Margaret G. Bickmore asked:
>>What did you find out about its ingredients?  What is it?<<

I've got several replies to my question about Duphaston. Some said it was
contraindicated to breastfeed while taking Duphaston, others thought it was
not. So I made further inspection.
I got some information from the manufacturer about this medicine. Some of
them were very reassuring, some were less.

-Dydrogesteron is an orally active gestagen.
-It has no estrogenic, angrogenic, thermogenic, anabolic or corticoid effect
-Half life of this medicine is 5-7 hours. But it has 43 metabolites. Its
main metabolite is dihydrodydrogesteron and its half life is 14-17 hours.
-Peek: 0.5-2.5 hours
-MW: small
-84% of this medicine clears from the body in 24 hours; all of it needs 72
hours to clear.
-63% of oral dydrogesteron is secreted in urine
No info on protein binding yet (the manufacturer promised to find out).

I also talked to my OB who was very supportive of breastfeeding. He said he
never tells women to stop nursing while taking progesterone. He said the
same thing many of us thought in the first place: progesterone is a natural
body hormone. Even those contraceptives contain it that can be taken while
breastfeeding. My OB also said Duphastone was the most advanced medicine in
its type, that is why it is prescribed rather than anything else.

Then I checked the most recent issue of Pharmindex - the book used by
doctors and pharmacist. Comtraindications: pregnancy and lactation. (For
pregnancy, there is the exception if abortion needs to be prevented.)

I checked dr. Hale's book (Medications and Mother's milk). He says natural
progesterone is poorly bioavailable. (That is why vaginal administration is
preferred.) Sounds good, no problem with breastfeeding. (AAP approved.)

I started thinking:  what about Duphaston? Which is not the same natural
progesterone. Its bioavailability must be better (dydrogesteron is an orally
active gestagen). Then could it harm the nursing baby?

Now, I'm totally confused.

(I think the best I can tell my client is to ask her doctor for
alternatives. She might get progesterone by injection, vaginal gel, or an
intravaginal progesterone ring. )

Ideas are appreciated.

Warmly,
Ibolya Rozsa, LLLL, IBCLC
Hungary

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