Progynova 2mg Tablet 28s

Progynova 2mg Tablet is a well-established hormonal medicine belonging to the oestrogen drug class, with estradiol valerate as its active pharmaceutical ingredient — manufactured by Bayer AG, Germany and distributed in Malaysia by Bayer Co. (Malaysia) Sdn Bhd, with the product registered with the National Pharmaceutical Regulatory Authority (NPRA) of Malaysia as a prescription-only medicine (POM). As with all hormonal medicines, Progynova 2mg can cause side effects, and the most commonly reported ones include headache, breast tenderness or pain, nausea, and breakthrough vaginal bleeding or spotting — particularly during the first few months of treatment as your body adjusts to the medication. It is very important that you only take this medicine under the strict guidance of your doctor, as it carries specific risks related to cardiovascular health, blood clotting, and hormone-sensitive cancers that must be carefully assessed for every individual patient before and during treatment. Before purchasing, please ensure you have a valid prescription from a registered doctor, inform your healthcare provider of your full medical history, and only buy from a licensed pharmacy or verified online platform to guarantee you receive a genuine, NPRA-registered product.

How to Take Progynova 2mg Tablet

Progynova 2mg Tablet is taken orally — swallow the tablet whole with a glass of water and do not crush, chew, or break it; it may be taken with or without food, although taking it after a meal may help reduce the chance of stomach discomfort. Treatment with Progynova is typically continuous, meaning you begin the next pack immediately after finishing the current one with no break in between, and it is important to take the tablet at the same time each day to maintain consistent hormone levels in your body. Always follow your prescribing doctor’s specific instructions, as individual dosing regimens, timing, and whether you require an additional progestogen may vary based on your menopausal status and whether your uterus is intact.

Dosage of Progynova 2mg Tablet

The standard recommended dose is one Progynova 2mg tablet taken orally once daily, on a continuous basis — your doctor may initiate treatment at the lower 1mg strength and adjust to 2mg based on your individual response and symptom control, always using the lowest effective dose for the shortest duration appropriate to your clinical needs. Women with an intact uterus must also be prescribed a progestogen alongside Progynova — this is a critical safety measure that your doctor will advise on — while women who have had a hysterectomy may take oestrogen alone.

Shelf Life of Progynova 2mg Tablet

Progynova 2mg Tablet has a manufacturer-stated shelf life that is clearly printed on the outer carton and individual blister strips — you should always check this expiry date before taking any tablet. Do not consume this medication after the stated expiration date, even if the tablets appear visually unchanged, as chemical degradation may affect the potency and safety profile of the product over time. As a general guide, unopened packs stored correctly under the recommended conditions maintain their full pharmaceutical quality for the duration indicated on the packaging. Once dispensed by a pharmacy, always observe any expiry date or “use by” date applied on the dispensing label, which may be earlier than the manufacturer’s stated date.

How to Store Progynova 2mg Tablet

Store Progynova 2mg Tablet below 30°C in a cool, dry location, away from direct sunlight, heat, and moisture. Keep the tablets in their original manufacturer blister packaging until you are ready to take them — the foil-blister packaging provides an essential light and moisture barrier that protects tablet integrity. In Malaysia’s warm, humid tropical climate, take particular care to avoid storing this medication in bathrooms, on bedroom windowsills exposed to afternoon sun, in kitchen cabinets near the stove, or in your vehicle’s glove compartment where temperatures can rise significantly. Store all medicines, including Progynova, securely out of sight and out of reach of children and pets at all times. Dispose of any unused, damaged, or expired tablets through a licensed pharmacy medication return programme or in accordance with local pharmaceutical waste disposal guidelines; do not flush tablets down the drain or discard them in household waste.

Active Ingredient of Progynova 2mg Tablet

The active pharmaceutical ingredient (API) in each Progynova 2mg Tablet is Estradiol Valerate, present at a strength of 2.0mg per tablet. Estradiol valerate is the 17-valerate ester of the endogenous female sex hormone estradiol (17β-estradiol). It is classified as a prodrug — meaning that after oral administration, it is rapidly hydrolysed by esterases in the plasma and liver into its pharmacologically active form, estradiol, which then exerts its biological oestrogen agonist effects by binding to nuclear oestrogen receptors (ERα and ERβ) throughout the body.

Pharmacokinetically, estradiol valerate is quickly and completely absorbed from the gastrointestinal tract following oral ingestion, reaching peak plasma estradiol concentrations within 0.5 to 3 hours. A second plasma peak typically appears at 6 to 8 hours, likely reflecting enterohepatic recirculation. Plasma protein binding is high — approximately 37% of circulating estradiol binds to sex hormone-binding globulin (SHBG) and 61% to albumin. The absolute bioavailability of estradiol from an oral dose of estradiol valerate is 3–5%, due to significant first-pass hepatic metabolism. The primary metabolic pathway involves hydroxylation of estradiol to estrone and estriol, which are excreted largely as glucuronide and sulphate conjugates in the urine.

Each Progynova 2mg tablet also contains the following inactive excipients (pharmaceutical fillers and coating agents): lactose monohydrate, maize starch, povidone 25000, talc, magnesium stearate, sucrose, povidone 700000, macrogol 6000, calcium carbonate, montan glycol wax, glycerol 85%, titanium dioxide (E171), and indigo carmine lake (E132) — the last of which gives the tablet its characteristic blue colour. Patients with known lactose intolerance, sucrose intolerance, or galactose intolerance should consult their doctor or pharmacist before use due to the presence of lactose monohydrate and sucrose.

Side Effects of Progynova 2mg Tablet

As with all medicines — and particularly with hormonal therapies — Progynova 2mg Tablet may cause side effects in some patients, though not everyone will experience them. The likelihood, nature, and severity of side effects depend on the individual, their medical history, dose, and duration of use. The following side effects have been associated with estradiol valerate / oestrogen HRT:

Common Side Effects (may affect up to 1 in 10 people):

• Headache or migraine
• Breast tenderness, breast pain, or breast swelling (mastalgia)
• Nausea or mild stomach discomfort
• Breakthrough bleeding or spotting (particularly in the first few months of treatment)
• Abdominal bloating, cramping, or pelvic discomfort
• Oedema (fluid retention, mild swelling of the ankles or legs)
• Mood changes, depressive mood, or irritability
• Weight changes (gain or loss)
• Skin reactions at application area (not relevant for oral tablets)

Uncommon Side Effects (may affect up to 1 in 100 people):

• Dizziness or lightheadedness
• Skin rash, urticaria (hives), or pruritus (itching)
• Alopecia (hair thinning or hair loss)
• Increased blood pressure (hypertension)
• Palpitations or irregular heartbeat
• Varicose veins
• Contact lens intolerance (due to corneal curvature changes)
• Changes in vaginal discharge
• Glucose intolerance or worsening of existing diabetes
• Erythema nodosum (red, tender lumps usually on the shins)
• Changes in libido (increase or decrease in sexual desire)

Serious Side Effects — Seek Immediate Medical Attention:

• Venous thromboembolism (VTE) — formation of blood clots in deep veins (deep vein thrombosis / DVT) or in the lungs (pulmonary embolism / PE); symptoms include unexplained leg pain or swelling, sudden breathlessness, chest pain, or coughing up blood
• Arterial thromboembolism — including myocardial infarction (heart attack) or ischaemic stroke; symptoms include sudden chest pain, severe headache, sudden weakness or numbness on one side of the body, slurred speech, or sudden visual loss
• Endometrial hyperplasia and endometrial carcinoma — the risk is significantly elevated in women with an intact uterus who take oestrogen-only therapy without concurrent progestogen; any unexpected vaginal bleeding should be investigated promptly
• Breast cancer — long-term use of oestrogen-only HRT is associated with a modest increased risk of breast cancer; the risk is higher with combined oestrogen-progestogen HRT; regular breast examinations and mammograms as recommended by your doctor are important
• Hepatic (liver) disorders — including jaundice (yellowing of the skin or eyes), hepatocellular adenoma, or, very rarely, Budd-Chiari syndrome (hepatic vein thrombosis); discontinue immediately if jaundice or liver function deterioration occurs
• Severe allergic reactions (anaphylaxis or angioedema) — symptoms include sudden difficulty breathing, swelling of the face, lips, tongue or throat, or severe skin reactions; seek emergency medical care immediately
• New-onset or worsening migraine-type headaches — especially with aura; this should prompt immediate medical evaluation as it may indicate an increased stroke risk
• Sudden loss or deterioration of vision or hearing
• Dementia — data from the Women’s Health Initiative Memory Study (WHIMS) suggested an increased risk of probable dementia in postmenopausal women aged 65 years or older when using oestrogen-only HRT; the risk may be lower in women who commence HRT closer to menopause
• Ovarian cancer — long-term use of oestrogen-only HRT has been associated with a slightly elevated risk of ovarian cancer

Important: If you experience any new, persistent, or worsening symptoms while taking Progynova 2mg Tablet, stop the medication and consult your doctor without delay. Report suspected adverse drug reactions to the Malaysian Adverse Drug Reactions Advisory Committee (MADRAC) at www.npra.gov.my.

