Duphaston

Basic Duphaston information

• INN (international nonproprietary name): Dydrogesterone
• Brand names available in the United Kingdom: Duphaston (not currently marketed in the UK)
• ATC code: G03DB01
• Forms and dosages: Tablets 10 mg
• Manufacturers in the United Kingdom: Abbott Healthcare
• Registration status in the United Kingdom: Withdrawn from the UK market (2008)
• OTC / Rx classification: Prescription-only medicine (POM)

Everyday use and best practices

Taking Duphaston at the same time each day helps maintain stable hormone levels in the body. Some people find it easier to remember their dose in the morning with breakfast, while for others an evening dose fits better. Choose a time that fits into your daily life, and follow your prescriber's instructions on the days of the cycle on which to take it.

Taking with or without meals

Duphaston tablets can be taken with or without food. Patients who experience stomach discomfort may prefer to take them with a meal.

Safety priorities

Duphaston is not suitable for everyone. It must not be used by people with a known allergy to dydrogesterone or similar substances, or with a history of progestogen-dependent tumours. Individuals with active or severe liver disease, or undiagnosed vaginal bleeding, should also avoid it.

Activities to limit (driving, work safety)

Duphaston can affect alertness, so caution is advised when performing tasks that require high concentration, such as driving or operating machinery. Only drive when you feel fully alert, particularly when starting treatment or changing the dose.

Dosage and adjustments

The usual regimen for dydrogesterone varies with the condition being treated. A typical dose is 10 mg, taken as directed for indications such as secondary amenorrhoea or threatened miscarriage. Follow the prescribed instructions accurately, as adjustments may be necessary depending on individual circumstances.

Special cases (elderly, comorbidities)

Dosage considerations may differ, especially for elderly patients or those with comorbidities, such as hepatic or renal impairments. Healthcare providers often exercise caution with this demographic to avoid potential side effects or interactions. Adjustments might be made based on overall health, with careful monitoring.

What’s inside and how it works

Ingredients overview

Duphaston’s active ingredient is dydrogesterone, a synthetic form of the natural hormone progesterone.

This progestogen is used in hormonal therapy, particularly for issues related to the menstrual cycle and pregnancy.

It is prescribed for conditions such as secondary amenorrhoea and luteal insufficiency.

Each tablet contains 10 mg of dydrogesterone. Duphaston is no longer marketed in the UK.

Mechanism basics explained simply

In simple terms, dydrogesterone mimics the actions of natural progesterone in the body. It binds to progesterone receptors, helping to stabilise the uterine lining, which is important in conditions such as endometriosis or luteal insufficiency.

This stabilisation matters during the luteal phase of the menstrual cycle and in early pregnancy, reducing the risk of abnormal bleeding.

Main indications

Approved uses

When it was marketed in the UK, Duphaston was licensed for several uses, including:

• Secondary amenorrhoea
• Infertility due to luteal insufficiency
• Dysfunctional uterine bleeding
• Threatened abortion and habitual miscarriage
• Endometriosis and dysmenorrhoea
• Hormone replacement therapy when combined with oestrogen.

Off-label uses in UK clinics

In UK clinics, Duphaston has found various off-label uses.

Some practitioners prescribe it for conditions like:

• Premenstrual syndrome (PMS)
• Fertility treatments beyond standard indications
• Menstrual irregularities not responding to other treatments.

Off-label use is a matter for the prescriber's clinical judgement.

Interaction warnings

Food interactions (alcohol, tea/coffee)

Alcohol may intensify side effects, making you feel more tired or dizzy, so moderation is advised.

Drug conflicts

Some notable examples are:

• Enzyme-inducing medicines such as rifampicin: they can reduce the effect of dydrogesterone.
• Antiepileptic drugs such as carbamazepine and phenytoin: they might affect dydrogesterone levels, requiring dose adjustments.

Tell your prescriber about all the medicines you take. Suspected side effects can be reported through the Yellow Card scheme.

Alternative choices

NHS prescribing alternatives

For those considering alternatives to Duphaston, the NHS offers various options:

• Norethisterone: Often used for heavy menstrual bleeding, it can also help manage endometriosis.
• Medroxyprogesterone: Useful for regulating periods but may come with more side effects.
• Micronised progesterone: used in HRT and for luteal support; chemically identical to natural progesterone.

Each alternative has its own advantages and disadvantages; discuss the options with a healthcare provider.

Regulation snapshot

The approval process for Duphaston, which contains the active ingredient dydrogesterone, is overseen by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK. Dydrogesterone is a prescription-only medicine (POM). Duphaston was withdrawn from the UK market in 2008 and is no longer available.

For conditions such as secondary amenorrhoea or infertility, the NHS prescribes other progestogens and hormone replacement therapies instead. Patients who previously used Duphaston should discuss alternatives with their GP.

Frequently asked questions

Some common questions about Duphaston:

• Can I buy Duphaston over the counter? No. Dydrogesterone is a prescription-only medicine in the UK, and Duphaston is no longer marketed there.
• Can I take Duphaston and folic acid together? While many women take folic acid during pregnancy, consulting with a healthcare professional before combining any treatments is essential.
• Why is Duphaston not available in the UK? The Duphaston brand was withdrawn from the UK market in 2008. Patients should discuss alternative medication options with their GP.
• What are the alternatives to Duphaston? Alternatives may include other progestogens or hormone therapies, which a healthcare provider can suggest based on individual needs.

Guidelines for proper use

UK pharmacist counselling style

When counselling about progestogens such as dydrogesterone, UK pharmacists typically cover:

• The importance of adhering to prescribed dosages.
• How to manage potential side effects, which can include breast tenderness and headaches.
• Monitoring symptoms to track any changes in menstrual cycles or pregnancy signs.

NHS patient support advice

The NHS offers various resources for patients needing guidance during treatment, including:

• Contacting local support groups that connect individuals undergoing similar treatments.
• Utilising online resources available on NHS websites about hormonal therapies.
• Seeking advice from healthcare providers who can suggest appropriate alternative medications and treatments.