Gradual dose escalation protocol for progestin

Day	Dose (based on progestin component)	Number of capsules × capsule dose per day	Total daily dose
Day 1	1.25 mcg in AM; 2.5 mcg in PM	1 × 1.25 mcg; 2 × 1.25 mcg	3.75 mcg
Day 2	2.5 mcg in AM, 12.5 mcg in PM	2 × 1.25 mcg; 1 × 12.5 mcg	15 mcg
Day 3	12.5 mcg in AM, 25 mcg in PM	1 × 12.5 mcg; 2 × 12.5 mcg	37.5 mcg
Day 4	37.5 mcg in AM, 37.5 mcg in PM	3 × 12.5 mcg; 3 × 12.5 mcg	75 mcg
Day 5	50 mcg in AM, 75 mcg in PM	1 × 50 mcg; 1 × 50 mcg + 2 × 12.5 mcg	125 mcg
Day 6	250 mcg	2 × 125 mcg	250 mcg
Day 7	500 mcg	4 × 125 mcg	500 mcg
Day 8	500 mcg	4 × 125 mcg	500 mcg
Day 9	1 mg	1 × 1 mg	1 mg

Capsules (or liquid preparations for the smallest doses) are prepared by a compounding pharmacy. Target dose for this protocol: Norethindrone 1 mg/ethinyl estradiol 0.02 mg.
Note that this protocol has been performed in a very small number of patients by experienced allergy specialists. The efficacy in larger numbers of patients awaits further study. UpToDate suggests that allergy specialists supervise such protocols whenever possible.

Reproduced from: Foer D, Buchheit JM, Gargiulo AR, et al. Progesterone hypersensitivity in 24 cases: Diagnosis, management, and proposed renaming and classification. J Allergy Clin Immunol Pract 2016; 4:723. Table used with the permission of Elsevier Inc. All rights reserved.

Graphic 115602 Version 3.0

خرید پکیج

Gradual dose escalation protocol for progestin