Progestins For Noncontraceptive Use (Systemic)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your health care professional will make. For progestins, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual reaction to progestins. If using progesterone capsules or injection, tell your doctor if you are allergic to peanuts. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet - Make certain your health care professional knows if you are on any special diet, such as a low-sodium or low-sugar diet.

Pregnancy - Progesterone, a natural hormone that the body makes during pregnancy, has not caused problems. In fact, it is sometimes used in women to treat a certain type of infertility and to aid in egg donor or infertility procedures.

Other progestins have not been studied in pregnant women. Be sure to tell your doctor if you become pregnant while using any of the progestins. It is best to use some kind of birth control method while you are receiving progestins in high doses. High doses of progestins are not recommended for use during pregnancy since there have been some reports that they may cause birth defects in the genitals (sex organs) of a male fetus. Also, some of these progestins may cause male-like changes in a female fetus and female-like changes in a male fetus, but these problems usually can be reversed. Low doses of progestins, such as those doses used for contraception, have not caused major problems when used accidentally during pregnancy.

Breast-feeding - Although progestins pass into the breast milk, they have not been shown to cause problems in nursing babies. However, progestins may change the quality or amount (increase or decrease) of the mother's breast milk. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children - Although there is no specific information comparing use of progestins in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Adolescents - Although there is no specific information comparing use of progestins in teenagers with use in other age groups, this medicine is not expected to cause different side effects or problems in teenagers than it does in adults.

Older adults - This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking a progestin, it is especially important that your health care professional know if you are taking any of the following:

• Aminoglutethimide (e.g., Cytadren) or
• Carbamazepine (e.g., Tegretol) or
• Phenobarbital or
• Phenytoin (e.g., Dilantin) or
• Rifabutin (e.g., Mycobutin) or
• Rifampin (e.g., Rifadin, Rimactane) - These medicines may decrease the effects of progestins

Other medical problems - The presence of other medical problems may affect the use of progestins. Make sure you tell your doctor if you have any other medical problems, especially:

• Asthma or
• Epilepsy (or history of) or
• Heart or circulation problems or
• Kidney disease (severe) or
• Migraine headaches - Progestins may cause fluid build-up and may cause these conditions to become worse

• Bleeding problems, undiagnosed, such as blood in urine or changes in vaginal bleeding - May make diagnosis of these problems more difficult

• Blood clots (or history of) or
• Stroke (or history of) or
• Varicose veins - May have greater chance of causing blood clots if these conditions are already present when high doses of progestins are taken

• Breast disease (such as breast lumps or cysts) (history of) - May make this condition worse in certain types of diseases that do not react in a positive way to progestins

• Central nervous system (CNS) disorders, such as mental depression (or history of) or
• High blood cholesterol - Effects of progestins may cause these conditions, or may make these conditions worse

• Diabetes mellitus (sugar diabetes) - May cause an increase in your blood sugar and a change in the amount of medicine you take for diabetes; progestins in high doses are more likely to cause this problem

• Liver disease - Effects of progestins may be increased and may make this condition worse

• Other conditions that increase the chances for osteoporosis (brittle bones) - Since it is possible that certain doses of progestins may cause temporary thinning of the bones by changing your hormone balance, it is important that your doctor know if you have an increased risk of osteoporosis. Some things that can increase your risk for having osteoporosis include cigarette smoking, abusing alcohol, taking or drinking large amounts of caffeine, and having a family history of osteoporosis or easily broken bones. Some medicines, such as glucocorticoids (cortisone-like medicines) or anticonvulsants (seizure medicine), can also cause thinning of the bones. However, it is thought that progestins can help protect against osteoporosis in postmenopausal women