Contraindications of Progynova 2mg Tablet

Absolute Contraindications:

• Known or suspected breast cancer (current, previous, or strongly suspected) — oestrogen is contraindicated in all hormone-receptor-positive and receptor-unknown breast cancer
• Known or suspected oestrogen-dependent malignant tumours — including endometrial cancer or other hormone-sensitive cancers of the reproductive system
• Untreated endometrial hyperplasia — oestrogen-only therapy without progestogen will worsen this condition
• Undiagnosed abnormal vaginal or uterine bleeding — the cause must be established before commencing oestrogen therapy
• Active or previous venous thromboembolism (VTE) — including deep vein thrombosis (DVT) and pulmonary embolism (PE)
• Known thrombophilic disorders — including hereditary or acquired predispositions to thrombosis such as protein C deficiency, protein S deficiency, antithrombin III deficiency, and Factor V Leiden mutation
• Active or recent arterial thromboembolic disease — including myocardial infarction (heart attack), stroke, unstable angina, or transient ischaemic attack (TIA) within the preceding 12 months
• Acute liver disease or chronic severe liver disease (where liver function tests have not returned to normal) — including hepatocellular adenoma, malignant liver tumour, or history of Dubin-Johnson or Rotor syndrome
• Porphyria — including acute intermittent porphyria; oestrogen is known to precipitate acute attacks
• Known hypersensitivity or allergy to estradiol valerate or to any of the inactive excipients (lactose, sucrose, indigo carmine, etc.)
• Pregnancy — Progynova 2mg is strictly contraindicated during pregnancy; treatment must be withdrawn immediately upon confirmed or suspected pregnancy
• Breastfeeding — oestrogen reduces the quantity of breast milk and has been shown to be excreted in human breast milk; Progynova should not be used during lactation
• Children and adolescents under 18 years of age — Progynova is not indicated for use in paediatric or adolescent patients

Use with Caution (Requires Medical Review and Close Monitoring):

• Uterine fibroids (leiomyomata) — oestrogen may stimulate fibroid growth
• Endometriosis — oestrogen-only HRT may reactivate or worsen endometriosis
• History of endometrial hyperplasia (previously treated)
• Risk factors for venous or arterial thromboembolism — including obesity (BMI > 30), smoking, prolonged immobilisation, family history of VTE, hypertension, or hyperlipidaemia
• Gallbladder disease — oestrogens may increase the risk of gallstones and worsen existing gallbladder disease
• Hypertriglyceridaemia — oral oestrogen can significantly raise serum triglycerides in susceptible individuals, increasing pancreatitis risk; transdermal routes may be preferable
• Renal (kidney) impairment — fluid retention associated with oestrogen therapy may worsen renal function; close monitoring required
• Epilepsy — hormonal changes may alter seizure thresholds; monitor closely
• Systemic lupus erythematosus (SLE) — oestrogen may exacerbate the disease
• Asthma, migraine, or other conditions that may worsen with fluid retention
• History of liver disease where liver function tests have normalised — use only with monitoring
• Women with a strong family history of breast cancer or known BRCA1/BRCA2 mutations — a thorough risk-benefit discussion with a specialist is essential before commencing HRT

Drug & Food Interaction of Progynova 2mg Tablet

Drug Interactions — Medications That May Reduce Progynova’s Effectiveness:

• CYP3A4 and CYP1A2 enzyme inducers — these drugs accelerate the hepatic metabolism of estradiol, significantly reducing its plasma levels and therapeutic effect. Key examples include: anti-epileptics (phenobarbital, carbamazepine, phenytoin, primidone, oxcarbazepine, topiramate), rifampicin (anti-tuberculosis antibiotic), HIV antiretrovirals (ritonavir, nelfinavir, nevirapine, efavirenz), and griseofulvin (antifungal). Women on these medications may experience hormonal breakthrough symptoms and loss of oestrogen effect
• St. John’s Wort (Hypericum perforatum) — this commonly used herbal remedy for depression is a potent CYP3A4 inducer; concurrent use with Progynova can substantially reduce estradiol plasma levels and render the treatment ineffective. Do not combine without medical advice

Drug Interactions — Medications Whose Levels May Be Affected by Progynova:

