Medroxyprogesterone

Introduction

Written by Helen Marshall BPharm MRPharmS
Medically reviewed by Melissa Badowski, PharmD, MPH, FCCP
Updated on August 23, 2023

Medroxyprogesterone (me DROKS ee proe JES te rone) is a generic medication prescribed for birth control, hormone replacement therapy, and certain menstrual conditions. Medroxyprogesterone belongs to a group of drugs called progestins.

The Food and Drug Administration (FDA) has approved medroxyprogesterone to:

• help prevent pregnancy in females* of reproductive age
• treat irregular periods or periods that have stopped in females of reproductive age
• reduce the risk of endometrial cancer in females of postmenopausal age receiving estrogen hormone replacement therapy for menopause

These approved uses differ based on the form of medroxyprogesterone your doctor prescribes.

This article doesn’t provide coupons for all forms of medroxyprogesterone. To find coupons for medroxyprogesterone injection, see this article.

* Sex and gender exist on spectrums. In this article, we use the term “female” to refer to a person’s sex assigned at birth.

Boxed warnings

Medroxyprogesterone has boxed warnings, which are the most serious warnings from the Food and Drug Administration (FDA). These warnings differ based on the form of the drug.

Medroxyprogesterone injection* has a boxed warning about the risk of loss of bone mineral density.

Medroxyprogesterone oral tablet has boxed warnings about the following:

• risk of breast cancer
• risk of heart and blood vessel problems
• risk of dementia

For details about these risks, see the “Interactions and warnings for medroxyprogesterone” section.

* Medroxyprogesterone injection is given into your muscle.

Side effects of medroxyprogesterone

Medroxyprogesterone may cause mild or serious side effects. More common mild side effects of medroxyprogesterone and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about medroxyprogesterone’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for medroxyprogesterone listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of medroxyprogesterone are listed below. These side effects may differ based on the drug form you take.

This article doesn’t include all possible mild side effects of the drug. To learn more about medroxyprogesterone’s side effects based on the form, refer to the drug’s prescribing information listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects bother you, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Mild side effects of medroxyprogesterone oral tablet include:

• breast pain or tenderness
• nausea
• headache
• change in your menstrual period, such as spotting or lighter, heavier, or irregular periods
• mild allergic reaction*

Mild side effects of medroxyprogesterone injection† include:

• weight gain
• headache
• abdominal pain or discomfort
• change in your menstrual period, such as spotting or lighter, heavier, or irregular periods
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for medroxyprogesterone” section.
† Medroxyprogesterone injection is given into your muscle.

Serious side effects

Serious side effects of medroxyprogesterone are listed below. These side effects may differ based on the drug form you take.

This article doesn’t include all possible serious side effects of the drug. To learn more about medroxyprogesterone’s side effects based on the form, refer to the prescribing information for medroxyprogesterone listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, medroxyprogesterone’s serious side effects include:

• jaundice (yellowing of the skin or whites of the eyes)
• depression
• boxed warnings:* risks of loss of bone mineral density, breast cancer, heart and blood vessel problems, and dementia
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for medroxyprogesterone” section.

Common questions about medroxyprogesterone

Below you’ll find answers to a few commonly asked questions about medroxyprogesterone.

What brand names are available for medroxyprogesterone?

The brand-name version of medroxyprogesterone injection* is Depo-Provera. The brand-name version of medroxyprogesterone oral tablet is Provera.

Medroxyprogesterone is a generic medication. A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are considered to be just as safe and effective as brand-name drugs. And generic drugs typically cost less than brand-name drugs.

If you’re interested in a brand-name version of medroxyprogesterone, talk with your doctor.

* Medroxyprogesterone injection is given into your muscle.

How does medroxyprogesterone work? And how long does it take to start working?

Medroxyprogesterone is a synthetic (made in a lab) form of progesterone. This is one of the hormones involved in regulating your menstrual cycle. Medroxyprogesterone works by mimicking the effect of progesterone. How long it takes the drug to work depends on the reason you’re taking it.

For birth control:

• Medroxyprogesterone helps prevent pregnancy by stopping your ovaries from releasing an egg each month. The drug also thickens the mucus in your cervix, which makes it harder for sperm to enter your uterus (womb). And it thins the lining of your uterus, making it harder for an egg to implant (attach).
• If you receive medroxyprogesterone injection in the first 5 days of your menstrual cycle, the drug works to help prevent pregnancy right away. (Day 1 is the first day of your period.) If you have it at any other time in your cycle, the drug won’t help prevent pregnancy for 7 days.

