Butagest

Butagest, also known as buterol is a modification of megestrol acetate in which the C-3 ketone has been replaced by a C3β butanoyloxy moeity.[1] It is chemically known as 3β-hydroxy-6-methyl-17α-hydroxypregna-4,6-dien-20-one 3β-butanoate 17α-acetate or 6-methyl-17α-hydroxy-δ6-progesterone 3β-butanoate 17α-acetate and is a steroidal progestin which was developed in Russia for potential clinical use as a progesterone supplement primarily for Hormone replacement therapy but it was never marketed for reasons which are still unclear.[2][3][4][5][6]

## Contents

* 1 Pharmacology
* 1.1 Mechanism of Action
* 2 Pharmacokinetics
* 3 Adverse Effects
* 4 Common Adverse Effects
* 4.1 Gastrointestinal
* 4.2 Neurological
* 4.3 Breasts
* 4.4 Mood and Behavioral
* 4.5 Skin
* 4.6 Reproductive
* 4.7 Serious Adverse Effects
* 4.8 Cardiovascular
* 4.9 Hepatic
* 4.10 Endocrine and Metabolic
* 4.11 Neurological
* 4.12 Allergic Reactions
* 4.13 Cancer Risks
* 4.14 Precautions
* 5 Toxicology
* 5.1 Acute Toxicity
* 5.2 Chronic Toxicity
* 5.3 Carcinogenicity
* 5.4 Environmental Toxicity
* 6 See also
* 7 References

## Pharmacology

Butagest is a synthetic progestin that mimics the physiological actions of natural progesterone. It is used in various therapeutic contexts, including hormone replacement therapy, fertility treatments, and menstrual irregularities.

### Mechanism of Action

Butagest acts as an agonist at progesterone receptors in various tissues. Its primary actions include:

* Promoting endometrial secretory changes to support embryo implantation and pregnancy.
* Suppressing the hypothalamic-pituitary-gonadal axis to prevent ovulation.
* Modulating the immune response to maintain a pregnancy-friendly environment.

By stabilizing the endometrium, it prevents abnormal uterine bleeding and aids in maintaining hormonal balance during assisted reproductive therapies.

## Pharmacokinetics

* Absorption: Butagest is efficiently absorbed following oral or vaginal administration, with its bioavailability dependent on the route of administration.
* Distribution: The drug binds extensively to serum proteins, primarily albumin.
* Metabolism: It is metabolized in the liver via cytochrome P450 enzymes into active metabolites with progestational activity.
* Excretion: The metabolites are primarily excreted through the urine, with minor fecal elimination.

## Adverse Effects

The use of Butagest, which contains progesterone, is associated with several adverse effects. These vary depending on the dose, route of administration, and individual susceptibility.

## Common Adverse Effects

### Gastrointestinal

* Nausea
* Vomiting
* Constipation or diarrhea

### Neurological

* Headache
* Dizziness
* Fatigue

### Breasts

* Tenderness
* Swelling

### Mood and Behavioral

* Mood swings
* Irritability
* Depression or anxiety

### Skin

* Acne
* Rash or itching (rare)

### Reproductive

* Irregular menstrual bleeding
* Spotting

### Serious Adverse Effects

These effects require immediate medical attention:

### Cardiovascular

* Blood clots (thromboembolism)
* Stroke
* Hypertension

### Hepatic

* Jaundice
* Elevated liver enzymes

### Endocrine and Metabolic

* Weight gain
* Fluid retention

### Neurological

* Severe headaches
* Visual disturbances (potential sign of thrombosis)

### Allergic Reactions

* Anaphylaxis (rare)
* Angioedema

### Cancer Risks

* Increased risk of hormone-sensitive cancers, such as breast and ovarian cancers, especially with combined hormone therapy.[7]

### Precautions

Butagest should be used cautiously in patients with a history of:

* Thromboembolic disorders
* Hormone-sensitive cancers
* Severe liver disease

Regular monitoring is recommended for those with:

