Drug reference

medroxyprogesterone acetate

Synthetic Progestin (Pregnane) · Contraceptive; Sex Hormone

Synthetic Progestin (Pregnane)Contraceptive; Sex HormoneATC null

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

FDA category + note

Top interactionssee all 12 →

AcitretinSevereDatabaseDDInter
AmprenavirSevereDatabaseDDInter
BexaroteneSevereDatabaseDDInter
BoceprevirSevereDatabaseDDInter

Mechanism

Medroxyprogesterone acetate is a C21 steroid with selective progestational effects similar to progesterone. It is thought to exert contraceptive effects by preventing ovulation (at high plasma levels) and by altering cervical mucus and the endometrium. It may decrease the favorable HDL increase caused by conjugated estrogens.

Indications

menopausal hormone therapylong-acting injectable contraceptiveprevention or arrest of preterm labortreatment for breakthrough uterine bleeding (gender transition)Management of advanced-stage endometrial carcinoma (particularly in low-grade tumors)Metastatic hormone-dependent breast cancerHormone replacement therapy (adjuvant to estrogens)Dysfunctional uterine bleedingContraceptionEndometrial carcinomaHot flashes in women

Dosing

Adult: 10 mg/day (with estrogen for sexual maturation induction); 104 mg (SC, as depot MPA); 150 mg (IM, as depot MPA); 150 mg every 3 months (for breakthrough uterine bleeding in gender transition); 250 mg weekly (intramuscularly for prevention of preterm birth)

Pharmacokinetics

Protein binding

primarily to albumin

Contraindications

undiagnosed vaginal bleeding
benign or malignant liver disease
known or suspected breast cancer
Use for diagnosis of pregnancy
Early pregnancy (can cause masculinization of female foetus and other congenital abnormalities)
Long-term HRT (may increase risk of breast cancer)

Side effects

Common

headachemood changesweight gainirregular, unpredictable spotting and breakthrough bleedingHot flashesDepressionAmenorrheaWeak androgenic propertyAntiestrogenic propertyBreast engorgement (with higher doses)Headache (with higher doses)Rise in body temperature (with higher doses)Edema (with higher doses)Esophageal reflux (with higher doses)Acne (with higher doses)Mood swings (with higher doses)Complete disruption of menstrual bleeding pattern or total amenorrhoea (more common with DMPA)

Serious

decreased bone density
decreases HDL levels
increases LDL levels
Bone loss (with long-term use)
Masculinization of female foetus and other congenital abnormalities (if given in early pregnancy)
Long-term use in HRT may increase the risk of breast cancer
Blood sugar may rise and diabetes may be precipitated by long-term use
Bone mineral density may decrease after 2–3 years of use (especially with DMPA)

Pregnancy & lactation

Pregnancy

Drug interactions

Acitretin

Severe

Database

Clinical effect not specified

Source: DDInter

Amprenavir

Severe

Database

Drug interaction classified as: others

Source: DDInter

Bexarotene

Severe

Database

Drug interaction classified as: metabolism

Source: DDInter

Boceprevir

Severe

Database

Drug interaction classified as: metabolism

Source: DDInter

Bosentan

Severe

Database

Decreased plasma concentrations and efficacy of medroxyprogesterone acetate, leading to potential breakthrough bleeding or reduced contraceptive efficacy.

Consider alternative or additional contraceptive methods. Monitor for reduced efficacy.

Source: DDInter

Brigatinib

Severe

Database

Drug interaction classified as: metabolism

Source: DDInter

Dabrafenib

Severe

Database

Clinical effect not specified

Source: DDInter

Encorafenib

Severe

Database

Clinical effect not specified

Source: DDInter

Fosamprenavir

Severe

Database

Clinical effect not specified

Source: DDInter

Griseofulvin

Severe

Database

Decreased plasma concentrations and efficacy of medroxyprogesterone acetate, leading to potential breakthrough bleeding or reduced contraceptive efficacy.

Consider alternative or additional contraceptive methods during and for at least 4 weeks after stopping griseofulvin. Monitor for reduced efficacy.

Source: DDInter

Lumacaftor

Severe

Database

Clinical effect not specified

Source: DDInter

Mycophenolate Mofetil

Severe

Database

Clinical effect not specified

Source: DDInter