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[flaxhigh]

Hi there
Can anyone reassure me about the following. I got a letter from my GP this morning saying:

please see attached letter confirming the approved change for Utrogestan 100mg caps to Progesterone 100mg capsules. Please be advised this is NOT a change in medication, strength or dose...The letter just says the same thing.

Has this happened to anyone else? They're stopping my utrogestan and putting me on this. Is it the EXACT same drug do you know? I'm hyper sensitive to all progesterone and it took me about 2 years to get on to 100 mg utrogestan so am fearful of any change. I know they say this is not a change in medication, strength or dose but I need that extra reassurance if anyone has any experience of going from one to the other.

I don't know what brand the new progesterone will be - probably just a generic one.

Thank you!

[Banjo1973]

Hi,

I was moved from Utro to Gepretix. I actually have less side effects from this one. Although i believe some women don't like it.

I really struggle with progesterone (i also struggle with change!) - but for me it was a positive experience.

Good luck x

[bombsh3ll]

The active ingredient is exactly the same.

If everyone demanded brand name prescriptions the NHS would be bankrupt in a day, and it is only fair to everyone using the NHS that its limited resources are used in the most responsible way.

Occasionally there is a legitimate clinical reason, such as an allergy to one of the excipients, for prescribing a particular brand, and if you feel this applies to you this should be discussed with your prescriber.

It is also worth noting that with Brexit, increased awareness of and hence demand for hormone therapy (this is a good thing but has strained supply chains) and the low priority attached to women's health by the government, medication shortages of various MHT products are common and likely here to stay.

If you are prescribed the item generically ie as Micronised Progesterone, the pharmacy have the flexibility of using whatever brand is available to fill your prescription, but those prescribed Utrogestan are more likely to be left without and face a stressful scramble in the event of shortages.

[Diana]

I was also changed from Utrogestan to Progesterone. I can only tolerate Utrogestan as I am seriously affected by all other progs.I was told by the pharmacist that I am not cost effective for the NHS.I have worked since 15 yrs old,never claimed a penny in benefits and am now retired.This wouldn't of been so bad had I not waited in the queue behind several 'robed' ladies,with children and men,who all had their prescriptions FREE.This is why the NHS has got to cut corners.It should not be at our expense though.My Doctor has told me to take the prescription to a chemist that will give my choice of Progesterone.
Just one other thought,the Pharmacist in question said they had lots of Utrogestan in stock,so,who is it for???

[joziel]

I take my progesterone vaginally and don't think the Gepretix breaks down up there as well as the utrogestan does. I requested to have it specified that I should only be prescribed utrogestan and my GP agreed. I no longer get Gepretix now. (I did tell a white lie and say that I was getting break through bleeding on the Gepretix and never on the utrogestan - and she then specified I should only have utrogestan.) Your GP has the power to specify one particular brand of product if you ask for this and give a valid reason.

[flaxhigh]

Many thanks for your replies. The question is though: is it the same drug? I know Utrogestan is micronised progesterone but some of your replies suggest that it that the alternative is not the same.

I don't have a brand name yet for the one I'm going to be given, but it's likely to be Gepretix, if that's what you are all taking. Google says it's identical to Utrogestan.

So Joziel, why do you think it doesn't break down vaginally - I take utrogestan vaginally. Is it a different capsule and is it a cream inside?

To complicate matters, I have to squeeze out a couple of drops each night (with consultant's agreement) - will I be able to do this on Gepretix?

Diana - what other progesterone did you try?

Banjo1973 - how does it differ from utrogestan? You say you have less side effects - how, if it's exactly the same drug?

I'd really appreciate more info - thanks!

[flaxhigh]

I've just looked Gepretix up and it looks like these are not suitable for vaginal use nor can be pierced to squeeze out the cream progesterone to reduce the dose as I'm doing under the supervision of the London Menopause clinic.

I am writing to my GP tomorrow to beg to be left on Utrogestan. If not, I will have to buy it privately which is affordable short term but since I am taking it for osteoporosis which will be life long will turn out to be very expensive. Wish me good luck!

[sheila99]

It seems to be a licensing issue not a medical one just as it is with utrogeston. Have a look at this post
https://www.menopausematters.co.uk/forum/index.php?topic=69288.0
It's used vaginally in other countries.

