Chemical formula: C₂₁H₃₀O₂ Molecular mass: 314.462 g/mol PubChem compound: 5994
Progesterone interacts in the following cases:
Drugs known to induce the hepatic CYP450-3A4 such as barbiturates, anti-epileptic agents (phenytoin, carbamazepine), rifampicin, phenylbutazone, bromcriptine, spironolactone, griseofulvin, some antibiotics (ampicillins, tetracyclines) and also herbal products containing St. John’s wort, (Hypericum perforatum) may increase metabolism and the elimination of progesterone.
Ketokonazole and other inhibitors of CYP450-3A4 such as ritonavir and nelfinavir may increase bioavailability of progesterone. The metabolism of progesterone by human liver microsomes was inhibited by ketoconazole (IC50 <0.1 μM).
An adjustment in anti-diabetic dosage may be required for women being treated concomitantly with progesterone.
Progesterone may enhance or reduce the anticoagulant effect of coumarins.
Aminoglutethimide markedly reduces the plasma concentrations of medroxyprogesterone acetate and megestrol, possibly through a hepatic enzyme-inducing effect.
Progesterone may raise the plasma concentration of ciclosporin.
Progesterone may increase the plasma concentration of diazepam.
Progesterone antagonises the anticoagulant effect of phenindione.
There have been occasional reports of breakthrough bleeding when terbinafine is used concomitantly with progesterone.
Progesterone may increase the plasma concentration of tizanidine.
The concomitant use of ulipristal acetate with progesterone may result in reduced efficacy of progesterone.
Patients with a history of depression need to be closely observed. Consider discontinuation if symptoms worsen.
If any of the following conditions are present, have occurred previously, and/or have been aggravated during pregnancy or previous hormone treatment, the patient should be closely supervised. It should be taken into account that these conditions may recur or be aggravated during treatment with progesterone, in particular:
If pregnancy occurs during medication, progesterone should be withdrawn immediately.
Clinically, data on a large number of exposed pregnancies indicate no adverse effects of progesterone on the foetus. The results of most epidemiological studies to date relevant to inadvertent foetal exposure to combinations of estrogens + progesterone indicate no teratogenic or foetotoxic effect.
Prescription of progesterone beyond the first trimester of pregnancy may reveal gravidic cholestasis.
There is limited and inconclusive data on the risk of congenital anomalies, including genital abnormalities in male or female infants, following intrauterine exposure during pregnancy. The rates of congenital anomalies, spontaneous abortion and ectopic pregnancies observed during the clinical trial were comparable with the event rate described in the general population although the total exposure is too low to allow conclusions to be drawn.
In case of corpus luteum deficiency, progesterone can be used during the first month of pregnancy.
Progesterone is excreted in human milk and it should not be used during breast-feeding.
Not relevant.
Progesterone has minor or moderate influence on the ability to drive and use machines. Progesterone may cause drowsiness and/or dizziness; therefore caution is advised in drivers and users of machines.
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