Note when taking Utrogestan 100mg in the first 3 months of pregnancy

Utrogestan medicine 100mg is made in the form of capsules for oral or vaginal use. The drug has the active ingredient progesterone, which is indicated for cases of threatened miscarriage, infertility, menopause,... What issues should pregnant women when taking Utrogestan 100mg during the first 3 months of pregnancy? 
 

1. What is Utrogestan?

Utrogestan is a prescription medication containing micronized progesterone, a hormone that plays a crucial role in supporting pregnancy and regulating the menstrual cycle.

The medication is available in capsule forms of 100mg and 200mg, suitable for oral administration or vaginal insertion. This discussion focuses on the oral form. Patients may take Utrogestan 100mg or 200mg during pregnancy, strictly under the guidance of a physician.

2. Indications and Contraindications for Using Utrogestan 100mg

2.1. Indications for Oral Utrogestan 100mg

Utrogestan is used to treat or manage the following medical conditions:

• Luteal phase deficiency: A common cause of infertility in women.
• Hormone replacement therapy (HRT): To complement estrogen in postmenopausal women.
• Threatened miscarriage: To support early pregnancy in women with hormonal insufficiency.
• Prevention of preterm labor: For women at high risk of delivering prematurely.
• Infertility: Both primary (never conceived) and secondary (difficulty conceiving after a previous pregnancy) due to inadequate progesterone production.
• Gynecological disorders: Including:

  • Premenstrual syndrome (PMS): Hormone-related mood and physical symptoms before menstruation.

  • Ovulatory dysfunction or anovulation: Issues with egg release during the menstrual cycle.

  • Irregular menstruation: Unpredictable or abnormal cycles.

  • Benign breast conditions: Such as fibrocystic breast disease.

  • Perimenopause: Hormonal changes leading up to menopause.

2.2. Contraindications for Oral Utrogestan

Utrogestan is not suitable for the following individuals:

• Patients with severe liver disease, as the medication is metabolized in the liver.
• Those with a known allergy to progesterone or any inactive ingredients in the formulation.

3. How to Administer Utrogestan 100mg

Instructions for Use

• Oral Administration: Swallow the capsule whole with water. Do not take with food, as food can affect the absorption of the medication.It is best to take Utrogestan before bedtime to promote restful sleep and reduce daytime drowsiness or lack of concentration.

Dosage Recommendations

• Typical Dosage: 200–300mg/day, divided into 1–2 doses. Example: Take 200mg in the evening before bed. If necessary, an additional 100mg in the morning may be prescribed by a doctor.

Dosage for Specific Conditions

• Luteal Phase Deficiency: for conditions such as premenstrual syndrome, irregular periods, benign breast conditions, and perimenopause, take 200mg/day for 10 days per cycle (typically from Day 17 to Day 26).
• Hormone Replacement Therapy: When estrogen-only therapy is unsuitable, progesterone may be added during the final 2 weeks of the HRT cycle. After this period, all hormone treatments are paused for 1 week to allow for a withdrawal bleed.
• Prevention of Preterm Labor: Acute phase: Administer 400mg as required based on clinical response, Maintenance phase: Continue with 3 x 200mg daily until the 36th week of pregnancy.

Vaginal Administration: Method of Use: Wash hands thoroughly with soap or hand sanitizer to prevent infection. Dry hands and insert the capsule gently into the vagina to a depth of about one finger.

• Specific Vaginal Dosages:
  • Ovulation Disorders or Irregular Periods: Take 200mg/day for 10 days per cycle (from Day 17 to Day 26).
  • Luteal Phase Deficiency in Infertility Treatment: Start with 100mg/day on Days 13 and 14 of the embryo transfer cycle. From Days 15 to 25, increase to 100mg twice daily. If pregnancy occurs, increase the dose weekly by 100mg/day until reaching 600mg/day (divided into 3 doses). Maintain this dosage until Day 60 of pregnancy.
  • Threatened Miscarriage or Recurrent Miscarriage Prevention Due to Luteal Phase Deficiency: Use 200–400mg/day divided into 2 doses, continuing until the 12th week of pregnancy.

4. Side Effects of Utrogestan 100mg

When taking Utrogestan 100mg orally, patients may experience some side effects, including:

• Headaches, Temporary drowsiness or dizziness, particularly in patients using low-dose estrogen in combination with Utrogestan. These symptoms often subside with dose reduction.
• Symptoms of jaundice, bile retention, or pruritus (itching), Digestive disorders.
• Menstrual Cycle Changes: Altered menstrual cycles, such as irregular bleeding between periods or amenorrhea (absence of menstruation).

5. Precautions when using Utrogestan 100mg

Here are some important considerations when taking Utrogestan 100mg:

• Not a contraceptive: Utrogestan is not a birth control method. Taking it too early in the menstrual cycle, particularly before day 15, may shorten the cycle or cause bleeding.
• In case of uterine bleeding: Utrogestan should not be used until the underlying cause of the bleeding is accurately diagnosed.
• Risk of blood clots: Utrogestan treatment should be discontinued if the patient experiences severe headaches, double vision, vision loss, retinal blood vessel damage, deep vein thrombosis, or sudden absence of menstruation. It is crucial to ensure the patient is not pregnant, and those with a history of blood clotting disorders should be closely monitored.
• Use during pregnancy and breastfeeding: There are no specific contraindications for using
• Utrogestan during pregnancy, including the early stages. However, as there is no detailed research on whether progesterone passes into breast milk, breastfeeding women should ideally avoid using this medication.

Overdose: If a patient takes more than the prescribed dose, they should seek immediate medical attention.

Missed dose: If a dose is missed, the patient should take it as soon as they remember. If it is near the time for the next dose, they should skip the missed dose and continue with the prescribed schedule. Do not take a double dose to make up for the missed one.

6. Drug interactions of oral Utrogestan

Oral Utrogestan may interact with several types of medications, including: Diabetes medication, Diazepam, Bromocriptine, Spironolactone, Anti-tuberculosis medications (Rifampicin, Rifabutin), Multiple sclerosis medications (Tizanidine), Antibiotics (Ampicillin, Tetracycline), Anticoagulants (Coumarin, Phenindione), Emergency contraception (Ulipristal Acetate), Immunosuppressive drugs (Cyclosporin), Antifungal medications (Ketoconazole, Griseofulvin, Terbinafine), HIV medications (Nevirapine, Efavirenz, Ritonavir, Nelfinavir)

Oral Utrogestan 100mg is prescribed for women at risk of miscarriage, preterm birth, or infertility. It can be used during the first trimester of pregnancy but must be taken strictly according to the doctor's instructions. If any severe side effects occur, patients should seek immediate medical attention for appropriate care.

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