Drug Interaction:
Interacting drugs- summary
Aminoglutethimide +
Medoxyprogesterone- aminoglutethimide increase the hepatic metabolism of Medroxyprogesterone medoxyprogesterone decreasing its therapeutic effects.
Rifampin- rifampin reduce the plasma levels of norethindrone via hepatic
+ Norethindrone- microsoamal enzyme induction, decreasing its pharmacologic effects
Drug/Lab interactions- laboratory testsof hepatic function,coagulation tests, (increase in prothreombin, Factors VII, VIII, IX, ans X) thyroid, metyrapone tst and endocrine functions may be affected by progestins A decrease inglucose tolerance has been observed in a small percentage of patients on estrogen-progestin combination drugs.
Indication:
Amenorrhea Abnormal uterine bleeding Endometriosis Contraception
Adverse Reaction:
CNS- insomnia, somnolence, mental depression
Dermatolgic- rash (allergic), with or without puritus, acne, melasma or chlosma, photensensitivity, small percentage of patients have a local reactions at the site of injection. Progesterone is irriatiting at the injectin site whether the oil or aqueous vehoicle is used
GI- changes in weight (increase or decrease) ,nausea
GU- breakthrough bleeding , spotting, cahnge in menstrual flow, amenorrhea, changes in cervical eversion, cervical secretions
Miscellaneous- breast changes (tenderness ) masculization of female fetus, edema, cholestatic jaundice, hirsutism
Medoxyprogestrone acetate- sensitivit reactions ranging from pruritus and uriticaria to generalized rash, aloipecia,
hirsutism
Contra-Indications:
Hypersensitivity to progestins
Thrombophlebitis, thromboembolic disorders,
cerebral hemnmorrhage or patients with a history of these conditions
impaired liver function or disease
carcinima of the breast or genital organs
undiagnosed vaginal bleeding , missed abortion, as a test for pregnancy
Special precautions
Pretretment physical examination- should include breates and pelvic rgans, as well as papanicolau smear. Advice the pathologist of progestin therapy when relevant specimens are submitted. In cases of regular vaginal bleeding consider nonfunctional causes. Adequately diagnose all cases of vaginal bleeding
Fluid retension- may occur therfore conditions influenced by this factor (epilepsy, migraine, asthma,cardiac or renal dysfunction ) require careful observation.
Depression- observe patients who have a history of psychic depression and discontinue the drug if depression occurs to a serious degree.
Menopause- age of the patient constitutes no absolute limiting, although treatment with progestins may mask the onset of the climacteric.
Benzyl alcohol- contained insome of the products as preservativre has beennassociated with a fatal - gasping syndrome- in premature infants.
Photosentization- may occur. Caution patients to take protective measures ie sunsreens , protective clothing ,against exposure to ultraviolet light or till tolerance is determined
Warnings
Opthalmologic effects- discontinue medication pending examination if there is sudden onset of proptosis diplopia or migraine. If papilledema or retinal vascular lesions are present discontinue use.
Thrombotic disorders- (thrombophlebitis ,cerebrovascular disorders, retinal thrombosis, pulmonary embolism) occassionally occur in patients taking progestins , be alert to the earliest manifestations of the disease. if these occur or suspected discontinue the drug immediately.
Pregnancy- use is not recommended
Lactation- medoxyprogesterone does not adversely affect lactation and may increase milk production and duration of lactation if given the puerperium
Dosages/ Overdosage Etc:
Amenorrhea Abnormal uterine bleeding Endometriosis Contraception
Dosage-
For IM use . The drug is irritating at the injectin site
Ammenoorhea- administer 5 to 10mg daily for 6 to 8 consecutive days. Ifovarian activity has produced a proliferative endometrium expect withdrawal bleeding 48 to 72 hours after the lastt injectin
Functional normal bleeding- administer 5 to 10mg daily for 6 doses. Bleeding should cease within 6 days.
Patient Information:
1. If GI upset ocurs, take with food.
2. Diabetic patients - Glucose tolerance may be increased , monitor urine sugar closely and report any abnormalities to physician
3.Notify physician if pregnancy is suspected or if any of the following occurs. Sudden severe headache , visual disturbances , numbness in an arm or leg.
4. May cause photosentivity. Avoid prolonged exposure to the sun and other ultraviolet light.
Pharmacology/ Pharmacokinetics:
Pharmacology-
Progestertin a principle of corpus luteum is the primry endogenous progestional substance. Progestins (progesterone and derivatives ) transform proliferative endometrium into seecretory endometrium. They inhibit (at usual dose range) or facilitate through positive feedback the secretion of pituitary gonadotropins which in turn prevents follicular maturation and ovulation or alternatively promotes it for the -primed - vehicle.
Pharmocokinetics-
Absorption of oral tablets and parentral oily solutions of progestins is rapid, however the hormone undergoes prompt hepatic transformation.
Pregnancy and lactation:
Pregnancy- use is not recommended
Lactation- medoxyprogesterone does not adversely affect lactation and may increase milk production and duration of lactation if given the puerperium
Manufacturer Details