Gravibinan Injection 1ml (Hydroxyprogesterone + Estradiol Valerate)

Drug Class: Hormonal Combination — Progestogen & Oestrogen | Form: Intramuscular (IM) Injection | Prescription Status: Prescription Only (Rx) — DRAP Registered

What is Gravibinan Injection 1ml?

Gravibinan Injection 1ml is a hormonal medicine containing two active ingredients — Hydroxyprogesterone and Estradiol Valerate. It belongs to a group of medicines called sex hormones and is used to support pregnancies that are at risk of miscarriage (اسقاط حمل کا خطرہ). It works by providing the hormonal support needed to maintain a healthy pregnancy lining in the womb during the critical early stages. It is also used in certain hormone replacement therapies. Gravibinan is given as a deep injection into the muscle and must always be administered by a trained healthcare professional or nurse. It must never be self-injected at home and must only be used under the direct supervision of a qualified doctor.

What is Gravibinan Injection Used For?

Gravibinan Injection 1ml is prescribed for the following conditions:

• Threatened Miscarriage (Endangered Pregnancy) — supporting pregnancies at risk of being lost in the early stages due to hormonal deficiency (خطرے میں پڑا ہوا حمل — اسقاط حمل کے خطرے کی صورت میں)
• Habitual or Recurrent Miscarriage — women who have experienced repeated pregnancy loss due to inadequate progesterone or oestrogen levels (بار بار اسقاط حمل کی تاریخ)
• Luteal Phase Deficiency — insufficient hormone production after ovulation that may prevent successful implantation or early pregnancy maintenance
• Hormone Replacement Therapy (HRT) — supplementing oestrogen and progesterone levels in women with hormonal deficiency conditions
• Dysfunctional Uterine Bleeding — abnormal uterine bleeding caused by hormonal imbalance (ہارمون کی عدم توازن کی وجہ سے غیر معمولی رحم کی خون ریزی)
• Secondary Amenorrhoea — absence of menstrual periods caused by hormonal deficiency (ہارمونز کی کمی سے ماہواری کا بند ہو جانا)

How Does Gravibinan Injection Work?

Gravibinan Injection contains two hormones that work together to support the uterus and maintain pregnancy:

Hydroxyprogesterone (Progestogen): Progesterone is the most important hormone for maintaining a pregnancy. It prepares the lining of the uterus (رحم کی اندرونی دیوار) to receive and support a fertilised egg. It also relaxes the muscles of the uterus, preventing early contractions that could lead to miscarriage. In women whose bodies do not produce enough natural progesterone — particularly during the first trimester — the risk of miscarriage is significantly increased. Hydroxyprogesterone is a synthetic form of progesterone that supplements the body's own supply, providing the hormonal support the uterus needs to hold the pregnancy safely.

Estradiol Valerate (Oestrogen): Oestrogen works alongside progesterone to prepare and maintain the uterine lining, support blood flow to the placenta, and ensure the overall hormonal environment is favourable for pregnancy continuation. Estradiol Valerate is a naturally derived form of oestrogen that complements the action of hydroxyprogesterone — together they provide balanced hormonal support for the developing pregnancy.

Because the injection delivers both hormones directly into the muscle, they are absorbed into the bloodstream efficiently and begin working quickly — making this an effective choice when fast hormonal support is needed.

Dosage and Administration

⚠️ This injection must only be given by a qualified doctor or trained nurse. Do not attempt to self-inject at home. The dose and frequency will be decided entirely by your doctor based on your hormone levels, pregnancy status, and individual medical situation. Never change the dose or stop treatment without consulting your doctor — sudden discontinuation of hormonal support during pregnancy can be harmful.

• Given as a deep intramuscular injection — usually into the upper outer buttock or thigh
• Injection site should be rotated with each dose to avoid tissue irritation at the same site
• Treatment duration during pregnancy is usually continued through the first trimester and adjusted based on clinical response and hormone monitoring
• Your doctor will regularly assess hormone levels and pregnancy status to determine if and when treatment can be gradually reduced or stopped
• Do not stop treatment suddenly — your doctor will guide you on how to taper the dose safely if needed

Active Ingredients

Please check the product label or ask your pharmacist for the exact strength of each ingredient per 1ml ampoule.

Who Should NOT Use Gravibinan Injection?

Do not use this injection if you:

• Are allergic to Hydroxyprogesterone, Estradiol Valerate, or any other ingredient in the formulation
• Have or have ever had breast cancer or any other hormone-sensitive cancer (چھاتی کا سرطان یا ہارمون سے متاثر ہونے والا کوئی بھی کینسر)
• Have active or past blood clots in the veins (deep vein thrombosis) or lungs (pulmonary embolism) (خون کے لوتھڑے)
• Have undiagnosed abnormal vaginal bleeding
• Have severe liver disease or a history of liver tumours
• Have had a heart attack or stroke
• Have a known or suspected pregnancy-related condition where oestrogen is contraindicated
• Have active or severe thromboembolic disorders

Tell your doctor before use if you have:

• A history of blood clots, stroke, or heart disease
• High blood pressure (بلند فشارِ خون) — hormonal medicines can affect blood pressure
• Diabetes — oestrogen and progesterone can affect blood sugar levels
• Migraine — particularly migraine with aura, which can be worsened by hormonal medicines
• Epilepsy or a history of seizures
• Kidney or liver disease
• Depression — hormonal changes can affect mood
• A history of ectopic pregnancy — rule out before starting treatment
• A history of cholestasis (جگر میں پت کا رکنا) during a previous pregnancy or with previous hormonal treatment
• If you smoke — especially if you are over 35 years of age — smoking combined with hormonal medicines increases the risk of serious blood clot and cardiovascular events

Side Effects

Like all medicines, Gravibinan Injection can cause side effects. Not everyone will experience them.

