medroxyprogesterone, Provera, Depo-Provera, Depo-Sub Q Provera 104

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What is medroxyprogesterone, and how does it work (mechanism of action)?

Progestins and estrogens are the two major classes of female hormones. Medroxyprogesterone is a derivative of the naturally occurring female progestin, progesterone. Progestins are responsible for changes in the mucus and inner lining of the uterus (endometrium) during the second half (secretory phase) of the menstrual cycle. Progestins prepare the endometrium for implantation of the embryo. Once an embryo implants in the endometrium and pregnancy occurs, progestins help maintain the pregnancy. At high doses, progestins can prevent ovulation (release of the egg from the ovary) and thereby prevent pregnancy. Progestins were first isolated in 1933, and progesterone itself was synthesized in the 1940s.

What brand names are available for medroxyprogesterone?

Provera, Depo-Provera, Depo-Sub Q Provera 104

Is medroxyprogesterone available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for medroxyprogesterone?

Yes

What are the side effects of medroxyprogesterone?

Breast tenderness and leakage of liquid from the nipple occur rarely with medroxyprogesterone. Various skin reactions, including hives, acne, hair growth and hair loss, also have been reported occasionally. Break-through bleeding (menstrual-like bleeding in the middle of the menstrual cycle), vaginal spotting of blood, changes in menstrual flow, increased or decreased weight, nausea, fever, insomnia, and jaundice have all been reported.

Blood clots are an occasional serious side effect of progestin therapy, and cigarette smokers are at a higher risk for clots. Therefore, females requiring progestin therapy are strongly encouraged to quit smoking.

People with diabetes may experience difficulty controlling blood glucose when taking medroxyprogesterone for unclear reasons. Therefore, increased monitoring of blood sugar and adjustment of medications for diabetes is recommended.

The Women's Health Initiative (WHI) study found an increased risk of heart attacks, stroke, breast cancer, blood clots, and pulmonary emboli (blood clots that lodge in the lungs) in postmenopausal women (50 to 79 years of age) who took medroxyprogesterone in combination with estrogens for 5 years, as well as an increased risk of dementia in the women over age 65. Therefore, medroxyprogesterone should not be used for the prevention of heart disease or dementia. Although medroxyprogesterone alone has not been demonstrated to promote breast cancer, since breast cancer has progesterone receptors, physicians usually avoid using progestins in women who have had breast cancer.

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What is the dosage for medroxyprogesterone?

The usual dose of medroxyprogesterone tablets is 5 or 10 mg daily.

  • Secondary amenorrhea is treated for 5 to 10 days.
  • Uterine bleeding is treated for 5 to 10 days beginning on day 16 or 21 of the menstrual cycle.
  • Endometrial hyperplasia is treated for 12 to 14 consecutive days beginning on day 1 or 16 of the menstrual cycle.
  • The dose for contraception is 150 mg every 3 months injected intramuscularly or 104 mg injected subcutaneously every 3 months.
  • The dose for endometrial or renal cancer is 400-1000 mg weekly initially followed by monthly maintenance doses.

Which drugs or supplements interact with medroxyprogesterone?

: Aminoglutethimide (Cytadren) may increase the elimination of medroxyprogesterone by the liver leading to a decrease in the concentration of medroxyprogesterone in blood and possibly a reduction in the effectiveness of the medroxyprogesterone.

Is medroxyprogesterone safe to take if I'm pregnant or breastfeeding?

Medroxyprogesterone inhibits fertility at high doses. It should not be given during pregnancy.

Medroxyprogesterone is secreted in breast milk. The effect on the infant has not been determined.

What else should I know about medroxyprogesterone?

What preparations of medroxyprogesterone are available?

  • Tablets: 2.5, 5, and 10 mg.
  • Intramuscular injection: 150 and 400 mg/ml.
  • Prefilled Syringe Suspension: 104 mg/0.65 ml

How should I keep medroxyprogesterone stored?

Medroxyprogesterone should be stored at room temperature, between 20 C and 25 C (68 F and 77 F).

Reference: FDA Prescribing Information

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Summary

Medroxyprogesterone acetate (Provera, Depo-Provera, Depo-Sub Q Provera 104) is a drug prescribed for amenorrhea, abnormal uterine bleeding, endometrial cancer, and renal cancer. Side effects and drug interactions should be reviewed with your physician prior to taking this medication.

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Reviewed on 12/9/2014
References
Reference: FDA Prescribing Information

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