Medroxyprogesterone tablets

Medroxyprogesterone (also known as medroxyprogesterone acetate) is a type of medicine called a progestogen. Progestogens are similar to a natural hormone made in the body called progesterone.

Medroxyprogesterone works in the same way as natural progesterone, but has stronger effects.

It's used for hormonal conditions, including heavy periods, endometriosis, polyendocrine metabolic ovarian syndrome (PMOS) and symptoms of the menopause. It's also sometimes used for hot flushes caused by treatments for prostate cancer.

Medroxyprogesterone tablets are only available on prescription.

Medroxyprogesterone also comes as an injection that's used as contraception.

It also comes mixed with another hormone called oestrogen. This is used as a type of hormone replacement therapy (HRT), for menopause symptoms.

High dose medroxyprogesterone tablets (100mg, 200mg and 400mg) are used to treat some types of cancer.

Most adults, and girls who have started their periods, can take medroxyprogesterone tablets.

Medroxyprogesterone tablets are not suitable for some people. To make sure it's safe for you, tell your doctor before starting to take this medicine if you:

• have ever had an allergic reaction to medroxyprogesterone or any other medicine
• are pregnant, trying to get pregnant or breastfeeding
• have a rare condition called porphyria
• have had breast cancer or another type of cancer that is affected by hormones, or if a close relative has had one of these cancers
• have ever had liver problems
• have had a blood clot in a vein (deep vein thrombosis – DVT) or in your lung (pulmonary embolism)
• have had a type of brain tumour called a meningioma
• have high blood pressure
• have had a heart attack or have a heart condition called angina
• have ever had mental health problems
• have migraines
• have diabetes
• have epilepsy
• have hearing loss caused by otosclerosis
• have asthma
• have gallstones
• have lupus

Medroxyprogesterone comes as 2.5mg, 5mg and 10mg tablets. These strengths are used for period problems, endometriosis, symptoms of the menopause and hot flushes caused by treatment for prostate cancer.

Medroxyprogesterone also comes as higher strength 100mg, 200mg and 400mg tablets but these are only used for certain types of cancer.

Dose for period problems

If you take medroxyprogesterone tablets for period problems or heavy vaginal bleeding, the usual dose is 2.5mg to 10mg once a day for 5 to 10 days during your menstrual cycle.

You'll usually take it for 2 or 3 cycles, starting 16 to 21 days after the start of your last period. Your doctor will tell you what day of your cycle to start taking it and how many days to take it for.

Dose for endometriosis

The usual dose for endometriosis is 10mg three times a day, every day for 3 months (or 3 cycles of your periods), starting on the first day of a period.

Dose for polycystic ovary syndrome

For polycystic ovary syndrome (PCOS), if your periods are infrequent or you're not having periods, the usual dose is 10mg once a day, taken for 14 days every 1 to 3 months.

Dose for hot flushes caused by prostate cancer treatment

The usual dose for hot flushes caused by treatment for prostate cancer is 20mg (two 10mg tablets) once a day.

Dose for menopause symptoms

If you're taking medroxyprogesterone along with an oestrogen (another hormone) for menopause symptoms, the treatment is called hormone replacement therapy (HRT).

You'll usually take it for part of each 28 day HRT cycle. Your doctor will advise you on the dose and which days to take it.

Dose for cancer

If you're taking high doses of medroxyprogesterone for cancer (100mg, 200mg or 400mg tablets), the doses can be very different depending on the type of cancer. Your doctor will tell you how much to take.

You can find out more about medroxyprogesterone for treating cancer on the Macmillan website.

Swallow the tablets with a drink of water.

You can take them with or without food.

If you take the tablets once a day, you can take them at any time, but try to stick to the same time each day.

If you take them 3 times a day, try to space your doses evenly throughout the day.

If you miss a dose of medroxyprogesterone, you might get some breakthrough bleeding or spotting of blood from your vagina.

If you forget to take a dose, take it as soon as you remember, unless it's nearly time for your next dose. In this case, skip the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

For period problems or endometriosis, you'll usually take medroxyprogesterone for short courses over 2 or 3 months. Sometimes you'll need to take another course if your symptoms come back. Your doctor will advise you on how long to take it for.

For hot flushes caused by prostate cancer treatment, you'll usually take medroxyprogesterone for 10 weeks at first. Your doctor will then review how well it's working and advise you whether to keep taking it.

If you take more than your prescribed dose of medroxyprogesterone, it could give you more of the common side effects.