Common Side Effects (relatively frequent):

• Pain, redness, or swelling at the injection site
• Nausea (متلی) or mild stomach discomfort
• Breast tenderness or swelling (چھاتی میں درد یا نرمی)
• Headache (سردرد)
• Mood changes — feeling emotional, low mood, or irritability
• Bloating or fluid retention — mild swelling in the hands, feet, or face
• Spotting or light vaginal bleeding in some patients — tell your doctor immediately

Serious Side Effects (less common — seek medical help immediately):

• Signs of blood clot — sudden pain, swelling, or redness in the leg (deep vein thrombosis)
• Sudden chest pain or difficulty breathing — may indicate a blood clot in the lung
• Sudden severe headache, vision changes, or weakness on one side of the body (signs of stroke)
• Severe allergic reaction — sudden rash, swelling of the face, lips, or throat, difficulty breathing
• Yellowing of skin or eyes (یرقان) — sign of liver problem
• Sudden heavy vaginal bleeding — seek emergency help immediately
• Significant worsening of depression or severe mood changes

If you notice any serious side effects, seek emergency medical help immediately or go to the nearest hospital.

Drug Interactions

Tell your doctor about ALL medicines you are currently taking. Gravibinan Injection may interact with:

Always inform your doctor about all medicines, vitamins, herbal products, or supplements you are taking — including any traditional or herbal remedies.

Storage Instructions

• Store below 25°C in a cool, dry place
• Protect from light — keep ampoules in the outer carton until ready for use
• Keep away from direct sunlight and excessive heat
• Do not freeze the injection (منجمد نہ کریں)
• Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں)
• Do not use after the expiry date printed on the ampoule or outer carton
• Discard any unused portion immediately after use — never store an opened ampoule
• Do not use if the solution appears cloudy, discoloured, or contains visible particles

Frequently Asked Questions

What is Gravibinan Injection used for?

Gravibinan Injection is primarily used to support pregnancies that are at risk of miscarriage due to low hormone levels — a condition known as threatened or endangered pregnancy. It provides supplemental progesterone and oestrogen to help maintain the uterine lining and prevent early pregnancy loss. It is also used in hormone replacement therapy and to treat certain menstrual irregularities.

How does Gravibinan help prevent miscarriage?

In some women, the body does not produce enough progesterone and oestrogen during the early stages of pregnancy to keep the uterine lining stable and the womb muscles relaxed. Without adequate hormonal support, the pregnancy may not be maintained and miscarriage can occur. Gravibinan Injection supplies these hormones directly, compensating for the deficiency and giving the pregnancy the hormonal environment it needs to continue safely.

How long will I need to take Gravibinan Injection during pregnancy?

This depends entirely on your individual situation and your doctor's assessment. In most cases of threatened miscarriage, hormonal support is continued through the first trimester — usually until 12 to 16 weeks of pregnancy — when the placenta takes over hormone production naturally. Your doctor will monitor your hormone levels and pregnancy progress closely and will guide you on when it is safe to gradually reduce and stop the injections.

Can I stop Gravibinan Injection suddenly if I feel better?

No. Never stop Gravibinan Injection suddenly without consulting your doctor — especially during pregnancy. Abrupt withdrawal of hormonal support can cause a sudden drop in progesterone and oestrogen levels, which may trigger uterine contractions and increase the risk of miscarriage. Your doctor will always guide you through a gradual reduction if and when it is safe to stop.

Are there any special precautions I should take while receiving this injection?

Yes. Attend all scheduled doctor appointments and do not miss any doses. Report any unusual vaginal bleeding, sudden severe headache, chest pain, swelling or pain in the legs, or significant mood changes to your doctor immediately. Avoid smoking during treatment as it significantly increases the risk of serious cardiovascular side effects when combined with hormonal medicines. Follow all dietary and lifestyle advice given by your doctor throughout your pregnancy.

Is Gravibinan Injection safe for every pregnant woman?

Gravibinan is not suitable for everyone. It must not be used in women with hormone-sensitive cancers, active blood clots, severe liver disease, or certain heart conditions. Before starting treatment, your doctor will take a full medical history and assess whether this medicine is safe and appropriate for your specific situation. Always be completely open with your doctor about your full medical history before receiving this injection.

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⚕️ Medical Disclaimer: This product description is for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified doctor or pharmacist before starting, stopping, or changing any medication. This product is a prescription medicine — it must only be used under the direct supervision of a licensed healthcare professional.

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DRAP Registered | Prescription Required (Rx) | For use under medical supervision only