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Maternal  (Expert Forum)
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Progesterone suppositories versus pills
Patient medical question and answer from The Maternal and Child Health Forum. Health topic area and articles about newborn care

Progesterone suppositories versus pills

by Dawn__0, May 23, 1999 12:00AM

Posted by Dawn on May 23, 1999 at 14:07:54
My doctor has prescribed Prometrium (200 mg 2x a day).  I was on Progesterone suppositories for my last two pregnancies (which I carried to full term) due to a drop in Progesterone levels around the 7th week.  I have scanned the archives and know you say that progesterone suppositories are safe but I can not find anything about Prometrium.  The label and the Web site for the Pharmacuetical company that makes it both state "Do not take if you are pregnant".  It says it is chemically identical to natural Progesterone but is it still synthetic?  I have read that synthetic Progesterone is dangerous.
My HCG levels are normal but my Progesterone dropped from 19 at 5 weeks to to 12.7 at 7 weeks.  Should I insist on Suppositories?  I much prefer the convenience of the pill but do not want to be irresponsible?
Also, If you advise to stop taking it, should I be concerned that I have been on it for 3 days?
Thank you  
Dawn

Posted by hfhs.md.rcs on May 23, 1999 at 18:47:05
Dear Dawn:
Prometrium is "mirconized progesterone": the real thing in crystals that are microsocpic in size. This improves solubility in water (most of our body is water, and not oil where progesterone is happiest) and absorption across the gastrointestinal lining. The "synthetic" in this setting refers to the way it is micronized, not the creation of a "cousin" drug that is artificial (not found in nature).
I have just reviewed a summary of the the reassuring literature on this subject: oral micronized, intramuscular, and vaginal progesterone formulations are all very able to replace progesterone that is not being made by the corpus luteum and support pregnancy.
The labelling of a product is directed by the Food and Drug Administration. The label reflects the information that a company has chosen to bring to the regulatory agency and their response. At this time, Solvay pharmaceutical has not been given approval to label their product safe in pregnancy. That does not mean it is harmful: it means the FDA has not made a determination.
Keywords: oral, mirconized progesterone, early pregnancy
This information is provided for education purposes and is not a medical consutlation. If you have specific questions, please speak with your healthcare provider.



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