Medroxyprogesterone Acetate: Brands, Price & Uses in Bangladesh

Medroxyprogesterone Acetate is a synthetic progestin used for the following indications, classified by strength of evidence:

Established / FDA-approved uses

• Contraception: the injectable (depot) suspension of Medroxyprogesterone Acetate is approved for prevention of pregnancy in women of reproductive potential.
• Secondary amenorrhea: oral Medroxyprogesterone Acetate is indicated for treatment of secondary amenorrhea due to hormonal imbalance, in the absence of pathologic causes such as uterine fibroids or uterine cancer.
• Abnormal uterine bleeding: oral Medroxyprogesterone Acetate is indicated for treatment of abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology (e.g. fibroids, polyps, malignancy).
• Endometrial hyperplasia prevention: Medroxyprogesterone Acetate is used as adjunctive/combination therapy with estrogen replacement in postmenopausal women who have an intact uterus, to reduce the risk of estrogen-induced endometrial hyperplasia (this use requires combination with estrogen; it is not effective alone for this purpose).

Guideline-supported / adjunct uses

• Endometriosis-associated pelvic pain: Medroxyprogesterone Acetate (oral or depot) is used as an adjunct option for symptomatic management, based on gynecologic society guidance, though it is not a first-line indication on all product labels.

Off-label uses (commonly used, not FDA-approved)

• Management of heavy menstrual bleeding in certain non-hormonal-imbalance settings.
• Adjunctive palliative therapy in selected hormone-responsive cancers (e.g. endometrial or renal cell carcinoma), under oncologist supervision.

The specific approved indication depends on the formulation (oral tablet vs. intramuscular/subcutaneous depot injection); a physician will select the appropriate form and regimen.

Contraception (depot injectable suspension)

• Adult dose: 150 mg intramuscularly every 3 months (12–13 weeks), or 104 mg subcutaneously every 3 months, depending on formulation.
• The first injection should be given during the first 5 days of a normal menstrual period (to ensure the patient is not pregnant), or within the first 5 days postpartum if not breastfeeding; if exclusively breastfeeding, the first dose is typically delayed until 6 weeks postpartum.
• Shake the vial vigorously immediately before use to ensure a uniform suspension.
• If the interval between injections exceeds the recommended window, pregnancy should be reasonably excluded before the next injection.

Abnormal uterine bleeding / secondary amenorrhea (oral tablets)

• Adult dose: 5–10 mg orally once daily for 5–10 days, typically started on the 16th–21st day of the menstrual cycle, as directed by the prescribing physician.

Endometrial hyperplasia prevention (with estrogen therapy)

• Adult dose: 5–10 mg orally once daily for 12–14 consecutive days per month, in combination with continuous estrogen therapy, as directed by the physician.

Renal/hepatic impairment

• No well-established dose adjustment exists for renal impairment; use with caution.
• Medroxyprogesterone Acetate is contraindicated in significant hepatic impairment or active liver disease (see Contraindications).

Doses and duration must be individualized by the treating physician based on indication and clinical response. Do not alter the dose or discontinue without medical advice.

Common and important side effects of Medroxyprogesterone Acetate include:

• Very common: menstrual irregularities (irregular bleeding or spotting), amenorrhea (absence of periods, increasingly common with continued use).
• Common: weight gain, headache, abdominal pain/bloating, mood changes (including depressive symptoms), decreased libido, breast tenderness, dizziness, nervousness.
• Notable with long-term depot use: significant loss of bone mineral density, which may not be fully reversible (see Precautions and Warnings); delayed return of fertility/ovulation after stopping the depot injection, which may take several months to a year.
• Less common but serious: thromboembolic events, jaundice, allergic reactions.

Report any severe, persistent, or concerning symptoms to your physician promptly.