Apo-Medroxy

Medroxyprogesterone is a generic drug that is available under various brand names, including Provera and Amen. These brand names indicate specific formulations of Medroxyprogesterone, which is commonly used for treating abnormal menstrual bleeding and restores normal menstrual periods in women that have been stopped for several months (amenorrhea). The medication can also be used in combination hormone replacement therapy with estrogens, reducing menopause symptoms, including hot flashes. Patients are advised to take the medicines as instructed by their doctors. Make sure to inform your medical provider about any medical history you have, as the lack of information can result in complications that can be life-threatening.

Medroxy, containing the active ingredient medroxyprogesterone acetate, is a prescription medication widely used to treat conditions associated with hormonal imbalance, like irregular menstrual periods and endometriosis. Medroxyprogesterone acetate is a synthetic form of the naturally occurring hormone progesterone, which plays a crucial role in managing the menstrual cycle and maintaining pregnancy. This medication is FDA-approved and has been tested to ensure its safety and effectiveness in regulating these conditions.

Medroxy is available in various tablet and injection forms, each with different strengths. It should be taken exactly as prescribed by a healthcare provider, usually once daily, at the same time each day, to maintain consistent hormone levels. This medication is suitable for women experiencing hormonal imbalances, and it works by mimicking the effects of natural progesterone, thereby regulating ovulation and menstrual cycles.

Common side effects of Medroxy may include nausea, headache, breast tenderness, and mood changes. It is crucial to follow your medical provider’s advice regarding the use of this medication to minimize side effects. Patients should inform their medical provider of any other medications they are taking and any pre-existing conditions. If a dose is missed or skipped, it should be taken as soon as remembered unless it is close to the time for the next dose; in such a situation, skip the missed dose. Overdose symptoms should be reported immediately to a healthcare provider. Medroxy should be stored at a specific temperature, away from moist places and heat, and out of reach of children.

Here are the common uses of Medroxyprogesterone:

• It is used as a long-acting contraceptive injection. For example, Depo-Provera.
• It helps in managing heavy or irregular menstrual bleeding.
• It prevents the excessive growth of the uterine lining.
• It can be used as a part of HRT or hormone replacement therapy to relieve menopausal symptoms.
• It can be used to reduce the risk of uterus cancer.

Strengths and Forms

Medroxyprogesterone is available in various forms and strengths. These are as follows:

• Oral Tablet: 2.5, 5, and 10 mg
• Intramuscular Injection: 150, and 400 mg/mL
• Prefilled Syringe Suspension: 104 mg/0.65 mL

Recommended Medroxy Dosage for Different Patients

For Period Problems

• The usual daily dose of Medroxy for period problems or heavy bleeding is 2.5 mg to 10 mg once daily. Continue the dosing schedule for 5 to 10 days during the menstrual cycle. Take the medicine for 2 or 3 cycles, starting 16 to 21 days after the beginning of the last period. Consult a medical professional; they will instruct you when to start your medication and the duration of the treatment.

For Endometriosis

• Take 10 mg thrice daily for 3 months, starting on the first day of your period.

For Polycystic Ovary Syndrome

• If you have infrequent periods or do not have them, take 10 mg of Medroxy each day for 14 days, every 1 to 3 months.

For Menopausal Symptoms

• Your medical provider will decide on the dosage. Generally, it is advised to take medicine for part of each 28-day HRT cycle.

For Cancer

• Doses can differ based on the type of cancer a patient might have. A medical professional will determine the appropriate dose.

For Contraception

• Intramuscular Injection: If the patients are taking the medication for contraception, it is advised to take 150 mg once every 3 months in the gluteal or deltoid muscle. 
• Subcutaneous Injection: Take 104 mg once every 3 months into the anterior thigh or abdomen. 

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

• Before taking this medication, make sure you have carefully read the patient information leaflet the pharmacist gave you.
• Follow your doctor’s instructions and take the medicines accordingly.
• Take the tablets by mouth, with or without food, as directed by your healthcare provider.
• If you are using this medicine as a part of hormone replacement therapy, take it once a day for the number of days prescribed by your doctor.
• Do not exceed or subceed the number of doses unless directed otherwise.
• For the treatment of stopper periods and abnormal bleeding, take this medicine once a day for 5 to 10 days during the second half of the regular menstrual cycle.
• Withdrawal bleeding generally takes place within 3 to 7 days once you stop taking the medicines. If the condition does not improve, talk to your medical practitioner immediately.
• If you are using tablets, try to swallow them as a whole.
• Do not crush, chew, or even break them.
• If you are unable to swallow your tablets, you can ask your doctor about the alternate options.
• Take your medicines at the same time each day to get the most benefit out of it.
• If you are taking your tablets 3 times a day, try to keep a space between each dose throughout the day.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

