Medroxyprogesterone Acetate Injectable: Contraception Guidance

Therapeutic action

Hormonal contraceptive, progestogen.

Indications

• Long-acting contraception.
• Long-term treatment of functional uterine bleeding.

Forms and strengths, route of administration

• 150 mg in 1 ml vial (150 mg/ml) for IM injection.

Dose

Adolescent and adult: 150 mg every 3 months (13 weeks). Subsequent injections may be administered up to 2 weeks before or 4 weeks after the scheduled date.

The injection may be administered at any moment of the cycle if it is reasonably certain the woman is not pregnant, including when switching from another form of contraception.

For contraception, use condoms for 7 days after the injection if it is administered more than 7 days after the start of menstruation, more than 28 days postpartum if not breastfeeding, or more than 7 days after an abortion.

Duration

Contraception: as long as this method of contraception is desired and well tolerated.

Long-term treatment of functional uterine bleeding: according to clinical response.

Contra-indications, adverse effects, precautions

• Do not administer to patients with breast cancer, severe hypertension of 160/100 or more, active thromboembolic disorders, uncontrolled or complicated diabetes, or severe or recent hepatic disease.
• May cause menstrual irregularities, amenorrhoea, menometrorrhagia, breast tenderness, headache, weight gain, acne, mood change, abdominal pain, and gastrointestinal disturbances.
• The contraceptive efficacy of medroxyprogesterone does not seem to be reduced in women taking enzyme-inducing drugs.
• Pregnancy: contraindicated.
• Breast-feeding: no contra-indication.
• Shake the vial vigorously before use to homogenise the suspension.
• Return to fertility is delayed for 3 to 12 months after stopping injections.
• Also comes in a prefilled single-use injection system (104 mg/0.65 ml) for SC self-administration in the abdomen or anterior thigh.