WARNINGS
CARDIOVASCULAR AND OTHER RISKS
Estrogens with progestins should not be used for the prevention of cardiovascular disease or dementia. (See CLINICAL STUDIES and WARNINGS, Cardiovascular disorders and Dementia.)
The Women's Health Initiative (WHI) estrogen plus progestin substudy reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis (DVT) in postmenopausal women (50 to 79 years of age) during 5.6 years of treatment with daily oral conjugated estrogens (CE 0.625 mg) combined with medroxyprogesterone acetate (MPA 2.5 mg) relative to placebo. (See CLINICAL STUDIES and WARNINGS, Cardiovascular disorders and Malignant neoplasms, Breast cancer.)
The Women's Health Initiative Memory Study (WHIMS), a substudy of the WHI study, reported increased risk of developing probable dementia in postmenopausal women 65 years of age or older during 4 years of treatment with daily CE 0.625 mg combined with MPA 2.5 mg, relative to placebo. It is unknown whether this finding applies to younger postmenopausal women. (See CLINICAL STUDIES and WARNINGS, Dementia, and PRECAUTIONS, Geriatric Use.)
In the absence of comparable data, these risks should be assumed to be similar for other doses of CE and MPA and other combinations and dosage forms of estrogens and progestins. Because of these risks, estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.
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PROVERA SUMMARY
PROVERA Tablets contain medroxyprogesterone acetate, which is a derivative of progesterone. It is a white to off-white, odorless crystalline powder, stable in air, melting between 200 and 210°C. It is freely soluble in chloroform, soluble in acetone and in dioxane, sparingly soluble in alcohol and in methanol, slightly soluble in ether, and insoluble in water.
PROVERA Tablets are indicated for secondary amenorrhea and for abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology, such as fibroids or uterine cancer. PROVERA Tablets are also indicated to reduce the incidence of endometrial hyperplasia in nonhysterectomized postmenopausal women receiving 0.625 mg conjugated estrogen.
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NEWS HIGHLIGHTS
Published Studies Related to Provera (Medroxyprogesterone)
Elagolix, an oral GnRH antagonist, versus subcutaneous depot medroxyprogesterone
acetate for the treatment of endometriosis: effects on bone mineral density. [2014] This randomized double-blind study, with 24-week treatment and 24-week
posttreatment periods, evaluated the effects of elagolix (150 mg every day, 75 mg
twice a day) versus subcutaneous depot medroxyprogesterone acetate (DMPA-SC) on
bone mineral density (BMD), in women with endometriosis-associated pain (n =
252)...
A four week randomised control trial of adjunctive medroxyprogesterone and
tamoxifen in women with mania. [2014] Emerging research has suggested that hormone treatments such as selective
oestrogen receptor modulators (SERMs) or progestins may be useful in the
treatment of mania. The current pilot study compared the use of the SERM
tamoxifen and the progestin medroxyprogesterone acetate (MPA), as an adjunct to
mood stabiliser medications, for the treatment of mania symptoms in 51 women in a
28-day double blind, placebo controlled study...
Differential effects of estrogen and micronized progesterone or medroxyprogesterone acetate on cognition in postmenopausal women. [2011.08] OBJECTIVE: To investigate possible differential effects of the coadministration of conjugated equine estrogen (CEE) and a placebo (CEE + PL), CEE and medroxyprogesterone acetate (CEE + MPA), or CEE and micronized P (CEE + MP) on aspects of cognitive functioning in naturally postmenopausal women...
Effects of percutaneous estradiol-oral progesterone versus oral conjugated equine estrogens-medroxyprogesterone acetate on breast cell proliferation and bcl-2 protein in healthy women. [2011.03.01] In a prospective, randomized clinical study 77 women were assigned randomly to receive sequential hormone therapy with either conventional oral conjugated equine estrogens (0.625 mg) with the addition on 14 of the 28 days of oral medroxyprogesterone acetate (5 mg) or natural E(2) gel (1.5 mg) with oral micronized P (200 mg) on 14 of the 28 days of each cycle.
