Medroxyprogesterone is a synthetic progestogen medication primarily used to regulate female hormonal balance. This drug mimics the action of natural progesterone in the body and is commonly used in the treatment of menstrual irregularities, endometriosis, and as an ovulation induction aid in fertility treatments. Its chemical structure is similar to natural progestogens, but it has a longer duration of action, making it advantageous for long-term therapy.
This medication can be administered orally or via injection, depending on the treatment purpose. In gynecology, it is also used to assess endometrial response to estrogen or as an adjunct in intrauterine device (IUD) therapy to reduce bleeding risks.
The generic name of Medroxyprogesterone is "Medroxyprogesterone acetate." Common brand names in Taiwan and Hong Kong include:
This medication is classified as a "Progestogen receptor modulator" and belongs to the class of progestin hormones. Its pharmacological action mainly involves mimicking the hormonal environment of the luteal phase to regulate the endometrial condition and suppress ovulation.
Main indications include:
Additionally, it can be used for:
Mild side effects include:
Serious side effects requiring immediate medical attention:
Contraindications: Pregnancy is strictly contraindicated, as it may cause fetal abnormalities. Patients with a history of deep vein thrombosis, breast cancer, or liver disease should use this medication only after medical evaluation.
Black Box Warning: This drug may increase the risk of blood clots, especially with long-term use, and requires regular monitoring. The FDA pregnancy category is X; use during pregnancy may cause uterine contractions and miscarriage.
Concurrent use with anticoagulants (such as warfarin) may increase bleeding risk, requiring dose adjustments. Use with hepatic enzyme inducers (like carbamazepine) may reduce effectiveness; inform your healthcare provider of all medications being taken.
Avoid combining with antidiabetic drugs, as it may affect blood glucose control. Herbal supplements such as St. John’s Wort may interfere with drug metabolism; consult your physician before use.
Oral doses typically range from 10-20 mg daily, adjusted according to treatment goals. Higher doses (e.g., 160 mg daily) may be used for endometriosis. Injectable formulations are administered once every three months by healthcare professionals.
Take medication at the same time each day, with or without food. When combined with estrogen, follow your doctor’s instructions for dose adjustments.
If a dose is missed, take it as soon as remembered; if close to the next scheduled dose, skip the missed dose and resume the regular schedule. Do not double doses to make up for missed ones.
Overdose may cause severe abdominal pain, vomiting, uterine bleeding, or jaundice. Seek immediate medical attention and bring the medication container for assessment.
If the patient experiences confusion or difficulty breathing, treat as a medical emergency and call emergency services.
Q: How should I handle missed doses of Medroxyprogesterone?
A: If you forget to take your medication and it has been more than 12 hours since the scheduled time, take it as soon as you remember. If it is close to the next dose, skip the missed dose and continue with your regular schedule. Do not take double doses to compensate. Setting reminders and establishing a fixed routine can help reduce missed doses.
Q: Is irregular menstrual bleeding normal after starting Medroxyprogesterone?
A: Initial use may cause changes in menstrual cycles, such as irregular bleeding or changes in flow, which are usually temporary. If irregular bleeding persists beyond three months or if bleeding becomes excessive, consult your doctor for possible dose adjustment or alternative treatment.
Q: Will combining Medroxyprogesterone with NSAIDs affect its efficacy?
A: When used together, NSAIDs (like ibuprofen) may increase gastrointestinal discomfort. It is recommended to take them after meals and follow medical advice regarding timing. If you experience upper abdominal pain or gastrointestinal bleeding, stop medication and seek medical attention.
Q: Are there dietary or activity restrictions while on this medication?
A: It is advisable to avoid excessive caffeine and alcohol intake, as they may worsen side effects like dizziness or mood swings. Light to moderate exercise is generally safe, but if treating conditions like endometriosis, strenuous activity should be avoided to prevent discomfort. Follow your physician’s guidance for specific restrictions.
Q: Does long-term use of Medroxyprogesterone affect bone density?
A: Long-term use of progestogens may impact calcium metabolism. Regular bone density scans every 6 to 12 months are recommended. Adequate intake of calcium-rich foods or supplements, along with vitamin D, can help maintain bone health and reduce osteoporosis risk.
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