Leitura clínica
Comentário
É hormônio natural secretado por ovários, glândulas adrenais placenta. Forma sintética usa-se em anticoncepção, controle sangramento uterino anormal, manutenção gravidez prevenção da hiperplasia endometrial. Administração oral, vaginal, intramuscular ou como componente de dispositivo intrauterino. Excreta-se em leite materno em quantidade clinicamente não significativa (Croxatto 1987). Não observaram problemas em bebês que mamam cujas mães tomavam (Wamboldt 2021, Roy 2020, Reisman 2018, Massai 1999, Chen 1998, Díaz 1997, Shaaban 1991, Díaz 1985 e 1984, Croxatto 1982). Níveis em plasma daqueles bebês foram indetectáveis ou muito baixos (Croxatto 1987). Progesterona não afeta produção leite materno nem estabelecimento duração da amamentação (Carr 2016, Allen 2016, Phillips 2016, Berens 2015, Massai 2005 e 1999, Sivin 1997). Durante amamentação são preferíveis anticoncepcionais com só progestágeno aos combinados com estrogênio. Primeiras 4 a 6 semanas pós-parto métodos não hormonais são de primeira escolha. Se associam estrogênios podem inibir amamentação. Escolher anticoncepcionais com mínima quantidade estrogênios ou melhor com só progestágenos (Berens 2015, CDC 2013, Rowe 2013, Amir 2011, Erkkola 2005, WHO 1994). Academia Americana Pediatria: medicação geralmente compatível com amamentação (AAP 2001).
Encontrabilidade
Outros nomes e marcas
Sinônimos e grafias 8
- Dioxipregneno; Pregnenodiona
- Progestina
- Προγεστερόνη
- بروجيستيرون
- Прогестерон
- 黄体酮
- プロゲステロン
- G03DA04
Marcas comerciais na fonte 29
- Alterpure
- Crinone
- Cuerpo Amarillo Fuerte
- Cyclogest
- Darstin
- Endometrin
- Evocanil
- Fertiring
- Geslutin
- Gestel
- Gestone
- Hormoral
- Lubion
- Lutigest
- Lutinus
- Mafel
- Mastopon-Treat
- Nomagest
- Premastan
- Progeffik
- Progendo
- Progering
- Progest
- Prolutex
- Proluton
- Prometrium
- Prosphere
- Utrogestan
- Vasclor
Dados da fonte
Farmacocinética
| Variável | Valor | Unidade |
|---|---|---|
| Biodisp. oral | Baja - Low | % |
| Peso Molecular | 315 | daltons |
| Unión proteínas | 96 - 99 | % |
| Tmax | Oral: 2 - 6 / vaginal: 25 -50 | horas |
| T½ | 0,1 - 0,3 | horas |
| Dosis Teórica | 0,0009 | mg/Kg/d |
Rastreabilidade
Bibliografia
- Wamboldt R, Shuster S, Sidhu BS. Lactation Induction in a Transgender Woman Wanting to Breastfeed: Case Report. J Clin Endocrinol Metab. 2021 Jan 29. pii: dgaa976. Resumen Texto completo (enlace a fuente original)
- Roy M, Hazra A, Merkatz R, Plagianos M, Alami M, Gaur LN, Aruldas K, Sussman H, Variano B, Sitruk-Ware R; Progesterone Vaginal Ring Study Group at Participating Centers.. Progesterone vaginal ring as a new contraceptive option for lactating mothers: Evidence from a multicenter non-randomized comparative clinical trial in India. Contraception. 2020 Sep;102(3):159-167. Resumen Texto completo (enlace a fuente original)
- Reisman T, Goldstein Z. Case Report: Induced Lactation in a Transgender Woman. Transgend Health. 2018 Jan 1;3(1):24-26. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Phillips SJ, Tepper NK, Kapp N, Nanda K, Temmerman M, Curtis KM. Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception. 2016;94:226-52. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Allen SS, Allen AM, Lunos S, Tosun N. Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial. Nicotine Tob Res. 2016 Nov;18(11):2145-2153. Epub 2016 Aug 18. Resumen Texto completo (enlace a fuente original)
