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[robotwars]

Hi, Just a quick question which I'm hoping you can help me with, I know this needs to be taken at night but does it matter if its been taken with food or on an empty stomach? I have been advised to take it earlier as I feel a little hung over in the morning and just wanted to check?

[aspie65]

The instructions with mine say 2 hours after food or 1 hour before.  I find this really troublesome as I graze.  As far as I know if the stomach is full some of it may be lost by being absorbed by the food (really not sure about this but it's something like this). 

[Wilks]

Hi- yes, it has to be taken 2 hours after food or 1 hour before food (on an empty stomach). If you take it with food, more of it is absorbed into your body so you risk having too much.

[weathergirl]

My script has no directions like this. I take it with food as it agrees with me better this way.

[Wilks]

Have you checked the patient information leaflet? It's important not to take it with food.

[Hurdity]

Personally I don't think it matters about taking it with food (despite the instructions) if this aspect causes you more problems than the progesterone itself. As Wilks says - more is absorbed when taken with food - but used orally that may not be such a bad thing since much is lost to digestion and consequently there can be greater variability in actual dose getting to where you need it, possibly leading to spotting or irregular bleeding as your levels fluctuate.

It would potnetially be more of a concern if there was less absorption if taken with food - as you were suggesting might be the case aspie65.

The most important thing is consistency as this will be the best way to ensure as consistent a dose as you can. The dosages ( ie 100 mg or 200 mg), the systemic levels achieved and the degree of endometrial clearance (shedding the lining = the withdrawal bleed) obtained presumably were carried out when taken on a (fairly) empty stomach.

Of course if taken vaginally you neatly circumvent this problem 

Hurdity x

[Wilks]

Sorry Hurdity, but I disagree. I would respect the instructions that say “Do not take with food”. The oral dosage has been worked out based on the bioavailability (i.e. the amount of drug that gets into your circulation and thus available to cause an effect) of the drug when taken on an empty stomach.
If taken with food, the bioavailability increases two-fold. Utrogestan, like most medications, comes with risks. If you are regularly taking it with food, you are putting yourself at increased risk of adverse effects. I'm sure the occasional dose with food is ok, but I wouldn't do it regularly.

[Hurdity]

Yes I do agree that if bio-availability is increased then this does increase the chances of side effects - which may be undesirable - but also may mean that more gets to the uterus. Several women have complained of poor control of bleeding (especially when using the continuous combined regime) and perhaps taking with food would be one way to help with this rather than increase the dose actually ingested.

Interestingly the paper reporting the research on bioavailability compared progesterone levels when taken in close proximity to meals, to women taking the same doses in the fasting state (ie before breakfast)  - (having had a quick look only) - in reality it is not likely to be as much as two fold - just some undefinable amount more - if you wait eg two hours after eating!

Hurdity x

[aspie65]

Would love to learn more about this topic.  Hurdity, can you post a link to the study please?