For certain menstrual conditions:

• Medroxyprogesterone helps restore hormonal imbalances that cause your period to become irregular or stop altogether.
• You’ll take medroxyprogesterone oral tablet for 5–10 days each month as your doctor prescribes. This mimics the rise in progesterone that usually causes your period. Typically, you’ll get your period toward the end of taking the tablets. This helps make your periods regular.

For reducing the risk of endometrial cancer with estrogen hormone replacement therapy (HRT):

• Medroxyprogesterone works by opposing the effect of estrogen HRT. This type of HRT thickens the uterine lining, which increases your endometrial cancer risk. (Endometrial cancer is cancer of the lining of the uterus.)
• You’ll take medroxyprogesterone oral tablet for 12–14 days each month. This causes the lining to shed each month, similar to a period. You’ll typically experience monthly bleeding toward the end of taking the tablets. The shedding of the uterine lining helps reduce your risk of endometrial cancer.

If you have questions about how medroxyprogesterone works, talk with your doctor or pharmacist.

Uses of medroxyprogesterone

The Food and Drug Administration (FDA) approves prescription drugs such as medroxyprogesterone for certain conditions. Approved uses for medroxyprogesterone are described below. These uses differ based on the form of medroxyprogesterone prescribed.

Note: Sex and gender exist on spectrums. In this article, we use the term “female” to refer to a person’s sex assigned at birth.

Use for pregnancy prevention

Doctors may prescribe medroxyprogesterone injection for helping prevent pregnancy. It’s used for this purpose in females who’ve started menstruating. It’s usually prescribed as a long-term treatment.

Medroxyprogesterone is a long-acting form of birth control. Your doctor or another healthcare professional will inject the drug into your muscle every 3 months.

Doctors may not prescribe medroxyprogesterone injection for longer than 2 years unless other forms of birth control aren’t suitable. This is because long-term use may cause loss of bone mineral density.*

* Medroxyprogesterone injection has a boxed warning* for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more about this, see the “Interactions and warnings for medroxyprogesterone” section.

Use for certain menstrual conditions

Doctors may prescribe medroxyprogesterone oral tablet for treating irregular periods or periods that have stopped. It’s used for this purpose in females who’ve started menstruating. It’s usually prescribed as a long-term treatment.

With irregular or no periods, you may have an imbalance of the hormones that regulate your menstrual cycle. Medroxyprogesterone oral tablet helps restore the imbalance so you have regular periods.

Doctors may not prescribe medroxyprogesterone oral tablet in certain situations. These include irregular periods caused by problems such as fibroids (unusual growths in or on the uterus).

Use as part of hormone replacement therapy to reduce endometrial cancer risk

Doctors may prescribe medroxyprogesterone oral tablet to reduce the risk of endometrial cancer* associated with estrogen hormone replacement therapy (HRT). It’s used for this purpose in certain females who’ve undergone menopause. It’s usually prescribed as a long-term treatment.

Estrogen HRT is prescribed to relieve symptoms of menopause. But in females with an intact uterus (womb), estrogen HRT causes the uterine lining to grow and build up. This can raise the risk of endometrial cancer.

Medroxyprogesterone treatment balances the effect of estrogen HRT. It makes the lining of your uterus shed, which helps lower your risk of endometrial cancer.

If you have questions about medroxyprogesterone treatment, talk with your doctor for more information.

* Endometrial cancer is cancer of the lining of the uterus.

Interactions and warnings for medroxyprogesterone

Below, you’ll find information about medroxyprogesterone’s possible interactions and warnings.

Interactions of medroxyprogesterone

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take medroxyprogesterone, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for medroxyprogesterone” section below.

Warnings for medroxyprogesterone

Some people should not take medroxyprogesterone, and others should take it cautiously.

Boxed warnings

Medroxyprogesterone injection has a boxed warning about the following risks. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

To learn more about these warnings, read below. You can also talk with your doctor or pharmacist. Note that these risks depend on the form of the drug you’re taking.

