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Are the drugs Maintane and Orgagest safe during pregnancy?

Q: My wife, who is 12 weeks pregnant now, has been prescribed Maintane and Orgagest since past one month of her pregnancy. In India, allylestrenol (Maintane by Jagsonpal Pharma) is prescribed to prevent recurrent abortion. But the same drug is banned in USA or Europe. The original company Organon does not even make the drug in its home country (orgnanon.com). Progesterone tablets (orgagest) are also prescribed. But it has been contraindicated in pregnant woman by FDA (Source : fda.gov). Should the drug be continued? I don't have faith in a medicine not supported or approved by FDA, USA. Please help.

A:There are many agents under the broad category of progestogens including allyloestrenol (Maintane). Once the product patent (that gives monopoly production rights with monopoly price) expires, the innovator manufacturers lose interest in the medicine and come up with another similar molecule so that they can sell the same at monopoly prices. Allyloestrenol is one such example. There is hardly any difference between allyloestrenol and other progestogens such as drydogesterone, hydroxyprogesterone, medroxyprogesterone and progesterone. In fact allyloestrenol (Maintane) is a good option since it has predominant progestrogenic and very little oestrogenic activity. Progestogens are indicated in a wide variety of disorders including deficiency of the hormone, menstrual disorders, endometriosis, recurrent miscarriage, hormonal replacement therapy and as hormonal support during pregnancy. The very fact that they are used to prevent miscarriage means that they are to be used during pregnancy. Your gynaecologist is the best judge to decide on the appropriate therapy. Maintane is widely used as hormonal support during pregnancy.

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