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Medroxyprogesterone is a prescription hormone medication used to treat a variety of conditions including menstrual periods that have stopped or abnormal vaginal bleeding. It is also used to prevent an overgrowth of the lining of the uterus in women taking estrogen who have gone through menopause. Medroxyprogesterone works by replacing progesterone hormone that the body is unable to make.

This medication comes in tablet form and is taken once daily for a certain amount of days in a row (decided by your doctor) each month. Medroxyprogesterone is also available in two injectable forms that are used as long-acting birth control as well as other indications.

Common side effects include breast tenderness, spotting, and headaches.

Medroxyprogesterone (oral) is a prescription medicine used to:

• treat menstrual periods that have stopped or to treat abnormal uterine bleeding. 
• reduce the chances of getting cancer of the uterus in women after menopause.

Medroxyprogesterone (injectable) is also used to:

• prevent pregnancy (long-acting birth control)
• relieve pain from endometriosis (subcutaneous form)
• relieve symptoms of advanced endometrial cancer (intramuscular form)
• relieve symptoms of kidney cancer (intramuscular form)

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

The following side effects have been reported with the use of medroxyprogesterone alone:

• Breast tenderness
• Breast milk secretion
• Breakthrough bleeding
• Spotting (minor vaginal bleeding)
• Irregular periods
• Amenorrhea (absence of menstrual periods)
• Vaginal secretions
• Headaches
• Nervousness
• Dizziness
• Depression
• Insomnia, sleepiness, fatigue
• Premenstrual syndrome-like symptoms
• Thrombophlebitis (inflamed veins)
• Blood clot
• Itching, hives, skin rash
• Acne
• Hair loss, hair growth
• Abdominal discomfort
• Nausea
• Bloating
• Fever
• Increase in weight
• Swelling
• Changes in vision and sensitivity to contact lenses

The following side effects have been reported with the use of medroxyprogesterone with an estrogen.

Side effects are grouped by how serious they are and how often they happen when you are treated:

Serious but less common side effects of estrogen include:

• Breast cancer
• Cancer of the uterus
• Stroke
• Heart attack
• Blood clots
• Dementia
• Gallbladder disease
• Ovarian cancer
• High blood pressure
• Liver problems
• High blood sugar
• Enlargement of benign tumors of the uterus ("fibroids")

Some of the warning signs of these serious side effects include:

• Breast lumps
• Unusual vaginal bleeding
• Dizziness and faintness
• Changes in speech
• Severe headaches
• Chest pain
• Shortness of breath
• Pains in your legs
• Changes in vision
• Vomiting
• Yellowing of the skin, eyes or nail beds

Call your healthcare provider right away if you get any of these warning signs, or any other unusual symptom that concerns you.

Less serious but common side effects include:

• Headache
• Breast pain
• Irregular vaginal bleeding or spotting
• Stomach/abdominal cramps, bloating
• Nausea and vomiting
• Hair loss
• Fluid retention
• Vaginal yeast infection

These are not all the possible side effects of medroxyprogesterone with or without estrogen. For more information, ask your healthcare provider or pharmacist.

Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take thyroid medications including:

• liothyronine (Cytomel)
• liotrix (Thyrolar)
• levothyroxine (Levothroid, Levoxyl, Synthroid, Tirosint, Unithroid)
• thyroid (Armor Thyroid, Nature-Thyroid, Westhroid)

This is not a complete list of medroxyprogesterone drug interactions. Ask your doctor or pharmacist for more information.

Studies have shown that using combination hormone therapy, or combination HT (estrogen and progesterone) increases the risk for heart attacks, stroke, breast cancer, dementia, and blood clots. Because of these risks, combination HT should only be used short-term at the lowest possible dose.

Medroxyprogesterone injection can cause bone loss, which may increase your risk for osteoporosis (weak and thinning bones) and fractures. The medication should not be used for longer than two years unless absolutely necessary as long-term therapy will increase risk of bone loss.

Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your health care provider should check any unusual vaginal bleeding to find out the cause.

