|
Medroxyprogesterone acetate
Medroxyprogesterone acetate (Depo-Provera C-150, Provera)
Medroxyprogesterone acetate
(meh-
drox-see-proh-
JESS-ter-ohn)
Pregnancy Category: X
Alti-MPA
Amen
Curretab
Cycrin
Depo-Provera
Depo-Provera C-150
Gen-Medroxy
Novo-Medrone
Provera
(Rx)
Classification:
Progestational hormone, synthetic
See Also:
See also
Progesterone and Progestins and
Antineoplastic Agents
[.
]
Action/Kinetics:
Synthetic progestin devoid of estrogenic and androgenic activity. Prevents stimulation of endometrium by pituitary gonadotropins. Priming with estrogen is necessary before response is noted. Rapidly absorbed from GI tract.
Maximum levels: 1-2 hr.
t
1/2, after PO: 2-3 hr for first 6 hr; then, 8-9 hr.
t
1/2, long-acting forms IM: About 10 weeks with maximum levels within 24 hr.
Uses:
Secondary amenorrhea, abnormal uterine bleeding due to hormonal imbalance (no organic pathology). Adjunct in palliative treatment of inoperable, recurrent, or metastatic endometrial or renal carcinoma. Long-acting contraceptive (injectable form). Reduce endometrial hyperplasia in postmenopausal women receiving 0.625 mg conjugated estrogen for 12 to 14 days/month; can begin on the 1st or 16th day of the cycle.
Investigational: Polycystic ovary syndrome, precocious puberty. With estrogen to treat menopausal symptoms and hypermenorrhea. To stimulate respiration in obesity-hypoventilation syndrome (oral).
Contraindications:
Clients with or a history of thrombophlebitis, thromboembolic disease, cerebral apoplexy. Liver dysfunction. Known or suspected malignancy of the breasts or genital organs. Missed abortion; as a diagnostic for pregnancy. Undiagnosed vaginal bleeding. Use during the first 4 months of pregnancy.
Special Concerns:
The overall risk of breast, liver, ovarian, endometrial, and cervical cancer is not thought to increase with use of the injectable long-acting contraceptive preparation. Possibility of ectopic pregnancy. Use with caution in clients with a history of depression. Due to the possibility of fluid retention, use with caution in clients with epilepsy, migraine, asthma, or cardiac or renal dysfunction.
Side Effects:
GU: Amenorrhea or infertility for up to 18 months.
CV: Thrombophlebitis,
pulmonary embolism.
GI: Nausea (rare), jaundice.
CNS: Nervousness, drowsiness, insomnia, fatigue, dizziness, headache (rare).
Dermatologic: Pruritus, urticaria, rash, acne, hirsutism, alopecia, angioneurotic edema.
Miscellaneous:
Hyperpyrexia, anaphylaxis decrease in glucose tolerance, weight gain, fluid retention.
Drug Interactions:
Aminoglutethimide may
 metabolism of medroxyprogesterone
 effect.
How Supplied:
Injection: 150 mg/mL, 400 mg/mL;
Tablet: 2.5 mg, 5 mg, 10 mg
Dosage
?Tablets
Secondary amenorrhea.
5-10 mg/day for 5-10 days, with therapy beginning at any time during the menstrual cycle. If endometrium has been estrogen primed: 10 mg medroxyprogesterone/day for 10 days beginning any time.
Abnormal uterine bleeding with no pathology.
5-10 mg/day for 5-10 days, with therapy beginning on day 16 or 21 of the menstrual cycle. If endometrium has been estrogen primed: 10 mg/day for 10 days, beginning on day 16 of the menstrual cycle. Bleeding usually begins within 3-7 days.
?IM
Endometrial or renal carcinoma.
Initial: 400-1,000 mg/week;
then, if improvement noted, 400 mg/month. Medroxyprogesterone is not intended to be the primary therapy.
Long-acting contraceptive.
150 mg of depot form q 3 months by deep IM injection given only during the first 5 days after the onset of a normal menstrual period, within 5 days postpartum if not breastfeeding, or 6 weeks postpartum if breastfeeding. |
