As part of assisted reproductive technology (ART; fertility treatment), vaginal progesterone (Crinone, Endometrin) is used to help women who are infertile (not getting pregnant despite having carefully timed, unprotected sex) become pregnant and maintain their pregnancy. For women experiencing (lack of menstruation in women of childbearing age who had previously had regular periods and later stopped), vaginal progesterone (Crinone) is also used. Progesterone belongs to a group of drugs known as progestins (female hormones). By boosting embryo implantation and lowering the risk of miscarriage, it functions as a component of ART. Progesterone works to keep the pregnancy going once an embryo has been implanted. It triggers menstruation by substituting for the deficient natural progesterone in some people. By substituting for the natural progesterone that some women lack, it helps to initiate menstruation.

Both a vaginal tablet (Endometrin) and a vaginal gel (Crinone) are available as forms of vaginal progesterone. Two or three times daily for up to ten days, progesterone vaginal pills are typically placed into the vagina. Progesterone vaginal gel is often administered once or twice daily for up to 10 to 12 weeks if it is used as part of ART/fertility treatment. Progesterone vaginal gel is typically injected into the vagina once every other day for a total of six doses if it is being used to treat amenorrhea. Your doctor could advise taking an additional 6-dose course of medication if necessary. Follow the instructions on your prescription label carefully, and if there is anything you are unsure about, contact your doctor or pharmacist to clarify it. Utilize vaginal progesterone as directed. Never use more or less of it or take it more frequently than your doctor has instructed.

The pill or gel for vaginal progesterone is applied using a particular applicator that is included with the product. You will receive usage instructions with your prescription. Please carefully read and adhere to these directions. If you have any concerns regarding how to utilize vaginal progesterone, consult your physician or pharmacist.

The Endometrin vaginal pill should be used as described below:

1. When handling the vaginal tablet, first wash and dry your hands.
2. Take the vaginal tablet out of the blister pack and unwrap the applicator.
3. Insert the vaginal pill into the opening at the applicator’s end. The implant must be well secured and must not budge.
4. Knees bowed, you may stand, sit, or lie down. The position you feel most comfortable in should be chosen.
5. As you would with a plastic tampon applicator, gently put the applicator into your vagina. Press the plunger to release the insert.
6. Dispose of the applicator as you would a plastic tampon after removing it from your vagina. Don’t keep or use the applicator again.

These measures should be followed to utilize the cronone vaginal gel:

1. The prefilled applicator and plunger can be taken out by opening the sealed wrapper. Keep the twist-off cap on.
2. Plunge the plunger into the applicator’s open end until it clicks into place. The plunger should be visible for about 1 inch outside the applicator.
3. Turning the cap counterclockwise will allow you to remove it from the applicator’s end. When removing the cap, avoid pushing the plunger.
4. Sit on the edge of a bed or chair with your knees apart, or lie on your back with bent knees. The position you feel most comfortable in should be chosen.
5. To release the gel, gently push the applicator into your vagina like you would a plastic tampon applicator.
6. As you would a plastic tampon applicator, remove the applicator from your vagina and throw it away. The applicator shouldn’t be kept or used again.

For a copy of the manufacturer’s information for the patient, ask your pharmacist or doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before using vaginal progesterone,

• If you have an allergy to progesterone, any other drugs, or any of the substances in vaginal progesterone tablets or gel, let your doctor and pharmacist know right once. Request a list of the components from your pharmacist.
• Inform your doctor and pharmacist about any additional prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you are now taking or intend to use. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• Other vaginal items, especially vaginal antifungal medications like clotrimazole and miconazole (Monistat), may interact with vaginal progesterone. These nonprescription or herbal treatments may also do so. Before beginning to use vaginal progesterone, be sure to let your healthcare professional know if you are taking these medications. While using vaginal progesterone, do not begin taking any of these medications without first consulting your healthcare professional.
• Inform your doctor if you have or have ever experienced unexplained vaginal bleeding between periods, a miscarriage when some tissue was left in the uterus, or any other of the following: a missed abortion, which is the term used to describe pregnancies that end when the fetus dies in the uterus but is not evacuated from the body; a tubal pregnancy, often known as a pregnancy outside the uterus, or an ectopic pregnancy; liver disease, cancer of the breasts or female organs, or blood clots in the legs, lungs, eyes, brain, or anywhere else in the body. Most likely, your doctor will advise against using progesterone vaginal products.
• Inform your doctor if you suffer from or have ever suffered from seizures, migraines, asthma, diabetes, depression, stroke or ministroke, renal illness, or heart disease.
• Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor if you become pregnant while using vaginal progesterone.

Keep eating normally unless your doctor instructs you otherwise.

As soon as you remember, take the missed dose or re-insert it. Skip the missed dose and carry on with your regular dosing plan, nevertheless, if it is almost time for the subsequent dose. Never take two doses or add more cream to make up for a missed dose.

Progesterone used vaginally may have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Headache
• Breast sensitivity, discomfort, or hypertrophy
• Bloating or gas
• Abdominal pain
• Nausea
• Vomiting
• Constipation
• Diarrhea
• Tiredness
• Drowsiness
• Joint, bone, or muscle pain
• Mood changes
• Irritability
• Vaginal oozing
• Vaginal discomfort or pain
• Alteration of sexual desire
• Difficulty sleeping

Some adverse effects can be very harmful. Stop taking vaginal progesterone and seek emergency medical attention if you suffer any of the following symptoms:

• An abrupt, bad headache
• Faintness or dizziness
• Slow or challenging speech
• An arm or leg that is weak or numb
• Loss of balance or a lack of coordination
• Breathing difficulty
• Intense chest ache
• Spitting blood
• Leg swells or hurts
• Eyesight impairment or hazy vision
• Dual perception
• Abnormal vaginal bleeding
• Depression
• Eyes or skin that have a yellow tint
• Hives
• Rash
• Itching
• Breathing or swallowing challenges
• Edema of the hands, feet, ankles, lower legs, cheeks, neck, tongue, lips, and eyes

Other negative effects from vaginal progesterone are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online at http://www.fda.gov/Safety/MedWatch or by phone at 1-800-332-1088 if you have a serious side event.

Keep this medication tightly closed in the original container and out of the reach of children. Keep it at room temperature and out of the bathroom and other places with excessive heat and moisture.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.http://www.upandaway.org

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilizing a medicine take-back program is the easiest approach to get rid of your medication. To find out about take-back programs in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back program, see the FDA’s Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for additional information.

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Keep all of your appointments with your physician and the lab.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.