Differential effects of estrogen and micronized progesterone or
medroxyprogesterone acetate on cognition in postmenopausal women. [2011] OBJECTIVE: To investigate possible differential effects of the coadministration
of conjugated equine estrogen (CEE) and a placebo (CEE + PL), CEE and
medroxyprogesterone acetate (CEE + MPA), or CEE and micronized P (CEE + MP) on
aspects of cognitive functioning in naturally postmenopausal women... These findings need to be
replicated with a larger sample size before their potential clinical implications
can be determined.
Clinical Trials Related to Provera (Medroxyprogesterone)
Pilot Study of Femring Estrogen Supplementation During Depo-Provera Initiation [Completed]
Many women choose Depo-Provera for birth control because it is easy to use and very
effective. However, a significant number of Depo-Provera users experience irregular bleeding
during the first 90 days. Many users discontinue after their first injection due to
irregular bleeding. This study will evaluate the effect of using an estrogen vaginal ring
during the first 90 days of Depo-Provera use to see if it is acceptable to women and whether
it decreases irregular bleeding during the first 90 days of use and increases continuation
to a second injection.
Depo Provera Self-Administration Study: Putting a Patient-Centered Practice to the Test at Planned Parenthood [Not yet recruiting]
This randomized clinical trial will study subcutaneous depot medroxyprogesterone acetate
(DMPA sc) self-administration at two Planned Parenthood affiliates serving diverse patient
populations. Prior studies demonstrate that DMPA self-injection is safe, effective,
feasible, and acceptable for women and adolescents. A total of 400 female patients (ages
15-44) requesting DMPA will be randomized to self-administration of DMPA sc or clinic
administration (usual care). Subjects will be followed for one year. The primary study
outcome is DMPA continuation at one year by self-report in both study arms. Secondary
outcomes include patient-reported satisfaction with treatment; satisfaction with home use;
and costs associated with contraceptive care. The investigators hypothesize higher
continuation rates among self-injection users compared to patients who receive standard
care. Secondary exploratory hypotheses include higher patient satisfaction and lower costs
associated with contraceptive care among self-injection users.
Pharmacokinetic Interactions Between DMPA and LPV/Rit Among HIV-Infected Women [Completed]
This study is being done to look at the level of Depo-Provera, an injectable birth control,
in the blood to see whether it is affected by the anti-HIV drug Kaletra (lopinavir/ritonavir
[LPV/r]). It is not known whether taking Depo-Provera together with Kaletra changes the
amount of Kaletra in blood. Therefore, this study will also look at the levels of HIV and
Kaletra before and after receiving a shot of Depo-Provera. This study will take a look at
the safety of Depo-Provera and Kaletra when they are used together. In addition to what is
stated above, this study will also explore any effect of Depo-Provera on the immune system.
Timing of Postpartum Depot Medroxyprogesterone Acetate Administration on Breastfeeding, Contraceptive Continuation, and Depression [Recruiting]
In the United States, depot medroxyprogesterone acetate (DMPA) is given to women after
delivery and before hospital discharge with the belief that women who delay starting DMPA
may be more likely to become pregnant when they are not yet ready to be pregnant and that
giving DMPA before discharge has little to no negative effect on breastfeeding.
Administering DMPA to breastfeeding women has not been widely questioned because the limited
existing studies do not show any adverse impact of DMPA on breastfeeding. However, these
studies used inappropriate control groups and did not control for prior lactation
experience.
The investigators plan to enroll 184 women who are planning to breastfeed and use DMPA after
delivery to find out whether the timing of postpartum administration of DMPA (prior to
hospital discharge or 4-6 weeks after delivery) affects the duration or exclusivity of
breastfeeding among women who plan to breastfeed their infants. The investigators will also
look at rates of use of highly effective contraception (defined as DMPA, intrauterine
device, implant, sterilization, or lactational amenorrhea) and postpartum depression.
