A Drug Study on
DUPHASTON
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A Drug Study Presented To
The Faculty of the Nursing Department
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In Partial Fulfillment of Requirements in NCM 218
Intensive Care Unit Rotation
Submitted By:
October 20, 2022
Generic Name Dydrogesterone
Brand Name Duphaston
Drug Classification Estrogens, Progesterones & Related Synthetic Drugs
Pregnancy Category A
Mode of Action Dydrogesterone is an orally-active progestogen which
produces a complete secretory endometrium in an
estrogen-primed uterus thereby providing protection against
the increased risk for endometrial hyperplasia and/or
carcinogenesis induced by estrogens. It is indicated in all
cases of endogenous progesterone deficiency.
Ordered Dose Duphaston1 tab BID
Suggested Dose & ● Dysmenorrhea
Frequency ➔ 10 or 20 mg dydrogesterone per day from day 5 to day
25 of the menstrual cycle.
● Endometriosis
➔ 10 to 30 mg dydrogesterone per day from day 5 to day
25 of the cycle or continuously.
● Dysfunctional uterine bleeding
➔ When treatment is started to arrest a bleeding
episode, 20 or 30 mg dydrogesterone per day is to be
given for up to 10 days.
➔ For continuous treatment, 10 or 20 mg dydrogesterone
per day should be given during the second half of the
menstrual cycle.
● Irregular cycles
➔ 10 or 20 mg dydrogesterone per day starting with the
second half of the menstrual cycle until the first day of
the next cycle.
● Threatened miscarriage
➔ An initial dose of up to 40 mg dydrogesterone may be
given followed by 20 or 30 mg per day until symptoms
remit.
● Habitual miscarriage:
➔ 10 mg dydrogesterone twice daily until the twelfth
week of pregnancy.
Indication ● For the prevention of threatened and habitual
miscarriages. Also indicated for the treatment of
Dysfunctional Uterine Bleeding problems and other
menstrual irregularities.
Contraindication ● Known hypersensitivity to the active substance or to
any of the excipients.
● Known or suspected progestogen dependent
neoplasms (e.g. meningioma).
● Undiagnosed vaginal bleeding.
● Treatment for luteal support as part of an Assisted
Reproductive Technology (ART) treatment should be
discontinued upon diagnosis of abortion/miscarriage.
● Contraindications for the use of estrogens when used
in combination with dydrogesterone.
Side Effect ➔ Abdominal pain
➔ Bloating
➔ Headache
➔ Dizziness
➔ Depression
➔ Breast tenderness
➔ Hot flushes
➔ Vaginal discharge
➔ Joint pain
➔ Urinary problems
➔ Nausea
➔ Fatigue or extreme tiredness
➔ Somnolence or sleepiness
➔ Vaginal hemorrhage
➔ Pruritus (severe itching of the skin)
Adverse Effect Thrombophlebitis, cerebrovascular disorders, retinal
thrombosis, pulmonary embolism occurs rarely.
Drug Interaction ● DRUG:
➔ The metabolism of dydrogesterone and DHD may be
increased by concomitant use of substances known to
induce CYP enzymes such as anticonvulsants (e.g.,
phenobarbital, phenytoin, carbamazepine),
anti-infectives (e.g., rifampicin, rifabutin, nevirapine,
efavirenz)
● HERBAL:
➔ St John's Wort (Hypericum perforatum), sage, or
gingko biloba may increase its effects.
● FOOD:
➔ None known.
● LAB VALUES:
➔ May alter HDL, cholesterol, triglycerides, LDL. May
➔ increase serum ALT, AST.
Nursing 1. Acquire the patient's complete medical history.
Responsibilities
R: To watch out for contraindications and cautions or any
known allergies to this drug to avoid adverse reactions.
2. Perform a thorough physical assessment.
R: To establish baseline data before drug therapy begins, to
determine effectiveness of therapy, and to evaluate for
occurrence of any adverse effects associated with drug
therapy.
3. Educate the client on drug therapy.
R: To promote understanding and compliance.
4. Teach the patient to swallow the drug as a whole
with water; they should not crush, break or chew
it.
R: Chewing them can alter the drug absorption and action. It
may also cause mouth, throat, or stomach irritation.
5. Instruct the patient that if they forget to take the
medication, they should take it as soon as
possible. If more than 12 hours have passed since
their last dose, skip the missed dose and resume
their regular dosing schedule.
R: Missed doses should be avoided at all costs, as they
increase the risk of irregular bleeding.
6. Instruct the patient that if they take too much of
this medicine, they should try to seek a medical
emergency.
R: Overdose of this medicine can lead to some serious
symptoms like abnormal bleeding, severe pain in the
stomach, vomiting or diarrhea.
7. Teach the patient to keep the drug at room
temperature between 20ºC and 25ºC.
R: Direct contact with heat, air and light may damage your
medicines. Exposure to medicine may cause some harmful
effects.
8. Instruct the patient to avoid or limit intake of
caffeine-containing beverages, alcohol, and spicy
food.
R: These are known triggering agents for hot flushes, which
is one of the side effects of the drug,
9. Caution the patient to avoid driving and other
activities that require alertness until response to
medication is known.
R: May occasionally cause dizziness.
10. Instruct the patient to wear loose clothes before
going to bed and sleep in a cool, well-ventilated
room.
R: Doing this can prevent symptoms of hot flushes and night
sweats.
References:
https://www.mims.com/philippines/drug/info/duphaston?type=full
https://www.medicoverhospitals.in/medicine/dydrogesterone
https://www.mims.com/philippines/drug/info/dydrogesterone?mtype=generic
https://www.apollopharmacy.in/medicine/duphaston-10mg-tablet