• Ciclosporin (immunosuppressant) — oestrogen inhibits the metabolism of ciclosporin, potentially increasing ciclosporin plasma concentrations and the risk of nephrotoxicity and hepatotoxicity; close therapeutic drug monitoring is required
• Tamoxifen and aromatase inhibitors (e.g., anastrozole, letrozole, exemestane) — oestrogen directly antagonises the anti-oestrogenic and oestrogen-suppressing effects of these drugs used in breast cancer treatment; concurrent use is contraindicated and may result in treatment failure
• Thyroid hormone replacement therapy (levothyroxine) — oestrogen increases thyroid-binding globulin (TBG) levels, which may increase the required dose of levothyroxine in hypothyroid patients; thyroid function should be monitored
• Anticoagulants (e.g., warfarin, acenocoumarol, phenprocoumon) — oestrogen has a complex bidirectional effect on coagulation; it may increase clotting factor production and reduce anticoagulant effect, while simultaneously elevating VTE risk; INR should be closely monitored
• Corticosteroids — oestrogen can increase plasma concentrations of cortisol and other corticosteroids by reducing their clearance; monitor for increased corticosteroid-related side effects
• Antidiabetic agents (insulin and oral hypoglycaemics) — oestrogen may alter glucose tolerance and insulin sensitivity, requiring dosage adjustments; blood glucose should be monitored more closely
• Antihypertensives — oestrogen may cause fluid retention and mild blood pressure elevation, potentially reducing the effectiveness of antihypertensive therapy; monitor blood pressure regularly

Food & Lifestyle Interactions:

• Alcohol — chronic or heavy alcohol intake may exacerbate liver metabolism effects, increase triglycerides, and worsen VTE risk
• Smoking — significantly increases the risk of arterial thromboembolism (heart attack, stroke) in women aged ≥35 years using oral oestrogen therapy; strongly advised to cease smoking prior to HRT initiation
• Grapefruit & grapefruit juice — may inhibit CYP3A4 in the gut wall and liver; this can alter estradiol metabolism and slightly increase plasma levels, although the clinical significance is minor; moderation is recommended

Quick Tips for Progynova 2mg Tablet Users

• Always take the tablet at the same time each day to maintain steady hormone levels
• Do not miss doses; if a dose is missed by less than 12 hours, take it as soon as remembered; if more than 12 hours, skip and continue next day
• Do not double the dose to compensate for missed tablets
• Store tablets in original blister packs and avoid exposure to moisture or heat
• Keep a symptom diary (bleeding, mood changes, breast tenderness) to help your doctor monitor therapy effectiveness
• Inform your doctor of all medications and supplements, including herbal remedies, to avoid interactions
• Report unusual bleeding, severe headaches, chest pain, or leg swelling immediately
• Attend regular check-ups including blood pressure, mammogram, and gynaecological examinations
• Do not start or stop any therapy without consulting your healthcare provider

Frequently Asked Questions (FAQ) for Progynova 2mg Tablet

1. Is Progynova 2mg Tablet safe for long-term use?

Progynova can be used long-term under medical supervision. The lowest effective dose should be used, and regular monitoring for breast health, cardiovascular health, liver function, and endometrial health is required. Long-term therapy may increase the risk of breast cancer, VTE, and stroke.

2. Can I take Progynova if I have a history of blood clots?

No. Progynova is contraindicated in patients with a history of venous or arterial thromboembolism, or thrombophilia. Your doctor may recommend alternative non-oral oestrogen therapies or non-hormonal treatments.

3. Can I use Progynova while breastfeeding?

Progynova is not recommended during breastfeeding because it may reduce milk production and pass into breast milk.

4. What should I do if I miss a dose?

If a dose is missed by less than 12 hours, take it as soon as remembered. If more than 12 hours have passed, skip the missed dose and continue with the next scheduled dose. Do not double up.

5. Can Progynova cause weight gain?

Some women may experience mild weight changes due to fluid retention or fat redistribution. Maintaining a healthy diet and regular exercise can help mitigate this.

6. Do I need regular check-ups while taking Progynova?

Yes. Regular follow-up is necessary to monitor blood pressure, breast health, endometrial health, liver function, and overall hormone response. Your doctor may also recommend mammograms and pelvic examinations at intervals.

7. Can I take other medications with Progynova?

Some medications, especially enzyme inducers (like certain anti-epileptics, rifampicin, and St. John's Wort), may reduce effectiveness. Progynova may also affect the levels of other drugs such as anticoagulants, corticosteroids, thyroid hormones, and antidiabetics. Always inform your doctor of all medications you take.

8. Can I drink alcohol while taking Progynova?

Moderate alcohol intake is generally allowed, but heavy drinking should be avoided as it can worsen liver effects, triglyceride levels, and VTE risk.

9. Can I smoke while taking Progynova?

Smoking significantly increases the risk of cardiovascular complications. Women over 35 years old are strongly advised to stop smoking before starting oestrogen therapy.

10. How long before I notice benefits?

Symptom relief (hot flashes, night sweats, mood swings) may begin within 2–4 weeks, but full benefit may take 2–3 months. Individual response varies.