What Are The Functions And Requirement Of Susten And Duphastone?

Posted on Mon, 22 Dec 2014

Question: Dear Sir/madam,
My wife is in 20 week Pregnency. Where as, she has to undergo Macdonald strich due to "incompetent cervical os with bulging bag of membranes".
Other info: She is O-ve, hypothyroic, near to diabetic sugar levels and it is G3A2 (one miscarrige in 5th month)
Doctor has prescribed following:
1. Susten SR 200mg twice daily
2. Duephastone- twice daily
3. Duvadilan retard- twice daily
4. HUCOG5000IU injection- once weekly
5. Maintain injection- once weekly
Apart from above livogen-z and calcium and complete bed rest were also recommended.
QUESTIONS:
1.whether both susten and duphastone are required to take? Do they have different functions?
2. Whether HUCOG inect. is required? Is it given in 2nd and 3rd trimesters also?
3. Whether FOLIC ACID is NOT required to be taken in Second trimester? My Dr. has not prescribd it..

Please answer My questions ON URGENT BASIS I am in urgent need, as these medicines are causing severe burden on my wife's body as she complains that her body is generating over heat like feeling and unable to digest as she has NO PHYSICAL ACTIVITY DUE TO COMPLETE BED REST..
Pls suggest urgently how to go about it..

Answered by Dr. Manisha Jain (1 hour later)

Brief Answer:
take duphaston and not susten

Detailed Answer:
Hello, I appreciate your concern for her health.
Duphaston and susten have same function so take either of them otherwise she will feel nauseated and low mood.
HCG is usually needed only in first trimester.
But taking it till stitch application will be helpful.
Livogen Z already has folic acid so no need to take extra tablet for that.
The symptoms of uneasiness and heat is all due to the effect of high progesterone so just discuss with her gynecologist and take only duphaston twice a day and not susten.
All the best and in case you have any questions I will be happy to help.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Jain (1 hour later)

Ma'm, thank you very much. One gyne. in XXXXXXX suggested to use Susten instead of duphastone. I am confused, how r they different?..

Answered by Dr. Manisha Jain (1 hour later)

Brief Answer:
duphaston best

Detailed Answer:
See usual practice is to give duphaston till 16 weeks and then switch over to micronised progesterone like susten. But overall duphaston is the best form of progesterone but shift to susten is to save money and decreased need of progesterone after 16 weeks because placenta starts functioning at that time.
(Duphaston is the costliest but the best progesterone).
She can take any out of them if you can afford but certainly not both of them at same time.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar