Medroxyprogesterone Acetate (DMPA)

SCOPE: this covers the page's PRIMARY item only — the 150 mg/mL intramuscular depot for contraception (Depo-Provera). The fetched bundle contains NO dose for Sayana Press 104 mg/0.65 mL SUBCUTANEOUS, none for endometriosis, and none for heavy menstrual bleeding; those parts of the existing page remain unsourced and have not been re-sourced here. || VERBATIM §2 / §2.1: 'The recommended dose is 150 mg of medroxyprogesterone acetate injectable suspension every 3 months (13 weeks) administered by deep, intramuscular (IM) injection in the gluteal or deltoid muscle.' and 'The recommended dose is 150 mg of medroxyprogesterone acetate injectable suspension every 3 months (13 weeks) administered by deep intramuscular (IM) injection using strict aseptic technique in the gluteal or deltoid muscle, rotating the sites with every injection.' || ⚠️ INTERVAL: the source says every 3 months (13 weeks). This page currently states 'every 12 weeks' for the IM product, which is the usual UK convention for Depo-Provera; the figure published above is the SOURCE figure, and the 12-week versus 13-week interval must be settled against the UK SPC for the specific UK product before this goes live. The UK SPC in this bundle is for the oral tablets, but its §4.6 does independently describe the injection in the same terms: 'In nursing mothers treated with medroxyprogesterone acetate injection 150 mg IM every 3 months, milk composition, quality, and amount are not adversely affected.' || TIMING OF THE FIRST INJECTION, verbatim §2.1: 'To ensure the patient is not pregnant at the time of the first injection, the first injection should be given ONLY during the first 5 days of a normal menstrual period; ONLY within the first 5-days postpartum if not breast-feeding; and if exclusively breast-feeding, ONLY at the sixth postpartum week. If the time interval between injections is greater than 13 weeks, the physician should determine that the patient is not pregnant before administering the drug. The efficacy of medroxyprogesterone acetate injectable suspension depends on adherence to the dosage schedule of administration.' || SWITCHING, verbatim §2.2: 'When switching from other contraceptive methods, medroxyprogesterone acetate injectable suspension should be given in a manner that ensures continuous contraceptive coverage based upon the mechanism of action of both methods, (e.g., patients switching from oral contraceptives should have their first injection of medroxyprogesterone acetate injectable suspension on the day after the last active tablet or at the latest, on the day following the final inactive tablet).' || DELIBERATELY NOT PUBLISHED — WRONG PRODUCT, ROUTE AND INDICATION: the bundle's UK SPC is for MEDROXYPROGESTERONE ACETATE 200 mg ORAL TABLETS, whose §4.2 reads 'Endometrial and renal cell carcinoma 200 - 600 mg daily. Breast carcinoma 400 - 1500 mg daily.' Those are oral oncology doses, not this page's injectable contraceptive indication, and putting them on this page would be a route-and-indication error. That SPC also notes 'Response to hormonal therapy may not be evident until after at least 8-10 weeks of therapy' and 'Paediatric population: The product is not anticipated for paediatric use in the indications recommended.'

NOT weight-based, so dosePerKg is null and no weight calculator applies — §2.1, verbatim: 'Dosage does not need to be adjusted for body weight.' §8.4 Pediatric Use, verbatim: 'Medroxyprogesterone acetate injectable suspension is not indicated before menarche. Use of medroxyprogesterone acetate injectable suspension is associated with significant loss of BMD. This loss of BMD is of particular concern during adolescence and early adulthood, a critical period of bone accretion. In adolescents, interpretation of BMD results should take into account patient age and skeletal maturity. It is unknown if use of medroxyprogesterone acetate injectable suspension by younger women will reduce peak bone mass and increase the risk of osteoporotic fractures in later life. Other than concerns about loss of BMD, the safety and effectiveness are expected to be the same for postmenarchal adolescents and adult women.' Read alongside §2.1's 2-year duration caution. Confirm against a children's formulary and current UK contraception guidance before use in under-18s.