Dangerous Drug: Medroxyprogesterone Acetate(me drox’ ee proe jess’ te rone)
Oral: Apo-Medroxyprogesterone (CAN), Gen-Medroxy (CAN), Provera
Parenteral: Depo-Provera, depo-subQ provera 104
PREGNANCY CATEGORY X
Drug Classes
Antineoplastic
Contraceptive
Hormone
Progestin
Therapeutic Actions
Progesterone derivative; endogenous progesterone transforms proliferative endometrium into secretory endometrium; inhibits the secretion of pituitary gonadotropins, which prevents follicular maturation and ovulation; inhibits spontaneous uterine contraction.
Indications
Reduction of endometrial hyperplasia in postmenopausal women
Oral: Treatment of secondary amenorrhea
Oral: Abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology
Parenteral: Adjunctive therapy and palliation of inoperable, recurrent, and metastatic endometrial carcinoma or renal cell cancer; long acting contraceptive (Depo-Provera)
Subcutaneous depot: Long-acting contraceptive; management of endometriosis-associated pain (depo-subQ provera 104)
Unlabeled use for depot form: Treatment of breast cancer
Contraindications and Cautions
Contraindicated with allergy to progestins; thrombophlebitis, thromboembolic disorders, cerebral hemorrhage or history of these conditions; hepatic disease, carcinoma of the breast, ovaries, or endometrium, undiagnosed vaginal bleeding, missed abortion; pregnancy (fetal abnormalities, including masculinization of the female fetus have been reported); lactation.
Use cautiously with epilepsy; migraine; asthma; cardiac or renal impairment.
Available Forms
Tablets—2.5, 5, 10 mg; injection—150, 400 mg/mL; 104 mg/0.65 mL (depo-subQ)
Dosages
Adults
Contraception monotherapy: 150 mg IM every 3 mo. For depo-subQ Provera: 104 mg subcutaneously into thigh or abdomen every 12–14 wk.
Secondary amenorrhea: 5–10 mg/day PO for 5–10 days. A dose for inducing an optimum secretory transformation of an endometrium that has been primed with exogenous or endogenous estrogen is 10 mg/day for 10 days. Start therapy at any time; withdrawal bleeding usually occurs 3–7 days after therapy ends.
Abnormal uterine bleeding: 5–10 mg/day PO for 5–10 days, beginning on the 16th or 21st day of the menstrual cycle. To produce an optimum secretory transformation of an endometrium that has been primed with estrogen, give 10 mg/day PO for 10 days, beginning on the 16th day of the cycle. Withdrawal bleeding usually occurs 3–7 days after discontinuing therapy. If bleeding is controlled, administer two subsequent cycles.
Endometrial or renal carcinoma: 400–1,000 mg/wk IM. If improvement occurs within a few weeks or months and the disease appears stabilized, it may be possible to maintain improvement with as little as 400 mg/mo IM.
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