Medroxy works by replacing the hormone progesterone that the body is unable to make. This hormone helps regulate the menstrual cycle. Its active ingredient, medroxyprogesterone acetate, binds to progesterone receptors in the body, which stabilizes the lining of the uterus, prevents overgrowth, and regulates periods. By balancing hormone levels, the medication helps manage conditions like irregular menstrual cycles and endometriosis, providing relief from symptoms and promoting normal reproductive function.

Common side effects of Medroxy may include:

• Nausea
• Headache
• Irregular bleeding
• Spotting between periods
• Breast tenderness
• Weight gain
• Depression
• Feeling nervous
• Insomnia
• Higher body temperature
• Dizziness
• Tiredness
• Itchy skin
• Acne
• Hair loss
• Changes in vaginal discharge
• Changes in menstrual cycle
• Vaginal itching
• Bloating

Serious side effects of Medroxy may include:

• Swelling, pain, or redness in a leg or arm
• Allergic reactions
• Sudden numbness
• Slurred speech
• Vision changes
• Loss of balance
• Chest pain
• Difficulty in breathing
• Blood cough
• Excessive sweating
• Not feeling hungry
• Upper stomach pain
• Fever
• Dark urine
• Clay-colored stools
• Jaundice
• Unusual vaginal bleeding
• Confusion
• Memory problems
• Breast lump
• Sleep problems
• Mood changes

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

• Visual Abnormalities: It is highly likely that the use of Medroxy can cause visual abnormalities. If you are experiencing partial or complete loss of vision or noticing a sudden onset of proptosis and migraine, discontinue its use and consult your doctor for expert guidance.
• Ovarian Cancer: The estrogen plus progestin substudy observed that the daily use of CE/MPA for the long term raises the risk of ovarian cancer. Talk to your medical practitioner before starting your treatment.
• Venous Thromboembolism: Women using the combination of CE (estrogen) and MPA (progestin) have an increased risk of VTE. Discuss every risk and benefit with your healthcare provider to prevent any complications.
• Increased Blood Pressure: Women undergoing hormone replacement therapy may experience high blood pressure. Therefore, patients are advised to closely monitor their blood pressure levels when using HRT.

Medroxy Boxed Warning

• Bone Mineral Density Loss: Women who use Medroxy injections, either intramuscular or subcutaneous, may experience significant bone mineral density loss over time. The risks are higher with continuous usage, and the effects can not be reversed even if you stop the injections. It is not known whether SC or IM use during adolescence might impact peak bone mass or increase the risk of osteoporotic fracture in the future. Therefore, long-term use (more than 2 years) of IM or SC is not advised for endometriosis pain.
• Cardiovascular Risks: It is usually recommended not to take estrogens with progestins to prevent cardiovascular diseases. Studies have noticed high chances of invasive breast cancer, myocardial infarction, stroke, pulmonary embolism, and DVT in postmenopausal women within the age group of 50-79 years. This group includes women who have been undergoing treatment for over 5.6 years with oral conjugated estrogens and medroxyprogesterone acetate.
• Dementia Risks: The combination of estrogens and progestins is not recommended for the prevention of dementia. This usage can increase the risk of dementia in postmenopausal women within the age group of 65 years and older. This group includes women who have been undergoing treatment with CE and MPA for the last 4 years.

