Dosing of Medicine differ in Adult & Pediatrics ↓

Adult Dose

S.No	Ailment	Route	Dose Min	Dose Max	Unit	Dosage Form	Frequency	Additional Info
1	Dysfunctional uterine bleeding or amenorrhoea	IM	5	10	mg	Injection		Given about 5 to 10 days until 2 days before the anticipated onset of menstruation.
2	Amenorrhoea	Vaginal	45		mg	Vaginal gel		Given on alternate days for up to 6 doses; the dose may be increased to 90 mg in those who do not respond to the lower dose.
3	Amenorrhoea	Oral	400		mg		h.s.	Given for 10 days
4	History of recurrent miscarriage and proven progesterone deficiency	IM	25	100	mg	Injection	b.d.	Given from about day 15 of the pregnancy until 8 to 16 weeks, has been used. The dose may be increased to 200 mg daily if necessary. Vaginal doses of micronised progesterone 200 to 400 mg daily, in 2 divided doses, have also been given until week 12 of pregnancy. A similar intramuscular schedule has been used for luteal support in IVF or gamete intra-fallopian transfer techniques with treatment beginning on the day of transfer of embryo or gametes. A vaginal gel may be given at a dose of 90 mg daily; it is given for 30 days if pregnancy occurs, and may be continued until there is placental autonomy (up to 10 to 12 weeks). A dose of 90 mg twice daily has been used in women with ovarian failure.
5	History of recurrent miscarriage and proven progesterone deficiency							Test
6	Premenstrual syndrome	Vaginal or rectal	200	400	mg	Vaginal Suppositories	b.d.	Treatment usually starts on day 12 to 14 of the menstrual cycle and continues until the onset of menstruation. Similar vaginal or rectal doses have also been used in the treatment of puerperal (post-natal) depression.
7	Menopausal HRT	Oral	200		mg	Capsule	h.s.	Given 12 to 14 days of each month. Alternatively, a dose of 100 mg daily may be given from day 1 to 25 of each cycle, resulting in less withdrawal bleeding.
8	hormonal contraceptive							A progesterone-releasing intra-uterine device has been used as a hormonal contraceptive; the device contains 38 mg of progesterone and is effective for up to 12 months. A vaginal ring device that releases 10 mg of progesterone daily is used in some countries for contraception in lactating women. The first ring is inserted 6 weeks after delivery, then replaced every 90 days.

Adult Dose

S.No	Ailment	Route	Dose Min	Dose Max	Unit	Dosage Form	Frequency	Additional Info
1	Dysfunctional uterine bleeding or amenorrhoea	IM	5	10	mg	Injection		Given about 5 to 10 days until 2 days before the anticipated onset of menstruation.
2	Amenorrhoea	Vaginal	45		mg	Vaginal gel		Given on alternate days for up to 6 doses; the dose may be increased to 90 mg in those who do not respond to the lower dose.
3	Amenorrhoea	Oral	400		mg		h.s.	Given for 10 days
4	History of recurrent miscarriage and proven progesterone deficiency	IM	25	100	mg	Injection	b.d.	Given from about day 15 of the pregnancy until 8 to 16 weeks, has been used. The dose may be increased to 200 mg daily if necessary. Vaginal doses of micronised progesterone 200 to 400 mg daily, in 2 divided doses, have also been given until week 12 of pregnancy. A similar intramuscular schedule has been used for luteal support in IVF or gamete intra-fallopian transfer techniques with treatment beginning on the day of transfer of embryo or gametes. A vaginal gel may be given at a dose of 90 mg daily; it is given for 30 days if pregnancy occurs, and may be continued until there is placental autonomy (up to 10 to 12 weeks). A dose of 90 mg twice daily has been used in women with ovarian failure.
5	History of recurrent miscarriage and proven progesterone deficiency							Test
6	Premenstrual syndrome	Vaginal or rectal	200	400	mg	Vaginal Suppositories	b.d.	Treatment usually starts on day 12 to 14 of the menstrual cycle and continues until the onset of menstruation. Similar vaginal or rectal doses have also been used in the treatment of puerperal (post-natal) depression.
7	Menopausal HRT	Oral	200		mg	Capsule	h.s.	Given 12 to 14 days of each month. Alternatively, a dose of 100 mg daily may be given from day 1 to 25 of each cycle, resulting in less withdrawal bleeding.
8	hormonal contraceptive							A progesterone-releasing intra-uterine device has been used as a hormonal contraceptive; the device contains 38 mg of progesterone and is effective for up to 12 months. A vaginal ring device that releases 10 mg of progesterone daily is used in some countries for contraception in lactating women. The first ring is inserted 6 weeks after delivery, then replaced every 90 days.

