Medroxy
Generic Name
Medroxyprogesterone Acetate (MPA)
Manufacturer
ACI Limited (example)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| medroxy 150 mg injection | ৳ 48.00 | N/A |
Description
Overview of the medicine
Medroxyprogesterone Acetate (MPA) is a synthetic progestin used as a long-acting reversible contraceptive (LARC) administered via injection. It is also used in the treatment of endometriosis, abnormal uterine bleeding, and as an adjunctive therapy for certain hormone-dependent cancers.
Uses & Indications
Dosage
Adults
For contraception: 150 mg intramuscularly or subcutaneously every 13 weeks (3 months). For other indications, dosage varies as per medical advice.
Elderly
Generally not indicated for contraception in elderly. For other indications, use with caution and adjust dose based on clinical response and comorbidities.
Renal_impairment
No specific dosage adjustment is typically required for renal impairment.
How to Take
Administer 150 mg as a deep intramuscular injection into the gluteal or deltoid muscle, or as a subcutaneous injection in the abdomen or thigh, every 13 weeks (3 months). Ensure proper aseptic technique. Shake vial well before use.
Mechanism of Action
Medroxyprogesterone Acetate works primarily by inhibiting ovulation by suppressing the hypothalamic-pituitary-ovarian axis, leading to a decrease in estrogen and progesterone levels. It also causes thickening of cervical mucus, making it difficult for sperm to penetrate, and thins the endometrial lining, making it less hospitable for implantation.
Pharmacokinetics
Onset
Contraceptive effect begins within 24 hours if given within the first 5 days of a menstrual cycle; otherwise, backup contraception may be needed for 7 days.
Excretion
Excreted primarily in the urine as glucuronide conjugates, with some fecal excretion.
Half life
Highly variable, ranging from approximately 40 to 60 days (average ~50 days) after a single IM dose.
Absorption
Slow and sustained absorption from intramuscular or subcutaneous injection site, reaching peak plasma concentrations within 1-3 weeks.
Metabolism
Extensively metabolized in the liver via hydroxylation and conjugation pathways (primarily by CYP3A4).
Side Effects
Contraindications
- Known or suspected pregnancy
- Undiagnosed abnormal genital bleeding
- Known or suspected breast cancer
- Significant liver disease
- History of thrombophlebitis or thromboembolic disorders (for contraceptive use)
Drug Interactions
Aminoglutethimide
May significantly decrease MPA plasma concentrations, reducing its efficacy.
CYP3A4 Inducers (e.g., Rifampicin, Phenytoin, Carbamazepine, St. John's Wort)
May reduce MPA plasma levels, potentially decreasing contraceptive effectiveness (though less significant for injectable forms).
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Protect from light. Do not freeze.
Overdose
Overdose is rare due to the administration method. No specific antidote exists. Management should be symptomatic and supportive.
Pregnancy & Lactation
Contraindicated during pregnancy due to potential fetal harm. Small amounts pass into breast milk; generally considered compatible with breastfeeding, but it's advisable to delay initial use until 6 weeks postpartum to allow establishment of lactation.
Side Effects
Contraindications
- Known or suspected pregnancy
- Undiagnosed abnormal genital bleeding
- Known or suspected breast cancer
- Significant liver disease
- History of thrombophlebitis or thromboembolic disorders (for contraceptive use)
Drug Interactions
Aminoglutethimide
May significantly decrease MPA plasma concentrations, reducing its efficacy.
CYP3A4 Inducers (e.g., Rifampicin, Phenytoin, Carbamazepine, St. John's Wort)
May reduce MPA plasma levels, potentially decreasing contraceptive effectiveness (though less significant for injectable forms).
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Protect from light. Do not freeze.
Overdose
Overdose is rare due to the administration method. No specific antidote exists. Management should be symptomatic and supportive.
Pregnancy & Lactation
Contraindicated during pregnancy due to potential fetal harm. Small amounts pass into breast milk; generally considered compatible with breastfeeding, but it's advisable to delay initial use until 6 weeks postpartum to allow establishment of lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24-36 months from the date of manufacture, depending on the manufacturer.
Availability
Pharmacies, clinics, hospitals
Approval Status
FDA and DGDA approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of medroxyprogesterone acetate for contraception and other indications, with ongoing studies continuing to evaluate long-term effects.
Lab Monitoring
- Regular follow-up for bone mineral density (especially for long-term use, >2 years).
- Lipid profile (periodic monitoring).
- Blood pressure monitoring.
- Liver function tests (if liver disease suspected).
Doctor Notes
- Thorough patient counseling regarding potential for BMD loss and delayed return of fertility is crucial before initiation.
- Exclude pregnancy prior to each injection. Consider baseline and periodic BMD assessment, especially in adolescents and women with osteoporosis risk factors.
- Advise patients on lifestyle modifications to support bone health.
Patient Guidelines
- Receive injections regularly every 3 months as scheduled.
- Understand that menstrual bleeding patterns may change (e.g., irregular bleeding, spotting, or no bleeding).
- Be aware of the potential for bone mineral density loss, especially with long-term use; discuss calcium and vitamin D intake.
- Report any severe or persistent side effects to your healthcare provider.
- Fertility may take some time to return after stopping the injection (up to 12 months or more).
Missed Dose Advice
If more than 13 weeks (or the prescribed interval) have passed since the last injection, exclude pregnancy before administering the next dose. If pregnancy cannot be excluded, use a non-hormonal method of contraception for 7 days after the injection.
Driving Precautions
Medroxyprogesterone Acetate injection is not known to impair the ability to drive or operate machinery. However, if you experience dizziness or fatigue, avoid such activities.
Lifestyle Advice
- Maintain adequate calcium and vitamin D intake through diet or supplements to support bone health.
- Engage in regular weight-bearing exercise to help maintain bone density.
- Avoid smoking, as it can further reduce bone mineral density and increase the risk of cardiovascular events.
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Global Brand Names
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