Back بروجستيرون (دواء) Arabic 황체호르몬 Korean

Progesterone (medication)

This article is about progesterone as a medication. For its role as a hormone, see progesterone.
Not to be confused with medroxyprogesterone acetate, a synthetic progestogen.

Progesterone
Clinical data
Trade namesPrometrium, Utrogestan, Endometrin, others
Other namesP4; Pregnenedione; Pregn-4-ene-3,20-dione[1]
AHFS/Drugs.comMonograph
MedlinePlusa604017
Routes of
administration		By mouth, sublingual, topical, vaginal, rectal, intramuscular, subcutaneous, intrauterine
Drug classProgestogen; Antimineralocorticoid; Neurosteroid
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityOral: <2.4%[5]
Vaginal (micronized insert): 4–8%[6][7][8]
Protein binding98–99%:[9][10]
• Albumin: 80%
• CBGTooltip Corticosteroid-binding globulin: 18%
• SHBGTooltip Sex hormone-binding globulin: <1%
• Free: 1–2%
MetabolismMainly liver:
• 5α- and 5β-reductase
• 3α-Tooltip 3α-Hydroxysteroid dehydrogenase and 3β-HSDTooltip 3β-Hydroxysteroid dehydrogenase
• 20α-Tooltip 20α-Hydroxysteroid dehydrogenase and 20β-HSDTooltip 20β-Hydroxysteroid dehydrogenase
• Conjugation
• 17α-Hydroxylase
• 21-Hydroxylase
• CYPsTooltip CYP (e.g., CYP3A4)
Metabolites• Dihydroprogesterones
• Pregnanolones
• Pregnanediols
• 20α-Hydroxyprogesterone
• 17α-Hydroxyprogesterone
• Pregnanetriols
• 11-Deoxycorticosterone
(and glucuronide/sulfate conjugates)
Elimination half-life• Oral: 5 hours (with food)[11]
* Sublingual: 6–7 hours[12]
• Vaginal: 14–50 hours[13][12]
• Topical: 30–40 hours[14]
• IM: 20–28 hours[15][13][16]
• SC: 13–18 hours[16]
• IVTooltip Intravenous injection: 3–90 minutes[17]
ExcretionBile and urine[18][19]
Identifiers
  • (8S,9S,10R,13S,14S,17S)-17-acetyl-10,13-dimethyl-1,2,6,7,8,9,11,12,14,15,16,17-dodecahydrocyclopenta[a]phenanthren-3-one
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
Chemical and physical data
FormulaC21H30O2
Molar mass314.469 g·mol−1
3D model (JSmol)
Specific rotation[α]D25 = +172 to +182° (2% in dioxane, β-form)
Melting point126 °C (259 °F)
  • CC(=O)[C@H]1CC[C@@H]2[C@@]1(CC[C@H]3[C@H]2CCC4=CC(=O)CC[C@]34C)C
  • InChI=InChI=1S/C21H30O2/c1-13(22)17-6-7-18-16-5-4-14-12-15(23)8-10-20(14,2)19(16)9-11-21(17,18)3/h12,16-19H,4-11H2,1-3H3/t16-,17+,18-,19-,20-,21+/m0/s1 ☒N
  • Key:RJKFOVLPORLFTN-LEKSSAKUSA-N checkY
  (verify)

Progesterone (P4), sold under the brand name Prometrium among others, is a medication and naturally occurring steroid hormone.[20] It is a progestogen and is used in combination with estrogens mainly in hormone therapy for menopausal symptoms and low sex hormone levels in women.[20][21] It is also used in women to support pregnancy and fertility and to treat gynecological disorders.[22][23][24][25] Progesterone can be taken by mouth, vaginally, and by injection into muscle or fat, among other routes.[20] A progesterone vaginal ring and progesterone intrauterine device used for birth control also exist in some areas of the world.[26][27]

Progesterone is well tolerated and often produces few or no side effects.[28] However, a number of side effects are possible, for instance mood changes.[28] If progesterone is taken by mouth or at high doses, certain central side effects including sedation, sleepiness, and cognitive impairment can also occur.[28][20] The medication is a naturally occurring progestogen and hence is an agonist of the progesterone receptor (PR), the biological target of progestogens like endogenous progesterone.[20] It opposes the effects of estrogens in various parts of the body like the uterus and also blocks the effects of the hormone aldosterone.[20][29] In addition, progesterone has neurosteroid effects in the brain.[20]