- Carr SL, Gaffield ME, Dragoman MV, Phillips S. Safety of the progesterone-releasing vaginal ring (PVR) among lactating women: A systematic review. Contraception. 2016 Sep;94(3):253-61. Resumen Texto completo (enlace a fuente original)
- Berens P, Labbok M; Academy of Breastfeeding Medicine. ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. Breastfeed Med. 2015 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- CDC. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Resumen
- RamaRao S, Clark H, Merkatz R, Sussman H, Sitruk-Ware R. Progesterone vaginal ring: introducing a contraceptive to meet the needs of breastfeeding women. Contraception. 2013 Resumen
- Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Resumen
- Erkkola R, Landgren BM. Role of progestins in contraception. Acta Obstet Gynecol Scand. 2005 Resumen Texto completo (enlace a fuente original)
- Massai R, Quinteros E, Reyes MV, Caviedes R, Zepeda A, Montero JC, Croxatto HB. Extended use of a progesterone-releasing vaginal ring in nursing women: a phase II clinical trial. Contraception. 2005 Resumen
- AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Massai R, Miranda P, Valdés P, Lavín P, Zepeda A, Casado ME, Silva MA, Fetis G, Bravo C, Chandía O, Peralta O, Croxatto HB, Díaz S. Preregistration study on the safety and contraceptive efficacy of a progesterone-releasing vaginal ring in Chilean nursing women. Contraception. 1999 Resumen
- Chen JH, Wu SC, Shao WQ, Zou MH, Hu J, Cong L, Miao L, Wang C, Dong J, Gao J, Xiao BL. The comparative trial of TCu 380A IUD and progesterone-releasing vaginal ring used by lactating women. Contraception. 1998 Resumen
- Díaz S, Zepeda A, Maturana X, Reyes MV, Miranda P, Casado ME, Peralta O, Croxatto HB. Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, Norplant implants, and Copper T 380-A intrauterine devices. Contraception. 1997 Resumen
- Sivin I, Díaz S, Croxatto HB, Miranda P, Shaaban M, Sayed EH, Xiao B, Wu SC, Du M, Alvarez F, Brache V, Basnayake S, McCarthy T, Lacarra M, Mishell DR Jr, Koetsawang S, Stern J, Jackanicz T. Contraceptives for lactating women: a comparative trial of a progesterone-releasing vaginal ring and the copper T 380A IUD. Contraception. 1997 Resumen
- WHO. Progestogen-only contraceptives during lactation: II. Infant development. World Health Organization, Task Force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development, and Research Training in Human Reproduction. Contraception. 1994 Resumen
- Shaaban MM. Contraception with progestogens and progesterone during lactation. J Steroid Biochem Mol Biol. 1991 Resumen
- Croxatto HB, Díaz S. The place of progesterone in human contraception. J Steroid Biochem. 1987;27(4-6):991-4. Review. Resumen
- Díaz S, Jackanicz TM, Herreros C, Juez G, Peralta O, Miranda P, Casado ME, Schiapacasse V, Salvatierra AM, Brandeis A, et al. Fertility regulation in nursing women: VIII. Progesterone plasma levels and contraceptive efficacy of a progesterone-releasing vaginal ring. Contraception. 1985 Dec;32(6):603-22. Resumen
- Díaz S, Peralta O, Juez G, Herreros C, Casado ME, Salvatierra AM, Miranda P, Croxatto HB. Fertility regulation in nursing women. VI. Contraceptive effectiveness of a subdermal progesterone implant. Contraception. 1984 Oct;30(4):311-25. Resumen
- Croxatto HB, Díaz S, Peralta O, Juez G, Casado ME, Salvatierra AM, Durán E. Fertility regulation in nursing women. II. Comparative performance of progesterone implants versus placebo and copper T. Am J Obstet Gynecol. 1982 Sep 15;144(2):201-8. Resumen