progesterone with 16 to 18 days when you do not take the medication. Your doctor will tell you exactly when to take progesterone. To help you remember to take progesterone, take it around the same time in the evening.

Take progesterone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take progesterone as directed even if you feel well. Do not stop taking progesterone without talking to your doctor.

What special precautions should I follow?

Before taking progesterone,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking while taking progesterone. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• the following herbal product may interact with progesterone: St. John's wort. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking progesterone. Do not start any of these medications while taking progesterone without discussing with your healthcare provider.

• tell your doctor if you have or have ever had unexplained vaginal bleeding between periods; a miscarriage in which some tissue was left in the uterus; cancer of the breasts or female organs; seizures; migraine headaches; asthma; diabetes; depression; blood clots in the legs, lungs, eyes, brain, or anywhere in the body; stroke or ministroke; vision problems; or liver, kidney, heart, or gallbladder disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking progesterone, call your doctor immediately.

• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking progesterone.

• you should know that progesterone may make you dizzy or drowsy. Do not drive a car or operate machinery until you know how this medication affects you. If progesterone does make you dizzy or drowsy, take your daily dose at bedtime.

• you should know that progesterone may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking progesterone. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

What special dietary instructions should I follow?

Talk to your doctor about drinking grapefruit juice while taking this medication.

What should I do if I forget to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medicine cause?

Progesterone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• breast tenderness or pain
• upset stomach
• vomiting
• diarrhea
• constipation
• tiredness
• muscle, joint, or bone pain
• mood swings, irritability or excessive worrying
• runny nose, sneezing, or cough
• vaginal discharge
• problems urinating

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them or any in the important warning section, call your doctor immediately or seek emergency care:

• breast lumps
• migraine headache
• bulging eyes or double vision
• unexpected vaginal bleeding
• shaking hands that you cannot control
• seizures
• stomach pain or swelling
• depression
• hives, skin rash itching or difficulty breathing or swallowing
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

Progesterone may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

What should I do in case of overdose?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What other information should I know?

Keep all appointments with your doctor.

Before having any laboratory test or biopsy (removal of tissue for testing), tell your doctor and the laboratory personnel that you are taking progesterone.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

Brand name(s)

• Prometrium^®
• also available generically