Side Effects of Prometrium progesterone Interactions Warnings

Side Effects of Prometrium progesterone Interactions Warnings

Side Effects of Prometrium (progesterone)

Prometrium (progesterone) is a man-made medication derived from a plant source and is identical to the female hormone progesterone produced in the ovaries used to help regulate the uterine lining in post-menopausal women.

Progesterone is involved in:

  • promoting mammary gland development,
  • causing changes in the endometrium,
  • relaxing uterine smooth muscles,
  • blocking ovulation, and
  • maintaining pregnancy.

Common side effects of Prometrium include

Serious side effects of Prometrium include

  • cardiovascular disorders,
  • breast cancer, and
  • possibly dementia in postmenopausal women.

Drug interactions of Prometrium include

  • ketoconazole,
  • clarithromycin, and
  • erythromycin because they slow progesterone breakdown and increase its levels in the body.

Prometrium should not be used during pregnancy. Prometrium may be found in trace amounts in breast milk. Consult your doctor before breastfeeding.

What are the side effects of Prometrium (progesterone)?

Side effects of progesterone are

Progesterone is also associated with

  • cardiovascular disorders,
  • breast cancer, and
  • possibly dementia in postmenopausal women.

Prometrium (progesterone) side effects list for healthcare professionals

Because clinical trials are conducted under varying conditions, adverse reaction rates observed in the trials of a drug cannot be directly compared to rates in the trials of another drug and may not reflect the rates observed in practice.

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In a randomized, double-blind, placebo-controlled clinical trial, the effects of Prometrium Capsules on the endometrium was studied in a total of 875 postmenopausal women.

Table 6 lists adverse reactions reported in an 875 patient placebo-controlled trial in postmenopausal women over a 3-year period.

TABLE 6. Adverse Reactions (≥ 2%) Reported in a 875 Patient Placebo-Controlled Trial in Postmenopausal Women Over a 3-Year Period [Percentage (%) of Patients Reporting]

Prometrium Capsules 200 mg with Conjugated Estrogens 0.625 mg Placebo
(n=178) (n=174)
Headache 31 27
Breast Tenderness 27 6
Joint Pain 20 29
Depression 19 12
Dizziness 15 9
Abdominal Bloating 12 5
Hot Flashes 11 35
Urinary Problems 11 9
Abdominal Pain 10 10
Vaginal Discharge 10 3
Nausea / Vomiting 8 7
Worry 8 4
Chest Pain 7 5
Diarrhea 7 4
Night Sweats 7 17
Breast Pain 6 2
Swelling of Hands and Feet 6 9
Vaginal Dryness 6 10
Constipation 3 2
Breast Carcinoma 2
Breast Excisional Biopsy 2
Cholecystectomy 2

Effects On Secondary Amenorrhea

In a randomized, double-blind, placebo-controlled clinical trial, the effects of Prometrium Capsules on secondary amenorrhea was studied in 49 estrogen-primed postmenopausal women.

Table 7 lists adverse reactions reported in patients using 400 mg/day in a placebo-controlled trial in estrogen-primed postmenopausal women.

TABLE 7. Adverse Reactions (≥ 5%) Reported in Patients Using 400 mg/day in a Placebo- Controlled Trial in Estrogen-Primed Postmenopausal Women

Adverse Experience Prometrium Capsules 400 mg Placebo
n=25 n=24
Percentage (%) of Patients
Fatigue 8 4
Headache 16 8
Dizziness 24 4
Abdominal Distention (Bloating) 8 8
Abdominal Pain (Cramping) 20 13
Diarrhea 8 4
Nausea 8 0
Back Pain 8 8
Musculoskeletal Pain 12 4
Irritability 8 4
Breast Pain 16 8
Infection Viral 12 0
Coughing 8 0

In a parallel-group, open label postmarketing dosing study consisting of three consecutive 28-day treatment cycles, 220 premenopausal women with secondary amenorrhea were randomized to receive daily conjugated estrogens therapy (0.625 mg conjugated estrogens) and Prometrium Capsules, 300 mg per day (n=113) or Prometrium Capsules, 400 mg per day (n=107) for 10 days of each treatment cycle.

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Overall, the most frequently reported treatment-emergent adverse reactions, reported in greater than or equal to 5 percent of subjects, were

  • nausea,
  • fatigue,
  • vaginal mycosis,
  • nasopharyngitis,
  • upper respiratory tract infection,
  • headache,
  • dizziness,
  • breast tenderness,
  • abdominal distension,
  • acne,
  • dysmenorrhea,
  • mood swing,
  • and urinary tract infection.

Postmarketing Experience

The following additional adverse reactions have been reported with Prometrium Capsules. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate the frequency or establish a causal relationship to drug exposure.

Genitourinary System

endometrial carcinoma, hypospadia, intra-uterine death, menorrhagia, menstrual disorder, metrorrhagia, ovarian cyst, spontaneous abortion.

Cardiovascular

circulatory collapse, congenital heart disease (including ventricular septal defect and patent ductus arteriosus), hypertension, hypotension, tachycardia.

Gastrointestinal

acute pancreatitis, cholestasis, cholestatic hepatitis, dysphagia, hepatic failure, hepatic necrosis, hepatitis, increased liver function tests (including alanine aminotransferase increased, aspartate aminotransferase increased, gamma-glutamyl transferase increased), jaundice, swollen tongue.

Skin
Eyes
Central Nervous System

aggression, convulsion, depersonalization, depressed consciousness, disorientation, dysarthria, loss of consciousness, paresthesia, sedation, stupor, syncope (with and without hypotension), transient ischemic attack, suicidal ideation.

During initial therapy, a few women have experienced a constellation of many or all of the following symptoms: extreme dizziness and/or drowsiness, blurred vision, slurred speech, difficulty walking, loss of consciousness, vertigo, confusion, disorientation, feeling drunk, and shortness of breath.

Miscellaneous

abnormal gait, anaphylactic reaction, arthralgia, blood glucose increased, choking, cleft lip, cleft palate, difficulty walking, dyspnea, face edema, feeling abnormal, feeling drunk, hypersensitivity, asthma, muscle cramp, throat tightness, tinnitus, vertigo, weight decreased, weight increased.

What drugs interact with Prometrium (progesterone)?

Drug-Laboratory Test Interactions

The following laboratory results may be altered by the use of estrogen plus progestin therapy:

  • Increased sulfobromophthalein retention and other hepatic function tests.
  • Coagulation tests: increase in prothrombin factors VII, VIII, IX and X.
  • Pregnanediol determination.
  • Thyroid function: increase in PBI, and butanol extractable protein bound iodine and decrease in T3 uptake values.
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Summary

Prometrium (progesterone) is a man-made medication derived from a plant source and is identical to the female hormone progesterone produced in the ovaries used to help regulate the uterine lining in post-menopausal women. Common side effects of Prometrium include headache, dizziness, fatigue, abdominal pain, nausea, breast tenderness, joint pain, depression, mood swings, and hot flashes. Prometrium should not be used during pregnancy. Prometrium may be found in trace amounts in breast milk.

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