Medroxyprogesterone, Contraceptive Injection

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KEY POINTS

• This medicine is given by injection (shot) to prevent pregnancy or to relieve endometriosis pain.
• You need regular checkups and exams while taking this medicine. Keep all appointments.
• This medicine may increase your risk for weak or brittle bones, or cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Certain other medicines may make this medicine less effective at preventing pregnancy. Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: hormone

Generic and brand names: medroxyprogesterone, contraceptive injection; Depo-Provera CI; Depo-Provera Contraceptive Injection; Depo-SubQ Provera 104

What is this medicine used for?

This medicine is given by injection (shot) to prevent pregnancy. Depo-SubQ Provera 104 may also be used to relieve pain caused by endometriosis.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before using this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A bleeding or blood-clotting disorder
• An abnormal mammogram, fibrocystic breast disease, breast lumps, or bleeding from your nipples
• An eating disorder such as anorexia nervosa
• Asthma
• Blood clots
• Breast cancer
• Depression
• Diabetes
• Heart disease or stroke
• High blood pressure
• Liver disease
• Kidney problems
• Migraine headaches
• Osteoporosis
• Seizures
• Unexplained vaginal bleeding, or irregular or lighter-than-usual menstrual periods

Tell your healthcare provider if you regularly drink alcohol or smoke.

Females of childbearing age: Tell your healthcare provider if you are pregnant or if you plan to become pregnant while taking this medicine. This medicine may cause birth defects if given during the first 4 months of pregnancy. Do not take this medicine if you are pregnant. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

These shots are usually given by a healthcare provider.

When given to prevent pregnancy, this medicine is started either:

• During the first 5 days of a normal menstrual period
• Within the first 5 days after giving birth, if you are not breastfeeding
• 6 weeks after giving birth, if you breastfeed your baby.

If you are switching from another form of birth control, your healthcare provider will tell you when you should receive your first injection of this medicine.

For prevention of pregnancy these shots must be given every 3 months. If you miss an appointment to receive your injection, contact your healthcare provider. You may not be protected from pregnancy if you do not get your shots on schedule.

For Endometriosis: If your periods have stopped or are not regular, your healthcare provider must test to make sure you are not pregnant before you get your first shot. These shots are given every 3 months. If you miss an appointment to receive your injection, contact your healthcare provider.

What should I watch out for?

You should not use this medicine for more than 2 years. This medicine may decrease the amount of calcium in your bones, especially when used for a long time. This may increase your risk of osteoporosis, weak bones, and broken bones. Your provider may tell you take calcium and vitamin D to lessen the loss of calcium from your bones. If you take this medicine for more than 2 years, you need to have bone density tests.

See your healthcare provider at least once a year for checkups while you are receiving this medicine. This is very important if you have a family history of breast cancer.

This medicine does not protect you from HIV or other sexually transmitted diseases.

Most women have changes in their menstrual period while taking this medicine. If you continue to use this medicine, your periods may stop completely. Talk with your healthcare provider about this.

You could miss a period or have a light period and not be pregnant. If this medicine fails to prevent pregnancy, you may have an increased risk of a pregnancy outside of your uterus (ectopic pregnancy). If you miss 1 or 2 periods or think you might be pregnant, see your healthcare provider as soon as possible.

Certain other medicines may make this medicine less effective at preventing pregnancy. Tell your healthcare provider about all the prescription medicines, non-prescription medicines, and natural remedies you are taking. Follow your healthcare provider’s instructions about using a back-up method of birth control.

If you plan to have children after you stop using this medicine, it may take a year or longer after your last shot before you can become pregnant. Talk with your healthcare provider about this.

You may have a lump, skin dimpling, or darkened skin where you had the shot. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you have received this medicine.

If you have diabetes: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Numbness or weakness in an arm or leg; chest pain; shortness of breath; coughing blood; depression; swelling, warmth, redness, or pain in your legs; yellowing of your skin or eyes; dark urine; light-colored bowel movements; severe stomach pain or vomiting; severe dizziness or fainting; unusual heavy or continued vaginal bleeding; swelling in hands or feet; continued pain, pus, or bleeding at the injection site; seizures.

Other: Breast tenderness or swelling, nervousness, headache, dizziness, mild stomach cramps or bloating, backache, trouble sleeping, acne, changes in menstrual periods, nausea, weight gain, tiredness, change in sexual ability or desire, vaginal discharge or irritation, hair loss or no hair growth, hot flashes, joint pain.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antianxiety medicines such as alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• Antibiotics such as amoxicillin (Amoxil, Moxatag), dicloxacillin, doxycycline (Doryx, Monodox, Vibramycin), minocycline (Dynacin, Minocin, Solodyn), oxacillin, penicillin, rifabutin (Mycobutin), rifampin (Rifadin), rifapentine (Priftin), and tetracycline
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin, Phenytek), and topiramate (Qudexy, Topamax, Trokendi)
• Aprepitant (Emend)
• Artemether/lumefantrine (Coartem)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Bosentan (Tracleer)
• Cancer medicines such as enzalutamide (Xtandi) and mitotane (Lysodren)
• Cholesterol-lowering medicines such as cholestyramine (Prevalite), colesevelam (Welchol), and colestipol (Colestid)
• Corticosteroids such as betamethasone (Celestone), cortisone, dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), prednisone (Prednisone Intensol), and triamcinolone (Aristospan, Kenalog)
• Diabetes medicines such as chlorpropamide, glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Glynase), insulin, metformin (Fortamet, Glucophage, Riomet), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia), and tolbutamide
• Griseofulvin (Grifulvin V, Gris-PEG)
• HIV medicines such as atazanavir (Reyataz), cobicistat (Tybost), delavirdine (Rescriptor), efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), and saquinavir (Invirase)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune) and mycophenolate (CellCept, Myfortic)
• Medicines to treat or prevent blood clots such as apixaban (Eliquis), rivaroxaban (Xarelto), and warfarin (Coumadin)
• Natural remedies such as bloodroot, chasteberry, damiana, oregano, St. John’s wort, and yucca
• Skin medicines such as acitretin (Soriatane), bexarotene (Targretin), isotretinoin (Absorica, Amnesteem, Claravis, Myorisan, Zenatane), and tretinoin (Atralin, Renova, Retin-A)
• Sleeping pills such as butabarbital (Butisol), flurazepam, phenobarbital, temazepam (Restoril), and triazolam (Halcion)
• Voriconazole (Vfend)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.