Precautions and Warnings With Progesterone Capsules

Specific Precautions and Warnings With Progesterone Capsules

Warnings and precautions to be aware of prior to using progesterone capsules include the following:
  • Progesterone capsules are often used in combination with estrogen medications. Many of the warnings and precautions that are typically provided for progesterone capsules are actually problems seen in studies that used a combination of an estrogen medication with a synthetic progesterone-like medication (a "progestin"). It is not known if taking progesterone capsules (a bio-identical progesterone) is any more safe than the synthetic progestin used in these studies. It is also not known if taking this medication alone (without estrogen) also carries such risks.
  • Studies have shown that estrogen-plus-progestin hormone replacement therapy increases the risks of heart attacks, strokes, and blood clots in the legs and lungs. In no case should progesterone capsules be used to prevent heart disease (see Hormone Replacement Therapy and Heart Health), as they are not effective for this use.
  • Similar progesterone-like medications (combined with estrogen) may increase the risk of breast cancer and ovarian cancer. Adding a progestin to an estrogen medication may increase the risk of breast cancer, compared to taking just an estrogen. Proper screening and monitoring (as determined by your healthcare provider), such as yearly mammograms and monthly breast self-exams, is recommended.
  • Progesterone capsules can cause fluid retention (water weight gain), which can cause problems for people with seizures, epilepsy, migraines, heart problems, or kidney disease.
  • Let your healthcare provider know if you have depression or a history of depression, as progesterone capsules could make this condition worse.
  • Let your healthcare provider know right away if you have any vision changes or if you get a migraine for the first time while taking progesterone capsules.
  • Let your healthcare provider know if you have abnormal vaginal bleeding (such as heavy bleeding or bleeding between periods) while taking progesterone capsules.
  • Estrogen-plus-progestin hormone replacement therapy seems to increase the risk of dementia. In no case should progesterone capsules be used to prevent or treat dementia, as they are not effective for this use.
  • If you have diabetes, your healthcare provider may recommend that you monitor your blood sugar more closely when starting or stopping progesterone capsules in case you experience any changes in your blood sugar control.
  • This medication can cause dizziness and low blood pressure (especially upon standing).
  • Progesterone capsules can interact with a number of different medications (see Drug Interactions With Progesterone Capsules).
  • Progesterone capsules are considered a pregnancy Category B medication, which means that they are probably safe for use during pregnancy, although the full risks are not known (see Prometrium During Pregnancy).
  • The hormones in progesterone capsules pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Prometrium and Breastfeeding).
Last reviewed by: Kristi Monson, PharmD
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