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chance of getting heart attacks, strokes, breast cancer, and blood clots.

Using estrogens with or without progestins may increase your risk of dementia, based on a study of women age 65 years or older.

You and your healthcare provider should talk regularly about whether you still need treatment with medroxyprogesterone.

Do not start taking medroxyprogesterone if you:

• have undiagnosed vaginal bleeding.
• currently have or have had certain cancers.
  • Estrogen plus progestin may increase your chance of getting certain cancers, including cancer of the breast. If you have or have had cancer, talk with your healthcare provider about whether you should use medroxyprogesterone.

• had a stroke or heart attack in the past year.
• currently have or have had blood clots.
• currently have or have had liver problems.
• think you may be pregnant.
  • Tell your healthcare provider if you think that you may be pregnant or having a miscarriage. There may be an increased risk of minor birth defects in children whose mothers take this drug during the first 4 months of pregnancy. If you take medroxyprogesterone and later find out you were pregnant when you took it, be sure to discuss this with your doctor as soon as possible.
  • medroxyprogesterone should not be used as a test for pregnancy.

• are allergic to any of the ingredients in medroxyprogesterone.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of medroxyprogesterone, there are no specific foods that you must exclude from your diet when receiving this medication.

Tell your healthcare provider:

• If you are breastfeeding. The hormone in medroxyprogesterone can pass into your breast milk.
• About all of your medical problems. Your healthcare provider may need to check you more carefully if you have certain conditions, such as asthma (wheezing); epilepsy (seizures); migraine headaches; endometriosis (severe pelvic pain); lupus; problems with your heart, liver, thyroid, or kidneys; or if you have high calcium levels in your blood.
• About all the medicines you take. This includes prescription and nonprescription medicines, vitamins, and herbal supplements. Some medicines may affect how medroxyprogesterone works. medroxyprogesterone may also affect how other medicines work.
• If you are going to have surgery or will be on bed rest. If you are taking estrogen in addition to medroxyprogesterone, you may need to stop taking estrogen and medroxyprogesterone.

Medroxyprogesterone should not be taken during pregnancy. Tell your healthcare provider right away if you become pregnant while receiving medroxyprogesterone. 

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Medroxyprogesterone falls into category X. These medicines should never be used by pregnant women.

Tell your healthcare provider if you are breastfeeding. Medroxyprogesterone has been detected in human breast milk and should not be used while breastfeeding.

Medroxyprogesterone comes as a tablet to be taken by mouth, usually once daily. It is prescribed to be taken for 5 to 10 days in a row per month (cycle dosing). If you miss an oral dose, take it as soon as you remember unless it is almost time for the next dose. Do not take a double dose to make up for a missed one.

This medication also comes in intramuscular and subcutaneous injectable forms that are given once every 3 months.

If you take too much medroxyprogesterone, call your healthcare provider or local Poison Control Center right away.

Store medroxyprogesterone at room temperature 20° to 25°C (68° to 77°F).

Keep medroxyprogesterone and all medicines out of the reach of children.

WARNINGS

CARDIOVASCULAR AND OTHER RISKS

Estrogens with progestins should not be used for the prevention of cardiovascular disease or dementia. 

The Women's Health Initiative (WHI) estrogen plus progestin substudy reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis (DVT) in postmenopausal women (50 to 79 years of age) during 5.6 years of treatment with daily oral conjugated estrogens (CE 0.625 mg) combined with medroxyprogesterone acetate (MPA 2.5 mg) relative to placebo.

The Women's Health Initiative Memory Study (WHIMS), a substudy of the WHI study, reported increased risk of developing probable dementia in postmenopausal women 65 years of age or older during 4 years of treatment with daily CE 0.625 mg combined with MPA 2.5 mg, relative to placebo. It is unknown whether this finding applies to younger postmenopausal women. 

In the absence of comparable data, these risks should be assumed to be similar for other doses of CE and MPA and other combinations and dosage forms of estrogens and progestins. Because of these risks, estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.