Indication of Depo Provera:
Depo-Provera can be used in the palliative treatment of recurrent and/or metastatic breast, renal cell or endometrial cancer.It can also be used in the treatment of visually proven endometriosis when pregnancy is the desired treatment outcome, or when surgery is contraindicated or has been unsuccessful.Due to its ovulation-suppressing effects, a high dose of Medroxyprogesterone is also useful as a contraceptive agent. Depo-Provera can be administered every three months for this purpose.
Action of Depo Provera:
Medroxyprogesterone acetate is a hormonal agent that supports pregnancy. It transforms the endometrium (lining of the uterus) into the kind that supports pregnancy, it maintains pregnancy, delays labour/birth and suppresses ovulation. At high doses Depo-Provera can be used to treat certain cancers, where it has corticoid-like activity.
Dose Advice of Depo Provera:
Inoperable/recurrent/metastatic renal cell and endometrial cancer: - Initially 600-1200mg weekly.- 450-600mg every 1-4 weeks for maintenance.Breast cancer: - 500mg daily by IM injection.- Treat for at least 6 months.Endometriosis: - 50mg weekly or 100mg every 2 weeks by IM injection.- Treat for at least 6 months.Contraception: - 150mg every three months by deep IM injection.- Give first injection within 5 days of normal menstrual period.- If the period between injections is greater than 14 weeks, pregnancy needs to be excluded before the next injection.- The 50mg/1ml preparation is NOT to be used for contraception, the 150mg1/ml vial should be used Administration- If volumes larger than 25ml are to be injected, the dose should be divided and multiple sites used, as gluteal infiltration and abscess formation may occur with large doses.- Long term use of cyclical oestrogens with Depo-Provera is not recommended
Schedule of Depo Provera:
S4
Common side effects of Depo Provera:
- Menstrual irregularities.- Prolonged bleeding.- Spotting.- Cessation of periods.- Depression.- Weight gain.- Moderate increase in blood pressure.- Decreased glucose tolerance.Increased appetite: The most commonly reported side effect is an increase in appetite, causing some people to put on weight. Nausea and indigestion: Occasionally nausea is are present for the first few weeks of taking medroxyprogesterone acetate, but often the nausea then disappears. It can usually be relieved by taking the tablets with food and milk.Fluid retention: Some people have experienced mild ankle swelling caused by fluid retention. This is not harmful but can be uncomfortable.Vaginal bleeding (in women): Occasionally women may have some light vaginal bleeding (spotting) while having treatment with medroxyprogesterone acetate.
Uncommon side effects of Depo Provera:
- Nausea.- Vomiting.- Headache.- Dizziness.- Lethargy.- Breast discomfort.- Decreased libido.- Acne.- Backache.- Leg cramps.- Decreased hair growth/hair loss.- Bloating.- Hot flushes.- Nervousness.- Insomnia.- Fatigue.- Tremor.- Hives.- Itching.- Injection site reactions.- Fever.- Changes in vaginal and cervical secretions.
