Hydroxyprogesterone Hexanoate
Hydroxyprogesterone Hexanoate Uses, Dosage, Side Effects, Food Interaction and all others data.
The mechanism by which progesterone prevents preterm birth is not well understood, but many pathways are likely involved.
Progesterone plays a vital role in regulation of the female reproductive system and is important for successful implantation of the embryo and maintenance of pregnancy. It acts by binding to progesterone receptors in the uterus, ovaries, breasts and in the central nervous system. These receptors exist in 2 isoforms, PR-A and PR-B. Progesterone binding to these receptors ultimately leads to regulation of gene transcription.This results in an anti-inflammatory effect which blunts the proinflammatory state that occurs with initiation of labor, and maintains uterine queiscence by stabilizing progesterone acting on the myometrium.No specific pharmacodynamic studies have been performed to assess hydroxyprogesterone caproate injections. (4) However, the mechanism of action is likely related to increased interaction between progesterone and progesterone receptors. (5)
No specific pharmacodynamic studies have been performed to assess hydroxyprogesterone caproate injections. (4) However, the mechanism of action is likely related to increased interaction between progesterone and progesterone receptors. (5)
Trade Name | Hydroxyprogesterone Hexanoate |
Generic | Hydroxyprogesterone Caproate |
Hydroxyprogesterone Caproate Other Names | Caproate d'hydroxyprogesterone, Caproato de hidroxiprogesterona, Hydroxyprogesterone caproate, Hydroxyprogesterone hexanoate |
Type | |
Formula | C27H40O4 |
Weight | Average: 428.6041 Monoisotopic: 428.292659768 |
Protein binding | Hydroxyprogesterone caproate is extensively protein bound in the plasma. (3) |
Groups | Approved, Investigational |
Therapeutic Class | Hormone preparations for other uses |
Manufacturer | |
Available Country | |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
Hydroxyprogesterone is a progestin used to reduce the risk of preterm birth in women with a singleton pregnancy who have a history of singleton spontaneous preterm birth. The effectiveness of Makena is based on improvement in the proportion of women who delivered <37 weeks of gestation. There are no controlled trials demonstrating a direct clinical benefit, such as improvement in neonatal mortality and morbidity.
Hydroxyprogesterone Hexanoate is also used to associated treatment for these conditions: Abnormal Uterine Bleeding, Premature Births, Primary Amenorrhoea, Secondary Amenorrhea, Stage 3 adenocarcinoma of the uterine corpus, Stage 4 adenocarcinoma of the uterine corpus
How Hydroxyprogesterone Hexanoate works
The mechanism by which progesterone prevents preterm birth is not well understood, but many pathways are likely involved. (1) Progesterone plays a vital role in regulation of the female reproductive system and is important for successful implantation of the embryo and maintenance of pregnancy. It acts by binding to progesterone receptors in the uterus, ovaries, breasts and in the central nervous system. These receptors exist in 2 isoforms, PR-A and PR-B. Progesterone binding to these receptors ultimately leads to regulation of gene transcription. (2) This results in an anti-inflammatory effect which blunts the proinflammatory state that occurs with initiation of labor, and maintains uterine queiscence by stabilizing progesterone acting on the myometrium. (2)
Dosage
Hydroxyprogesterone Hexanoate dosage
Hydroxyprogesterone auto-injector: Administer subcutaneously using Hydroxyprogesterone auto-injector at a dose of 275 mg (1.1 mL) once weekly, in the back of either upper arm
Hydroxyprogesterone (single- and multi-dose vials): Administer intramuscularly at a dose of 250 mg (1 mL) once weekly in the upper outer quadrant of the gluteus maximus
Begin treatment between 16 weeks, 0 days and 20 weeks, 6 days of gestation
Continue administration once weekly until week 37 (through 36 weeks, 6 days) of gestation or delivery, whichever occurs first
Side Effects
Most Common: Injection site reactions (pain, swelling, pruritus, nodule), Hives, Itching, nausea, and diarrhea.Call your doctor if you get any of the symptoms bellow:
- Blood clots Symptoms: Leg swelling, Redness in your leg, a spot on your leg that is warm to touch, Leg pain that worsens when you bend your foot.
- Allergic reactions: Hives, Itching, Swelling of the face
Toxicity
Injection site pain is the most common adverse effect associated with hydroxyprogesterone caproate. Other commonly reported adverse effects include: injection site swelling, urticaria, pruritus, injection site pruritus, nausea, injection site nodule, and diarrhea. (4)
Precaution
Thromboembolic disorders: Discontinue if thrombosis or thromboembolism occurs
Allergic reactions: Consider discontinuing if allergic reactions occur
Decreased glucose tolerance: Monitor prediabetic and diabetic women receiving Makena
Fluid retention: Monitor women with conditions that may be affected by fluid retention, such as preeclampsia, epilepsy, cardiac or renal dysfunction
Depression: Monitor women with a history of clinical depression; discontinue Makena if depression recurs
Interaction
No drug-drug interaction has been reported.
Food Interaction
No interactions found.Volume of Distribution
Hydroxyprogesterone caproate has a high volume of distribution. (3)
Elimination Route
Absorption of 17-hydroxyprogesteron caproate is slow, occurring over a long period of time. (3)
Half Life
Half-life = 16 days (±6 days). (3)
Clearance
Clearance is highly variable from patient to patient. (3)
Elimination Route
Following intramuscular injection, approximately 50% of hydroxyprogesterone caproate metabolites are eliminated in the feces, while approximately 30% of metabolites are eliminated in the urine. (3)
Pregnancy & Breastfeeding use
Pregnancy category B. Low levels of progestins are present in human milk with the use of progestin-containing products, including hydroxyprogesterone caproate. Published studies have reported no adverse effects of progestins on the breastfed child or on milk production.
Contraindication
- Current or history of thrombosis or thromboembolic disorders.
- Known or suspected breast cancer, other hormone-sensitive cancer, or history of these conditions.
- Undiagnosed abnormal vaginal bleeding unrelated to pregnancy.
- Cholestatic jaundice of pregnancy.
- Liver tumors, benign or malignant, or active liver disease, Uncontrolled hypertension
Special Warning
Pediatric Use: Hydroxyprogesterone is not indicated for use in women under 16 years of age. Safety and effectiveness in patients less than 16 years of age have not been established. A small number of women under age 18 years were studied; safety and efficacy are expected to be the same in women aged 16 years and above as for users 18 years and older
Hepatic Impairment: No studies have been conducted to examine the pharmacokinetics of Hydroxyprogesterone in patients with hepatic impairment. Hydroxyprogesterone is extensively metabolized and hepatic impairment may reduce the elimination of Hydroxyprogesterone .
Acute Overdose
No adverse events associated with over dosage has been reported.
Storage Condition
Store at 20° to 25°C. Do not refrigerate or freeze. Protect auto-injector from light.
Innovators Monograph
You find simplified version here Hydroxyprogesterone Hexanoate
Hydroxyprogesterone Hexanoate contains Hydroxyprogesterone Caproate see full prescribing information from innovator Hydroxyprogesterone Hexanoate Monograph, Hydroxyprogesterone Hexanoate MSDS, Hydroxyprogesterone Hexanoate FDA label