• you've taken more than your prescribed dose of medroxyprogesterone tablets

Get help from 111 online or call 111

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the medroxyprogesterone packet or leaflet inside it, any remaining medicine, and any other medicines you take.

These common side effects of medroxyprogesterone tablets happen in more than 1 in 100 people. There are things you can do to help cope with them:

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Talk to your doctor if headaches last longer than a week or are severe.

Try taking your tablets with food. It may also help if you avoid rich or spicy food.

If it does not go away or is severe, tell your doctor. They may be able to prescribe an extra medicine to help with feeling sick.

If you take medroxyprogesterone in cycles, make sure you're taking your tablets on the correct days.

If this side effect carries on, speak to your doctor. You may need to change your dose.

Eating a healthy, balanced diet and regular exercise will help you keep to a healthy weight.

Try to wear a well-fitting and comfortable bra.

Talk to your doctor if you have problems with mood changes and it does not improve.

Avoid having a big meal, smoking, or drinking alcohol, tea or coffee in the evening. Try not to watch television or use your mobile phone before going to bed. Instead, try to relax for an hour before bedtime.

It might help to keep the room cool and use a fan. You could also spray your face with cool water or sip cold or iced drinks.

If you have a high temperature and feel unwell, speak to your doctor.

If you're taking it for hot flushes and you get this side effect, speak to your doctor. You may need to change to a different medicine.

Stop what you're doing and sit or lie down until you feel better. Do not drive, cycle or use tools or machinery if you're feeling dizzy.

Try to get plenty of rest. Do not drive, cycle or use tools or machinery if you're feeling tired. Do not drink alcohol as it will make you feel worse.

It may help to take an antihistamine which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you.

Wash with a mild soap or cleanser and lukewarm water. Avoid using too much make-up and cosmetics. Speak to a pharmacist for advice about treating acne.

Thinning hair or mild hair loss can be stressful but it is not usually a sign of anything to worry about. Talk to your pharmacist or doctor if you're concerned. Some hair loss treatments are available.

Changes including an increase in vaginal discharge are common and are not usually anything to worry about. Talk to your doctor if your discharge changes in smell, colour or texture, as it might be a sign of an infection.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects are rare and happen in less than 1 in 1,000 people.

Speak to your doctor or call 111 straight away if you get pain, swelling, redness and warmth in a leg or arm – this could be a sign of deep vein thrombosis (DVT).

• you're suddenly short of breath or get a sharp pain in your chest and a cough, or you're coughing up blood – these may be signs of a blood clot in your lungs
• you lose vision suddenly in one or both eyes – this could be a sign of a blood clot

Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance.

Bring all the medicines you take with you.

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to medroxyprogesterone tablets.

Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
• your throat feels tight or you're struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of medroxyprogesterone tablets. For a full list see the leaflet inside your medicine packet.

Do not take medroxyprogesterone tablets while you're pregnant. It can affect the hormone changes that happen naturally during pregnancy.

If you find that you're pregnant while taking medroxyprogesterone, stop taking the tablets and talk to your doctor.

The lower doses (2.5mg, 5mg and 10mg tablets) are unlikely to harm your baby if taken in the first few weeks before you knew you were pregnant.

It's OK to take medroxyprogesterone while breastfeeding.

It's not known how much medroxyprogesterone gets into breast milk when taken as tablets, but it's likely to be a low amount. Your baby will not be able to absorb a lot into their body from the breast milk.

If you need to take high dose medroxyprogesterone tablets for cancer, speak to your specialist who will be able to discuss your options with you.

If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor or midwife as soon as possible.

Medroxyprogesterone tablets may reduce your fertility while you're taking them, but your fertility should return after you stop taking them.

Talk to your doctor if you're taking medroxyprogesterone tablets and you're planning to get pregnant.

Tell your doctor if you're:

• trying to get pregnant
• pregnant
• breastfeeding

Some medicines can affect the way medroxyprogesterone tablets work.

Tell your doctor if you're taking any of these medicines before starting to take medroxyprogesterone tablets:

• rifampicin, an antibiotic
• medicines to treat HIV or hepatitis C
• carbamazepine, phenytoin, phenobarbital (phenobarbitone) or primidone, medicines for epilepsy
• warfarin, a medicine to help prevent blood clots

Do not take St John's wort, a herbal remedy used for depression, with medroxyprogesterone. It can affect the way medroxyprogesterone works.

There's not enough information to say that other complementary medicines, herbal remedies and supplements are safe to take with medroxyprogesterone. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.