Progesterone - rectal

Progesterone is a natural female hormone that is used to treat pre-menstrual syndrome (physical, emotional or mood change prior to a woman’s menstrual cycle).

This medicine may also be used to treat depression that occurs after giving birth.

Use Progesterone exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor.

Use it at the same time each day.

To use Progesterone pessary, follow these steps:

1. Wash your hands thoroughly.
2. Remove the pessary from the wrapper.
3. Lie on your left side and pull your right knee up to your chest.
4. Gently insert the pessary with the pointed end first into your rectum. Gently push the pessary as far as it would go.
5. Squeeze your buttocks together for a few seconds to hold the pessary in place. The pessary must remain in the rectum so that the medicine can be absorbed.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition.

This medicine must be administered on a regular interval for it to be effective. Do not stop treatment unless instructed by your doctor.

Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to administer your medicine, let your doctor and pharmacist know.

Do not use Progesterone if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or any of its ingredients.

Alert your doctor if you have the following conditions:

• unusual or unexplained vaginal bleeding
• known or suspected cancer of the breast or genital organs
• blood clots due to swollen veins or a blocked blood vessel
• porphyria (an inherited disorder that may cause skin or nerve problems)
• missed abortion or miscarriage (fetus dies but the body does not recognize pregnancy loss)
• ectopic pregnancy (pregnancy outside of the womb)
• severe liver disease

as Progesterone may not be suitable for you.

Inform your doctor if you have the following conditions:

• heart disease
• high blood pressure
• migraine
• epilepsy (fits or seizures)
• asthma
• diabetes
• high cholesterol level
• history of depression
• systemic lupus erythematosus (autoimmune disease that causes inflammation)
• history of blood clots in the vein such as in the legs or lungs
• obesity
• tobacco use
• kidney disease
• mild to moderate liver disease

Let your doctor know if you are pregnant or breastfeeding.

If you are going for any laboratory tests or operation, including minor surgery and dental work, inform your doctor or dentist that you are using this medicine.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. cholesterol levels, thyroid function test) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure during treatment.
• Breast and pelvic examination may also be done before or during treatment.

Progesterone may cause drowsiness or dizziness. If affected, do not drive or take part in any activity in which you need to be alert.

Other side effects include any of the following: nausea, vomiting, stomach pain, bloating, diarrhoea, constipation, tiredness, irritability, fever, cough, weight gain or loss, swelling of the ankles, feet or hand, muscle and joint pain, headache, nervousness, skin rash, patches of discolouration in the face, hair loss, difficulty sleeping, depression, anxiety, a sudden feeling of heat (hot flush), urinary problems, decrease sex drive, and breast pain, swelling, or tenderness.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• rashes, breathlessness, swelling of the face, eyes or mouth
• a lump in the breast, breast pain, nipple discharge
• excessive menstrual cramps, abnormal or heavy menstrual flow
• blurred vision, changes or any problems in your eyesight
• chest pain or pressure, difficulty of breathing, irregular heartbeat
• leg or arm swelling, warmth, numbness, change of colour, or pain

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking or using any of these medicines:

• rifampicin (medicine to treat TB [infection known as tuberculosis])
• medicines for epilepsy (fits or seizures) e,g. carbamazepine, phenytoin, phenobarbital
• medicines to treat fungal infection e.g. griseofulvin, ketoconazole
• ritonavir (medicine for HIV infection)
• spironolactone (water pill)
• ciclosporin (medicine used in organ transplant or certain immune disorders)
• medicines for diabetes
• St. John’s wort (herbal medicine)
• other vaginal products e.g. antifungal

This list does not include all medicines that may interact with Progesterone.

Always notify your doctor and pharmacist if you are taking or using any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.