From the Guidelines
No, Prometrium (progesterone) 200 mg capsules should not be crushed, as this would alter the medication's release pattern and potentially affect its effectiveness. These capsules contain micronized progesterone in an oil base and are designed to be swallowed whole. The specific formulation is designed to protect the hormone and ensure proper absorption in the digestive tract. According to the most recent evidence, when applicable, alternative drug delivery methods should be considered, such as liquids or topical formulations 1.
For patients who have difficulty swallowing the capsules, alternative formulations of progesterone are available, such as:
- Vaginal suppositories
- Gels
- Creams Some patients may also benefit from the progesterone-only mini-pill which comes in smaller tablet form. It is essential to consult with the prescribing healthcare provider before altering any medication or to discuss alternative administration options for patients with swallowing difficulties. The involvement of clinical pharmacists in the medication process can also help reduce medication errors, including those related to the modification of pharmaceutical formulations, such as crushing capsules 1.
In the context of real-life clinical medicine, it is crucial to prioritize the patient's safety and the medication's efficacy, and therefore, crushing Prometrium capsules is not recommended. Instead, healthcare providers should explore alternative formulations or administration routes that can ensure the patient receives the necessary medication while minimizing potential risks and complications.
From the Research
Crushing Prometrium (Progesterone) 200mg
- There is no direct evidence in the provided studies regarding the specific medication Prometrium (progesterone) 200mg and whether it can be crushed.
- However, the studies suggest that crushing tablets or opening capsules can have serious clinical consequences, including alteration of the drug's absorption, overdose, or underdosing 2, 3, 4, 5.
- Crushing tablets can disrupt a drug's sustained-release properties, leading to overdose, or destroy a gastro-resistant layer, resulting in underdosing 2.
- The decision to crush a tablet should be made with caution and consideration of the potential impact on the drug's effects 2, 3, 4, 5.
- In general, it is recommended to use a different dosage form or active ingredient if a patient has difficulty swallowing, rather than crushing a tablet 2, 3.
- One study found that crushing a specific medication (vibegron) did not affect its safety or the amount of the medication in the body over time 6, but this may not be applicable to all medications, including Prometrium (progesterone) 200mg.