Medroxyprogesterone
Unchecked
Medroxyprogesterone acetate (MPA)
Provera (oral), Depo-Provera (IM contraceptive), Depo-SubQ Provera 104 (SC)
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Summary
Common uses
Long-acting reversible contraception (Depo-Provera)0, Endometriosis0, Secondary amenorrhea0, Endometrial protection in estrogen-containing HRT0, Selected endometrial cancer (palliative/adjunct)0
Pharmacy
Starting dose
Contraception: Depo-Provera 150 mg IM every 13 weeks; Depo-SubQ 104 mg SC every 12-13 weeks; oral cycling: 5-10 mg PO daily ×5-10 days for amenorrhea
Preparations
2.5, 5, 10 mg oral tablets; Depo-Provera 150 mg/mL IM; Depo-SubQ Provera 104 mg/0.65 mL
US FDA Max
Indication-specific
Pharmacology
Routes
Oral, IM, SC
Onset
Contraceptive within 24 hours if given in first 5 days of cycle; otherwise backup for 7 days
Duration
Depot IM 13 weeks (designed); often persists longer
Half-life
~50 days (Depo-Provera; long depot release)[1]
Bioavailability
Oral ~90%; depot IM essentially 100% over the dosing interval[1]
Pregnancy
Contraindicated in known pregnancy.[citation needed]
Legal status
Purported mechanism
Medroxyprogesterone is a synthetic 17α-hydroxyprogesterone derivative that binds progesterone receptors with high affinity (also weak androgen receptor binding); it suppresses gonadotropin release (LH surge) to inhibit ovulation, thickens cervical mucus, and atrophies endometrium — combined contraceptive mechanism.0 Unlike bioidentical progesterone, MPA has been associated in the WHI substudies with increased breast cancer and cardiovascular risk relative to estrogen-alone HRT, which has shifted some clinical preference toward micronized progesterone for menopausal endometrial protection. Depo bone loss reverses partially over 1-2 years after discontinuation[1].
References
[edit | edit source]- ↑ 1.0 1.1 1.2 1.3 FDA Prescribing Information, Depo-Provera (medroxyprogesterone acetate), Pfizer, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020246s036lbl.pdf