Neogest
Generic Name
Dydrogesterone
Manufacturer
Nipro JMI Pharma (Bangladesh)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| neogest 2 mg tablet | ৳ 50.00 | ৳ 500.00 |
Description
Overview of the medicine
Neogest 2 mg Tablet contains Dydrogesterone, a synthetic progestogen structurally similar to natural progesterone. It is used to treat various conditions related to progesterone deficiency.
Uses & Indications
Dosage
Adults
Dosage varies widely based on indication. For menstrual disorders, typically 5-10 mg daily. For threatened miscarriage, an initial dose of 40 mg followed by 10 mg every 8 hours until symptoms abate. For recurrent miscarriage, 10 mg twice daily until the 20th week of pregnancy. For HRT, often 10 mg daily for 14 consecutive days of a 28-day cycle, or in continuous combined regimens. The 2 mg strength would be for specific, individualized low-dose regimens, possibly in some HRT protocols or for minor progesterone support.
Elderly
No specific dose adjustment is generally required for elderly women receiving HRT, but caution should be exercised in those with existing liver or renal impairment.
Renal_impairment
No specific studies on renal impairment. Use with caution. Dydrogesterone and its metabolites are primarily excreted renally, so dosage adjustment may be needed based on clinical judgment.
How to Take
Take the tablet orally, with or without food, as directed by your physician. It should be swallowed whole with water.
Mechanism of Action
Dydrogesterone acts directly on the progesterone receptors in the uterus, inducing a full secretory endometrium in an estrogen-primed uterus, thereby preventing estrogen-induced endometrial proliferation and maintaining pregnancy. It does not possess estrogenic, androgenic, anabolic, or corticosteroid properties.
Pharmacokinetics
Onset
Within hours of administration, therapeutic effects may begin.
Excretion
Excreted primarily in the urine (about 60-70%) as conjugated metabolites within 72 hours. Complete elimination occurs within 72 hours.
Half life
Dydrogesterone has a plasma half-life of 5-7 hours. Its main active metabolite, 20α-dihydrodydrogesterone (DHD), has a half-life of 14-17 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations are reached within 0.5-2.5 hours.
Metabolism
Extensively metabolized in the liver, primarily via ketonization of the 20-carbonyl group and hydroxylation of the 21-carbon position. The main metabolite is DHD.
Side Effects
Contraindications
- Hypersensitivity to dydrogesterone or any component of the tablet
- Known or suspected progestogen-dependent tumours (e.g., meningioma)
- Undiagnosed vaginal bleeding
- Severe hepatic disease or liver tumours (past or present)
Drug Interactions
Ritonavir, Nelfinavir (HIV medications)
May induce the metabolism of dydrogesterone.
Enzyme Inducers (e.g., Rifampicin, Phenobarbital, Phenytoin, Carbamazepine, St. John's Wort)
May increase the metabolism of dydrogesterone, potentially reducing its therapeutic effect. Dose adjustment may be necessary.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose are generally mild and may include nausea, vomiting, dizziness, and drowsiness. Treatment is supportive and symptomatic, as there is no specific antidote.
Pregnancy & Lactation
Dydrogesterone is used to support pregnancy in cases of threatened or recurrent miscarriage. However, for other indications, especially during later stages of pregnancy, it should only be used if clearly needed and after consulting a doctor. It is excreted in breast milk; therefore, it is generally not recommended during breastfeeding unless specifically advised by a physician.
Side Effects
Contraindications
- Hypersensitivity to dydrogesterone or any component of the tablet
- Known or suspected progestogen-dependent tumours (e.g., meningioma)
- Undiagnosed vaginal bleeding
- Severe hepatic disease or liver tumours (past or present)
Drug Interactions
Ritonavir, Nelfinavir (HIV medications)
May induce the metabolism of dydrogesterone.
Enzyme Inducers (e.g., Rifampicin, Phenobarbital, Phenytoin, Carbamazepine, St. John's Wort)
May increase the metabolism of dydrogesterone, potentially reducing its therapeutic effect. Dose adjustment may be necessary.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose are generally mild and may include nausea, vomiting, dizziness, and drowsiness. Treatment is supportive and symptomatic, as there is no specific antidote.
Pregnancy & Lactation
Dydrogesterone is used to support pregnancy in cases of threatened or recurrent miscarriage. However, for other indications, especially during later stages of pregnancy, it should only be used if clearly needed and after consulting a doctor. It is excreted in breast milk; therefore, it is generally not recommended during breastfeeding unless specifically advised by a physician.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 to 36 months from the date of manufacture.
Availability
Available in pharmacies and hospitals
Approval Status
Approved (internationally since 1960s, widely available)
Patent Status
Patent expired for generic molecule
Clinical Trials
Dydrogesterone has been extensively studied in numerous clinical trials across various indications, demonstrating its efficacy and safety profile, particularly in menstrual disorders, endometriosis, and pregnancy support.
Lab Monitoring
- Regular gynecological check-ups, including breast examination and cervical smear, are recommended before and during HRT.
- Liver function tests may be monitored in patients with pre-existing hepatic impairment or if symptoms suggest liver dysfunction.
Doctor Notes
- Emphasize the importance of adherence, particularly in miscarriage prevention.
- Monitor for breakthrough bleeding, and evaluate for underlying causes if persistent.
- Consider liver function tests in patients with a history of hepatic dysfunction.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking the medicine suddenly without consulting your doctor, especially if you are pregnant or taking it for recurrent miscarriage.
- Report any unusual vaginal bleeding or other severe side effects to your doctor immediately.
- Regular follow-up appointments with your doctor are important.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Dydrogesterone may cause mild dizziness in some individuals. If you experience dizziness, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise.
- Avoid smoking and excessive alcohol consumption, as these can affect hormonal balance and overall health.
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