Pharmacological action Depo Provera Injection:
Depo Provera Progestin, provided by i / m administration and long-term effect has not at this androgenic and estrogenic activity. Pituitary gonadotropin secretion inhibits (especially LH), resulting in women prevents maturation of the follicles and there is prolonged anovulation. Reduces vasomotor symptoms in menopause, inhibits secretory changes in the endometrium, increases the viscosity of cervical mucus, increases the number of intermediate cells in the maturation index of vaginal epithelium, has no effect on lactation. In men, progestins inhibit the production of testosterone. Possible manifestation of androgenic and anabolic effects. When administered for contraception reduces the risk of inflammatory diseases of the genital organs of vulvovaginal candidiasis. Most women with endometrial hyperplastic processes are observed to partial or complete regression. For parenteral administration in high doses has antitumor activity in hormone tumors. Antitumor activity determined by a complex effect on the pituitary gland, estrogen receptors and steroid hormone metabolism at the tissue level. When breast cancer is noted a correlation between the effectiveness of treatment and the concentration of estrogen receptors and progesterone receptors in tumor tissue. In large doses, has a GCS activity.
Indications Depo Provera Injection:
Contraception, particularly in women of late reproductive age, endometriosis, the differential diagnosis of primary and secondary amenorrhea, the correction of side effects from the endometrium by estrogen therapy in menopause, anovulatory metrorrhagia, secondary amenorrhea, premenstrual syndrome, vasomotor symptoms of menopause, prevention and treatment of osteoporosis in postmenopauznom period (in combination with estrogen therapy and Ca2 +). Additional and palliative care: renal cell carcinoma (recurrent and metastatic) breast cancer (hormone-dependent, recurrent, in postmenopauznom period), endometrial cancer (including metastatic) prostate cancer, prostatic hypertrophy (some forms), cancer cachexia in advanced tumors of different localization.
Contraindications Depo Provera Injection:
Hypersensitivity, pregnancy, tumors, genital or breast cancer (except for anticancer therapy), bleeding from the genital tract of unknown origin, lactation. Thrombophlebitis, thromboembolism, or stroke (increased risk of, or in history), hepatic failure, hypercalcemia, epilepsy, migraine, asthma, cardiac or renal failure, diabetes, depression.
Side effects Depo Provera Injection:
The nervous system: headache, dizziness, irritability, insomnia, drowsiness, fatigue, and depression. Part of the digestive system: nausea, abdominal pain and abdominal discomfort. On the part of hematopoiesis and hemostasis: thromboembolic disorders (thrombophlebitis, cerebrovascular disorders, thromboembolism of small branches of the pulmonary artery, renal thrombosis). Allergic reactions: rash, itching, rash, anaphylactoid reaction. From the Endocrine: increased sensitivity of nipples breast, galactorrhea, cervical erosion, dysmenorrhea, “spotting” the selection, reduced glucose tolerance. When used in a dose of 500 mg / day – “vulgar” acne, hirsutism, weight change, moon face. Other: pyrexia, alopecia. Local reaction at injection site – the pain, residual compaction, change in skin color.
Dosage and administration Depo Provera Injection:
The suppression of ovulation (contraception): The recommended dose – 150 mg every 3 months (deep i / m injection). To ensure that the patient is not pregnant at the time of initial application of the drug, it is recommended to make the first injection within 5 days after the start of the next menstrual period or before 6 weeks postpartum. Dysfunctional (anovulatory) uterine bleeding: oral, 5-10 mg / day for 10 days. During this time the bleeding gradually stopped. 3-7 days after withdrawal bleeding begins “cancel” progestin. After this treatment can be repeated, starting with a 16 day cycle for 2-3 cycles. Endometriosis: a / m, the recommended dose – 50 mg 1 time per week or 100 mg of 1 every 2 weeks for at least 6 months. Due to the prolonged action of the menstrual cycle recovery after such therapy may occur some time later. In addition to the i / m administration may conduct treatment of endometriosis by oral administration of 10 mg 3 times daily for 90 days starting from the first day of the cycle. Differential diagnosis of primary and secondary amenorrhea: drug is given at 5-10 mg / day for 10 days. For the prevention of endometrial hyperplasia during estrogen therapy in menopause: 5-10 mg / day for at least 10 days from 16 days the 25-day course of treatment with estrogens. Additional palliative treatment of recurrent and metastatic endometrial cancer and kidney cancer, or: at 200-600 mg / day, orally, with a / m administration depot form prescribed by 0.5-1 g / week, the maintenance dose – 500 mg / week. Breast cancer: oral, 400-1200 mg / day / m – 500 mg / day for 28 days, then transferred to a maintenance dose – 500 mg 1 every 2 weeks. The results of treatment may occur in 8-10 weeks. For the prevention and treatment of osteoporosis in postmenopausal women – from 12-15 to 25 day of the month at 5-10 mg 1 time a day.
Special instructions Depo Provera Injection:
In carrying out histopathological studies of certain organs and tissues must notify histologist of previous treatment with progestins. In the course of treatment may change during the following studies: determination of concentrations of gonadotropins, progestin, cortisol, testosterone (in men), estrogen (in women) in the plasma concentration determination pregnandiol in urine samples from holding sugar load to the test by a metapyron. If you have a history of depression requires careful monitoring during treatment. Before starting therapy should sanitize the erosion of the cervix. With the continued erosion – a careful medical supervision. With dysfunctional uterine bleeding necessarily rule out uterine cancer and other organic lesions. Suspected gipokoagulyatsii development requires immediate repeal.
Interaction Depo Provera Injection:
Aminoglutethimide reduces plasma concentrations and reduces efficiency.
