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Medroxyprogesterone

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VOL: 101, ISSUE: 10, PAGE NO: 30

Generic/proprietary names

 

Generic/proprietary names
- Medroxyprogesterone acetate: Adgyn Medro, Depo-Provera, Farlutal, Provera.

 

 

Action
- Medroxyprogesterone prevents follicular maturation and ovulation.

 

 

- Stimulates growth of mammary tissue.

 

 

- Antineoplastic action against endometrial cancer.

 

 

Classification
- Antineoplastic hormone contraceptive.

 

 

- Progesterone derivative.

 

 

Indications
- Contraception following appropriate counselling.

 

 

- Malignant disease.

 

 

- Dysfunctional uterine bleeding.

 

 

- Secondary amenorrhoea.

 

 

- Opposition of oestrogen in HRT.

 

 

- Mild to moderate endometriosis.

 

 

Contraindications
- Cancer of the breast or reproductive organs.

 

 

- Hypersensitivity.

 

 

- Severe liver impairment.

 

 

- Undiagnosed vaginal bleeding.

 

 

- Known or suspected pregnancy.

 

 

Cautions
- Breastfeeding.

 

 

- Hypertension.

 

 

- Asthma.

 

 

- Diabetes.

 

 

- Epilepsy.

 

 

- Cardiac or renal dysfunction.

 

 

- A history of blood clots.

 

 

Side-effects
- Change to the menstrual cycle.

 

 

- Premenstrual-like syndrome.

 

 

- Weight gain.

 

 

- Nausea and vomiting.

 

 

- Headache.

 

 

- Dizziness.

 

 

- Insomnia.

 

 

- Depression.

 

 

- Skin reactions.

 

 

Interactions
- Increases plasma ciclosporin concentration.

 

 

- Hormone antagonists reduce plasma concentration of medroxyprogesterone.

 

 

Administration
- 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.

 

 

Nursing considerations
- 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.

 

 

Patient teaching
- 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.

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