Progesterone was first isolated in pure form in 1934.[30][31] It first became available as a medication later that year.[32][33] Oral micronized progesterone (OMP), which allowed progesterone to be taken by mouth, was introduced in 1980.[33][22][34] A large number of synthetic progestogens, or progestins, have been derived from progesterone and are used as medications as well.[20] Examples include medroxyprogesterone acetate and norethisterone.[20] In 2021, it was the 167th most commonly prescribed medication in the United States, with more than 3 million prescriptions.[35][36]

  1. ^ Adler N, Pfaff D, Goy RW (6 December 2012). Handbook of Behavioral Neurobiology Volume 7 Reproduction (1st ed.). New York: Plenum Press. p. 189. ISBN 978-1-4684-4834-4. Retrieved 4 July 2015.
  2. ^ "Regulatory Decision Summary for pms-Progesterone". Drug and Health Product Register. 23 October 2014.
  3. ^ "Reproductive health". Health Canada. 9 May 2018. Retrieved 13 April 2024.
  4. ^ "Health product highlights 2021: Annexes of products approved in 2021". Health Canada. 3 August 2022. Retrieved 25 March 2024.
  5. ^ Levine H, Watson N (March 2000). "Comparison of the pharmacokinetics of crinone 8% administered vaginally versus Prometrium administered orally in postmenopausal women(3)". Fertility and Sterility. 73 (3): 516–521. doi:10.1016/S0015-0282(99)00553-1. PMID 10689005.
  6. ^ Griesinger G, Tournaye H, Macklon N, Petraglia F, Arck P, Blockeel C, et al. (February 2019). "Dydrogesterone: pharmacological profile and mechanism of action as luteal phase support in assisted reproduction". Reproductive Biomedicine Online. 38 (2): 249–259. doi:10.1016/j.rbmo.2018.11.017. PMID 30595525.
  7. ^ Pandya MR, Gopeenathan P, Gopinath PM, Das SK, Sauhta M, Shinde V (2016). "Evaluating the clinical efficacy and safety of progestogens in the management of threatened and recurrent miscarriage in early pregnancy-A review of the literature". Indian Journal of Obstetrics and Gynecology Research. 3 (2): 157. doi:10.5958/2394-2754.2016.00043.6. ISSN 2394-2746. S2CID 36586762.
  8. ^ Paulson RJ, Collins MG, Yankov VI (November 2014). "Progesterone pharmacokinetics and pharmacodynamics with 3 dosages and 2 regimens of an effervescent micronized progesterone vaginal insert". The Journal of Clinical Endocrinology and Metabolism. 99 (11): 4241–4249. doi:10.1210/jc.2013-3937. PMID 24606090.
  9. ^ Fritz MA, Speroff L (28 March 2012). Clinical Gynecologic Endocrinology and Infertility. Lippincott Williams & Wilkins. pp. 44–. ISBN 978-1-4511-4847-3.
  10. ^ Marshall WJ, Bangert SK (2008). Clinical Chemistry. Elsevier Health Sciences. pp. 192–. ISBN 978-0-7234-3455-9.
  11. ^ Pickar JH, Bon C, Amadio JM, Mirkin S, Bernick B (December 2015). "Pharmacokinetics of the first combination 17β-estradiol/progesterone capsule in clinical development for menopausal hormone therapy". Menopause. 22 (12): 1308–1316. doi:10.1097/GME.0000000000000467. PMC 4666011. PMID 25944519.
  12. ^ a b Khomyak NV, Mamchur VI, Khomyak EV (2014). "Клинико-фармакологические особенности современных лекарственных форм микронизированного прогестерона, применяющихся во время беременности" [Clinical and pharmacological features of modern dosage forms of micronized progesterone used during pregnancy.] (PDF). Доровье [Health]. 4: 90.
  13. ^ a b "Crinone® 4% and Crinone® 8% (progesterone gel)" (PDF). Watson Pharma, Inc. U.S. Food and Drug Administration. August 2013.
  14. ^ Mircioiu C, Perju A, Griu E, Calin G, Neagu A, Enachescu D, et al. (1998). "Pharmacokinetics of progesterone in postmenopausal women: 2. Pharmacokinetics following percutaneous administration". European Journal of Drug Metabolism and Pharmacokinetics. 23 (3): 397–402. doi:10.1007/BF03192300. PMID 9842983. S2CID 32772029.
  15. ^ Simon JA, Robinson DE, Andrews MC, Hildebrand JR, Rocci ML, Blake RE, et al. (July 1993). "The absorption of oral micronized progesterone: the effect of food, dose proportionality, and comparison with intramuscular progesterone". Fertility and Sterility. 60 (1): 26–33. doi:10.1016/S0015-0282(16)56031-2. PMID 8513955.