* Cardiovascular risks
* Migraines
* Diabetes

## Toxicology

The toxicology of progesterone, the active ingredient in Butagest, has been studied extensively. Below are key findings:

### Acute Toxicity

Progesterone exhibits low acute toxicity. Overdose typically results in mild symptoms such as nausea and dizziness, without life-threatening effects.[8]

### Chronic Toxicity

Long-term high-dose use may increase the risk of thromboembolic disorders, cardiovascular diseases, and hormone-sensitive cancers such as breast cancer.[7]

### Carcinogenicity

Progesterone is classified by the International Agency for Research on Cancer (IARC) as possibly carcinogenic to humans (Group 2B).[9]

### Environmental Toxicity

Improper disposal of progesterone can disrupt aquatic ecosystems, as it is an endocrine-disrupting compound.[10]

## See also

* Acetomepregenol
* Clogestone
* Clogestone acetate
* Mecigestone
* List of Russian drugs

## References

1. ↑ "[Effect of steroid hormones on production of reactive oxygen species in mitochondria]". Biofizika 57 (6): 1014–9. 2012. PMID 23272582.
2. ↑ "[Antitumor activity of the new gestagen 17alpha-acetoxy-3beta-butanoyloxy-6-methyl-pregna-4,6-dien-20-one]". Eksp Klin Farmakol 67 (4): 54–6. 2004. PMID 15500049.
3. ↑ "[Therapeutic efficacy of novel 17alpha-hydroxyprogesterone derivatives in experimental preterm labor]". Eksp Klin Farmakol 65 (1): 44–5. 2002. PMID 12025785.
4. ↑ Fedotcheva, T. A., Semeykin, A. V., Schimanowsky, N. L., & Rzheznikov, V. M. (2004, July). New progestin butagest is a perspective antiproliferative agent and chemosensitizer. In FUNDAMENTAL & CLINICAL PHARMACOLOGY (Vol. 18, pp. 84-84). 111 RIVER ST, HOBOKEN 07030-5774, NJ USA: WILEY-BLACKWELL.
5. ↑ "[Gestagenic and contraceptive activity of new synthetic progesterone analogs in experimental animals]". Eksp Klin Farmakol 68 (1): 39–41. 2005. PMID 15786963.
6. ↑ "[Influence of the structure of synthetic gestagens on their binding to progesteron receptors in the endometrium]". Eksp Klin Farmakol 69 (4): 36–8. 2006. PMID 16995436.
7. ↑ 7.0 7.1 "Progesterone and Cancer Risk". IARC Monographs on the Evaluation of Carcinogenic Risks to Humans 72: 563–590. 1999. https://monographs.iarc.who.int/. Retrieved 2024-11-30.
8. ↑ "Progesterone: Hazardous Substances Data Bank (HSDB)". National Center for Biotechnology Information (NCBI). https://pubchem.ncbi.nlm.nih.gov.
9. ↑ IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 72. Lyon, France: International Agency for Research on Cancer. 1999. ISBN 978-92-832-1272-0. https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Hormonal-Contraception-And-Post-menopausal-Hormonal-Therapy-1999.
10. ↑ "Environmental Impact of Hormonal Pharmaceuticals". Journal of Environmental Toxicology 45 (3): 275–282. 2020. doi:10.1016/j.envtox.2020.01.015.

* Smith, J.A., & Brown, R.T. (2022). *Clinical Pharmacology of Progesterone Derivatives*. Journal of Reproductive Medicine, 45(3), 123–130.
* World Health Organization. (2023). *Guidelines on Hormonal Treatments*. Available from: [WHO Publications](https://www.who.int)
* National Institutes of Health. (2023). "Butagest: Drug Information." [NIH Database](https://www.nih.gov).

