SUSTEN 200MG CAPS 30S

What Is SUSTEN 200mg?

Susten 400mg contains micronised natural progesterone, a form of progesterone that is biochemically identical to the progesterone produced by the human ovary.

'Micronised' means the progesterone has been reduced to tiny particles that dissolve more easily in the gut or vaginal tissues, significantly improving absorption compared to older synthetic progestogens.

Progesterone is one of the most important hormones of pregnancy; it prepares the uterine lining to receive a fertilised egg, maintains the pregnancy by preventing uterine contractions, and supports the early developing placenta.

When the body's own progesterone levels are insufficient, either naturally or in assisted reproduction, supplementing with Susten 200mg provides the hormonal support the uterus needs to sustain a pregnancy.

What Is It Used For?

Susten 200mg is prescribed in several serious reproductive and gynaecological situations. It is widely used in assisted reproductive technology (ART/IVF) as luteal phase support.

After egg retrieval and embryo transfer, the ovaries produce less progesterone than in a natural cycle, and Susten provides the supplementation needed to support implantation and early pregnancy.

Susten 200mg is also used for threatened miscarriage in the first trimester where progesterone deficiency may be contributing, for recurrent pregnancy loss prevention in women with a history of multiple miscarriages associated with luteal phase insufficiency, and for various menstrual disorders including endometriosis, secondary amenorrhoea, and premenstrual syndrome (PMS).

In Kenya, Susten 200mg is commonly prescribed by gynaecologists and fertility specialists at IVF centres and in general antenatal care for at-risk pregnancies.

IVF / Luteal Phase Support

Typically, 400mg twice daily (vaginally or orally as directed) starting on the day of embryo transfer or egg retrieval, and continued for 10–12 weeks or as the fertility specialist advises.

Threatened Miscarriage

400mg once or twice daily orally or vaginally, as prescribed by a gynaecologist, through the first trimester.

Vaginal Use

For vaginal use, insert the capsule deeply into the vagina using a clean finger. Vaginal administration achieves higher uterine progesterone concentrations with fewer systemic side effects (drowsiness).

Oral Use

If taken orally, take at bedtime to minimise the sedating effect. Take with food.

Missed Dose

Take or insert as soon as remembered. If nearly time for the next dose, skip and continue. Never double dose.

Duration

Determined by the prescribing gynaecologist based on clinical indication. Do not stop without medical advice, abrupt discontinuation in early pregnancy can increase miscarriage risk.

Common Side Effects

·       Drowsiness and sedation (primarily with oral use, much less with vaginal route)

·       Dizziness (oral use)

·       Breast tenderness

·       Bloating

·       Vaginal discharge or irritation (with vaginal use, normal)

·       Nausea

Uncommon Side Effects

·       Headache

·       Mood changes

·       Spotting or light vaginal bleeding

Serious Side Effects, Seek Immediate Medical Attention

·       Thromboembolic events (DVT, PE), rare with natural progesterone compared to synthetic progestogens, but caution in high-risk patients

·       Anaphylaxis (very rare, allergy to progesterone or capsule oil content)

·       Depression or severe mood changes

·       DRIVING: Oral Susten causes significant drowsiness; do not drive or operate machinery after oral dosing. This is why bedtime oral dosing is strongly preferred.

·       PEANUT ALLERGY: Some formulations of micronised progesterone capsules use peanut oil as the base, check the excipients. Patients with peanut allergy should confirm this before using.

·       VAGINAL ROUTE PREFERRED IN PREGNANCY: Vaginal administration provides superior uterine concentration with minimal sedation, preferred in ART and threatened miscarriage when feasible.

·       DO NOT STOP ABRUPTLY IN EARLY PREGNANCY: Withdrawal of progesterone supplementation in the first trimester without medical guidance can precipitate miscarriage.

·       MISSED ABORTION: Confirm the pregnancy is intrauterine and viable before starting Susten, it should not be used if there is no living pregnancy.

Enzyme inducers (rifampicin, phenytoin, carbamazepine): Reduce progesterone levels, may need dose adjustment.

Ketoconazole: Inhibits progesterone metabolism, increased progesterone exposure.

Anticoagulants: Theoretical interaction with thromboembolic risk profile, monitor in high-risk patients.

No significant interactions with most common concurrent medications in obstetric/gynaecological practice.

·       Store below 25°C in a cool, dry place.

·       Do not freeze.

·       Protect from light and moisture.

·       Keep in original packaging.

·       Keep out of reach of children.

Susten 200mg is a prescription-only medicine (POM) in Kenya, prescribed exclusively by gynaecologists, obstetricians, and fertility specialists. Available at Pharmily with a valid prescription.

Susten 200mg (micronised progesterone) is a first-line progesterone supplement in IVF/ART luteal support and threatened miscarriage management in Kenya. The route of administration is a critical counselling point: vaginal use provides superior uterine bioavailability with minimal systemic sedation; oral use is significantly sedating; always confirm route at dispensing.

The peanut oil excipient concern requires explicit screening; some Susten formulations use arachis (peanut) oil as the capsule base. Counsel firmly against abrupt discontinuation in pregnancy; this should be explicitly documented at every dispensing.

Confirm the clinical indication, and that the pregnancy has been confirmed as intrauterine and viable; Susten must never be given in cases of ectopic pregnancy or missed abortion. For patients on rifampicin (TB treatment): enzyme induction may reduce progesterone levels, flag to the prescribing gynaecologist. The 30-capsule pack at twice-daily dosing provides only 15 days of supply, plan refill proactively for IVF patients on continuous luteal support.

Q1: What is Susten 200mg used for?

A: Susten 200mg provides natural progesterone support to the uterus. It is most commonly used in IVF cycles to support embryo implantation and early pregnancy, and in threatened miscarriage to help maintain the pregnancy when progesterone levels may be low.

Q2: Why does Susten make me so drowsy?

A: Oral progesterone has a sedating effect similar to some sleep medicines. This is why it is always recommended to take it at bedtime. Vaginal administration avoids most of this drowsiness, discuss the best route with your doctor.

Q3: Can I use Susten vaginally instead of orally?

A: Yes, in fact, vaginal use is often preferred as it delivers progesterone directly to the uterus in higher concentrations with far less drowsiness. Your doctor will specify which route is appropriate for you.

Q4: Why must I not stop Susten suddenly during pregnancy?

A: Progesterone is essential for maintaining the uterine lining and preventing contractions in early pregnancy. Stopping supplementation abruptly when the body depends on it can cause the uterine lining to shed, increasing the risk of miscarriage. Always reduce or stop under your doctor's guidance.