Medroxyprogesterone Acetate

Classification

Progesterone derivative

Brand Names

Provera ® , Depo-Provera

Form

2.5, 5, or 10 mg Oral tablets (Provera) or intramuscular injection (Depo-Provera)

Indications

Secondary amenorrhea (Provera), Contraception (Depo-Provera), with:

  • No current pregnancy
  • No breastfeeding
  • Liver dysfunction or disease
  • No thrombotic disorders
  • Known or suspected malignancy of breast or genital organs
  • Undiagnosed unusual vaginal bleeding
  • Incomplete miscarriage

Used for

Inducing a menstrual period in cases of amenorrhea (lack of menstrual bleeding). Also used for long-term contraception and for palliative treatment of advanced endometrial or renal carcinoma.

How does it work?

Possesses hormonal activities of follicle stimulating hormone (FSH).

Suggested Evaluations

Pre-RX

  • thyroid disease
  • ovarian enlargement or cyst formation
  • uterine fibroid tumors
  • undiagnosed unusual vaginal bleeding
  • estrogen levels
  • primary pituitary or ovarian failure or enlargement
  • evidence of prostate cancer in men
  • testicular failure
  • renal and hepatic functions

During RX

  • mid-cycle urine LH test (OPK)
  • estrogen levels
  • progesterone levels
  • mid-cycle ultrasound to detect follicle development

Usual Dosage

Provera
5 to 10 mgs daily for 5 to 10 days.
Depo-Provera
Injection by medical practitioner at 3-month intervals.

Instructions

For amenorrhea
May be started at any time during cycle. Withdrawal bleeding usually begins within 3 to 7 days after discontinuing tablets.
For contraception
Must be started during first 5 days of menstrual period to assure no pregnancy exists.

Common side effects

  • Injection site pain
  • Lower abdomen tenderness
  • Fluid retention
  • Headache
  • Emotional irritability
  • Breast discomfort
  • Fatigue
  • Multiple births

Side effects to report to your doctor

  • Severe pain or swelling in lower abdomen or extremities
  • Shortness of breath
  • Vomiting or diarrhea

Precautions

  • Pregnancy Category X: May cause birth defects if used during pregnancy.
  • Exercise caution if patient is breastfeeding.
  • May result in ovarian hyperstimulation.
  • May result in multiple births.

Drug interactions or incompatibility

Herbal preparations using blue or black cohosh.