[Clovie]

I was also changed from Utrogestan to Progesterone. I can only tolerate Utrogestan as I am seriously affected by all other progs.I was told by the pharmacist that I am not cost effective for the NHS.I have worked since 15 yrs old,never claimed a penny in benefits and am now retired.This wouldn't of been so bad had I not waited in the queue behind several 'robed' ladies,with children and men,who all had their prescriptions FREE.This is why the NHS has got to cut corners.It should not be at our expense though.My Doctor has told me to take the prescription to a chemist that will give my choice of Progesterone.
Just one other thought,the Pharmacist in question said they had lots of Utrogestan in stock,so,who is it for???

Ha, don't get me started!
About 5 years back my Utrogestan was stopped by my local NHS as it was suddenly, after years of use,   incredibly 'dangerous' to use.
Husband and I had a long back and forth ding dong with my surgery regarding this where we dared to suggest it down to cost. We had looked at cost of it against cost of synthetic prog. 
"No , no, no. Absolutely NOT!!   It's because it's so DANGEROUS for you to use!"   Which was an obvious lie. The rest of the UK, numerous places across the World etc,  including neighbouring areas not even 20 miles away were still prescribing it.

 I was offered (CHEAP) synthetic progesterone to which I am markedly intolerant, utrogestan being the only one I can tolerate. They would not relent even though my intolerance would mean Id have to stop HRT and I did not want to.

In the end I had to BUY both Utrogestan and Estrogel out of my own pocket because they stopped prescribing the gel to me as well.
This went on for three years.
I count myself extremely FORTUNATE that we are in a financial position to afford to do that, it wasn't cheap. I can't bear to think how unfair it was to women on a low income!    

2 years ago I was at the surgery where they mentioned in passing they could now prescribe it.... so I got it back.

It still makes me VERY cross when I think of it. 

[joziel]

So whilst they say that Gepretix and Utrogestan are the same, it's just the active ingredient (progesterone) which is the same. The capsule itself is different, as you'll see. Gepretix is much harder and utrogestan is squishy. Then the excipients inside are also different, I can't remember - something like one being peanut oil and one being some other oil. Which can affect absorption and how some women process it. So whilst it is in theory the same thing, it can lead to different absorption.

The NHS love Gepretix because it is cheaper. It's a money thing. (Of course.)

I've no idea if you can squeeze stuff out of it, I've never tried.

[flaxhigh]

Thanks Joziel. It looks and sounds like a harder shell and so probably not easy to pierce with a needle as I'm doing with the utrogestan. I will start a new thread to see if anyone would be kind enough to experiment for me with one!

[Lesred]

Can I just add that I get Zentiva sometimes instead of utrogeston which is very similar and squishy too? This is so that with any shortages I still get progesterone and I think it’s also probably cheaper so might that be a possible alternative if your gp is being unnecessarily tricky? I’ve had no problems with it and it seems, although I maybe wrong, exactly the same, or at least more similar than Gepretix.

Just a thought

X x

[JKS]

I've recently been given generic micronised progesterone made by Zentiva Pharma, & not noticed any difference so far. They feel almost as soft as Utrogestan, & I find them equally difficult to swallow.

Regarding absorption - each of us will absorb a medication differently, but there will be a standard that all generic makes of micronised progesterone will have to adhere to, so hardly anyone should notice any difference. As others have said, there will be differences in the excipients, which may cause issues (rather than the progesterone) Most of these excipients are standard chemicals that have been used in many preparations for years, so their side effects etc. are well known.

It's partly to do with costs (& don't we all have an obligation to try & keep NHS costs down if we can?) & flexibility, so more than 1 brand can be dispensed. Exactly the same as other medicines.

Perhaps give them a try & see how you get on? If there's a genuine reason why they don't suit you, most GPs will be happy to swap you back.

[flaxhigh]

Thanks JKS and Lesred - I will try and find out what I'm actually going to be given tomorrow by ringing up the supplier. Would be useful to have something similar to Utrogestan so far as the capsule.

[Banjo1973]

Hi,

I usually wash off the coating from getaprix and it does go squishy. I also used to wash the coating off Utrogestan as this caused irritation when taken vaginally.

I started taking Utrogestan rectally as an experiment (which suited me better than other routes).

I find gepritix makes me less groggy in the morning and makes me less bloated and constipated.

Good luck x