Class: Progestin Hormone
Dosage Forms. Tablet: 2.5 mg, 5 mg, 10 mg
Common FDA Label Indication, Dosing, and Titration.
1. Abnormal uterine bleeding unrelated to menstrual cycle: 5-10 mg po daily × 5-10 d starting on days 16 or 21 of the menstrual cycle
2. Prevention of estrogen-induced endometrial hyperplasia: 5-10 mg po daily for 12-14 d starting on days 1 or 16 of the menstrual cycle, when estrogen is being administered
3. Secondary physiologic amenorrhea: 5-10 mg po daily × 5-10 d
1. Breast cancer, endometrial carcinoma: Dose is individualized
MOA. Medroxyprogesterone transforms proliferative into secretory endometrium. Androgenic and anabolic effects have been noted, but the drug is apparently devoid of significant estrogenic activity.
Drug Characteristics: Medroxyprogesterone
Medication Safety Issues: Medroxyprogesterone
Drug Interactions: Medroxyprogesterone
Adverse Reactions: Medroxyprogesterone
Efficacy Monitoring Parameters. Resolution of clinical signs of abnormal bleeding.
Toxicity Monitoring Parameters. Baseline pelvic and breast exam at therapy initiation; monitor BMD; diagnostic evaluation to rule out malignancy in the event of persistent or recurring vaginal bleeding.
Key Patient Counseling Points. Menstrual bleeding should occur 3-7 d after last dose. Patients should report if menstruation does not occur within 7 d after last dose.
Clinical Pearls. Injectable formulation of medroxyprogesterone is administered every 3 mo for contraception and for pain associated with endometriosis. Combination of estrogens and progestins should not be used for the prevention of cardiovascular disease. Increased risk of myocardial infarction, stroke, invasive breast cancer, PE, and DVT has been shown in postmenopausal women.