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Brand Name: Duphaston
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Generic Name: Dydrogesterone
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Therapeutic Class: Retroprogesterone (Synthetic Progestogen)
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Form: 10 mg film-coated tablets
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Key Feature:
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No androgenic/estrogenic/glucocorticoid activity
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Does not inhibit ovulation
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2. COMPOSITION
Component | Role |
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Dydrogesterone | Active ingredient (structurally similar to natural progesterone) |
Lactose monohydrate | Filler |
Hypromellose | Coating agent |
Magnesium stearate | Lubricant |
(Gluten-free formulation)
3. MECHANISM OF ACTION
✔ Binds selectively to progesterone receptors
✔ Produces secretory endometrium → supports implantation
✔ Maintains pregnancy by preventing uterine contractions
✔ No thermogenic effect (basal body temperature unchanged)
4. DOSAGE & ADMINISTRATION
By Indication
Condition | Dosage Regimen | Duration |
---|---|---|
Endometriosis | 10 mg 2-3x daily | Days 5-25 of cycle |
Dysmenorrhea | 10 mg 2x daily | Days 5-25 of cycle |
Threatened Miscarriage | 40 mg stat → 10 mg every 8h | Until symptoms resolve +1 week |
Luteal Phase Support | 10 mg 2x daily | From ovulation → 10-12 weeks gestation |
HRT Combination | 10 mg daily | Last 12-14 days of estrogen cycle |
Key Notes:
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Take with food to reduce nausea
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No need for dose tapering before discontinuation
5. INDICATIONS
✅ Menstrual disorders (dysmenorrhea, irregular cycles)
✅ Endometriosis
✅ Luteal phase defect (fertility treatments)
✅ Threatened/recurrent miscarriage
✅ HRT adjunct (endometrial protection)
6. STORAGE CONDITIONS
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Temperature: Below 30°C
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Humidity: Keep in original blister pack
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Shelf Life: 3 years
7. KEY RECOMMENDATIONS
✔ For fertility patients:
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Start after confirmed ovulation (avoid anovulatory cycles)
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Combine with ultrasound monitoring
✔ For HRT:
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Ensure adequate estrogen priming first
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Withdraw bleeding expected after progestin phase
✔ Safety advantage:
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No negative impact on lipids/carbohydrate metabolism
8. IMPORTANT SAFETY NOTES
Contraindications
❌ Severe hepatic impairment
❌ Known progesterone-sensitive tumors
❌ Undiagnosed vaginal bleeding
Adverse Effects
Common (≥1%) | Rare (<0.1%) |
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Breakthrough bleeding | Allergic reactions |
Mild nausea | Thrombotic events (very rare) |
Breast tenderness |
Pregnancy/Lactation
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Pregnancy (Category not assigned): Safe for luteal support
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Breastfeeding: Minimal milk transfer
9. COMPARISON WITH OTHER PROGESTINS
Parameter | Dydrogesterone | Medroxyprogesterone | Micronized Progesterone |
---|---|---|---|
Androgenic Effects | None | Mild | None |
Sedation | No | No | Yes |
Fertility-Friendly | Yes | No | Yes |
Metabolic Impact | Neutral | Negative | Neutral |
10. PATIENT COUNSELING
✔ Take consistently at same times daily
✔ Report:
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Heavy/prolonged bleeding
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Severe abdominal pain
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Visual disturbances (rare migraine precursor)
✔ Fertility patients: -
Continue until placenta forms (∼10-12 weeks)
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No abrupt discontinuation needed
CONCLUSION
Duphaston 10 mg offers targeted progesterone effects without androgenic/ metabolic side effects, making it ideal for:
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Fertility support (no ovulation suppression)
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Long-term endometrial protection in HRT
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High-risk pregnancy management
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