Medroxyprogesterone Acetate (Contraceptive Injection)

• Medroxyprogesterone acetate is a hormone medicine (a progestin).
• The injection form (Depo-Provera) is used for long-term birth control.
• The tablet form is used along with estrogen to protect the lining of the womb during hormone therapy for menopause symptoms.
• The tablet form is also used to treat irregular or missed periods caused by a hormone imbalance.
• Higher-dose tablets are sometimes used to help treat certain cancers of the womb lining or breast.

• If you use the injection: a nurse or doctor gives it as a shot deep into a muscle, once every 3 months. You do not give it to yourself.
• If you take the tablets: swallow the tablet with a glass of water. You can take it with or without food, whichever you prefer.
• Take this medicine exactly as your healthcare professional tells you. The amount and how often you take it will be on your prescription label.
• Try to take your tablets at the same time each day, especially if you're on a cycle-based schedule.

If you miss a dose

• If you use the injection: call your clinic right away to reschedule if you miss your appointment. Being late can reduce how well it prevents pregnancy, and you may need a backup birth control method or a pregnancy test.
• If you take the tablets: take the missed dose as soon as you remember. If it's almost time for your next dose, skip the missed one and go back to your regular schedule. Never take two doses at once.

• Do not use this medicine if you are pregnant or think you might be pregnant.
• Tell your doctor right away if you think you are pregnant while using this medicine.
• Small amounts of this medicine can pass into breast milk. Talk to your healthcare professional about the risks and benefits before using it while breastfeeding.

• Tell your healthcare professional about all your medical conditions, especially blood clots, stroke, heart disease, liver disease, breast cancer, migraines, seizures, diabetes, or depression.
• Tell your healthcare professional about every medicine, vitamin, and herbal product you take.
• Tell your healthcare professional if you smoke, especially if you are older than 35.
• Tell your healthcare professional if you are pregnant, could be pregnant, or are breastfeeding.
• This medicine will need regular check-ups, including blood pressure checks and breast exams. Keep all follow-up appointments.

Important warnings

• Long-term use of the injection can thin your bones over time. This may not fully reverse after you stop.
• Hormone therapy that combines this medicine with estrogen can raise your risk of heart attack, stroke, blood clots, and breast cancer.
• This medicine can cause serious blood clots in the legs, lungs, brain, or eyes.
• Serious allergic reactions can happen, from a rash to a life-threatening reaction.
• Liver problems, including yellowing of the skin or eyes, can occur.
• Sudden vision changes or loss of vision can occur and need urgent care.
• Long-term combined hormone therapy in women 65 and older has been linked to a higher chance of memory problems and dementia.
• Rare brain tumours called meningiomas have been reported with long-term use.

• Irregular or unpredictable spotting or bleeding, especially with the injection.
• Periods that stop completely, especially with the injection.
• Headache.
• Feeling nervous, dizzy, or tired.
• Breast tenderness or swelling.
• Weight gain.
• Swelling (fluid retention).
• Bloating or upset stomach.
• Nausea.
• Acne or extra hair growth.
• Hair thinning.
• Mood changes.

When to get emergency help

• Sudden vision loss, blurred vision, or double vision.
• Sudden severe headache unlike your usual headaches.
• Chest pain or a fast or irregular heartbeat.
• Sudden shortness of breath or coughing up blood.
• Pain, redness, warmth, or swelling in one leg.
• Signs of a stroke, such as sudden weakness, trouble speaking, or a drooping face.
• Signs of a severe allergic reaction, such as swelling of the face or throat, hives, or trouble breathing.
• Severe abdominal pain (if you use the injection, this can be a sign of a rare pregnancy outside the womb).

When to contact a healthcare professional

• You notice yellowing of your skin or eyes.
• You develop new or worsening depression.
• You have breast lumps or unusual nipple discharge.
• You have migraine headaches that are worse than usual.
• Your blood pressure readings are higher than normal.
• You think you might be pregnant.
• Bleeding during treatment is heavy or does not follow the pattern your doctor described.

• If you use the injection, food does not affect how it works.
• If you take the tablets, you can take them with or without food.
• Tell your healthcare professional about all medicines you take, including St. John's wort and other herbal products, since some can make this medicine less effective.
• Certain seizure medicines and the antibiotic rifampin can also make this medicine work less well.

• Store the tablets and the injection at room temperature.
• Protect the injection from freezing.
• Keep this medicine out of the reach and sight of children.
• Ask the Care365 care team how to safely dispose of any unused medicine.