Provera
Generic Name
Medroxyprogesterone Acetate 150 mg Injection
Manufacturer
Pfizer
Country
USA
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| provera 150 mg injection | ৳ 45.00 | N/A |
Description
Overview of the medicine
Provera 150 mg injection contains Medroxyprogesterone Acetate, a synthetic progestin hormone. It is primarily used as a long-acting contraceptive and for the management of certain gynecological conditions.
Uses & Indications
Dosage
Adults
Contraception: 150 mg intramuscularly every 3 months (13 weeks). Other indications may require different dosing schedules or strengths.
Elderly
No specific dosage adjustment for elderly women, but caution should be exercised in those with impaired liver or renal function.
Renal_impairment
No specific dosage adjustment required for mild to moderate renal impairment. Use with caution in severe renal impairment.
How to Take
Administer by deep intramuscular injection into the gluteal or deltoid muscle. Do not massage the injection site, as this may reduce absorption and efficacy. Ensure the patient is not pregnant before the first injection and subsequent injections if overdue.
Mechanism of Action
Medroxyprogesterone Acetate (MPA) acts by inhibiting gonadotropin secretion (FSH and LH) from the pituitary gland, thereby preventing ovulation. It also causes thickening of cervical mucus, making it difficult for sperm to penetrate, and thins the uterine lining (endometrium), making it unsuitable for implantation.
Pharmacokinetics
Onset
Contraceptive effect within 24 hours if given during the first 5 days of a normal menstrual cycle.
Excretion
Mainly via urine and feces as metabolites.
Half life
Approximately 50 days (range 30-160 days) after a single IM dose of 150 mg.
Absorption
Well absorbed after intramuscular (IM) injection, with peak plasma concentrations reached within 3 weeks.
Metabolism
Extensively metabolized in the liver via hydroxylation and conjugation, primarily by CYP3A4 enzymes.
Side Effects
Contraindications
- Known or suspected pregnancy
- Undiagnosed abnormal uterine bleeding
- Known or suspected breast cancer or other hormone-sensitive malignancies
- Active thrombophlebitis or history of thromboembolic disorders
- Severe liver disease
- Hypersensitivity to Medroxyprogesterone Acetate or any component of the injection
Drug Interactions
Aminoglutethimide
May significantly decrease the plasma concentrations of MPA, potentially reducing its contraceptive efficacy.
HIV protease inhibitors
Some interactions possible, consult prescribing information.
CYP3A4 Inducers (e.g., Carbamazepine, Phenytoin, Rifampin, St. John's Wort)
May increase the metabolism of MPA, leading to lower plasma levels and reduced efficacy.
Storage
Store at controlled room temperature (20-25°C). Protect from light. Do not refrigerate or freeze. Keep out of reach of children.
Overdose
No specific antidote exists for overdose. Management should be symptomatic and supportive.
Pregnancy & Lactation
Pregnancy: Provera 150 mg injection is contraindicated in pregnancy (Pregnancy Category X). Lactation: MPA and its metabolites are excreted in breast milk. While generally considered compatible with breastfeeding after the initial postpartum period, caution is advised, and a doctor should be consulted.
Side Effects
Contraindications
- Known or suspected pregnancy
- Undiagnosed abnormal uterine bleeding
- Known or suspected breast cancer or other hormone-sensitive malignancies
- Active thrombophlebitis or history of thromboembolic disorders
- Severe liver disease
- Hypersensitivity to Medroxyprogesterone Acetate or any component of the injection
Drug Interactions
Aminoglutethimide
May significantly decrease the plasma concentrations of MPA, potentially reducing its contraceptive efficacy.
HIV protease inhibitors
Some interactions possible, consult prescribing information.
CYP3A4 Inducers (e.g., Carbamazepine, Phenytoin, Rifampin, St. John's Wort)
May increase the metabolism of MPA, leading to lower plasma levels and reduced efficacy.
Storage
Store at controlled room temperature (20-25°C). Protect from light. Do not refrigerate or freeze. Keep out of reach of children.
Overdose
No specific antidote exists for overdose. Management should be symptomatic and supportive.
Pregnancy & Lactation
Pregnancy: Provera 150 mg injection is contraindicated in pregnancy (Pregnancy Category X). Lactation: MPA and its metabolites are excreted in breast milk. While generally considered compatible with breastfeeding after the initial postpartum period, caution is advised, and a doctor should be consulted.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Varies by manufacturer, typically 2-3 years. Refer to the product label for exact expiry date.
Availability
Available in hospitals, clinics, and pharmacies
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of Medroxyprogesterone Acetate for its approved indications, including contraception and management of gynecological disorders.
Lab Monitoring
- Regular blood pressure monitoring.
- Bone mineral density (BMD) assessment for long-term users (over 2 years).
- Liver function tests if clinically indicated.
Doctor Notes
- Thoroughly counsel patients on the benefits and risks, especially regarding potential bone mineral density loss and delayed return to fertility.
- Always confirm non-pregnancy before administering the first dose and subsequent doses if the patient is overdue for an injection.
- Monitor for signs of depression, thromboembolic events, and allergic reactions.
- Consider alternative contraception or methods for patients with significant risk factors for osteoporosis or those planning pregnancy soon.
Patient Guidelines
- Understand that this is a long-acting contraceptive and regular injections are crucial for efficacy.
- Report any unusual or severe side effects, especially signs of blood clots or severe depression.
- Discuss bone health with your doctor, particularly if you have risk factors for osteoporosis or plan long-term use.
- Use backup contraception if an injection is missed or delayed beyond 13 weeks.
- This injection does not protect against HIV/AIDS or other sexually transmitted infections.
Missed Dose Advice
If more than 13 weeks have passed since the last injection, use an alternative non-hormonal contraceptive method immediately and contact a healthcare professional. A pregnancy test may be required before the next injection.
Driving Precautions
Provera 150 mg injection may cause dizziness or lightheadedness in some individuals. Caution is advised when driving or operating machinery until you know how the medication affects you.
Lifestyle Advice
- Maintain a healthy diet rich in calcium and vitamin D, and engage in weight-bearing exercise to support bone health.
- Avoid smoking, as it may increase the risk of cardiovascular adverse effects.
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