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Patients with a history of treatment for clinical depression, epilepsy, asthma, migraine, cardiac or renal impairment should be carefully monitored while receiving MPA therapy. The half-life of oral MPA is approximately 17 hours. If bleeding occurs from a poorly proliferative endometrium, estrogens should be used concomitantly with MPA therapy. Pre-treatment and periodic physical examinations should include special reference to blood pressure, breasts, abdomen, and pelvic organs, including cervical cytology.
Lactation: MPA and its metabolites are excreted in breast milk. In a study designed to measure the metabolism of MPA, the results suggest that human cytochrome P 3A4 is primarily involved in the overall metabolism of MPA in human liver microsomes. Each tablet contains medroxyprogesterone acetate 5 mg or 10 mg.
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The unbound MPA modulates pharmacologic responses. Aminoglutethimide administered concomitantly with high doses of oral MPA may significantly depress the serum concentrations of MPA. Specific drug-drug interaction studies evaluating the clinical effects with CYP3A4 inducers or inhibitors on MPA have not been conducted and therefore the clinical effects of CYP3A4 inducers or inhibitors are unknown.
MPA has not been causally associated with the induction of thrombotic or thromboembolic disorders, however, MPA is not recommended in any patient with a history of venous thromboembolism VTE. Cardiovascular Disorders: Estrogens with or without progestins should not be used for the prevention of cardiovascular disease. MPA at high doses is an antifertility drug and high doses would be expected to impair fertility until the cessation of treatment.
Opposition of endometrial effects of estrogen in menopausal women being treated with estrogen Hormone Therapy HT: For women taking 0. Oral doses up to 3 g per day have been well tolerated. Renal Insufficiency: No clinical studies have evaluated the effect of renal disease on the pharmacokinetics of MPA. However, since MPA is almost exclusively eliminated by hepatic metabolism, no dosage adjustment should be necessary in women with renal insufficiency.
In one study, women who use HRT are at increased risk of fatal ovarian cancer. There is no evidence to suggest that this presents any hazard to the nursing child. Administration with food increases the bioavailability of MPA. The half-life of MPA was not changed with food. MPA was not mutagenic in a battery of in vitro or in vivo genetic toxicity assays. Known or suspected malignancy of the breast.
The score line is only to facilitate breaking for ease of swallowing and not to divide into equal doses.
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Common side effects include menstrual disturbances such as absence of periods, abdominal pain, and headaches. MPA was discovered in and was introduced for medical use in the United States in
Authored by Gary Young, MD