VOL: 101, ISSUE: 10, PAGE NO: 30
- Medroxyprogesterone acetate: Adgyn Medro, Depo-Provera, Farlutal, Provera.
- Medroxyprogesterone prevents follicular maturation and ovulation.
- Stimulates growth of mammary tissue.
- Antineoplastic action against endometrial cancer.
- Antineoplastic hormone contraceptive.
- Progesterone derivative.
- Contraception following appropriate counselling.
- Malignant disease.
- Dysfunctional uterine bleeding.
- Secondary amenorrhoea.
- Opposition of oestrogen in HRT.
- Mild to moderate endometriosis.
- Cancer of the breast or reproductive organs.
- Severe liver impairment.
- Undiagnosed vaginal bleeding.
- Known or suspected pregnancy.
- Cardiac or renal dysfunction.
- A history of blood clots.
- Change to the menstrual cycle.
- Premenstrual-like syndrome.
- Weight gain.
- Nausea and vomiting.
- Skin reactions.
- Increases plasma ciclosporin concentration.
- Hormone antagonists reduce plasma concentration of medroxyprogesterone.
- For contraception the first injection should be given within five days after the beginning of a normal menstrual period, and repeated every 12 weeks.
- Oral preparations are tolerated better when taken with milk or food to reduce gastrointestinal side-effects.
- Confusion can arise with drugs of similar name - methylprednisolone and Premarin.
- Medroxyprogesterone should not be given for contraception without full counselling backed by the manufacturer’s approved leaflet.
- It can take 9-10 months to become pregnant after stopping medroxyprogesterone as a contraceptive.
- Heavy bleeding has been reported in women who start this contraceptive in the immediate puerperium. It is therefore better to delay giving the first injection until six weeks postnatally.
- Blood pressure should be recorded at the beginning of treatment and then periodically.
- The prescribing health care professional should be informed if weight gain is a problem.
- Monitor mental status.
- Evaluate therapeutic response.
- When used for contraception lack of periods does not mean pregnancy when regular injections have been administered.
- If a contraceptive injection is late or missed, pregnancy can occur.
- Any unusual vaginal bleeding or breast lumps should be reported to the prescribing health care professional.
- Medroxyprogesterone does not provide protection against sexually transmitted diseases.
Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines.