BMA Concise Guide to Medicine & Drugs

Medroxyprogesterone

Brand names Adgyn Medro, Climanor, Depo-Provera, Farlutal, Provera

Used in the following combined preparations Indivina, Premique, Tridestra

QUICK REFERENCE

Drug group Female sex hormone

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Medroxyprogesterone is a progestogen, a synthetic female sex hormone similar to the natural hormone progesterone. This drug is used as part of hormone replacement therapy (HRT) for women who have a uterus and need progesterone in addition to their long-term oestrogen. Medroxyprogesterone is also often used to treat endometriosis, a condition in which there is abnormal growth of the uterine-lining tissue in the pelvic cavity. Depot injections of the drug are used as a contraceptive. However, since they may cause serious side effects, such as persistent bleeding from the uterus, amenorrhoea, and prolonged infertility, their use remains controversial, and they are recommended only under special circumstances.

Medroxyprogesterone may be used to treat some types of cancer, such as cancer of the breast, uterus, or kidney.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, injection.

Frequency and timing of doses 1–3 x daily with plenty of water (by mouth); tablets may need to be taken at certain times during your cycle; follow the instructions you have been given. Every 3 months (depot injection and intramuscular injection).

Adult dosage range Menstrual disorders 2.5–10mg daily. Endometriosis 30mg daily. Cancer 100–1,500mg daily. Contraception 150mg.

Onset of effect 1–2 months (cancer); 1–2 weeks (other conditions).

Duration of action 1–2 days (by mouth); up to some months (depot injection).

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. If your next dose is due within 3 hours, take a single dose now and skip the next.

Stopping the drug Do not stop the drug without consulting your doctor; symptoms may recur.

Exceeding the dose An occasional unintentional extra dose is unlikely to be a cause for concern. But if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor.

POSSIBLE ADVERSE EFFECTS

Medroxyprogesterone rarely causes serious adverse effects. Fluid retention may lead to weight gain, swollen ankles or feet, and breast tenderness. Consult your doctor if these are severe, if you have severe nausea with the drug, or if it causes fatigue, depression, or irregular menstruation. If you develop a rash, itching, acne, or jaundice, you should stop taking the drug and contact your doctor promptly. Long-term use of the drug is associated with increased risk of various disorders (see Prolonged use).

INTERACTIONS

Ciclosporin The effects of this drug may be increased by medroxyprogesterone.

Anticoagulants Medroxyprogesterone may reduce the effects of these drugs.

Rifamycin antibiotics, St John’s wort, anti-epileptics, griseofulvin, terbinafine, and barbiturates may reduce the effects of medroxyprogesterone.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have high blood pressure.

· You have had venous thrombosis, a heart attack, or a stroke.

· You have long-term liver or kidney problems.

· You have porphyria.

· You have epilepsy or a history of depression.

· You are taking other medicines.

Pregnancy Not prescribed. May cause abnormalities in the unborn baby. Discuss with your doctor.

Breast-feeding The drug passes into the breast milk, but at normal doses adverse effects on the baby are unlikely. Discuss with your doctor.

Infants and children Not usually prescribed.

Over 60 No special problems.

Driving and hazardous work No known problems.

Alcohol No known problems.

PROLONGED USE

Long-term use of this drug may slightly increase the risk of venous thrombosis in the leg veins. Irregular menstrual bleeding or spotting between periods may also occur during long-term use. The drug also increases the risk of osteoporosis and bone fractures. Bone loss is greatest in the first 2-3 years of treatment then stabilizes.

Monitoring Periodic checks on blood pressure, yearly cervical smear tests, and breast examinations are usually required.