Medroxyprogesterone +/- Cyclophosphamide & Methotrexate in Hormone Receptor-Negative Recurrent/Metastatic Breast Cancer [Completed]
The purpose of this study is to evaluate the impact of MPA alone and in combination with low
dose oral chemotherapy in patients with ER- and PR- advanced breast cancer.
Reports of Suspected Provera (Medroxyprogesterone) Side Effects
Breast Cancer Female (84),
Depression (31),
Breast Cancer (31),
Breast Cancer Metastatic (23),
Anxiety (21),
Drug Ineffective (14),
Pain in Extremity (12),
Breast Mass (9),
Insomnia (9),
Abdominal Pain (8), more >>
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PATIENT REVIEWS / RATINGS / COMMENTSBased on a total of 5 ratings/reviews, Provera has an overall score of 6.40. The effectiveness score is 7.60 and the side effect score is 6.80. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.
| Provera review by 46 year old female patient | | Rating |
Overall rating: | |           |
Effectiveness: | | Considerably Effective |
Side effects: | | Mild Side Effects | | Treatment Info |
Condition / reason: | | irregular menses |
Dosage & duration: | | 10 mg taken 12 days/month for the period of 6 months |
Other conditions: | | none |
Other drugs taken: | | none | | Reported Results |
Benefits: | | The treatment benefits of taking Provera were very good. I had very irregular menses that lasted for long periods of time. By taking the Provera day 15-26 of my cycle my periods began to normalize and become regular again. |
Side effects: | | The only side effects I noticed were during the first two days or so of taking Provera I was more tired than usual. I also noticed I felt more bloated than when I was not taking it. |
Comments: | | On day 15 of my cycle I took the Provera 10 mg for 12 days and then stopped to promote a period. It took a couple of cycles for this to become effective, but utilizing the drug in this manner did take care of the problem of irregular bleeding in between periods. |
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| Provera review by 53 year old female patient | | Rating |
Overall rating: | |           |
Effectiveness: | | Considerably Effective |
Side effects: | | Moderate Side Effects | | Treatment Info |
Condition / reason: | | heavy menses |
Dosage & duration: | | 10 mg taken 1 per day for the period of 4 months |
Other conditions: | | none |
Other drugs taken: | | none | | Reported Results |
Benefits: | | It did control my periods. Other benefits included a mild feeling of well being and return to health. |
Side effects: | | spotting, some mild depression, not unlike PMS symptoms when younger. There was some cramping and some spotting. |
Comments: | | following an episode of a 2 month long period with episodes of very heavy flow, doctor prescribed the Provera to regulate period until menopause resulted in the cessation of menses. |
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| Provera review by 26 year old female patient | | Rating |
Overall rating: | |           |
Effectiveness: | | Marginally Effective |
Side effects: | | Severe Side Effects | | Treatment Info |
Condition / reason: | | hormones |
Dosage & duration: | | 50mg taken 2 times dailey for the period of 3 monts |
Other conditions: | | none |
Other drugs taken: | | clomid | | Reported Results |
Benefits: | | resume ovulation and maintain hormonal balance |
Side effects: | | Horrible mood swings, crying episodes, confusion. |
Comments: | | In order to correct Polycystic ovarian syndrom and to get pregnant I was given Progestin and clomid to resume ovulation. I would NEVER* take either of these synthetics again! I was a basketcase with mood swings, crying, depression etc.. and once I discontinued use I was able to return to a normal mental state. I used this for over 3 months while my poor family suffered, never recieving the results I hoped for. I achieved results only when I went natural and used a natural progetserone cream from AIM made with wild yam and instead of horrific side effects I had pleasant ones...my acne cleared, my insomnia got better and my overall mood was improved, 3 months later I was pregnant! I will always try herbal before synthetics from now on. |
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Page last updated: 2015-08-10
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