Medroxyprogesterone (Medroxyprogesteronum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Antineoplastic hormonal agents and hormone antagonists

"Estrogens, gestagens, their homologues and antagonists"

Included in the formulation
  • Veraplex
    pills inwards 
    Teva Pharmaceutical Enterprises Co., Ltd.     Israel
  • Depo-Provera
    suspension w / m 
    Pfizer IFG Belgium N.V.     Belgium
  • Depo-Provera®
    suspension w / m 
    Pfizer IFG Belgium N.V.     Belgium
  • Medroxyprogesterone-LENS
    suspension w / m 
    LENS-PHARM, LLC     Russia
  • Prover®
    pills inwards 
    Pfizer H.C. Corporation     USA
    • Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):

    ONLS

    VED

    АТХ:

    L.02.A.B.02   Medroxyprogesterone

    L.02.A.B   Progestogens

    Pharmacodynamics:

    Pharmacological action - progestogen, contraceptive, antitumor.

    Inhibits the secretion of gonadotropins by the pituitary gland, prevents the maturation of the follicle and ovulation, promotes the thinning of the endometrium. In high doses with a normal content of estrogen causes the transformation of the proliferative endometrium into a secretory one. Possible manifestation of androgenic and anabolic effects.

    When taken for contraception reduces the risk of inflammatory diseases of the genitals, candidiasis vulvovaginitis. Taking into account the high contraceptive effectiveness and peculiarities of influence on hormone-dependent organs,use in women of late reproductive and older age is preferable, especially in the presence of hyperplastic processes of the endometrium, uterine fibroids, endometriosis. In most women with hyperplastic processes of the endometrium, partial or complete regression is observed. The effectiveness in breast cancer depends on the concentrations of estrogen receptors and progesterone in the tumor tissue.

    Pharmacokinetics:Binding to plasma proteins is 90-95%, half-life - 30 hours Metabolised in the liver. It is excreted mainly by the kidneys in the form of a metabolite.
    Indications:
    Contraception, especially in women of late reproductive age; inoperable, recurrent and metastatic endometrial carcinoma and kidney (additional palliative therapy), hormone-dependent forms of recurrent breast cancer in postmenopausal women.

    Inside - secondary amenorrhea, dysfunctional uterine bleeding, premenstrual syndrome, vasomotor symptoms during menopause, endometriosis, diagnosis of primary and secondary amenorrhea, prevention and treatment of osteoporosis in the postmenopausal period (in combination with estrogens and calcium preparations),prevention of changes in the endometrium during replacement therapy with estrogen in postmenopausal women.
    ICD-10

    II.C50.C50   Malignant neoplasm of breast

    II.C51-C58   Malignant neoplasms of female genital organs

    II.C51-C58.C54   Malignant neoplasm of uterine body

    II.C64-C68.C64   Malignant neoplasm of kidney, except for renal pelvis

    XIV.N80-N98.N80   Endometriosis

    XIV.N80-N98.N91   Absence of menstruation, meager and rare menstruation

    XIV.N80-N98.N93   Other abnormal bleeding from the uterus and vagina

    XIV.N80-N98.N94.3   Premenstrual tension syndrome

    XIV.N80-N98.N95.1   Menopause and menopause in women

    XXI.Z30-Z39.Z30.0   General advice and advice on contraception

    Contraindications:Hypersensitivitythrombophlebitis, thromboembolichistory of a syndrome or a stroke, liver disease, vaginal bleeding, unspecified etiology, pregnancy, breast-feeding (terminate).
    Carefully:With extreme caution medroxyprogestheron should be used in patients with thrombophlebitis, thromboemboliccomplications, severe impairment of liver function, hypercalcemia.
    Pregnancy and lactation:Contraindicated in pregnancy. Does not affect lactation. Is allocated with breast milk in a small amount. The adverse effect of parenteral use of the breast-feeding medroxyprogesterone on the child before reaching pubertal period is not fixed. Possible reduction of bone mineral density in the mother. The potential risk and benefit should be correlated.
    Dosing and Administration:

    Intramuscularly, as a contraceptive and for the removal of vasomotor symptoms during menopause - 150 mg once every 3 months; with endometriosis - 50 mg once a week or 100 mg once every 2 weeks for at least 6 months.

    Intravenously, with endometrial or renal cancer - 400-1000 mg weekly, when the clinical improvement is reached - 400 mg once a month.

    Inside, with endometrial cancer or kidneys - 200-600 mg per day, with breast cancer - 400-1200 mg per day. For the prevention and treatment of osteoporosis in postmenopause - from 12-15th to 25th day of the month, 5-10 mg once a day.

    Side effects:Menstrual irregularities, thromboembolism, insomnia, irritability, drowsiness, fatigue, weakness, depression, dizziness, headache, swelling, nausea,pain and discomfort in the abdomen, breast tenderness, galactorrhea, cervical erosion, hirsutism, alopecia, fever, weight change, lunate face, osteoporosis, urticaria, pruritus, acne, anaphylaxis and anaphylactoid reactions.
    Overdose:Treatment symptomatic.
    Interaction:
    When combined with aminoglutethimide, a decrease in the concentration of medroxyprogesterone in the blood plasma is possible.
    When used simultaneously with drugs that induce the induction of microsomal liver enzymes (carbamazepine, griseofulvin, phenobarbital, phenytoin), it is possible to weaken the contraceptive effect of medroxyprogesterone.
    It is possible to change the effectiveness of hypoglycemic drugs.
    It is possible to suppress the metabolism of cyclosporine, increase its concentration in the blood plasma and increase the risk of toxicity.
    Special instructions:

    When taking medroxyprogesterone, it is possible to change the results of a number of laboratory tests (including functional hepatic tests) - decrease in the level of steroids in blood plasma and urine (progesterone, estradiol, pregnanediol, testosterone, cortisol), gonadotropins, sex hormone binding globulin, T3, an increase in the prothrombin content, factors VII, VIII, IX, X.

    Before using medroxyprogesterone for the treatment of gynecological diseases and contraception, it is necessary to exclude the presence of a tumor of genital organs or mammary glands in the patient.

    When carrying out pathohistological examination of certain organs and tissues, it is necessary to warn the histologist about the previous treatment with progestogens. Against the background of the use of medroxyprogesterone, changes in the results of the following studies are possible: determination of the content of gonadotropins, progesterone, cortisol, testosterone (in men), estrogens (in women) in blood plasma; pregnanediol in the urine; samples with sugar loading; test with metapyron.

    Instructions
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