• Secondary amenorrhea due to idiopathic hormonal imbalance in absence of fibroids, uterine cancer:
    • PO 5-10mg OD *5-10 days
    • Progestin withdrawal bleeding usually occurs within 3-7 days after discontinuing medroxyprogesterone
    • Start on day 16 or 21 of cycle
  • Abnormal uterine bleeding:
    • PO 5-10mg OD *5-10 days
    • Progestin withdrawal bleeding usually occurs within 3-7 days after discontinuing medroxyprogesterone
    • Start on day 16 or 21 of cycle
  • Postmenopausal hyperplasia reduction:
    • PO 5-10mg OD *10-14days every 4 weeks
    • In patients receiving daily 0.625mg conjugated estrogens, either beginning on the 1st or 16th day of the cycle
    • Initiate at the lowest dose 
  • Contraception:
    • Sexually active with regular menses: IM 150mg every 3 months OR SC 104mg every 3 months
    • Breastfeeding mothers: IM 150mg every 3 months OR SC 104mg every 3 months
      • Give 1st injection after 6th postpartum week
      • Potential risk of milk production
  • Endometriosis-associated pain:
    • IM 150mg every 3 months OR SC 104mg every 3 months
  • Tablets:
    • 5mg
  • Depot injection:
    • 150mg
    • 104mg/0.65mL
  • Expect withdrawal bleeding 3-7 days after discontinuing treatment
  • IM injection given in the deltoid or gluteus
  • After withdrawal of depot injection, return of fertility is delayed by 10 months

Progestins

It inhibits pituitary gonadotropin release which prevents follicular maturation and ovulation and also causes thickening cervical mucus. Collectively, these actions contribute to its contraceptive effects

  • Menstrual irregularities
  • Amenorrhea
  • Nausea
  • Breast pain and tenderness
  • Decreased libido
  • Galactorrhea
  • Weight changes
  • Fluid retention
  • Headache
  • Insomnia
  • Somnolence
  • Mood changes
  • Dizziness
  • Rash
  • Acne
  • Hirsutism
  • Alopecia
  • Decreased glucose tolerance
  • Hypersensitivity to drug/components
  • Undiagnosed vaginal bleeding
  • Breast cancer or history of same
  • Estrogen or progesterone-dependent cancer
  • Venous thromboembolism or history of same
  • Arterial thromboembolism within 12 months
  • Hepatic disease or impairment
  • Pregnancy
  • Missed abortion
  • Tranexamic acid may increase risk of thromboembolic event
  • Aminoglutethimide

                          Drug Status

Availability Prescription only
Pregnancy Category X
Breastfeeding Can be used 6 weeks postpartum
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Depo-Provera 150mg/mL Injection 1’s Pfizer Labs Pfizer Labs
Lydia 150mg/mL Injection 25’s DKT International DKT International
Provera 5mg Tablet 24’s Pfizer Labs Pfizer Labs
Sayana Press 104mg/0.65mL Injection 1’s Pfizer Labs Pfizer Labs