1. Introduction
Medroxyprogesterone is a synthetic form of the hormone progesterone, primarily used to treat menstrual and uterine disorders, as well as for contraception. It belongs to the progestin class and works by mimicking the effects of natural progesterone, regulating the menstrual cycle, and preventing ovulation at higher doses.
2. Indications
- Irregular menstrual periods
- Secondary amenorrhoea
- Abnormal uterine bleeding
- Endometriosis
- Hormone replacement therapy (in combination with oestrogen)
- Contraception (as an injection or implant)
- Prevention of endometrial hyperplasia in postmenopausal women
3. Dosage
Oral:
- For secondary amenorrhoea/irregular periods: 5-10 mg daily for 5-10 days, starting on Day 16-21 of the menstrual cycle.
- For abnormal uterine bleeding: 5-10 mg daily for 5-10 days.
Injectable (Depot):
- For contraception: 150 mg intramuscularly every 12 weeks.
Subcutaneous (Depot):
- 104 mg every 12-14 weeks.
4. Administration
- Oral tablets should be taken with water, preferably at the same time each day.
- Depot injections should be administered intramuscularly or subcutaneously by a healthcare provider.
- For contraceptive use, the first dose should ideally be given within the first 5 days of the menstrual cycle.
5. Forms Available
- Oral tablets: 2.5 mg, 5 mg, 10 mg
- Intramuscular injection (Depot): 150 mg/mL
- Subcutaneous injection: 104 mg/0.65 mL
6. Side Effects
6.1 Common Side Effects:
- Weight gain
- Headache
- Fatigue
- Breast tenderness
- Irregular bleeding or spotting
6.2 Less Common Side Effects:
- Nausea
- Mood changes
- Decreased libido
- Acne
6.3 Rare but Serious Side Effects:
- Deep vein thrombosis (DVT)
- Pulmonary embolism
- Severe allergic reactions
- Osteoporosis with long-term use (especially injectable forms)
7. Warnings
- May increase the risk of thromboembolic events (DVT, stroke).
- Prolonged use of injectable forms may reduce bone density; ensure calcium and vitamin D intake.
- Contraindicated in pregnancy, undiagnosed vaginal bleeding, and active or recent history of thrombosis.
8. Precautions
- Use with caution in patients with a history of depression, migraines, or diabetes.
- Regular follow-up is essential for long-term use, particularly for bone health and cardiovascular risk.
9. Interactions
- Enzyme inducers (e.g., carbamazepine, rifampin) may reduce the effectiveness of Medroxyprogesterone.
- Anticoagulants: Increased risk of clotting complications.
- Corticosteroids: May enhance corticosteroid effects.
10. Monitoring Parameters
- Bone density (especially for long-term injectable use).
- Menstrual cycle regularity.
- Weight and blood pressure.
- Signs of thromboembolic events.
11. Use in Children
- Safety and efficacy are not established in prepubertal children.
- Injectable forms are sometimes used in adolescents for contraception under medical supervision.
12. Use in Pregnancy
- Contraindicated during pregnancy due to potential risks to the foetus.
13. Use in Elderly
- Rarely indicated in older women unless part of hormone replacement therapy.
- Monitor for increased thromboembolic risk.
14. Use in Kidney Disease
- Generally safe, but caution is advised in severe renal impairment.
15. Use in Liver Disease
- Use with caution in mild to moderate liver impairment; avoid in severe liver disease.
16. Patient Counselling Points
- For oral tablets, adhere strictly to prescribed doses and timing.
- For contraceptive use, regular follow-up is important to monitor bone health and effectiveness.
- Report any signs of thrombosis (e.g., leg pain, shortness of breath) immediately.
- Maintain adequate calcium and vitamin D intake if on long-term injectable forms.
- Irregular bleeding may occur initially but usually resolves with continued use.
17. Table of Brand Names, Manufacturer, and Prices in USD
Brand Name | Manufacturer | Strength/Dosage Form | Price (USD) |
---|---|---|---|
Provera | Pfizer | 5 mg Tablet | $15 (30 tablets) |
Depo-Provera | Pfizer | 150 mg/mL Injection | $45 (1 vial) |
Sayana Press | Pfizer | 104 mg/0.65 mL | $40 (1 device) |
18. 15 FAQs (Frequently Asked Questions)
1. What is Medroxyprogesterone?
Medroxyprogesterone is a synthetic hormone used for menstrual disorders, contraception, and hormone replacement therapy.
2. How does Medroxyprogesterone work?
It mimics the action of progesterone, regulating the menstrual cycle, reducing uterine bleeding, and preventing ovulation.
3. What is the recommended dosage for Medroxyprogesterone?
Dosage varies based on the indication, ranging from 5-10 mg orally to 150 mg intramuscularly for contraception.
4. Can Medroxyprogesterone be used during pregnancy?
No, it is contraindicated during pregnancy.
5. Can I use Medroxyprogesterone while breastfeeding?
Yes, injectable forms are considered safe during breastfeeding.
6. What are the common side effects of Medroxyprogesterone?
Common side effects include weight gain, headache, and irregular bleeding.
7. Are there serious risks with Medroxyprogesterone?
Rare but serious risks include thrombosis and reduced bone density with long-term use.
8. What should I do if I miss a dose?
Follow your doctor’s advice; for injections, contact your healthcare provider to reschedule.
9. What happens if I overdose on Medroxyprogesterone?
Overdose is rare but may cause nausea or withdrawal bleeding. Seek medical attention if concerned.
10. Can Medroxyprogesterone interact with other medicines?
Yes, enzyme-inducing drugs may reduce its effectiveness.
11. Is Medroxyprogesterone safe for children?
Not typically used in prepubertal children; consult a doctor for adolescents.
12. Is Medroxyprogesterone safe for elderly patients?
Use cautiously in elderly women, especially those at risk of thrombosis.
13. How should Medroxyprogesterone be stored?
Store tablets at room temperature and injections in a cool, dry place.
14. Do I need a prescription for Medroxyprogesterone?
Yes, it is prescription-only.
15. Can Medroxyprogesterone be taken with alcohol or specific foods?
There are no specific restrictions, but consult your doctor for personalised advice.