Generic Prometrium

Introduction

Prometrium is a prescription medication that supplies the natural hormone progesterone. It is classified within the Women’s Health group and is used primarily to address hormonal deficiencies that affect the menstrual cycle, fertility, and the maintenance of early pregnancy. The product is marketed by Watson Pharmaceuticals (now part of Teva UK) and is available in the United Kingdom in 100 mg hard‑gel capsules. In addition to its primary indication for luteal‑phase support, Prometrium is sometimes prescribed for menopausal hormone therapy, the treatment of abnormal uterine bleeding, and to reduce the risk of endometrial hyperplasia in women receiving estrogen without a progestogen.

What is Prometrium?

Prometrium is a hard‑gel capsule that contains micronised progesterone, the same molecule that is endogenously produced by the ovaries after ovulation. The product is manufactured according to Good Manufacturing Practice (GMP) standards and is supplied as a pharmaceutical‑grade oral preparation.

• Classification: Hormone replacement therapy (HRT); progestogen.
• Development: The progesterone used in Prometrium is derived from plant sterols and is chemically identical to endogenous progesterone.
• Manufacturer: Originally developed by Watson Pharmaceuticals; currently distributed by Teva UK.

Prometrium provides a regulated, reproducible dose of progesterone that is bioequivalent to the body’s own hormone, allowing clinicians to restore a physiologic hormonal environment when natural production is insufficient.

How Prometrium Works

Progesterone binds to intracellular progesterone receptors (PR‑A and PR‑B) that are expressed in the uterus, breast, brain, and other target tissues. Upon binding, the receptor complex translocates to the cell nucleus and modulates gene transcription. Key actions relevant to therapy include:

• Preparation of the endometrium: Progesterone converts the estrogen‑primed proliferative endometrium into a secretory state, essential for embryo implantation and maintenance of early pregnancy.
• Inhibition of myometrial contractions: By reducing gap‑junction communication and altering calcium signalling, progesterone helps maintain uterine quiescence.
• Negative feedback on the hypothalamic–pituitary axis: It suppresses luteinising hormone (LH) and follicle‑stimulating hormone (FSH) secretion, preventing premature follicular development.

After oral ingestion, micronised progesterone is rapidly absorbed; peak plasma concentrations occur within 2–4 hours. The drug is metabolised mainly by hepatic CYP3A4 to inactive metabolites and eliminated primarily in the urine, with a terminal half‑life of approximately 4–7 hours.

Conditions Treated with Prometrium

• Luteal‑phase support in assisted reproduction – Women undergoing in‑vitro fertilisation (IVF) or embryo transfer often have an inadequate luteal phase. Supplemental progesterone improves implantation rates and reduces early miscarriage.
• Hormone Replacement Therapy (HRT) for menopausal symptoms – When combined with estrogen, progesterone prevents endometrial hyperplasia, a prerequisite for safe estrogen therapy in women with an intact uterus.
• Abnormal uterine bleeding (AUB) related to anovulation – Progesterone stabilises the endometrium, reducing irregular bleeding in conditions such as polycystic ovary syndrome (PCOS).
• Prevention of preterm birth in selected high‑risk pregnancies – Some guidelines endorse progesterone supplementation for women with a prior spontaneous preterm delivery or a short cervical length.

In the United Kingdom, the National Institute for Health and Care Excellence (NICE) endorses progesterone for luteal support and for certain high‑risk obstetric scenarios, reflecting its evidence‑based efficacy and safety profile.

Suitable Candidates for Prometrium Treatment

• Women undergoing IVF or embryo transfer who require luteal‑phase support, particularly when a natural corpus luteum function is insufficient.
• Postmenopausal women with an intact uterus who are prescribed estrogen therapy; progesterone is essential to counteract estrogen‑induced endometrial proliferation.
• Women with documented luteal‑phase deficiency causing recurrent miscarriage or early pregnancy loss.
• Patients with anovulatory bleeding (e.g., PCOS) where cyclic progesterone can restore regular shedding of the endometrium.

Contra‑indications include:

• Known or suspected pregnancy when progesterone is not indicated (e.g., for early‑stage miscarriage).
• Unexplained bleeding of unknown origin.
• Active or previous thromboembolic disease, liver disease, or hormone‑sensitive malignancy, unless the benefits clearly outweigh risks.

Clinicians must assess individual risk factors, especially in older women or those with cardiovascular comorbidities, before initiating therapy.

Risks, Side Effects, and Interactions

Common

• Mild gastrointestinal disturbance – nausea, bloating, or abdominal discomfort.
• Sleep‑related changes – increased drowsiness or vivid dreams (often reported with night‑time dosing).
• Headache – typically transient and self‑limiting.

Rare

• Allergic reactions – rash, pruritus, or urticaria.
• Elevated liver enzymes – observed in isolated case reports; routine monitoring is advised in long‑term use.

Serious

• Thromboembolic events – although the absolute risk with oral micronised progesterone is low, women with a personal or family history of deep‑vein thrombosis should be evaluated carefully.
• Severe hypersensitivity – anaphylaxis, though exceedingly uncommon.
• Exacerbation of hormone‑sensitive cancers – progesterone may stimulate certain tumour types; oncological consultation is required before use in this context.

