Quote from: brc on September 21, 2012, 02:30:06 AM
Follow the manufacturer's advice. I think they know the best way to administer their drug. Some drugs require the liver to metabolise them so that they can be effective otherwise they are inert.
It isn't their drug.
Nobody owns a drug except god (if you believe in such a thing).
You can patent and lay claim to how you discovered how to synthesis it. But it's still just an expression of natural phenomenons involving matter and physics.
Progynova is estradiol valerate. Estradiol just being the primary human estrogen (they can hardly lay claim to something the body has been producing since we before the discovery of molecular chemistry), which has been chemically bonded with valeric acid, also a naturally occurring substance, to produce the estradiol valerate compound. You can lay claim to the exact discovery of having synthesized in a lan substances which occur naturally, and then somewhat lay claim to the discovery of the semi-synthetic compound you have created in a lab by combining them through chemical bonds. But it's still only their discovery of a natural phenomenon, not 'their drug'. Drugs in fact throughout history have been synthesized by different people completely independent of each other. Because they are more discoveries of preexisting potential phenomenons rather than inventions.
Additionally. Sublingual administration does NOT prevent the medication going through the liver, where the compound be stripped of its valerate ester to form estradiol. It will reach the liver by virtue of entering your blood stream.
You are correct that some drugs do rely on first pass metabolism, a phenomenon of swallowed medications, to form their active compound. Codeine for example, must be taken orally, because it relies on first pass metabolism to form its parent compound morphine and other metabolites, without that effect it is actually somewhat dangerous in its unaltered form in your blood stream.
Estradiol valerate however, is NOT an example of such a drug. It is routinely used in injectable form where it will not be affected by first pass metabolism, and does not rely on it.
I can say from first hand experience and testing that sublingual progynova, on the balance of evidence available to me, likely does result in an increased serum concentration than you would get by swallowing.
However you should always follow what the blood tests indicate. If your estradiol levels are low, by all means consider sublingual, if however they are high, and/or you have no history of liver problems, you're pretty much fine to just swallow them.
