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|Trade names||Prometrium, Utrogestan, Endometrin, Crinone, others|
|Pregnancy category||B (US)|
|Routes of administration||• By mouth (capsule) • Sublingual (tablet) • Topical (cream, gel) • Vaginal (capsule, tablet, gel, suppository, ring) • Rectal (suppository) • IM injection (oil solution) • SC injection (aq. soln.) • Intrauterine (IUD)|
|Drug class||Progestogen; Antimineralocorticoid; Neurosteroid|
|ATC code||G03DA04 ( WHO )|
|Legal status||In general: ℞ (Prescription only)|
|Bioavailability||Oral: <2.4%  Vaginal: 4–8%   |
|Protein binding||98–99%:   • Albumin: 80% • CBG: 18% • SHBG: <1% • Free: 1–2%|
|Metabolism||Mainly liver: • 5α- and 5β-reductase • 3α- and 3β-HSD • 20α- and 20β-HSD • Conjugation • 17α-Hydroxylase • 21-Hydroxylase • CYPs (e.g., CYP3A4)|
|Metabolites||• Dihydroprogesterones • Pregnanolones • Pregnanediols • 20α-Hydroxyprogesterone • 17α-Hydroxyprogesterone • Pregnanetriols • 11-Deoxycorticosterone (And glucuronide/sulfate conjugates)|
|Elimination half-life||• Oral: 5 hours (with food)  * Sublingual: 6–7 hours  • Vaginal: 14–50 hours   • Topical: 30–40 hours  • IM: 20–28 hours    • SC: 13–18 hours  • IV: 3–90 minutes |
|Excretion||Bile and urine  |
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|Progesterone alternative name||agolutin, belgest, ciclosterona, crinone, cyclogest, cygest, darstin, endometrin, esolut, estima, evapause, florgynal, geslutin, gestagen, gester, gesterol, gestone, hormoral, lugesteron, luteina, luteum, lutogynestryl, lutogynon, mafel, mastoprofen, menaelle, microgest, naturogest, premastan, prochieve, progeffik, progehormon, progenar-gele, progendo, progest, progestan, progesteron, progesterona, progesteronum, progestin, progestogel, progeston, progestosol, prolusteron, proluton, prontogest, prosphere, susten, trophigil, utrogest, utrogestan, utrogestran, vasclor|
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BMJ. 350: h2135. doi: 0.8, 39 Estrogen progesterone capsule 2ESR2Nuclear receptorIncreased. 8, 39 Myc proto-oncogene proteinc-MYCTranscription factorIncreased 140 Cyclin D1CCND1Cell progesterone capsule regulatorIncreased 140 Growth regulating progesterone capsule receptor binding 1GREBGrowth regulatorIncreased 140 Fibroblast growth factor 9FGF-9Secreted growth factorIncreased 141 Steroid receptor coactivator-1SRC-1Transcriptionalco-activatorIncreased 142 When endometrial tissue fails to respond properly to P4 exposure, this is termed P4 resistance, and it manifests itself in endometriosis as failed induction of PGR activation, or P4 target gene transcription in the presence of bioavailable P46, Under this definition, P4 resistance has been well-established in both the endometriotic lesions and eutopic endometrium of women with endometriosis.
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