  16. ^ a b Cometti B (November 2015). "Pharmaceutical and clinical development of a novel progesterone formulation". Acta Obstetricia et Gynecologica Scandinavica. 94 (Suppl 161): 28–37. doi:10.1111/aogs.12765. PMID 26342177. S2CID 31974637. The administration of progesterone in injectable or vaginal form is more efficient than by the oral route, since it avoids the metabolic losses of progesterone encountered with oral administration resulting from the hepatic first-pass effect (32). In addition, the injectable forms avoid the need for higher doses that cause a fairly large number of side-effects, such as somnolence, sedation, anxiety, irritability and depression (33).
  17. ^ Aufrère MB, Benson H (June 1976). "Progesterone: an overview and recent advances". Journal of Pharmaceutical Sciences. 65 (6): 783–800. doi:10.1002/jps.2600650602. PMID 945344.
  18. ^ "Prometrium (progesterone, USP) Capsules 100 mg" (PDF). Solvay Pharmaceuticals, Inc. U.S. Food and Drug Administration. 1998.
  19. ^ "Progesterone Injection USP in Sesame Oil for Intramuscular Use Only Rx Only" (PDF). U.S. Food and Drug Administration. January 2007.
  20. ^ a b c d e f g h i Kuhl H (August 2005). "Pharmacology of estrogens and progestogens: influence of different routes of administration". Climacteric. 8 (Suppl 1): 3–63. doi:10.1080/13697130500148875. PMID 16112947. S2CID 24616324.
  21. ^ Cite error: The named reference pmid28159148 was invoked but never defined (see the help page).
  22. ^ a b Cite error: The named reference RuanMueck2014 was invoked but never defined (see the help page).
  23. ^ Filicori M (November 2015). "Clinical roles and applications of progesterone in reproductive medicine: an overview". Acta Obstetricia et Gynecologica Scandinavica. 94 (Suppl 161): 3–7. doi:10.1111/aogs.12791. PMID 26443945.
  24. ^ Ciampaglia W, Cognigni GE (November 2015). "Clinical use of progesterone in infertility and assisted reproduction". Acta Obstetricia et Gynecologica Scandinavica. 94 (Suppl 161): 17–27. doi:10.1111/aogs.12770. PMID 26345161. S2CID 40753277.
  25. ^ Choi SJ (September 2017). "Use of progesterone supplement therapy for prevention of preterm birth: review of literatures". Obstetrics & Gynecology Science. 60 (5): 405–420. doi:10.5468/ogs.2017.60.5.405. PMC 5621069. PMID 28989916.
  26. ^ Whitaker A, Gilliam M (2014). Contraception for Adolescent and Young Adult Women. Springer. p. 98. ISBN 978-1-4614-6579-9.
  27. ^ Chaudhuri (2007). Practice of Fertility Control: A Comprehensive Manual (7Th ed.). Elsevier India. pp. 153–. ISBN 978-81-312-1150-2.
  28. ^ a b c Goletiani NV, Keith DR, Gorsky SJ (October 2007). "Progesterone: review of safety for clinical studies". Experimental and Clinical Psychopharmacology. 15 (5): 427–444. doi:10.1037/1064-1297.15.5.427. PMID 17924777.
  29. ^ Stute P, Neulen J, Wildt L (August 2016). "The impact of micronized progesterone on the endometrium: a systematic review" (PDF). Climacteric. 19 (4): 316–328. doi:10.1080/13697137.2016.1187123. PMID 27277331.
  30. ^ Cite error: The named reference Josimovich2013 was invoked but never defined (see the help page).
  31. ^ Cite error: The named reference CoutinhoSegal1999 was invoked but never defined (see the help page).
  32. ^ Cite error: The named reference Seaman2011 was invoked but never defined (see the help page).
  33. ^ a b Cite error: The named reference Simon1995 was invoked but never defined (see the help page).
  34. ^ Cite error: The named reference pmid6925387 was invoked but never defined (see the help page).
  35. ^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  36. ^ "Progesterone - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.

Rich TVX News Network Site

Rich TVX News Network Info

© MMXXIII Rich X Search. We shall prevail. All rights reserved. Rich X Search