Duphaston: Progesterone Support for Hormonal Balance
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Duphaston (dydrogesterone) is a synthetic progestogen medication designed to mimic the effects of natural progesterone in the body. It is widely prescribed to address a range of hormone-related conditions, particularly those involving progesterone deficiency or imbalance. With its high selectivity for progesterone receptors and favorable safety profile, Duphaston offers targeted therapeutic action without androgenic, estrogenic, or glucocorticoid effects. It is commonly used in the management of menstrual disorders, endometriosis, and infertility, as well as in hormone replacement therapy.
Features
- Contains dydrogesterone, a structurally retroprogesterone with high oral bioavailability
- Selective action on progesterone receptors without significant cross-reactivity
- No androgenic, estrogenic, or glucocorticoid activity
- Well-established pharmacokinetic profile with rapid absorption and elimination
- Available in 10 mg tablet form for precise dosing
- Manufactured under strict pharmaceutical quality control standards
Benefits
- Effectively supports endometrial preparation and maintenance in menstrual cycle disorders
- Reduces the risk of endometrial hyperplasia in estrogen replacement therapy
- Helps manage symptoms of endometriosis, including pelvic pain and dysmenorrhea
- Supports luteal phase supplementation in assisted reproductive technology (ART) cycles
- Minimizes androgenic side effects such as acne or hirsutism often associated with other progestins
- Provides predictable, dose-dependent progesterone activity with low incidence of systemic side effects
Common use
Duphaston is indicated for a variety of progesterone-dependent conditions. It is commonly prescribed for irregular menstrual cycles, including oligomenorrhea and amenorrhea, where it helps establish regular withdrawal bleeding. In endometriosis management, it reduces ectopic endometrial tissue growth and associated pain. For infertility treatment, it supports the luteal phase to improve implantation rates. It is also used in hormone replacement therapy (HRT) combinations to protect the endometrium from unopposed estrogen effects. Additionally, it may be prescribed for threatened or habitual abortion under specific clinical circumstances.
Dosage and direction
Dosage varies significantly based on indication and individual patient factors. For menstrual disorders: 10 mg twice daily from day 11 to day 25 of the cycle. For endometriosis: 10 mg two to three times daily from day 5 to day 25 of the cycle, or continuously. In infertility treatment: 10 mg twice daily starting after confirmed ovulation, continuing through the first trimester if pregnancy occurs. For HRT combination: typically 10 mg daily for the last 12-14 days of estrogen therapy. Tablets should be swallowed whole with water, with or without food, at approximately the same times each day. Always follow the specific dosing regimen prescribed by your healthcare provider.
Precautions
Patients with a history of depression should be monitored closely as progestogens may worsen symptoms. Use with caution in patients with pre-existing hepatic impairment, as metabolism occurs primarily in the liver. Diabetic patients may require adjustment of hypoglycemic therapy as progestogens can affect glucose tolerance. Those with pre-existing renal conditions should be monitored, although dosage adjustment is typically not required. Patients should be advised that Duphaston may cause dizziness or drowsiness, affecting ability to drive or operate machinery. Regular monitoring of endometrial status is recommended during prolonged use.
Contraindications
Duphaston is contraindicated in patients with known hypersensitivity to dydrogesterone or any excipients in the formulation. It should not be used in cases of undiagnosed vaginal bleeding, as this may indicate underlying pathology requiring different management. Patients with a history of or current thromboembolic disorders (deep vein thrombosis, pulmonary embolism) should avoid use. Those with known or suspected progesterone-dependent neoplasms, such as meningioma, should not take Duphaston. Severe hepatic impairment or hepatic tumors constitute absolute contraindications due to the drug’s hepatic metabolism.
Possible side effect
Common side effects (≥1/100 to <1/10) include headache, nausea, breast tenderness, and breakthrough bleeding. Uncommon side effects (≥1/1,000 to <1/100) may include dizziness, vomiting, skin rash, pruritus, and fatigue. Rare side effects (≥1/10,000 to <1/1,000) include jaundice, edema, and weight changes. Very rare side effects (<1/10,000) include hemolytic anemia, hypersensitivity reactions, and depression. Most side effects are dose-dependent and transient, often resolving with continued therapy or dosage adjustment. Patients should report persistent or severe reactions to their healthcare provider.
Drug interaction
Duphaston may interact with drugs that induce hepatic enzymes, such as rifampicin, phenobarbital, and carbamazepine, potentially reducing its efficacy. Conversely, drugs that inhibit CYP3A4 (e.g., ketoconazole, ritonavir) may increase dydrogesterone levels. Concurrent use with other hormonal therapies may require dosage adjustments. The medication may affect the metabolism of anticoagulants, potentially necessitating monitoring of coagulation parameters. Interactions with St. John’s Wort may decrease progestogen effectiveness. Always inform healthcare providers of all medications, including over-the-counter drugs and supplements.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to make up for a missed one. Maintaining consistent dosing is particularly important in cycle regulation and fertility treatments. If multiple doses are missed or uncertainty exists about proper management, consult the prescribing physician for specific guidance based on the treatment indication.
Overdose
No specific antidote exists for dydrogesterone overdose. Symptoms may include nausea, vomiting, dizziness, and drowsiness. In case of suspected overdose, seek immediate medical attention. Treatment is supportive and symptomatic, including gastric lavage if ingestion was recent. Monitor vital signs and provide appropriate symptomatic care. Due to the drug’s favorable safety profile, serious consequences from overdose are unlikely, but medical evaluation is recommended, particularly with large ingestions.
Storage
Store below 30°C (86°F) in the original packaging to protect from light and moisture. Keep the container tightly closed and out of reach of children. Do not use after the expiration date printed on the packaging. Do not dispose of medication in wastewater or household waste; return unused medication to pharmacy for proper disposal. Tablets should be protected from excessive heat and humidity to maintain stability.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Individual treatment should always be determined by a qualified healthcare professional based on specific medical circumstances. Dosage and indications may vary based on regional prescribing information. Always consult the official prescribing information and your physician before starting or modifying any treatment regimen. The manufacturer does not accept liability for incorrect use or interpretation of this information.
Reviews
Clinical studies demonstrate Duphaston’s efficacy in regulating menstrual cycles with success rates of 85-90% in appropriate patient populations. In endometriosis management, studies show significant reduction in pain scores and improved quality of life measures. For luteal phase support in fertility treatments, meta-analyses indicate comparable efficacy to natural progesterone with improved tolerability. Long-term safety data from post-marketing surveillance confirms the favorable risk-benefit profile when used as directed. Patient-reported outcomes frequently note satisfaction with reduced symptoms and improved cycle regularity, though individual experiences may vary based on underlying conditions and treatment adherence.