Hydroxyprogesterone Overview

Reviewed: September 24, 2012

Hydroxyprogesterone is a prescription hormone medication used in pregnant women to lower the risk of delivering a baby too early. Hydroxyprogesterone belongs to a group of drugs called progestin hormones. It is not known how progestins work to prevent preterm labor.

This medication comes in an injectable form to be given into the muscle by a healthcare provider. It is usually given once every week, beginning in the 16th week of pregnancy until the 37th week (through 36 weeks, 6 days) of gestation or delivery, whichever occurs first. 

Common side effects of hydroxyprogesterone include pain, swelling, or itching at the site of the injection.


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  • Other
  • Abortion, Spontaneous
  • Amenorrhea
  • Endometriosis
  • Uterine Hemorrhage
  • Uterine Neoplasms

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Hydroxyprogesterone Cautionary Labels


Uses of Hydroxyprogesterone

Hydroxyprogesterone is a prescription medication used to prevent preterm delivery (having a baby too soon) in pregnant women who:

  • Are pregnant with one baby
  • Have had a preterm delivery of one baby in the past

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

Hydroxyprogesterone Brand Names

Hydroxyprogesterone may be found in some form under the following brand names:

Hydroxyprogesterone Drug Class

Hydroxyprogesterone is part of the drug class:

Side Effects of Hydroxyprogesterone

Hydroxyprogesterone may cause serious side effects. See the "Drug Precautions" section. 

The most common side effects of hydroxyprogesterone include:

  • pain, swelling, itching, bruising or a hard bump at the injection site
  • itching
  • nausea
  • diarrhea
  • fatigue
  • dizziness
  • headache
  • fever
  • skin rash

Call your healthcare provider if you have the following at your injection site:

  • Increased pain over time
  • Oozing of blood or fluid
  • Swelling

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of hydroxyprogesterone. For more information, ask your healthcare provider or pharmacist.

Call your healthcare provider for medical advice about side effects or pregnancy complications. You may report side effects to FDA at 1-800-FDA-1088.

Hydroxyprogesterone Interactions

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

  • theophylline (Theo-24, Elixophyllin, Theolair)
  • tizanidine (Zanaflex)
  • clozapine (Clozaril, Fazaclo)
  • acetaminophen (Tylenol)
  • nicotine (Nicotrol)
  • efavirenz (Sustiva, in Atripla)
  • bupropion (Aplenzin, Fortivo XL, Wellbutrin, Wellbutrin SR, Wellbutrin XL)
  • methadone (Methadose, Dolophine)

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

Hydroxyprogesterone Precautions

Serious side effects have been reported with hydroxyprogesterone including the following:

Blood Clots. Tell your doctor immediately if you experience any of the following:

  • Leg swelling
  • Redness in your leg
  • A spot on your leg that is warm to touch
  • Leg pain that worsens when you bend your foot

Allergic reactions. Severe and potentially life-threatening allergic reactions are possible during treatment with hydroxyprogesterone. Get emergency medical attention immediately if you develop any of the following symptoms of a severe allergic reaction:

  • sudden difficulty breathing
  • sudden and abnormal swelling of the face, lips, tongue, and/or throat
  • hives
  • sudden development of a red blister-like skin rash
  • sudden drop in blood pressure

Depression. Tell your doctor immediately if you notice a change in your mood. 

Reduced glucose tolerance. Hydroxyprogesterone can reduce your body's ability to tolerate large amounts of glucose. Be sure to inform your physician if you have diabetes or prediabetes, as this can affect how your body responds to this medication.

Jaundice. Tell your doctor immediately if you notice yellowing of your skin and the whites of your eyes. 

Hydroxyprogesterone can also cause dizziness and/or drowsiness. Do not drive or operate heavy machinery until you know how Makena affects you.

Do not receive hydroxyprogesterone if you:

  • are allergic to hydroxyprogesterone or to any of its ingredients 
  • have or suspect you may have breast cancer or any other hormone-sensitive cancers
  • have unusual vaginal bleeding due to an unknown cause
  • have a medical condition called cholestatic jaundice of pregnancy (yellowing of your skin due to liver problems during your pregnancy)
  • have liver tumors or any active liver disease
  • have untreated high blood pressure
  • have or have a history of blood clots

Hydroxyprogesterone Food Interactions

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 hydroxyprogesterone, there are no specific foods that you must exclude from your diet when receiving this medication.

Inform MD

Before you receive hydroxyprogesterone, tell your healthcare provider if you have:

  • An allergy to hydroxyprogesterone caproate, castor oil, or any of the other ingredients in hydroxyprogesterone
  • Diabetes or prediabetes
  • Epilepsy
  • Migraine headaches
  • Asthma
  • Heart problems
  • Kidney problems
  • Depression or have a history of depression
  • Blood clots or other blood clotting problems or a history 
  • Breast cancer or other hormone-sensitive cancers or have a history
  • Unusual vaginal bleeding not related to your current pregnancy
  • Yellowing of your skin due to liver problems during your pregnancy
  • Liver problems including liver tumors
  • Uncontrolled high blood pressure

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Hydroxyprogesterone and Pregnancy

Hydroxyprogesterone is intended for use during pregnancy to help prevent giving birth to a baby too soon. Hydroxyprogesterone is not intended for use in the first trimester. Hydroxyprogesterone should be started between weeks 16 and 20 of pregnancy.

Hydroxyprogesterone and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed.

You will likely stop taking hydroxyprogesterone at 37 weeks of gestation or when the baby is born. This medication, a progestin hormone, is likely to be excreted in breast milk as progestins are known to pass through breast milk in small amounts.

Hydroxyprogesterone Usage

Use hydroxyprogesterone exactly as prescribed.

  • Do not give yourself hydroxyprogesterone injections. A healthcare professional will give you the injection into the muscle in your hip area (upper outer area of the buttocks) once a week (every 7 days).
  • You will start receiving hydroxyprogesterone injections anytime from 16 weeks and 0 days of your pregnancy up to 20 weeks and 6 days of your pregnancy.
  • You will continue to receive hydroxyprogesterone injections once weekly until week 37 of your pregnancy or when your baby is delivered, whichever happens first.

You will receive this injection in a clinic or doctor's office. Your doctor will need to check your progress on a regular basis while you are using this medication.

It is very important that you do not miss a dose of hydroxyprogesterone and that you continue to receive the medicine once a week. If you miss a dose, talk to your healthcare provider for specific directions on how to get back on schedule.

Hydroxyprogesterone Dosage

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The recommended dose of hydroxyprogesterone to prevent preterm delivery is 250 mg (1 mL) once a week.


Hydroxyprogesterone Overdose

Hydroxyprogesterone is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.