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This safety guide outlines critical information about the risks and precautions associated with using progesterone. Please read carefully and consult your healthcare provider if you have any questions or concerns.

• Risk of Blood Clots: Progesterone may increase the likelihood of blood clots, particularly when combined with estrogen medications. This can lead to serious conditions such as heart attacks, strokes, or pulmonary embolisms (blood clots in the lungs). Discuss all your medical conditions with your doctor before starting this medication. Seek immediate medical help if you experience leg or arm pain, chest pain, sudden severe headaches, breathing difficulties, or sudden speech changes. Increased risk factors include a personal or family history of blood clots, high blood pressure, diabetes, high cholesterol, smoking, obesity, and systemic lupus erythematosus (SLE).

• Vision Concerns: Progesterone may lead to retinal thrombosis, causing blood clots in the eyes. Contact your healthcare provider immediately if you encounter vision changes, sudden vision loss, bulging eyes, double vision, or migraines.

• Fluid Retention: This medication can cause fluid retention, especially in the legs, ankles, and feet, potentially worsening conditions like kidney issues or heart failure. Inform your doctor if you have these conditions before using progesterone. Seek medical attention if you notice unexplained swelling, unexpected weight gain, or sudden breathing difficulties.

• Pneumonia Risk: In rare cases, progesterone may cause a specific type of pneumonia that can impact breathing. This is most likely to occur within the first 2 to 4 weeks of treatment and may resolve upon stopping the medication or with corticosteroid treatment. If you experience sudden shortness of breath, fever, cough, and chest pain that worsens with deep breaths, contact your healthcare team or seek medical care immediately.

Contraindications: Do not use this medication if you have any of the following conditions, as it may pose serious health risks:

• Blood clotting disorders
• Liver issues
• Breast cancer or cancer of any genital organ (e.g., ovarian, cervical)
• Undiagnosed vaginal bleeding
• Missed abortion
• Allergy to sesame oil or seeds

Always discuss your full medical history with your healthcare provider to ensure safe use of this medication.

Common side effects:

• Pain at the injection site
• Swelling at the injection site
• Redness at the injection site
• Breast tenderness
• Weight changes
• Acne
• Nausea
• Increased hair growth on the body or scalp
• Decreased hair growth on the body or scalp
• Drowsiness
• Dizziness

Less common but important to monitor:

• Unrelenting nausea or vomiting
• Unusual vaginal bleeding or discharge
• Cessation of menstrual periods
• Breast lumps
• Swelling of the ankles or feet
• Significant mood changes
• Dark patches on the skin
• Frequent or painful urination
• Dark urine
• Yellowing of the eyes or skin
• Stomach or abdominal pain

Serious side effects:

• Blood clots
• Heart attacks
• Strokes
• Clots in the lungs
• Clots in the legs
• Clots in the eyes
• Chest, jaw, or left arm pain
• Sudden weakness on one side of the body
• Difficulty speaking
• Sudden vision changes
• Confusion
• Severe headaches
• Very serious allergic reaction
• Rash
• Itching
• Significant swelling
• Difficulty breathing
• Severe dizziness

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Abametapir
• Conivaptan
• Eslicarbazepine Acetate
• Fosnetupitant
• Netupitant