WHAT IS THIS MEDICINE?
Cyclogest pessaries contain natural micronised progesterone.
Progesterone is a hormone produced by the ovaries after ovulation, essential
for preparing and maintaining the uterus for pregnancy. Cyclogest is used for
luteal phase support in assisted reproduction (IVF), threatened miscarriage,
and progesterone deficiency states.
2. HOW TO TAKE THIS MEDICINE
Cyclogest pessaries can be used vaginally (preferred for IVF)
or rectally. For vaginal use: insert pessary deep into the vagina at bedtime
(or as directed). For rectal use: insert into the rectum as directed — this
route is used if vaginal use causes excessive discharge or irritation. Do not
swallow.
For abnormal uterine bleeding – 5 to 10 mg once daily for a
total of 6 doses. If estrogen therapy is also used, delay
initiation of progesterone until 2 weeks after estrogen therapy is initiated.
If menstrual flow begins during therapy, discontinue use
Assisted reproductive technology (IVF) - 50 to 100 mg once
daily.
Note: When used as a combination regimen
with intravaginal progesterone, 50 mg IM every 3 days has been described
For prevention of Spontaneous preterm birth in high-risk patients – usually 200 mg once daily at bedtime.
3. POSSIBLE SIDE EFFECTS
Common side effects include the following. Contact your
doctor or pharmacist if any side effect worries you.
|
Side Effect |
Frequency |
What To Do |
|
Vaginal discharge |
Very common (vaginal route) |
Wear a panty liner; this is normal |
|
Breast tenderness |
Common |
Usually mild; review if severe |
|
Bloating |
Common |
Usually resolves with continued treatment |
|
Dizziness / drowsiness |
Common |
Especially after rectal use; avoid driving if
affected |
|
Headache |
Common |
Paracetamol if needed; report if persistent |
|
Mood changes / depression |
Uncommon |
Report to fertility specialist or obstetrician |
|
Rectal discomfort |
Uncommon (rectal route) |
Use vaginal route if possible |
|
⚠ IMPORTANT WARNING |
|
If you experience heavy vaginal bleeding,
severe abdominal pain, or symptoms of ectopic pregnancy (one-sided pain,
shoulder-tip pain, dizziness) while on Cyclogest, seek emergency medical help
immediately. |
4. WHO SHOULD NOT TAKE THIS MEDICINE
Contraindicated in undiagnosed vaginal bleeding, known or
suspected breast/genital tract cancer, active thromboembolic disease, and known
hypersensitivity to progesterone. Use with caution in depression, migraine,
epilepsy, diabetes, and cardiovascular disease.
5. DRUG INTERACTIONS
Cyclogest may interact with anticoagulants (warfarin),
antidiabetic medicines, and antiepileptics. Progesterone can affect blood
glucose levels. Rifampicin and some anticonvulsants may reduce progesterone
levels. Inform your fertility specialist about all medicines.
6. HOW TO STORE
Store below 25°C. Do not refrigerate or freeze — pessaries
may become too hard. Keep out of reach of children and direct sunlight.
7. PRESCRIPTION STATUS
Prescription Only Medicine (POM). Usually prescribed by
fertility specialists or obstetricians for clearly defined indications.
|
💚 PATIENT TIP |
|
Insert your Cyclogest pessary at bedtime to
allow maximum absorption while lying down. This also reduces the amount of
discharge during the day. Use unscented panty liners for comfort. |
8. PHARMACIST'S NOTE
Counsel patients on the correct route of administration
(vaginal vs rectal). Vaginal discharge from pessaries is normal and expected —
recommend panty liners. In IVF cycles, reassure patients that progesterone is
essential for embryo implantation and continuing the pessaries as prescribed is
vital.
9. FREQUENTLY ASKED QUESTIONS
|
FREQUENTLY ASKED QUESTIONS |
|
Q: Why do I need
Cyclogest after IVF? A: During IVF, the hormonal process that would
naturally produce progesterone from the corpus luteum is disrupted by egg
retrieval. Cyclogest replaces this progesterone to support embryo
implantation and early pregnancy. |
|
Q: How long do I take
Cyclogest during IVF? A: Typically from the day of embryo transfer
until 10–12 weeks of pregnancy, when the placenta takes over progesterone
production. Your fertility clinic will give you specific instructions. |
|
Q: Can Cyclogest prevent
miscarriage? A: Evidence is emerging that progesterone
supplementation may reduce miscarriage risk in women who bleed in early
pregnancy and have a history of miscarriage (the PRISM trial showed benefit
in this group). Your doctor will advise based on your individual situation. |
|
Q: What if I miss a dose? A: Insert the pessary as soon as you remember.
If it is almost time for the next dose, skip the missed one. During IVF,
contact your clinic if you miss more than one dose. |
|
Q: Can I have intercourse
while using Cyclogest vaginally? A: Your fertility clinic will advise —
typically intercourse is avoided or guided by protocol during embryo transfer
cycles. Follow their specific instructions. |