Depo-Provera CI (Medroxyprogesterone Acetate Injectable Suspension)

Depo-Provera CI (Medroxyprogesterone Acetate Injectable Suspension)
© The Swiss Pharmacy

Depo-Provera Contraceptive Injection is a
progestin indicated for use by females of
reproductive potential to prevent pregnancy.
It is also used to treat endometriosis, abnormal
uterine bleeding, abnormal sexuality in males, and
certain types of cancer.

Depo-Provera Contraceptive Injection
is manufactured by Pfizer,
Belgium in the strength of 150mg/ml.

Chemical Structure

The active ingredient contained in Depo-Provera
Contraceptive Injection is Medroxyprogesterone
Acetate.
Each Depo-Provera injection contains 150 mg of
Medroxyprogesterone Acetate per ml.

Uses of Depo-Provera Contraceptive Injection 150mg/ml:
Depo-Provera CI (Medroxyprogesterone Acetate injectable Suspension)
is used to prevent pregnancy.
Medroxyprogesterone is like a natural hormone made by the body. It
works mainly by preventing the growth and release of an egg (ovulation)
during your menstrual cycle. It also makes vaginal fluid thicker to help
prevent sperm from reaching an egg (fertilization) and changes the lining
of the uterus (womb) to prevent attachment of a fertilized egg.
Using this medication does not protect you or your partner against
sexually transmitted diseases (such as HIV, gonorrhea, chlamydia).

Recommended Adult Dosage
The recommended dose of Depo-Provera Contraceptive Injection
for preventing pregnancy is 150 mg every 3 months (13 weeks)
administered by deep, intramuscular (IM) injection in the gluteal
or deltoid muscle.
To make sure you are not pregnant, the first injection is usually
given during the first 5 days of your menstrual period.
Endometriosis:
The recommended dose of Depo-Provera CI given
intramuscularly is 50mg weekly or 100mg every 2 weeks for at
least 6 months.

Recommended Adult Dosage
Endometrial or Renal Carcinoma:
Doses of 400 mg to 1000 mg of Depo-Provera Sterile Aqueous Suspension per
week are recommended initially. If improvement is noted within a few weeks or
months and the disease appears stabilized, it may be possible to maintain
improvement with as little as 400 mg per month. Medroxyprogesterone acetate
is not recommended as primary therapy, but as adjunctive and palliative
treatment in advanced inoperable cases including those with recurrent or
metastatic disease.
Breast Cancer:
The recommended dosage schedule is Depo-Provera 500mg to 1000mg per
day intramuscularly for 28days. The patient should then be placed on a
maintenance schedule of 500mg twice weekly as long as she is responding to
treatment.

Contraindications
➔
Depo-Provera CI is contraindicated in patients with a known
hypersensitivity to Medroxyprogesterone Acetate or any component of the
injection.
➔
Known or suspected pregnancy or as a diagnostic test for pregnancy.
➔
Active thrombophlebitis, or current or past history of thromboembolic
disorders, or cerebral vascular disease.
➔
Known or suspected malignancy of breast.
➔
Significant liver disease.
➔
Undiagnosed vaginal bleeding.

Storage Instructions
Depo-Provera CI (Medroxyprogesterone Acetate
injectable Suspension) have to be stored at controlled
room temperature i.e. from 20°C to 25°C (68°F to 77°F)
with excursions permitted between 15° to 30°C (59° to
86°F).
Keep this as well as all other medicines away from
children and pets.

Warnings
Thromboembolic disorders: Depo-Provera CI has not been causally associated with the
induction of thrombotic or thromboembolic disorders (thrombophlebitis, cerebrovascular
disorders, pulmonary embolism, and retinal thrombosis), however, Medroxyprogesterone
Acetate (MPA) is not recommended in any patient with a history of venous
thromboembolism (VTE).
Ocular Disorders: Medication should not be readministered pending examination if there is a
sudden partial or complete loss of vision, or if there is a sudden onset of proptosis,
diplopia, or migraine. If examination reveals papilloedema or retinal vascular lesions,
medication should not be readministered.
Bleeding Irregularities: Most women using Depo-Provera CI experience disruption of
menstrual bleeding patterns following the administration of either a single or multiple
doses of MPA(e.g., irregular or unpredictable bleeding/spotting, rarely, heavy or
continuous bleeding). If unexpected vaginal bleeding occurs or abnormal bleeding persists or
is severe, appropriate investigations should be instituted to rule out the possibility of organic
pathology and appropriate treatment should be instituted when necessary.

Warnings
Loss of BMD: Contraception And Endometriosis: Use of Depo-Provera CI reduces serum
estrogen levels in premenopausal women and is associated with a statistically significant
loss of BMD as bone metabolism accommodates to a lower estrogen level. Decreases in
serum estrogen due to Depo-Provera CI may result in a decrease in BMD in a pre-
menopausal woman and may increase her risk for developing osteoporosis later in life.
Cancer Risks: Long-term case-controlled surveillance of users of Depo-Provera CI found
slight or no increased overall risk of breast cancer and no overall increased risk of ovarian,
liver, or cervical cancer.
Accidental Pregnancies: Infants from unintentional pregnancies that occur 1 to 2
months after injection of Depo-Provera CI may be at increased risk of low birth weight,
which in turn, is associated with an increased risk of neonatal death.
Ectopic pregnancy: As with all forms of hormonal contraception, health-care providers
should be alert to the possibility of an ectopic pregnancy among women using
Depo-Provera CI who become pregnant or complain of severe abdominal pain.