Risk of loss of bone mineral density. Medroxyprogesterone injection* can cause a loss of bone mineral density that may weaken your bones. This may raise your risk of fractures. You may have more bone loss the longer you take medroxyprogesterone injection. Your bones may not recover fully after you stop taking the injection.

This side effect was commonly reported in studies of medroxyprogesterone injection. It’s not known whether it’s safe to take this medication while your bones are still growing. For instance, it may increase your risk of osteoporosis (thinning bones) and fractures later in life.

If you have concerns about low bone mineral density with medroxyprogesterone injection, talk with your doctor. They can help determine whether this form of birth control is right for you. They’ll likely recommend that you do not take the drug for longer than 2 years.

Your doctor may recommend taking calcium and vitamin D supplements while you’re receiving medroxyprogesterone injections. These supplements can help keep your bones strong.

Risk of breast cancer. Taking medroxyprogesterone oral tablet with estrogen for hormone replacement therapy (HRT) for menopause may increase your risk of breast cancer.

This side effect was rarely reported in studies of females† ages 50 years and older who took medroxyprogesterone with estrogen for HRT.

Symptoms of breast cancer can include a breast lump, pain in the breast, and nipple discharge (other than breast milk).

If you have concerns about this risk, talk with your doctor for more information. They can help you weigh the risks and benefits of HRT for menopausal symptoms.

Risk of heart and blood vessel problems. Taking medroxyprogesterone oral tablet with estrogen for HRT for menopause may increase your risk of certain heart and blood vessel problems. These include heart attack, stroke, and blood clots in your legs or lungs.

These side effects were rarely reported in studies of females† ages 50 years and older who took medroxyprogesterone with estrogen for HRT.

Symptoms may include sudden chest pain, shortness of breath, weakness on one side of your body, difficulty speaking, or pain and swelling in your leg.

If you have concerns about this risk, tell your doctor. They can help you weigh the risks and benefits of taking HRT for menopausal symptoms.

Risk of dementia. Taking medroxyprogesterone oral tablet with estrogen for HRT for menopause may raise your risk of dementia. Dementia was rarely reported in studies of females† ages 65 years and older who took medroxyprogesterone with estrogen for HRT. Different types of dementia were reported in these studies, including Alzheimer’s disease and vascular dementia.

With dementia, you have difficulty remembering, thinking, understanding, and communicating.

If you have concerns about the risk of dementia with HRT, tell your doctor. They can help you determine whether HRT is right for you.

* Medroxyprogesterone injection is given into your muscle.
† Sex and gender exist on spectrums. In this article, we use the term “female” to refer to a person’s sex assigned at birth.

Other warnings

Medroxyprogesterone could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether medroxyprogesterone is a safe option for you. These warnings may differ based on the form of medroxyprogesterone you take.

Ask your doctor about specific warnings for medroxyprogesterone, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Medroxyprogesterone can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to medroxyprogesterone or any of its ingredients, your doctor will likely not prescribe medroxyprogesterone. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to medroxyprogesterone, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of medroxyprogesterone

If you take medroxyprogesterone by mouth, you should not take more medroxyprogesterone than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much medroxyprogesterone, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and medroxyprogesterone

Information about medroxyprogesterone and pregnancy and breastfeeding is described below.

Medroxyprogesterone and pregnancy

Medroxyprogesterone should not be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. Your doctor may suggest birth control options to use during treatment with medroxyprogesterone oral tablet.

Medroxyprogesterone and breastfeeding

Medroxyprogesterone oral tablet should not be taken while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with medroxyprogesterone oral tablet.

What to ask your doctor

Let your doctor know if you have questions about medroxyprogesterone or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• How many people have side effects with medroxyprogesterone?
• Can medroxyprogesterone injection be reversed if I have bothersome side effects?
• For how long will I take medroxyprogesterone?
• How does medroxyprogesterone compare with my other treatment options?

Resources

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Medroxyprogesterone acetate – Drug summary. (n.d.). https://www.pdr.net/drug-summary/Depo-Provera-Contraceptive-Injection-medroxyprogesterone-acetate-1373
• Medroxyprogesterone acetate injectable suspension, for intramuscular use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/0655670a-d127-4e08-8a23-ace64b2503b2/spl-doc
• Medroxyprogesterone acetate tablets USP. (2015). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/a9e05272-aa4e-4df8-b08b-481abca3e8fd/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.