Medogen

Indications

Tablets:

• abnormal bleeding from the womb caused by a hormone imbalance;
• periods that have stopped for some months (secondary amenorrhoea), after pregnancy and other causes are ruled out;
• endometriosis (womb-lining tissue growing outside the womb);
• with oestrogen in hormone replacement therapy, to protect the lining of the womb.

Injection: long-acting birth control, one injection every 3 months. Higher doses are used by specialists for some cancers (such as cancer of the womb lining or kidney), as prescribed.

How It Works

Medroxyprogesterone Acetate is a man-made progestogen that acts like the natural hormone progesterone. It controls the growth and shedding of the womb lining. As a contraceptive injection, it stops the ovaries from releasing an egg and thickens the mucus at the neck of the womb so sperm cannot pass.

Dosage and Administration

Tablets, abnormal bleeding or stopped periods: usually 2.5 mg to 10 mg a day for 5 to 10 days of each cycle, as prescribed. Endometriosis and hormone replacement therapy: as prescribed.

Contraceptive injection: 150 mg into a deep muscle every 12 to 13 weeks, given by a doctor or nurse. The first injection is usually given within the first 5 days of a period.

Cancer treatment: only as prescribed by a specialist.

If a tablet dose is missed, take it when you remember unless the next dose is near. If an injection is more than 1 week late, use condoms and ask your doctor; a pregnancy test may be needed.

Interactions

• Medicines that speed up liver enzymes, such as Rifampicin, Carbamazepine and Phenytoin, may reduce the effect of the tablets.
• Blood thinners and diabetes medicines may need closer monitoring.

Tell your doctor about all medicines and herbal products you take.

Contraindications

• Known or suspected pregnancy
• Vaginal bleeding without a known cause
• Breast cancer or other hormone-sensitive cancer (unless it is being used to treat a cancer)
• Severe liver disease or liver tumour
• Current or past blood clots, stroke or heart attack (especially for tablets and high doses)
• Allergy to Medroxyprogesterone Acetate

Side Effects

Common: irregular bleeding or spotting, periods stopping (common with the injection), weight gain, breast tenderness, headache, mood changes, bloating, acne and nausea.

With long-term injection use, bones can become thinner; this mostly recovers after stopping. Fertility may take up to a year or more to return after the last injection.

Get medical help at once for pain or swelling in one leg, chest pain or sudden breathlessness, a sudden severe headache or problems with sight or speech, yellowing of the skin or eyes, very heavy bleeding, severe low mood, or swelling of the face and trouble breathing.

Pregnancy and Lactation

It must not be used during pregnancy. If you think you are pregnant, stop and see your doctor. The contraceptive injection can be used while breastfeeding, usually starting 6 weeks after the birth; only small amounts pass into the milk. For tablets, ask your doctor.

Precautions and Warnings

• Because of bone thinning, the injection is usually reviewed after 2 years of use. Enough calcium, vitamin D and exercise help bones.
• Tell your doctor if you have depression, diabetes, migraine, epilepsy, asthma, or heart or kidney disease.
• It does not protect against sexually transmitted infections.

Overdose

Serious effects are unlikely. Too much may cause nausea or vaginal bleeding. Contact a doctor for advice.

Therapeutic Class

Progestogen (female sex hormone) and hormonal contraceptive.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Do not freeze the injection.