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trademark for preparations of medroxyprogesterone acetate, a progestational agent.

medroxyprogesterone acetate

Apo-Medroxy (CA), Climanor (UK), Depo-Provera, Depo-SUBQ-Provera 104, Dom-Medroxyprogesterone (CA), Gen-Medroxy (CA), Novo-Medrone (CA), PMS-Medroxyprogesterone (CA), Provera, Ratio-MPA

Pharmacologic class: Hormone

Therapeutic class: Progestin

Pregnancy risk category X

FDA Box Warning

• Injection form may cause significant bone density loss. Loss increases with duration of use and may not be completely reversible. It is unknown if use during adolescence or early adulthood reduces peak bone mass and increases risk for osteoporotic fracture later in life.

• Injection form should be used as long-term contraceptive (more than 2 years) only if other contraceptive methods are inadequate.


Inhibits pituitary gonadotropin secretion, preventing follicular maturation, ovulation, and pregnancy


Suspension for depot injection: 150 mg/ml, 400 mg/ml

Suspension for depot subcutaneous injection: 104 mg/0.65 ml in prefilled single-use syringes

Tablets: 2.5 mg, 5 mg, 10 mg

Indications and dosages

Secondary amenorrhea

Adults: 5 to 10 mg/day P.O. for 5 to 10 days, starting at any time during menstrual cycle

Dysfunctional uterine bleeding; menses induction

Adults: 5 to 10 mg/day P.O. for 5 to 10 days, starting on day 16 or 21 of menstrual cycle

To prevent estrogen-related endometrial changes in postmenopausal women

Adults: 2.5 to 5 mg/day P.O. given with 0.625 mg conjugated estrogens P.O. (monophasic regimen); or 5 mg/day P.O. on days 15 to 28 of cycle, given with 0.625 mg conjugated estrogens P.O. daily throughout cycle (biphasic regimen)

Management of endometriosis-associated pain

Adults: 104 mg (Depot-subcutaneous-Provera) in anterior thigh or abdomen q 12 to 14 weeks

To prevent pregnancy

Adults: 150 mg (Depo-Provera) deep I.M. injection q 13 weeks or 104 mg (Depot-subcutaneous-Provera) in anterior thigh or abdomen q 12 to 14 weeks. Give first injection during first 5 days of normal menstrual period or first 5 postpartal days if patient isn't breastfeeding, or during sixth postpartal week if patient is breastfeeding exclusively.

Renal or endometrial cancer

Adults: 400 to 1,000 mg I.M.; may repeat weekly. If improvement occurs, decrease to 400 mg q month.

Off-label uses

• Advanced breast cancer


• Hypersensitivity to drug or its components
• Cerebrovascular or thromboembolic disease
• Hepatic dysfunction or disease
• Breast or genital cancer
• Undiagnosed vaginal bleeding
• Known or suspected pregnancy


Use cautiously in:
• seizure disorder, renal or cardiovascular disease, asthma, diabetes mellitus, depression, migraine
• history of hepatic disease.


• Before starting therapy, obtain thorough history and physical examination, with emphasis on breast and pelvic organs. Also obtain Pap smear, and repeat annually during therapy.
• With contraceptive use, rule out pregnancy before first dose and when more than 14 weeks have passed since previous dose.
• For I.M. injection, inject deep into gluteal, deltoid, or anterior thigh muscle. Rotate injection sites.
• Be aware that when drug is used to prevent estrogen-related endometrial changes in postmenopausal women, lowest dosage should be used for shortest time, because treatment exceeding 1 year correlates with cancer. (Some combination products have 0.3 mg estrogen/1.5 mg progesterone or 0.45 mg estrogen/1.5 mg progesterone.)

Adverse reactions

CNS: insomnia, migraine, nervousness, drowsiness, dizziness, fatigue, depression, mood changes

CV: thrombophlebitis, thromboembolism

EENT: diplopia, proptosis, retinal vascular lesions, papilledema

GI: abdominal pain, bloating

GU: amenorrhea, leukorrhea, spotting, cervical secretions, galactorrhea, breast tenderness and secretion, cervical erosions, pelvic pain, infertility

Hepatic: jaundice

Metabolic: fluid retention, hyperglycemia

Musculoskeletal: leg cramps, back pain

Respiratory: pulmonary embolism

Skin: pruritus, urticaria, rash, acne, alopecia, hirsutism, chloasma, melasma, sterile abscesses, induration at I.M. site

Other: weight and appetite changes, edema, angioedema, allergic reactions including anaphylaxis


Drug-drug.Bromocriptine: decreased bromocriptine efficacy

Carbamazepine, phenobarbital, phenytoin, rifampin: decreased contraceptive efficacy

Drug-diagnostic tests.Alkaline phosphatase, low-density lipoproteins: increased levels

High-density lipoproteins, pregnanediol excretion: decreased levels

Thyroid hormone assays: altered results

Drug-behaviors.Alcohol use: additive CNS depression

Patient monitoring

• Monitor patient for fluid retention and for signs and symptoms of thrombophlebitis, including pain, swelling, and redness of lower legs.

Assess for visual disturbances and headache. If ocular exam shows papilledema or retinal vascular lesions, drug should be discontinued.
• Evaluate liver function tests.

Watch for abdominal pain, fever, malaise, jaundice, darkened urine, and clay-colored stools.

Patient teaching

• Advise patient that drug may cause nausea, vomiting, headache, abdominal pain, painful breast swelling, and abnormal bleeding pattern. Instruct her to report these effects if pronounced.

Tell patient to promptly report bloating, swelling, appetite loss, rash, yellowed skin, mood changes or depression, nervousness, dizziness, chest pain, shortness of breath, visual disturbances, or severe headache.
• Teach patient how to perform breast self-exams.
• Tell patient she must undergo yearly physical examinations with Pap smear.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.


A trademark for a preparation of medroxyprogesterone acetate.


a trademark for a progestin (medroxyPROGESTERone acetate).


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It is also an opportunity for Pirelli to take advantage of the great expertise and experience of its two Russian partners, said Pirelli s Tronchetti Provera.
Imani Walker, Executive Director of the Rebecca Project stated, "our nonpartisan anti-Depo Provera advocacy is about protecting Black women's reproductive health and protecting low-income communities, because Black women experience significant health disparities.
Tronchetti Provera said: "Does Tevez still interest us?
The Controversy: Though Depo- Provera made its way into the country fifteen years ago and has been available in the private sector, the proposal to introduce it on a large scale in public sector was withdrawn at that time due to the protests of women's groups.
Egemen Bagis later met with the Deputy Chairperson of the Foreign Affairs Committee of the European Parliament, Fiorello Provera, and EP Turkey Rapporteur Ria Oomen Rujiten.
The drug - Depo Provera - was prescribed to him by highly-respected Dr Alimorad Farshchian, who was concerned about Jackson's behaviour.
Long-term contraceptives which could be encouraged include Depo Provera, a hormone injection which lasts for three months, and Implanon, a small rod inserted under the skin in the arm which releases a hormone over three years.
Q I RECENTLY went on to depo provera, the birth control injection, as I kept forgetting to take my pill.
Adtech Provera SpA in Rovato, Italy, held an open house in April to demonstrate a 5-meter-wide cast stretch-film line with four extruders (180-, 160-, and two 120-mm diam.
This included 44% Depo Provera, 31% oral contraception and 25% who switched methods during follow-up.
The strategic cooperation enables Bruckner Formtec to enlarge it product portfolio and Adtech Provera to widen its worldwide presence.
She had been using Depo Provera, which caused her to bleed every day and was transitioning off, when she conceived.