Medroxyprogesterone Acetate: Uses, Dosage, and Side Effects Explained

Summary or Key Points

Medroxyprogesterone acetate is a prescription medication used to manage hormone-related conditions such as abnormal uterine bleeding, endometriosis, and amenorrhea. It is also prescribed for contraception and hormone replacement therapy. This medication works by mimicking the hormone progesterone. Always consult a healthcare provider before starting or adjusting your dose. You can also speak with one of our providers through telemedicine for personalized advice.

Names of Medication

US Brand Name: Provera

Generic Name: Medroxyprogesterone acetate

The generic name is the standard name of a medication, while the brand name is assigned by the manufacturer. In this article, the generic name will be listed in parentheses.

Pharmacologic Category

Progestins

Medroxyprogesterone Dosage

Medroxyprogesterone acetate is used to treat various conditions, and the dosage will depend on the specific condition being treated. Always follow your doctor’s instructions and consult them before making any changes to your treatment. You can also schedule a telemedicine appointment with one of our providers for further guidance.

Endometrial Hyperplasia

To prevent endometrial hyperplasia, the typical dose is 5 to 10 mg taken orally once daily for 12 to 14 days of each 28-day cycle, often in combination with estrogen therapy.

Endometriosis

The usual dose for endometriosis is 104 mg administered via intramuscular injection every 3 months. The duration of treatment may vary based on your doctor’s recommendation.

Abnormal Uterine Bleeding

For abnormal uterine bleeding, the typical dose is 5 to 10 mg taken orally once daily for 5 to 10 days, starting on day 16 or 21 of the menstrual cycle.

Amenorrhea

For secondary amenorrhea (absence of menstruation), the recommended dose is 5 to 10 mg taken orally once daily for 5 to 10 days.

Medroxyprogesterone for Contraception

For contraception, medroxyprogesterone acetate is given as a 150 mg intramuscular injection every 3 months. It is important to receive injections on time to maintain effectiveness.

Hormone Replacement Therapy (HRT)

When used with estrogen for hormone replacement therapy, the typical dose is 5 to 10 mg taken orally once daily for 12 to 14 days of each 28-day cycle.

Uterine Cancer

For the treatment of uterine cancer, the dose may range from 200 to 400 mg taken orally once daily. The duration of treatment will be determined by your healthcare provider.

Premenstrual Syndrome (PMS)

Medroxyprogesterone acetate is sometimes used off-label for PMS. The dose and duration of treatment will be determined by your doctor based on your symptoms.

Menstrual Disorders

For irregular menstrual cycles, the typical dose is 5 to 10 mg taken orally once daily for 5 to 10 days, starting on day 16 or 21 of the menstrual cycle.

Ovarian Cancer

Medroxyprogesterone acetate may be used in certain cases of ovarian cancer. The dose and treatment plan will be individualized by your healthcare provider.

Dosage Forms and Strengths

Oral tablets: 2.5 mg, 5 mg, 10 mg

Intramuscular injection: 150 mg/mL

Subcutaneous injection: 104 mg/0.65 mL

Administration Instructions

Medroxyprogesterone acetate can be taken orally or administered via injection. If you are taking the oral form, it’s important to take it at the same time each day, with or without food. For injections, your healthcare provider will administer the medication, typically every 3 months for contraception or endometriosis. Be sure to follow your doctor’s instructions carefully, and feel free to contact us via telemedicine if you have any questions or concerns about your treatment plan.

Medroxyprogesterone Side Effects

Like all medications, medroxyprogesterone acetate can cause side effects. Some are common, while others are rare but more serious. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers for further evaluation.

Common Side Effects: These occur in more than 1 in 10 people.

1. Weight gain: Some patients may notice an increase in weight while taking this medication.
2. Headache: Mild to moderate headaches are a common side effect.
3. Nausea: Some patients may experience nausea, especially when starting the medication.

Less Common Side Effects: These occur in 1 in 100 to 1 in 10 people.

1. Breast tenderness: Some patients may experience soreness in the breast area.
2. Acne: Skin breakouts can occur in some individuals.
3. Depression: Mood changes, including feelings of sadness or depression, have been reported.

Serious Side Effects: These are rare but require immediate medical attention.

1. Blood clots: Symptoms include swelling, pain, or redness in the legs, or sudden shortness of breath.
2. Severe allergic reactions: Signs include rash, itching, swelling, or difficulty breathing.
3. Vision changes: Any sudden changes in vision should be reported to your doctor immediately.

Contraindications

A contraindication is a specific situation or condition where a particular medication should not be used because it may cause harm. In the case of medroxyprogesterone acetate, there are several situations where it is not safe to take this medication.

Pregnancy: Medroxyprogesterone acetate should not be used during pregnancy as it may harm the developing fetus, potentially leading to birth defects or other complications.

Active or history of blood clots (thrombosis): If you have a history of blood clots in your legs (deep vein thrombosis), lungs (pulmonary embolism), or other parts of your body, medroxyprogesterone acetate can increase the risk of clot formation.

Severe liver disease: This medication is processed by the liver, and if you have severe liver disease, it may not be metabolized properly, leading to toxic effects.

Unexplained vaginal bleeding: If you have abnormal vaginal bleeding that has not been diagnosed, medroxyprogesterone acetate should not be used until the cause of the bleeding is determined, as it may mask underlying conditions like cancer.