Warnings
Sexually Transmitted Infections: Depo-Provera CI 150mg/mL is intended to prevent
pregnancy. Women should be counselled that Depo-Provera CI does not protect against
sexually transmitted infections(STIs)including HIV infections (AIDS) but equally, DMPA is
a sterile injection and, used as directed, will not expose them to sexually transmitted
infections.
Anaphylactic and anaphylactoid reactions: Anaphylactic and anaphylactoid reactions have
occasionally been reported in patients treated with IM Medroxyprogesterone Acetate.
Physical examination: A complete medical and family history should be taken before the
initiation of any hormone therapy. The pre-treatment and periodic physical examination
should include special reference to blood pressure, breasts, abdomen and pelvic
organs, including cervical cytology (Papanicolaou smear).
Fluid retention: Depo-Provera CI may cause some degree of fluid retention, therefore,
caution should be exercised in treating any patient with a pre-existing medical condition
that might be adversely affected by fluid retention, such as epilepsy, migraine, asthma, or
cardiac or renal dysfunction.

Warnings
Breakthrough Bleeding: Unexpected vaginal bleeding during therapy with Depo-Provera CI
should be investigated. Breakthrough bleeding is likely to occur in patients being treated for
endometriosis. No other hormonal intervention is recommended for managing this
bleeding. Non-functional causes should also be borne in mind and in cases of undiagnosed
vaginal bleeding, adequate diagnostic measures are indicated.
Carbohydrate Metabolism: Some patients receiving Depo-Provera CI may exhibit a decreased
glucose tolerance. The mechanism of this decrease is obscure. For this reason, diabetic
patients should be carefully observed while receiving such therapy.
CNS Disorders and Convulsions: Patients with a history of treatment for clinical depression
should be carefully monitored while receiving Depo-Provera CI therapy and the drug
discontinued if the depression recurs to a serious degree.
Weight Changes: There was a tendency for women to gain weight while on therapy with
MPA.
Return Of Fertility: The median time to conception for those who do conceive is 10 months
following the last injection with a range of 4 to 31 months, and is unrelated to the duration
of use.

Warnings
Liver Function: Certain endocrine and possible liver function tests may be affected by
treatment with Depo-Provera CI. Therefore, if such tests are abnormal in a patient taking
Depo-Provera CI, it is recommended that they be repeated after the drug has been
withdrawn.
Patient Age: The age of the patient constitutes no absolute limiting factor, although
treatment with progestogens may mask the onset of the climacteric.
Pathology Tests: The pathologist (laboratory) should be informed of the patient’s use of
Depo-Provera CI if endometrial or endocervical tissue is submitted for examination.
IM Administration: Gluteal infiltration and abscess formation may occur with IM
administration.
General: Because of the prolonged action and the resulting difficulty in predicting the time
of withdrawal bleeding following injection, Depo-Provera CI is not recommended for
treatment for secondary amenorrhoea or dysfunctional uterine bleeding. In these
conditions, oral therapy is recommended.

Possible Side Effects
Most common Depo-Provera CI (Medroxyprogesterone Acetate
injectable Suspension) side effects with an incidence rate of
greater than or equal to 5% include menstrual irregularities
(bleeding or spotting) 57% at 12 months, 32% at 24 months,
abdominal pain / discomfort 11%, weight gain greater than 10 lbs
at 24 months 38%, dizziness 6%, headache 17%, nervousness 11%,
decreased libido 6%.

Possible Side Effects
The following side effects occurred in between 1 and 5% of patients:
Body as a Whole: Asthenia/fatigue (4.2%), Backache(2.2%),
Dysmenorrhea (1.7%), Hot flashes(1.0%)
Digestive: Nausea(3.3%), Bloating(2.3%)
Metabolic/Nutritional: Edema(2.2%)
Musculoskeletal: Leg cramps (3.7%), Arthralgia(1.0%)
Nervous: Depression (1.5%), Insomnia(1.0%),
Skin and Appendages: Acne (1.2%), No hair growth/alopecia(1.1%),
Rash(1.1%)
Urogenital: Leukorrhea (2.9%), Breast pain (2.8%), Vaginitis(1.2%)

Depo-Provera CI During Pregnancy
has been classified by the US FDA as Pregnancy Category X.
Depo-Provera Contraceptive Injection should not be administered during
pregnancy. Studies in animals have shown that progestogens, including
Medroxyprogesterone Acetate, may have an adverse effect on the developing fetus,
including teratogenicity and fetotoxicity.
In addition, other animal studies have shown that high doses of
progestogens can cause masculinisation of the female fetus. Some reports suggest
an association between intrauterine exposure to progestational drugs in the first
trimester of pregnancy and genital abnormalities in male and female fetuses.
If Depo-Provera CI is used during pregnancy, or if the patient becomes pregnant
while using this drug, the patient should be apprised of the potential hazard to the
fetus.

Depo-Provera Contraceptive Injection is
manufactured by Pfizer in Belgium.
For More details Click Here

Depo-Provera CI (Medroxyprogesterone Acetate Injectable Suspension)

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