Ref :-  Book : Martindale    Page : 2334   Edition : 37  

Pediatric Dose

Ref :- Book :    Page :    Edition :   

Precaution :- If a Patient is using 'Progesterone' drug in  Acute Intermittent Porphyria  disease, then Please Do not use .

►  Side Effect : Gastrointestinal disturbances, Changes in appetite or weight, Fluid retention, Oedema, Acne, Chloasma (melasma), Allergic skin rashes, Urticaria, Mental depression, Gynaecomastia, Changes in libido, Hair loss, Hirsutism, Fatigue, Drowsiness, Insomnia, Fever, Headache, Premenstrual syndrome-like symptoms, Altered menstrual cycles, Irregular menstrual bleeding, Alterations in the serum lipid profile, amenorrhoea, Pain, Diarrhoea, Flatulence, Breast tenderness, Spotting, Breakthrough bleeding
Ref :-   Book : Martindale    Page : 2263,2275,2333   Edition : 37.  
►  Drug Interaction : Drug interaction of Progesterone is with ,  Carbamazapine , Griseofulvin , Phenobarbital , Phenytoin , Rifampicin , Aminoglutethimide
Ref :-   Book : Martindale    Page : 2333   Edition : 37.  

Drug interaction

Drug Interaction : Drug interaction of Progesterone is with ,  Carbamazapine , Griseofulvin , Phenobarbital , Phenytoin , Rifampicin , Aminoglutethimide

Book : Martindale    Page : 2333   Edition : 37.  

  ►    Mechanism of Drug Drug Interaction :  Enzyme-inducing drugs such as carbamazepine, griseofulvin, phenobarbital, phenytoin, and rifampicin may enhance the clearance of progesterone. These interactions are likely to reduce the efficacy of progesterone-only contraceptives, and additional or alternative contraceptive measures are recommended. Aminoglutethimide markedly reduces the plasma concentrations of medroxy progesterone acetate and megestrol, possibly through a hepatic enzyme-inducing effect; an increase in progesterone dose is likely to be required. Since progesterone and other progestogens can influence diabetic control an adjustment in antidiabetic dosage could be required. progesterone may inhibit ciclosporin metabolism leading to increased plasma ciclosporin concentrations and a risk of toxicity
Ref :-   Book : Martindale    Page : 2333   Edition : 37.  

Mechanism of Drug

Mechanism of Drug Drug Interaction : Enzyme-inducing drugs such as carbamazepine, griseofulvin, phenobarbital, phenytoin, and rifampicin may enhance the clearance of progesterone. These interactions are likely to reduce the efficacy of progesterone-only contraceptives, and additional or alternative contraceptive measures are recommended. Aminoglutethimide markedly reduces the plasma concentrations of medroxy progesterone acetate and megestrol, possibly through a hepatic enzyme-inducing effect; an increase in progesterone dose is likely to be required. Since progesterone and other progestogens can influence diabetic control an adjustment in antidiabetic dosage could be required. progesterone may inhibit ciclosporin metabolism leading to increased plasma ciclosporin concentrations and a risk of toxicity

Book : Martindale    Page : 2333   Edition : 37.  

►  Contraindication : It should be used with caution in patients with hypertension, cardiac or renal impairment, asthma, epilepsy, and migraine, or other conditions which may be aggravated by fluid retention. Progestogens can decrease glucose tolerance and diabetic patients should be carefully monitored. They should also be used with care in persons with a history of depression., It should not be given to patients with undiagnosed vaginal bleeding, nor to those with a history or current high risk of arterial disease and should generally be avoided in hepatic impairment, especially if severe. Unless progestogens are being used as part of the management of breast or genital- tract carcinoma they should not be given to patients with these conditions.
Ref :-   Book : Martindale    Page : 2333   Edition : 37.  

  ►  Mechanism of Action :   Progestins enter the cells and bind to progestron receptors that are distributed between the nucleus and cytoplasm. The ligand receptor complex bind to a progesteron response element to activate gene transcriptions. a progesterone receptor complex form a dimer before binding to DNA. It can form hetrodimers as well as homodimers between to isoforms A and B. These isoform are produced by alternative splicing of the same gene.
Ref :-   Book : Basic & Clinical pharmacology    Page : 723   Edition : 12.  

►   Route of Elimination :   Hepatic (Metabolism), Renal
Ref :-   Book : Martindale    Page : 2334   Edition : 37.  
►    Plasma Half-life :   Min value :-   5 minutes,    Max value :-   .  
Ref :-   Book : Basic & Clinical pharmacology    Page : 723   Edition : 12.  
►    Peak Plasma Concentration :   Min value :-   NA    Max value :-   NA