Breast cancer or other hormone-sensitive cancers: Since medroxyprogesterone acetate is a hormone, it can stimulate the growth of hormone-sensitive cancers, such as breast cancer.

Allergy to Medroxyprogesterone acetate: If you have had an allergic reaction to medroxyprogesterone acetate or any of its ingredients, you should not take this medication.

Drug to Drug Interactions

Medroxyprogesterone acetate can interact with other medications, potentially reducing its effectiveness or increasing the risk of side effects. It’s important to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Medroxyprogesterone acetate:

1. Rifampin (Rifadin): This antibiotic can reduce the effectiveness of Medroxyprogesterone acetate by speeding up its breakdown in the liver.
2. Carbamazepine (Tegretol): Used to treat seizures, this medication can decrease the effectiveness of Medroxyprogesterone acetate by increasing its metabolism.
3. Phenytoin (Dilantin): Another anti-seizure medication that can lower Medroxyprogesterone acetate levels in the body, reducing its effectiveness.
4. St. John’s Wort: This herbal supplement is known to reduce the effectiveness of hormonal medications, including Medroxyprogesterone acetate.
5. Warfarin (Coumadin): Medroxyprogesterone acetate may affect how your body processes blood thinners like warfarin, increasing the risk of bleeding or clotting complications.

Medroxyprogesterone Acetate in Pregnancy

Is it Safe to Take Medroxyprogesterone Acetate When Pregnant?

No, Medroxyprogesterone acetate is not considered safe during pregnancy. It is classified as a Category X medication by the FDA, meaning it can harm a developing fetus. It should not be used if you are pregnant or planning to become pregnant. If you become pregnant while taking this medication, contact your healthcare provider immediately.

Medroxyprogesterone Acetate While Breastfeeding

Is it Safe to Take Medroxyprogesterone Acetate While Breastfeeding?

Medroxyprogesterone acetate may pass into breast milk but is generally considered safe during breastfeeding. However, it is important to discuss this with your healthcare provider, who will weigh the benefits and risks based on your specific situation. If you notice any changes in your baby, such as feeding difficulties or unusual symptoms, contact your provider immediately.

Estimated Cost of Medroxyprogesterone Acetate

The cost of Medroxyprogesterone acetate can vary depending on the pharmacy and location. Without insurance, the estimated cost for a 30-day supply of Medroxyprogesterone acetate (10 mg tablets) ranges from $12 to $20 with a GoodRx coupon. Prices may vary, so check with your pharmacy for the most accurate pricing.

Possible Alternatives to Medroxyprogesterone Acetate

If Medroxyprogesterone acetate is not suitable for you, alternative treatments and lifestyle changes may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss these options.

1. Endometrial hyperplasia: Alternatives include other progestins like norethindrone or lifestyle changes such as weight loss and managing diabetes to reduce the risk of endometrial hyperplasia.
2. Endometriosis: Hormonal treatments like oral contraceptives or GnRH agonists (e.g., leuprolide) may be used. Surgical options are available for severe cases.
3. Abnormal uterine bleeding: Other hormonal therapies, such as oral contraceptives or a levonorgestrel-releasing intrauterine device (IUD), may be considered.
4. Amenorrhea: Treatment options include lifestyle changes such as maintaining a healthy weight, managing stress, or using other hormonal therapies like estrogen and progesterone combinations.
5. Contraception: Alternatives include oral contraceptives, IUDs, or barrier methods like condoms. Discuss with your provider which method is best for you.
6. Hormone replacement therapy: Other forms of hormone replacement, such as combined estrogen-progesterone therapy, may be considered. Non-hormonal options like lifestyle changes (e.g., diet, exercise) may also help manage symptoms.
7. Uterine cancer: Treatment options include surgery, radiation, or chemotherapy, depending on the stage and type of cancer. Hormonal therapies may also be considered in some cases.
8. Premenstrual syndrome (PMS): Lifestyle changes, such as regular exercise, a balanced diet, and stress management, can help. Non-hormonal medications like NSAIDs (e.g., ibuprofen) may also be effective.
9. Menstrual disorders: Depending on the cause, treatments may include hormonal therapies, lifestyle changes, or surgical interventions.
10. Ovarian cancer: Treatment typically involves surgery and chemotherapy. Hormonal therapies may be used in certain cases, but this should be discussed with your oncologist.

Recent Updates on Medroxyprogesterone Acetate Research

Recent studies have focused on the long-term safety of Medroxyprogesterone acetate, particularly in its use for contraception and hormone replacement therapy. Research indicates that while the medication is effective, prolonged use may slightly increase the risk of breast cancer, especially in women who use it for more than five years. However, the overall risk remains low, and the benefits of using Medroxyprogesterone acetate for contraception or hormone therapy often outweigh the risks for many women.

Ongoing studies are also exploring the potential use of Medroxyprogesterone acetate in combination with other medications for treating hormone-sensitive cancers, such as ovarian and uterine cancers. These studies are still in the early stages, and more research is needed to determine the effectiveness of these combinations.

As always, it is important to discuss any concerns or questions with your healthcare provider. If you would like to learn more about Medroxyprogesterone acetate or explore other treatment options, schedule a telemedicine appointment with one of our providers today.

James Kingsley

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