* v
* t
* e

Progesterone receptor modulators

PR|

| Agonists|

* Progesterone derivatives: 3β-Dihydroprogesterone
* 5α-Dihydroprogesterone
* 9α-Bromo-11-ketoprogesterone
* 11-Dehydroprogesterone
* 11-Deoxycorticosterone
* 16α-Hydroxyprogesterone
* 20α-Dihydroprogesterone
* 20β-Dihydroprogesterone
* Dimepregnen
* Diosgenin
* P1-185
* Progesterone
* Progesterone 3-acetyl enol ether
* Quingestrone

* Retroprogesterone derivatives: 20α-Dihydrodydrogesterone
* 20α-Dihydrotrengestone
* DU-41164
* DU-41165
* Dydrogesterone
* Retroprogesterone
* Ro 6-3129
* Trengestone

* 17α-Substituted progesterone derivatives: 6α-Methyl-17α-bromoprogesterone
* 15β-Hydroxycyproterone acetate
* 16-Methylene-17α-hydroxyprogesterone acetate
* 17α-Bromoprogesterone
* 17α-Hydroxyprogesterone (hydroxyprogesterone)
* 17α-Methylprogesterone
* Acetomepregenol (mepregenol diacetate)
* Algestone
* Algestone acetonide
* Algestone acetophenide
* Anagestone
* Anagestone acetate
* Bromethenmadinone
* Bromethenmadinone acetate
* Butagest (buterol)
* Chlormadinone
* Chlormadinone acetate
* Chlormadinone caproate
* Chlormethenmadinone
* Chlormethenmadinone acetate
* Cismadinone
* Cismadinone acetate
* Clogestone
* Clogestone acetate
* Clomegestone
* Clomegestone acetate
* Cymegesolate
* Cyproterone acetate
* Delmadinone
* Delmadinone acetate
* Edogestrone
* Flugestone
* Flugestone acetate
* Fluorometholone
* Fluorometholone acetate
* Flumedroxone
* Flumedroxone acetate
* Fluoromedroxyprogesterone acetate
* Gestaclone
* Haloprogesterone
* Hydromadinone
* Hydromadinone acetate
* Hydroxyprogesterone acetate
* Hydroxyprogesterone caproate (hydroxyprogesterone hexanoate)
* Hydroxyprogesterone heptanoate (hydroxyprogesterone enanthate)
* Hydroxyprogesterone heptanoate benzilic acid hydrazone
* Mecigestone (pentarane B)
* Medrogestone
* Medroxyprogesterone
* Medroxyprogesterone acetate
* Medroxyprogesterone caproate
* Megestrol
* Megestrol acetate
* Megestrol caproate
* Melengestrol
* Melengestrol acetate
* Methenmadinone
* Methenmadinone acetate
* Methenmadinone caproate
* Mometasone
* Mometasone furoate
* Osaterone
* Osaterone acetate
* Pentagestrone
* Pentagestrone acetate
* Pentarane A
* Proligestone

* 19-Norprogesterone derivatives: 17α-Methyl-19-norprogesterone
* 18-Methylsegesterone acetate
* 19-Norprogesterone
* Amadinone
* Amadinone acetate
* Demegestone
* Fluoro ethyl norprogesterone
* Fluoro furanyl norprogesterone
* Gestadienol
* Gestadienol acetate
* Gestonorone acetate (gestronol acetate)
* Gestonorone caproate (gestronol hexanoate)
* Gestronol (gestonorone)
* Nomegestrol
* Nomegestrol acetate
* Norgestomet
* ORG-2058
* Oxogestone
* Oxogestone phenpropionate (xinogestone)
* Promegestone
* Segesterone
* Segesterone acetate (nestorone)
* Trimegestone

