Prasterone: Benefits, Dosage, and Side Effects Overview

Summary of Key Points

Prasterone, also known as dehydroepiandrosterone (DHEA), is a hormone replacement therapy used to treat various conditions, including menopause symptoms, adrenal insufficiency, and sexual dysfunction. It has also shown effectiveness in managing chronic fatigue syndrome, osteoporosis, and certain autoimmune disorders. By helping to restore hormone levels, Prasterone can improve overall well-being. Always consult your healthcare provider before starting or adjusting your dose, and consider scheduling a telemedicine appointment with us for personalized care.

Names of Medication

US Brand Name: Intrarosa

Generic Name: Prasterone (dehydroepiandrosterone or DHEA)

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name will be listed in parentheses.

Pharmacologic Category

Categories:

1. Androgen
2. Adrenal steroid
3. Hormone replacement therapy

Prasterone Dosage

Prasterone is prescribed to treat several conditions in adults. Below are the recommended doses for each condition. Always consult your healthcare provider before making any changes to your medication plan. You can also schedule a telemedicine appointment with us for expert guidance.

1. Adrenal Insufficiency: 50-200 mg orally once daily. The duration of treatment depends on the patient’s response and should be closely monitored by a healthcare provider.
2. Osteoporosis: 50 mg orally once daily. Treatment is typically long-term to help maintain bone density.
3. Depression: 30-90 mg orally once daily. The length of treatment varies based on the patient’s condition and response to therapy.
4. Sexual Dysfunction: 25-50 mg orally once daily. Treatment may continue as long as symptoms persist.
5. Menopause Symptoms: 6.5 mg vaginal insert once daily at bedtime. Treatment is usually ongoing to provide symptom relief.
6. Chronic Fatigue Syndrome: 50-200 mg orally once daily. The duration of treatment depends on symptom improvement.
7. Fibromyalgia: 50-200 mg orally once daily. Treatment duration varies based on symptom control.
8. Autoimmune Disorders: 50-200 mg orally once daily. Treatment may be long-term depending on the condition.
9. Aging-Related Conditions: 25-50 mg orally once daily. Treatment is typically long-term to maintain hormone levels.
10. Hormone Deficiency: 25-50 mg orally once daily. Treatment is usually ongoing to maintain hormone balance.

Dosage Forms and Strengths

Prasterone is available in the following forms and strengths:

1. Vaginal Insert: 6.5 mg
2. Oral Tablet: 25 mg, 50 mg, 100 mg, 200 mg

Administration Instructions for Prasterone

Prasterone should be taken exactly as prescribed by your healthcare provider. For oral tablets, it can be taken with or without food, ideally at the same time each day. If using the vaginal insert, it should be applied once daily at bedtime. Always follow the instructions provided by your doctor or pharmacist. If you have any questions about how to use this medication, schedule a telemedicine appointment with one of our providers for further guidance.

Prasterone Side Effects and Adverse Reactions

Like all medications, Prasterone may cause side effects. Below is a list of potential side effects, categorized by how frequently they occur. If you experience any severe or persistent side effects, contact your healthcare provider immediately.

Common Prasterone Side Effects

1. Acne: Increased oil production in the skin may lead to breakouts.
2. Hair Loss: Some individuals may experience thinning hair or hair loss.
3. Increased Facial Hair: Women may notice more hair growth on the face.

Less Common Side Effects

1. Insomnia: Difficulty falling or staying asleep.
2. Mood Changes: Some individuals report feeling more irritable or anxious.
3. Headache: Mild to moderate headaches may occur.

Rare but Serious Side Effects

1. Liver Problems: Symptoms may include yellowing of the skin or eyes, dark urine, or severe stomach pain.
2. Severe Allergic Reactions: Symptoms may include rash, itching, swelling, or difficulty breathing.

Contraindications for Prasterone

A contraindication is a specific situation or condition where a medication should not be used because it may cause harm. Before starting any new medication, it’s important to know if you have any conditions that might make the drug unsafe for you. Below are the contraindications for taking Prasterone.

1. Allergy to Prasterone: If you have a known allergy to Prasterone or any of its ingredients, you should not take this medication. Allergic reactions can range from mild (rash, itching) to severe (difficulty breathing, swelling of the face or throat).
2. Hormone-sensitive cancers: Prasterone is a precursor to hormones like estrogen and testosterone. If you have a history of hormone-sensitive cancers, such as breast, ovarian, or prostate cancer, taking Prasterone could potentially stimulate cancer growth.
3. Pregnancy: Prasterone is not recommended during pregnancy (see the section on pregnancy below for more details).
4. Severe liver or kidney disease: If you have severe liver or kidney disease, your body may not be able to process Prasterone effectively, leading to potential toxicity or adverse effects.

