What is Dydrogesterone?
Diderogesterone is a synthetic progesterone hormone and lacks androgenic and estrogenic properties. Unlike many progesterone compounds, dydrogesterone does not cause a rise in temperature and does not prevent ovulation.
This drug belongs to the group of progesterone agonists (female sex hormone). It works by reducing the risk of endometrial hyperplasia (increasing endometrial thickness).
Diderogesterone is used in the following conditions:
Dysmenorrhea (painful periods of menstruation)
In combination with estrogen, it can be used to treat secondary amenorrhea (lack of menstrual periods for 6 months or more). This compound can also be used to treat heavy and irregular bleeding.
Diderogesterone, when used for hormone therapy, can prevent hot flashes, especially in postmenopausal women. It can also prevent bone resorption and destruction.
Mechanism of action
Diderogesterone is a progesterone that works by regulating healthy growth and natural shedding of the uterine lining by affecting progesterone receptors in the uterus.
Diderogesterone is an orally active progesterone that acts directly on the uterus and produces a complete secretory endometrium in the uterus with estrogen. At therapeutic levels, dydrogesterone has no contraceptive effect because it does not inhibit ovulation or corpus luteum. In addition, dydrogesterone is non-androgenic, non-estrogenic, non-corticoid, non-anabolic and is not excreted as pregnandiol. Diderogesterone helps regulate healthy growth and normal uterine wall shedding. Therefore, it may be useful in treating menstrual disorders such as irregular or painful menstruation, infertility, premenstrual syndrome and endometriosis.
Recurrent miscarriage: 10 mg until the 12th week of pregnancy.
Infertility due to luteal insufficiency: 10 or 20 mg per day starting in the second half of the menstrual cycle until the first day of the next cycle. Continue treatment for at least 3 consecutive periods.
Dysmenorrhea: 10 or 20 mg per day for 5 to 25 menstrual cycles per day.
Endometriosis: 10-30 mg daily from day 5-25 of the menstrual cycle or continuously for the entire cycle.
Risk of miscarriage: Initially a maximum of 40 mg, followed by 20 or 30 mg per day until symptoms resolve.
Endometrial protection during menopausal hormone replacement therapy: In addition to the estrogen dose: Continuous treatment: 10 mg daily for the last 14 days of each 28-day cycle.
Periodic treatment: 10 mg daily for 12-14 days with estrogen therapy. Depending on the clinical response, it may be adjusted to 20 mg per day.
Uterine bleeding: Cessation of bleeding periods: 20 or 30 mg per day for up to 10 days is prescribed.
Continuous treatment: 10 or 20 mg per day in the second half of the menstrual cycle.
The initial treatment and duration depends on the length of the course.
Secondary amenorrhea: 10 or 20 mg daily for 14 days in the second half of the cycle.
Irregular menstrual cycle: 10 or 20 mg per day from the second half of the menstrual cycle to the first day of the next cycle, treatment and the initial duration depends on the length of the period.
Premenstrual syndrome: 10 mg starts from the second half of the menstrual cycle until the first day of the next cycle, the initial treatment and its duration depends on the length of the period.
Absorption: It is rapidly absorbed from the gastrointestinal tract and its bioavailability is 28%.
Distribution volume: Unknown
Protein binding rate: Unknown
Metabolism: Completely metabolized to the metabolite 20 dihydrohydrogesterone (DHD).
Disposal route: Unknown
Half-life: didrogesterone: 5-7 hours, metabolite 20
dihydrohydrotestosterone (DHD): 14 to 17 hours
Uses of dydrogesterone
- Recurrent miscarriage
- Infertility due to luteal insufficiency
- Dysmenorrhea (early menstrual cramps)
- Possibility of abortion
- Protection of the endometrium during hormone replacement therapy during menopause
- Uterine bleeding
- Secondary amenorrhea
- Irregular menstrual cycle
- Premenstrual Syndrome
Stroke, jaundice, abnormal vaginal bleeding, breast cancer, heart attack, liver disorder or disease, blood clotting problems, bladder problems, genital cancer, any type of estrogen-dependent cancer, type of oral cancer due to oral contraceptives, anemia Sickle cell or other abnormal shapes, herpes during pregnancy
Known or suspected progesterone-dependent neoplasms (eg meningioma)
Undetected vaginal bleeding
Presence or history of serious liver disorders
Concomitant use of estrogen when using estrogen to prevent endometrial hyperplasia.
Side effects of dydrogesterone
Anemia, headache, nausea, dizziness, weakness, urticaria, skin reactions, pruritus, jaundice, abdominal pain, abnormal liver function, breast tenderness, spotting or intermenstrual bleeding
Common side effects:
Bleeding and spotting, venous thromboembolism, menstrual disorders (eg menorrhagia, amenorrhea, oligomenorrhea, dysmenorrhea and irregular menstruation), breast tenderness or pain, abnormal LFT (liver function tests).
Gastrointestinal disorders: nausea, vomiting.
Nervous system disorders: migraine, headache, dizziness
Psychiatric disorders: Depressed mood
Skin disorders: skin rash, itching, hives.
Potentially fatal side effects:
Increased risk of breast cancer or, rarely, ovarian cancer (when combined with estrogen)
In patients with porphyria, gestational herpes, atherosclerosis, severe pruritus, history of depression. Liver disorder. Pregnancy and lactation should be used with caution.
Drink the whole tablet with a glass of water and avoid chewing and crushing the tablets.
Can be consumed regardless of food.
Consumption in pregnancy
It is not known to have harmful effects on pregnancy
It can be used during pregnancy if prescribed correctly by a doctor.
Consumption in lactation
There is no information on the excretion of didrogesterone in breast milk. Experience with other progesterones shows that progesterones and metabolites are transferred to breast milk in small amounts. It is not clear if there is a danger to the child. Therefore, dydrogesterone should not be used during breastfeeding.
Medroxyprogesterone, hydroxy progesterone, progesterone (endometrium)
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