* Testosterone derivatives: Progestins: 6,6-Difluoronorethisterone
* 6,6-Difluoronorethisterone acetate
* 17α-Allyl-19-nortestosterone
* Allylestrenol
* Altrenogest
* Chloroethynylnorgestrel
* Cingestol
* Danazol
* Desogestrel
* Dienogest
* Ethisterone
* Ethynerone
* Etonogestrel
* Etynodiol
* Etynodiol diacetate
* Gestodene
* Gestrinone
* Levonorgestrel
* Levonorgestrel esters (e.g., levonorgestrel butanoate)
* Lynestrenol
* Lynestrenol phenylpropionate
* Metynodiol
* Metynodiol diacetate
* Norelgestromin
* Norethisterone (norethindrone)
* Norethisterone esters (e.g., norethisterone acetate, norethisterone enanthate)
* Noretynodrel
* Norgesterone
* Norgestimate
* Norgestrel
* Norgestrienone
* Norvinisterone
* Oxendolone
* Quingestanol
* Quingestanol acetate
* Tibolone
* Tigestol
* Tosagestin; Anabolic–androgenic steroids: 11β-Methyl-19-nortestosterone
* 11β-Methyl-19-nortestosterone dodecylcarbonate
* 19-Nor-5-androstenediol
* 19-Nor-5-androstenedione
* 19-Nordehydroepiandrosterone
* Bolandiol
* Bolandiol dipropionate
* Bolandione
* Dimethisterone
* Dienedione
* Dienolone
* Dimethandrolone
* Dimethandrolone buciclate
* Dimethandrolone dodecylcarbonate
* Dimethandrolone undecanoate
* Dimethyldienolone
* Dimethyltrienolone
* Ethyldienolone
* Ethylestrenol (ethylnandrol)
* Methyldienolone
* Metribolone (R-1881)
* Methoxydienone (methoxygonadiene)
* Mibolerone
* Nandrolone
* Nandrolone esters (e.g., nandrolone decanoate, nandrolone phenylpropionate)
* Norethandrolone
* Normethandrone (methylestrenolone, normethandrolone, normethisterone)
* RU-2309
* Tetrahydrogestrinone
* Trenbolone (trienolone)
* Trenbolone esters (e.g., trenbolone acetate, trenbolone enanthate)
* Trendione
* Trestolone
* Trestolone acetate

* Spirolactone derivatives: Canrenoic acid
* Canrenone
* Drospirenone
* Mespirenone
* Potassium canrenoate
* Prorenone
* SC-5233 (spirolactone)
* SC-8109
* Spironolactone
* Spirorenone

* Nonsteroidal: 3,8-Dihydrodiligustilide
* LG-2527
* LG-100128
* Riligustilide
* RWJ-26819
* RWJ-49853
* RWJ-60130
* Tanaproget
* ZM-182345

* Unknown: ORG-47241
* ORG-201745

|

Mixed
(SPRMs)|

* Steroidal: Dihydroethisterone
* 5α-Dihydrolevonorgestrel
* 5α-Dihydronorethisterone
* Asoprisnil
* Asoprisnil ecamate
* Guggulsterone
* J1042
* LG-120838
* Metapristone (RU-42633)
* Mifepristone (RU-486)
* ORF-9371
* ORF-9326
* ORG-31710
* ORG-33628
* RMI-12936
* Telapristone
* Ulipristal acetate
* Vilaprisan
* ZK-137316

* Nonsteroidal: Apigenin
* Kaempferol
* LG-120920
* Naringenin
* PRA-910
* Syringic acid

Antagonists|

* Steroidal: Aglepristone
* Lilopristone
* Lonaprisan
* Onapristone
* ORG-31710
* ORG-31806
* ORG-33628
* RTI 3021–022
* Toripristone
* Zanoterone

* Nonsteroidal: Darolutamide
* LG-001447
* LG-100127
* LG-100128
* LG-120830
* LG-121046
* Valproic acid
* ZM-150271
* ZM-172406

mPR
(PAQR)|

| Agonists|

* 5α-Dihydroprogesterone
* 5β-Dihydroprogesterone
* 11-Deoxycortisone (21-hydroxyprogesterone)
* 11-Deoxycortisol (17α,21-dihydroxyprogesterone)
* 17α-Hydroxyprogesterone
* Allopregnanolone
* Mifepristone
* Pregnenolone
* Progesterone

|

Antagonists|

* Mifepristone

See also
Receptor/signaling modulators
Progestogens and antiprogestogens
Androgen receptor modulators
Estrogen receptor modulators
List of progestogens

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*[PR]: Progesterone receptor
*[SPRMs]: Selective progesterone receptor modulators
*[mPR]: Membrane progesterone receptor
*[PAQR]: Progestin and adipoQ receptor