Duphaston

Duphaston (dydrogesterone) is a progestogen medication designed to address a range of conditions related to progesterone deficiency. It is widely prescribed in gynecological and obstetric practice due to its structural similarity to natural progesterone and its selective action on the endometrium. Unlike some synthetic progestogens, it does not exhibit androgenic, estrogenic, or glucocorticoid activity, making it a targeted therapeutic option. It is commonly used in the management of menstrual disorders, endometriosis, and in supporting early pregnancy.

Features

• Active ingredient: Dydrogesterone 10 mg
• Selective progestogenic action with no androgenic, estrogenic, or anabolic effects
• High oral bioavailability and predictable pharmacokinetics
• Well-tolerated with a favorable safety profile
• Does not inhibit ovulation when used appropriately

Benefits

• Effectively regulates menstrual cycles and reduces abnormal uterine bleeding
• Provides luteal phase support in infertility treatment and early pregnancy
• Alleviates symptoms associated with endometriosis, such as pelvic pain
• Helps prevent endometrial hyperplasia in estrogen replacement therapy
• Minimizes androgenic side effects like acne or hirsutism compared to some progestins
• Supports embryo implantation and maintenance of pregnancy in cases of corpus luteum insufficiency

Common use

Duphaston is indicated for a variety of progesterone-deficient conditions. It is frequently prescribed for dysfunctional uterine bleeding, amenorrhea, and irregular cycles due to luteal phase defects. In fertility treatments, it is used for luteal phase support. It is also employed in hormone replacement therapy (HRT) to protect the endometrium from unopposed estrogen. Additionally, it is utilized in the management of endometriosis, premenstrual syndrome (PMS), and threatened or habitual abortion.

Dosage and direction

Dosage varies significantly based on indication and individual patient factors. For menstrual disorders, typical dosing is 10 mg twice daily from day 11 to day 25 of the cycle. In endometriosis, 10 mg two or three times daily may be used continuously or cyclically. For luteal phase support in infertility, 10 mg twice daily is often started after confirmed ovulation and continued through early pregnancy if conception occurs. In HRT, it is commonly prescribed at 10 mg daily for the last 12–14 days of each estrogen cycle. Always follow the precise regimen prescribed by a healthcare provider, and do not adjust dosage without consultation.

Precautions

Use with caution in patients with a history of depression, as progestogens may exacerbate symptoms. Monitor patients with pre-existing renal or hepatic impairment, although no specific dose adjustment is usually required. Not intended for use as a contraceptive. Patients with undiagnosed vaginal bleeding should undergo thorough evaluation before initiation. Long-term use requires periodic reevaluation of the benefit-risk ratio. Caution is advised when prescribing to patients with conditions that may be influenced by fluid retention, such as epilepsy, migraine, or asthma.

Contraindications

Hypersensitivity to dydrogesterone or any excipients in the formulation. Known or suspected progestogen-dependent neoplasms, such as meningioma. Severe hepatic dysfunction. Undiagnosed vaginal bleeding. Acute arterial disease (e.g., stroke, myocardial infarction). Duphaston is not indicated during breastfeeding and is contraindicated in patients with a history of or current thrombophilic disorders.

Possible side effect

Most side effects are mild and dose-dependent. Commonly reported adverse reactions include nausea, headache, dizziness, and breast tenderness. Breakthrough bleeding or spotting may occur, especially during the first few cycles of use. Less frequently, patients may experience vomiting, fatigue, skin reactions, or mild peripheral edema. Mood changes, including depression or irritability, have been reported rarely. Severe allergic reactions are uncommon but require immediate medical attention.

Drug interaction

Enzymes inducers such as rifampicin, phenytoin, or carbamazepine may reduce the efficacy of dydrogesterone by accelerating its metabolism. Concurrent use with other hormonal therapies should be carefully managed to avoid additive effects. No clinically significant interactions with common anticoagulants or antihypertensives have been established, but monitoring is advised when initiating or discontinuing Duphaston in patients on such therapies.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next dose. In that case, skip the missed dose and resume the regular schedule. Do not double the dose to make up for a missed one. Consistently missed doses may reduce efficacy and cause breakthrough bleeding; patients should maintain a dosing diary or use reminders to support adherence.

Overdose

No specific antidote exists for dydrogesterone overdose. Symptoms may include nausea, vomiting, dizziness, or drowsiness. Treatment is supportive and symptomatic. Gastric lavage may be considered if ingestion was recent. Medical attention should be sought immediately in cases of suspected overdose, especially in children or vulnerable individuals.

Storage

Store below 30°C (86°F), in a dry place, protected from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Do not dispose of medication via wastewater or household waste; consult a pharmacist for proper disposal methods.

Disclaimer

This information is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or changing any medication regimen. Individual patient needs and responses may vary.

Reviews

Clinical studies and patient reports generally reflect positive experiences with Duphaston, particularly regarding its efficacy in cycle regulation and pregnancy support. Many users note fewer androgenic side effects compared to other progestins. Some report initial bloating or mild mood changes that often subside with continued use. Adherence to prescribed dosing is frequently emphasized as critical to achieving desired outcomes.