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GENITO URINARY SYSTEM AND SEX HORMONES › SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM › HORMONAL CONTRACEPTIVES FOR SYSTEMIC USE › Progestogens
medroxyprogesterone
G03AC06
Forms & Strengths
- Oral tablet: 2.5 mg, 5 mg, 10 mg
- Injectable suspension (Depo-Provera): 150 mg/mL
- Subcutaneous injection (Depo-SubQ Provera 104): 104 mg/0.65 mL
Adult Dosing
- Contraception: 150 mg IM every 3 months or 104 mg SC every 3 months
- Secondary amenorrhea: 5 to 10 mg orally daily for 5 to 10 days
- Abnormal uterine bleeding: 5 to 10 mg orally daily for 5 to 10 days starting on day 16 or 21 of cycle
- Endometrial or renal carcinoma (palliative): 400 to 1000 mg IM weekly, adjusting down to 400 mg monthly if improvement occurs
Pediatric Dosing
- Contraception (adolescents): 150 mg IM every 3 months or 104 mg SC every 3 months
- Endometriosis / other indications: Safety and efficacy not established in pre-menarchal pediatric patients
Indications
- Contraception to prevent pregnancy
- Treatment of secondary amenorrhea
- Treatment of abnormal uterine bleeding due to hormonal imbalance
- Palliative treatment of recurrent or metastatic endometrial or renal carcinoma
Mechanism of Action
- Acts as a synthetic progestin that inhibits the secretion of pituitary gonadotropins (LH and FSH)
- Prevents follicular maturation and ovulation
- Thins the endometrium and thickens cervical mucus to inhibit sperm penetration
Contraindications
- Known or suspected pregnancy (as a diagnostic test or for contraception)
- Active thrombophlebitis or current/past history of thromboembolic disorders or cerebrovascular disease
- Active liver disease or hepatic dysfunction
- Known or suspected malignancy of the breast or genital organs
- Undiagnosed vaginal bleeding
- Known hypersensitivity to medroxyprogesterone acetate
Adverse Reactions
- Menstrual irregularities (amenorrhea, heavy/prolonged bleeding, spotting)
- Weight gain
- Headache
- Dizziness
- Abdominal pain or discomfort
- Fatigue
- Decreased bone mineral density with long-term use
- Depression and mood changes
Drug Interactions
- CYP3A4 inducers (e.g., carbamazepine, rifampin, St. John's wort) may decrease plasma concentrations and reduce contraceptive efficacy
- Aminoglutethimide may significantly reduce the efficacy of medroxyprogesterone acetate
- May alter glucose tolerance and increase requirements for insulin or oral hypoglycemic agents in diabetics
Curated Content: Needs Vetting Before Put to Clinical Use