Drug to Drug Interactions

Prasterone, also known as dehydroepiandrosterone (DHEA), can interact with other medications, potentially increasing side effects or reducing the effectiveness of either drug. It’s important to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Prasterone:

Estrogen or hormone replacement therapy (HRT): Combining Prasterone with estrogen-based medications like Premarin (conjugated estrogens) or Estrace (estradiol) may lead to hormone imbalances or heightened side effects.

Testosterone or anabolic steroids: Medications such as AndroGel (testosterone) or Deca-Durabolin (nandrolone) may interact with Prasterone, potentially causing excessive hormone levels and side effects like acne, hair loss, or mood swings.

Anticoagulants: Blood thinners like Coumadin (warfarin) or Xarelto (rivaroxaban) may interact with Prasterone, increasing the risk of bleeding complications.

Corticosteroids: Medications like Prednisone (prednisone) may interact with Prasterone, potentially affecting how your body manages inflammation and immune responses.

Prasterone in Pregnancy

Is it Safe to Take Prasterone When Pregnant?

Prasterone is generally not recommended during pregnancy. As a precursor to hormones like estrogen and testosterone, it could potentially interfere with fetal development. If you are pregnant or planning to become pregnant, it’s essential to consult your healthcare provider before using Prasterone. If you are currently taking Prasterone and discover you are pregnant, contact your healthcare provider immediately to discuss whether you should continue or discontinue the medication.

Prasterone While Breastfeeding

Is it Safe to Take Prasterone While Breastfeeding?

There is limited information on whether Prasterone passes into breast milk or how it might affect a breastfeeding infant. Due to the lack of sufficient research, it is generally advised to avoid Prasterone while breastfeeding. Always consult your healthcare provider to carefully weigh the potential risks and benefits before using this medication while nursing.

Estimated Cost of Prasterone Medication

The cost of a 30-day supply of Prasterone can vary depending on the pharmacy and location. Using a GoodRx coupon, the estimated cost without insurance ranges from approximately $150 to $200. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a coupon service like GoodRx for the most up-to-date pricing.

Possible Alternatives to Prasterone

If Prasterone is not suitable for you, there are alternative treatments and lifestyle changes that may help manage the conditions it is commonly prescribed for. Always discuss any changes to your treatment plan with your healthcare provider. You may also consider scheduling a telemedicine appointment with one of our providers to explore your options.

1. Adrenal insufficiency: Alternatives may include corticosteroid replacement therapy (e.g., hydrocortisone or prednisone) and lifestyle modifications such as stress management and maintaining a balanced diet.
2. Osteoporosis: Other treatments include bisphosphonates (e.g., Fosamax [alendronate]), calcium and vitamin D supplements, and weight-bearing exercises to strengthen bones.
3. Depression: Antidepressants like selective serotonin reuptake inhibitors (SSRIs) (e.g., Zoloft [sertraline]) or therapy options such as cognitive-behavioral therapy (CBT) may be considered.
4. Sexual dysfunction: Alternatives include medications like Viagra (sildenafil) for men or hormone therapy for women, as well as lifestyle changes such as stress reduction and regular exercise.
5. Menopause symptoms: Hormone replacement therapy (HRT), non-hormonal medications like Effexor (venlafaxine), or lifestyle changes such as yoga and dietary adjustments may help manage symptoms.
6. Chronic fatigue syndrome: Treatment may include graded exercise therapy (GET), cognitive-behavioral therapy (CBT), and medications like Provigil (modafinil) to manage symptoms.
7. Fibromyalgia: Alternatives include medications like Lyrica (pregabalin), physical therapy, and stress management techniques.
8. Autoimmune disorders: Immunosuppressive drugs (e.g., Imuran [azathioprine]), anti-inflammatory medications, and lifestyle changes such as a balanced diet and regular exercise may be beneficial.
9. Aging-related conditions: Lifestyle changes such as regular physical activity, a healthy diet, and supplements like calcium and vitamin D can help manage aging-related conditions. Consult your healthcare provider for personalized advice.
10. Hormone deficiency: Hormone replacement therapy (HRT) or other hormone-regulating medications may be considered as alternatives to Prasterone.

Recent Updates on Prasterone Research

Recent studies on Prasterone have focused on its potential benefits for managing symptoms of menopause, sexual dysfunction, and autoimmune disorders. Some research suggests that Prasterone may help improve vaginal dryness and sexual function in postmenopausal women. Additionally, ongoing research is exploring its role in managing autoimmune conditions like lupus, as it may help modulate the immune response. However, more large-scale studies are needed to confirm these benefits and establish long-term safety. If you are interested in the latest research on Prasterone, consider discussing it with one of our telemedicine providers to determine if it’s the right option for you.

James Kingsley

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