Drug‑Drug Interactions

• CYP3A4 inducers (e.g., rifampicin, carbamazepine) may reduce progesterone plasma levels, potentially compromising therapeutic effect.
• CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) can increase progesterone concentrations, raising the likelihood of side effects.
• Anticoagulants – progesterone may modestly increase the risk of bleeding; INR monitoring is advisable for patients on warfarin.
• Hormonal contraceptives – concurrent use does not typically require dosage adjustment but should be discussed with a prescriber to avoid overlapping progestogenic exposure.

Patients should disclose all current medications, including over‑the‑counter supplements and herbal products, to minimise interaction risk.

Practical Use: Dosing, Missed Dose, Overdose

• Standard dosing for luteal‑phase support: 400 mg daily, divided into two 200 mg capsules taken orally in the evening. The dosage may be adjusted based on protocol, body weight, or serum progesterone levels.
• Menopausal HRT: 100 mg once daily, typically taken at bedtime to align with the natural nocturnal rise in progesterone.
• Missed dose: If remembered within 12 hours, take the missed capsule; otherwise, skip and continue the regular schedule. Doubling doses is not recommended.
• Overdose: Symptoms may include excessive drowsiness, nausea, or dizziness. In the event of suspected overdose, seek medical advice promptly; treatment is primarily supportive.

Administration tips

• Swallow capsules whole with a glass of water; do not crush or chew.
• Food does not markedly affect absorption, but taking the medication with a light snack can reduce gastrointestinal discomfort.
• Avoid concurrent heavy alcohol consumption, as it may potentiate sedation.

Buying Prometrium from Our Online Pharmacy

Prometrium can be purchased safely from our online pharmacy in the UK. Our service offers several advantages for patients seeking reliable access to this hormone therapy:

• Cost‑effective pricing – We source the medication at near‑manufacturer cost, passing savings directly to you.
• Verified quality – All batches are obtained from licensed overseas suppliers that meet stringent GMP standards.
• Discreet, reliable delivery – Packages are shipped in unmarked envelopes with tracking; standard delivery is typically 3‑5 working days, with an express option available within 7 days.
• International access – As a pharmacy‑broker service, we collaborate with accredited pharmacies worldwide, enabling patients to obtain medications that may be limited in local stock.
• Privacy‑first approach – Our platform respects patient confidentiality; payment and shipping details are encrypted and handled securely.

Choosing our online pharmacy provides a convenient, affordable pathway to obtain Prometrium when traditional pharmacies have limited availability or when you prefer the convenience of home delivery.

FAQ

• Is Prometrium available in both brand‑name and generic forms in the UK?
  Yes. Prometrium is the brand‑name product, while generic micronised progesterone capsules are also marketed by several manufacturers. Both contain the same active ingredient and are therapeutically equivalent.

• Does Prometrium require refrigeration?
  No. The capsules are stable at room temperature (15‑30 °C). They should be stored away from direct sunlight, moisture, and extreme heat.

• What does the capsule look like?
  Prometrium capsules are hard‑gel, opaque, and typically white to off‑white in colour. The imprint varies by batch but often includes “P” with a numerical code.

• Can I travel internationally with Prometrium?
  Yes, provided you carry the medication in its original labelled packaging and have a copy of the prescription or a physician’s letter. Some countries may require additional documentation, so it is advisable to check local regulations before travel.

• Are there any dietary restrictions while taking Prometrium?
  There are no specific food bans, but a high‑fat meal can modestly increase absorption. To minimise gastrointestinal upset, taking the capsule with a light snack or after a meal is commonly recommended.

• How does Prometrium differ from synthetic progestins like levonorgestrel?
  Prometrium supplies natural progesterone, which binds to progesterone receptors with a physiological profile and has a different side‑effect spectrum. Synthetic progestins may have additional androgenic or glucocorticoid activity, leading to distinct clinical effects.

• What are the legal requirements for importing Prometrium into the UK for personal use?
  Personal importation is permitted for a maximum supply of three months, provided the medication is for a legitimate medical purpose and the purchaser holds a valid UK prescription. The medication must be obtained from a reputable overseas pharmacy.

• Is there any risk of failing a drug test while on Prometrium?
  Standard workplace drug screens do not detect progesterone, as it is an endogenous hormone. However, specialized hormone panels could identify elevated levels, which would be expected with therapeutic use.

• Has Prometrium been evaluated in large clinical trials?
  Yes. Randomised controlled trials have demonstrated that oral micronised progesterone improves luteal support outcomes in IVF cycles and reduces miscarriage rates in women with confirmed luteal‑phase deficiency. Meta‑analyses support its safety profile relative to other progestogens.

• Can Prometrium be compounded into other dosage forms (e.g., creams or suppositories)?
  Compounding is possible but not commonly practiced in the UK because the oral capsule provides predictable pharmacokinetics. Any alternative formulation should be prepared by a qualified pharmacy under a physician’s direction.

Glossary

Micronised progesterone

Progesterone that has been reduced to microscopic particles to improve oral absorption and mimic the natural hormone’s bioavailability.

Luteal‑phase deficiency

A condition where the post‑ovulatory phase produces insufficient progesterone, leading to an unstable endometrium and potential implantation failure.

Endometrial hyperplasia

Over‑growth of the uterine lining caused by unopposed estrogen; progesterone therapy reduces this risk.

CYP3A4

A liver enzyme responsible for metabolising many drugs, including progesterone; its activity can be altered by other medications, affecting progesterone levels.

⚠️ Disclaimer

The information provided about Prometrium is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Prometrium for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.