You may need to plan your travel around your treatment schedule.Before your doctor prescribes this drug for you, they will confirm that you’re not pregnant.Your doctor should monitor certain health issues while you take this drug. Indicated for adjunctive therapy and palliative treatment of inoperable, recurrent, and metastatic endometrial carcinomaIndicated for adjunctive therapy and palliative treatment of inoperable, recurrent, and metastatic renal carcinomaIndicated for secondary amenorrhea due to hormonal imbalance in the absence of organic pathology, such as fibroids or uterine cancer5 or 10 mg PO qDay for 5-10 days; therapy may start at any timeProgestin withdrawal bleeding usually occurs within 3-7 days after discontinuing medroxyprogesteroneIndicated for abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology, such as fibroids or uterine cancer5 or 10 mg PO qDay for 5-10 days; begin day 16 or 21 of the menstrual cycleProgestin withdrawal bleeding usually occurs within 3-7 days after discontinuing medroxyprogesteroneIndicated for prevention of endometrial hyperplasia in nonhysterectomized postmenopausal women who are receiving daily oral conjugated estrogens 0.625-mg tablets5 or 10 mg PO qDay for 12-14 consecutive days per month, in postmenopausal women receiving daily 0.625 mg conjugated estrogens, either beginning on the 1st day or 16th day of the cycle; start at the lowest doseIndicated for prevention of pregnancy in females of reproductive potentialSexually active women who have regular menses: Administer first injection only during the first 5 days of a normal menstrual periodBreastfeeding women: Administer first injection during or after the sixth postpartum weekUse for >2 years is not recommended (unless other birth control methods or medical therapies for endometriosis-associated pain are considered inadequate) due to the impact on bone mineral density (BMD) with long-term useIndicated for prevention of pregnancy in females of reproductive potentialSexually active women who have regular menses: Administer first injection only during the first 5 days of a normal menstrual periodBreastfeeding women: Administer first injection during or after the sixth postpartum weekUse for >2 years is not recommended (unless other birth control methods or medical therapies for endometriosis-associated pain are considered inadequate) due to the impact on bone mineral density (BMD) with long-term useIn patients with fatty liver, the mean percent dose excreted in the 24-hr urine as intact MPA after a 10 mg or 100 mg dose was 7.3% and 6.4%, respectivelyIndicated for prevention of pregnancy in females of reproductive potentialSexually active women who have regular menses: Administer first injection only during the first 5 days of a normal menstrual periodBreastfeeding women: Administer first injection during or after the sixth postpartum weekUse for >2 years is not recommended (unless other birth control methods or medical therapies for endometriosis-associated pain are considered inadequate) due to the impact on bone mineral density (BMD) with long-term useIndicated for prevention of pregnancy in females of reproductive potentialSexually active women who have regular menses: Administer first injection only during the first 5 days of a normal menstrual periodBreastfeeding women: Administer first injection during or after the sixth postpartum weekUse for >2 years is not recommended (unless other birth control methods or medical therapies for endometriosis-associated pain are considered inadequate) due to the impact on bone mineral density (BMD) with long-term useKnown or suspected estrogen- or progesterone-dependent neoplasiaActive arterial thromboembolic disease (eg, stroke, MI), or a history of these conditionsUse caution in patients with asthma, diabetes mellitus, history of depression, epilepsy, migraine, porphyria, systemic lupus erythematosus, and hepatic hemangiomasProlonged use of SC or IM use may result in significant loss of bone density; long-term use is not recommended (ie, >2 years) as birth control method or medical therapy for endometriosis-associated pain unless other options considered inadequateIn women with osteoporosis risk factors, other birth control methods or therapies for endometriosis-associated pain should be considered risk/benefit analysis for SC use; SC can pose an additional risk in patients with risk factors for osteoporosis (eg, metabolic bone disease, chronic alcohol and/or tobacco use, anorexia nervosa, strong family history of osteoporosis, or chronic use of drugs that can reduce bone mass such as anticonvulsants or corticosteroids)Consider ectopic pregnancy if a woman receiving therapy becomes pregnant or complains of severe abdominal painProvide emergency medical treatment if anaphylaxis occursInform medroxyprogesterone contraceptive does not protect against HIV infection and other sexually transmitted diseasesAdding a progestin to estrogen therapy has been shown to reduce the risk of endometrial hyperplasia, which may be a precursor to endometrial cancerIn some epidemiologic studies, use of estrogen plus progestin and estrogen-only products, in particular for 5 or more years, has been associated with increased risk of ovarian cancer; however, duration of exposure associated with increased risk is not consistent across all epidemiologic studies and some report no associationDepression and other mood disorders have been reported; discontinue if it occursMost women experienced changes in menstrual bleeding patterns, such as amenorrhea, irregular unpredictable spotting or bleeding, prolonged spotting or bleeding, or heavy bleeding; in cases of unexpected abnormal vaginal bleeding, adequate diagnostic measures are indicatedMonitor blood pressure at regular intervals with estrogen plus progestin therapyIn women with preexisting hypertriglyceridemia, estrogen therapy may be associated with elevations of plasma triglycerides leading to pancreatitis; consider discontinuation of treatment if pancreatitis occursProgestins may cause some degree of fluid retention; women with condition influenced by fluid retention including epilepsy, migraine, asthma, cardiac or renal dysfunction, require careful observationEstrogen therapy should be used with caution in women with hypoparathyroidism as estrogen-induced hypocalcemia may occurTherapy should be discontinued pending examination if there is a sudden partial or complete loss of vision, or if there is a sudden onset of proptosis; diplopia or migraine; if examination reveals papilledema or retinal vascular lesions, medication should be withdrawnPatients may exhibit suppressed adrenal function; medroxyprogesterone acetate may have cortisol-like glucocorticoid activity and provide negative feedback to hypothalamus or pituitary; this may result in decreased plasma cortisol levels, decreased cortisol secretion, and low plasma ACTH levels; use of sterile aqueous suspension may, due to its cortisol-like glucocorticoid activity, also produce Cushingoid symptoms such as weight gain, edema/fluid retention, and facial swellingMonitor patients for hepatic dysfunction periodically and temporarily interrupt therapy if patient develops hepatic dysfunction; do not resume use until markers of liver function return to normalAny multidose use of vials may lead to contamination unless strict aseptic technique is observedTreatment with progestin may mask the onset of the climactericPersistent injection site reactions may occur after administration due to inadvertent SC administration or release of drug into SC space while removing the needleSome patients receiving progestins may exhibit a decrease in glucose tolerance; therefore, patients with diabetes may be at greater risk of hyperglycemia There is no use for medroxyprogesterone in pregnancy and therefore should be discontinued during pregnantWomen who may have been exposed to medroxyprogesterone injections had little or no increased risk of birth defects in early pregnancyIt is unknown whether medroxyprogesterone acetate can cause fetal harm when administered to a pregnant womanPublished studies report the presence of medroxyprogesterone acetate in human milkExercise caution when medroxyprogesterone acetate is administered to a nursing womanAlthough medroxyprogesterone acetate is detectable in the milk of mothers receiving DMPA-IM, milk composition, quality, and amount do not appear to be adversely affectedEffects on milk production and lactation initiation/duration remain unclear when administered before 6 weeks after deliveryA: Generally acceptable.

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