• Make sure to inform your doctor about any allergies you may have or if you are allergic to any of the medication’s ingredients. Some brands of this medication may include certain inactive ingredients like soybean which can result in severe allergic reactions. Therefore, people who have peanut allergies may also have soy allergies. Be cautious while taking this medication.
• Before starting your treatment with this medication, tell the professionals about your medical history, especially of:
  • Liver problems
  • Blood clots
  • Breast cancer
  • Vaginal bleeding
  • Brain bleeding
  • Missed abortion
  • Kidney disease
  • Obesity
  • Diabetes
  • Increased blood pressure
  • Seizures
  • Migraine
  • Asthma
  • High cholesterol
  • Depression
  • Strokes
  • Smoking
• Avoid drinking alcohol or marijuana, as the drug can make you dizzy. In such situations, patients are advised not to drive or operate any machinery that requires alertness.
• If you are undergoing any surgery or medical procedure, tell the medical professionals about every product you are using. This may include all prescription drugs, nonprescription drugs, and herbal products.
• Medroxy may cause darkness on the face and skin, commonly known as melasma. This condition can get worse with sunlight exposure. Therefore, limit your outdoor activities during the day and avoid tanning booths and sunlamps. Use protective measures like sunscreen and full clothing when going outdoors.
• Using this medication during pregnancy can cause harm to the fetus. So, if you are pregnant or planning to become one, discuss the risks with your medical provider to avoid any complications in the future.
• If you are a breastfeeding mother, avoid using Medroxy as the drug can pass into the breast milk and may cause harmful effects to the infant. Consult your medical provider before breastfeeding your child.

Medroxyprogesterone is contraindicated in patients who have:

• Hypersensitivity to the drug or any of the product’s ingredients.
• Liver diseases or liver function tests have failed to return to normal.
• Estrogen-dependent or progestin-dependent infectious neoplasia, like endometrial cancer, unless the medication is used as a treatment of breast cancer.
• Suspected or history of breast cancer, unless Apo-Medroxy is used for the treatment of breast cancer in postmenopausal women.
• Abnormal genital bleeding.
• Suspected or known pregnancy.
• Suspected or history of arterial thromboembolic diseases, including coronary heart disease, stroke, or myocardial infarction.
• Suspected or history of venous thromboembolism, including pulmonary embolism, deep vein thrombosis, or active thrombophlebitis.
• Partial or complete vision loss caused by ophthalmic vascular disease.

Generally, patients are advised to follow their prescription labels and not miss any dose of the medication. But if someone has mistakenly skipped a dose or two of their medication, they can:

• Take the missed dose as soon as possible or whenever they remember.
• If the time is near for a new dose, patients can skip the missed dose and take the new one as per their regular dosing schedule.
• Remember not to take double doses to catch up on the missed one.
• Patients can use medication apps or set reminders on the phone to avoid missing any doses.
• For expert guidance, they can ask their doctor.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

If someone has taken an overdose of Medroxy and is experiencing symptoms like depressed mood, tiredness, acne, or hirsutism, they should call their medical practitioner immediately. In female patients, overdose may cause amenorrhea of a variable length, along with irregular menstrual for several cycles. In such cases, do not panic and take preventive measures by getting medical help or calling 911.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

• Store the medication at a room temperature of 15° – 30°C,
• Keep these medicines somewhere safe that is out of reach and in sight of children.
• Store your medication in a tightly closed container.
• Make sure that the medications are away from heat and moisture.
• Do not keep them under direct sunlight.
• Keep them from freezing.
• Avoid storing outdated medications.
• Discard the medicine when not in use, but do not flush it down the toilet.
• Do not keep your medication in damp areas like the bathroom or near the sink.
• Ask your doctor or pharmacist how you should dispose of the product when not in use or expired.
• Lastly, read the product’s label for detailed storage instructions.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Here is a list of drugs that can interact with Medroxy and cause severe reactions:

• Amprenavir
• Acitretin
• Belzutifan
• Bosentan
• Brigatinib
• Bexarotene
• Boceprevir
• Clarithromycin
• Dabrafenib
• Etretinate
• Fosamprenavir
• Griseofulvin
• Mavacamten
• Mobocertinib
• Mycophenolate mofetil
• Mycophenolic acid
• Omaveloxolone
• Pexidartinib
• Repotrectinib
• Sugammadex
• Telaprevir
• Telithromycin
• Topiramate
• Tranexamic acid
• Troleandomycin
• Efavirenz
• Elagolix
• Elvitegravir
• Isotretinoin
• Ivosidenib
• Lesinurad
• Lorlatinib
• Theophylline
• Ulipristal

[Note: This isn’t a complete list, and there could be other drugs that interact with Medroxy. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

• Norethindrone
• Megestrol
• Sprintec
• Premarin
• Ethinyl estradiol/levonorgestrel
• Aviane
• Seasonique
• Mirena
• Lo Loestrin Fe
• Nexplanon
• Nuvaring
• Depo Provera
• Orilissa
• Lupron Depot
• Progesterone
• Zoladex
• Danazol
• Desogestrel / ethinyl estradiol
• Prometrium
• Endometrin
• Crinone

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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