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medroxyprogesterone acetate
Amen, Cycrin, Depo-Provera, Provera

Pregnancy Risk Category X

How supplied
Tablets:
2.5 mg, 5 mg, 10 mg
Injection (suspension):
150 mg/ml, 400 mg/ml

Action
Suppresses ovulation, possibly by inhibiting pituitary gonadotropin secretion, thus preventing follicular maturation and causing endometrial thinning.

Indications & dosage
Abnormal uterine bleeding due to hormonal imbalance--

Women:
5 to 10 mg P.O. daily for 5 to 10 days beginning on day 16 of menstrual cycle. If patient also has received estrogen--10 mg P.O. daily for 10 days beginning on day 16 or 21 of cycle.
Secondary amenorrhea--

Women:
5 to 10 mg P.O. daily for 5 to 10 days. Start at any time during menstrual cycle (usually during latter half of cycle).
Endometrial or renal cancer--

Adults:
400 to 1,000 mg I.M. weekly. (Dose may be decreased to 400 mg/month when disease has stabilized.)
Contraception--

Women:
150 mg I.M. once q 3 months.

Adverse reactions
CNS:
depression.
CV:
thrombophlebitis, pulmonary embolism, edema, thromboembolism, CVA.
EENT:
exophthalmos, diplopia.
GI:
bloating, abdominal pain.
GU:
breakthrough bleeding, dysmenorrhea, amenorrhea, cervical erosion, abnormal secretions.
Hepatic:
cholestatic jaundice, increased liver function test results.
Metabolic:
weight changes.
Skin:
rash, pain, induration, sterile abscesses, acne, pruritus, melasma, alopecia, hirsutism.
Other:
breast tenderness, enlargement, or secretion.

Interactions
Drug-drug.
Aminoglutethimide, carbamazepine, phenobarbital, phenytoin, rifampin: decreased progestin effects. Monitor for diminished therapeutic response. Tell patient to use a nonhormonal contraceptive during therapy with these drugs.
Drug-food.
Caffeine: may increase serum caffeine levels. Monitor effects.
Drug-lifestyle.
Smoking: increased risk of adverse CV effects. If smoking continues, may need alternative therapy.

Effects on diagnostic tests
Reduced response to metyrapone test.

Contraindications
Contraindicated in patients with hypersensitivity to drug and in those with active thromboembolic disorders or past history of thromboembolic disorders, cerebral vascular disease, apoplexy, breast cancer, undiagnosed abnormal vaginal bleeding, missed abortion, or hepatic dysfunction; also contraindicated during pregnancy. Tablets are contraindicated in patients with liver dysfunction or known or suspected malignant disease of genital organs.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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