Depo-Provera suspension for intramuscular administration 150 mg/ml 3.3 ml n1 fl

Side effects

Depo-Provera is valued for its absence of many side effects, which cannot be said, for example, about some hormonal pills. Due to the injections, the menstrual cycle may change slightly. This shouldn't be much of a concern. But still, if this condition is very worrying, it is better to go to the doctor. This is the only way to get rid of doubts and get recommendations about whether you can continue to use the chosen method of contraception.

But there are also situations in which going to the doctor is not advisable, but mandatory. This applies to cases where serious disruptions are observed during menstruation. For example, monthly bleeding disappears or does not occur in accordance with the usual schedule. A noticeable increase in your own weight, as well as the appearance of headaches and incomprehensible depression, should also alert you. With such symptoms, it may be necessary to stop the protective injections, but the main word remains with the specialist.

Depo-Provera

Progestogen-based contraceptive. Available in the form of a suspension for intramuscular administration (injections) and in the form of tablets. The most popular among doctors and patients is the suspension, which provides protection in a very comfortable way.

When administered by injection, the drug has a long-term contraceptive effect due to the fact that it suppresses the secretion of hormones produced by the pituitary gland, primarily luteinizing hormone. The consequence of this is the suppression of ovulation and the cessation of follicle maturation. In addition, Depo-Provera increases the viscosity of cervical mucus, which also contributes to the contraceptive effect.

When using Depo-Provera, the following manifestations of positive effects on the body are noted:

• reduction of vasomotor symptoms during menopause (fever, hot flashes, chills),
• reducing the risk of osteoporosis during menopause,
• reducing the risk of inflammatory diseases of the genital organs, vulvovaginal candidiasis,
• Most women with endometrial hyperplastic processes experience partial or complete regression,
• reducing the risk of endometriosis, breast, uterine and kidney cancer.

It is important that Depo-Provera does not affect lactation, and its concentration in breast milk is insignificant. Therefore, this means of contraception can be recommended for women during lactation.

Depo-Provera is prescribed by a gynecologist for contraception purposes, especially in women of late reproductive age (35+), as well as for:

• treatment of endometriosis,
• diagnosis of primary and secondary amenorrhea,
• therapy during menopause,
• treatment of premenstrual syndrome,
• prevention and treatment of osteoporosis during menopause,
• treatment of tumor formations in the area of ​​the kidneys, breast, endometrium (including with metastases).

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Contraindications to the use of Depo-Provera are:

• pregnancy,
• tumors of the genital organs or breast (in some cases),
• bleeding from the genital tract of unknown origin.

If you have a history of diseases such as thrombophlebitis, thromboembolism or stroke (including the risk of stroke), liver failure, hypercalcemia, epilepsy, migraine, bronchial asthma, heart or kidney failure, diabetes mellitus, frequent depression, be sure to tell us about it doctor. For such diseases, the doctor must take special care when prescribing contraception.

Side effects:

• headache, dizziness, causeless irritability, depression;
• insomnia or, conversely, drowsiness;
• increased fatigue;
• nausea, pain and discomfort in the abdomen;
• thromboembolic disorders;
• allergic reactions (urticaria, itching, rash);
• increased sensitivity of the nipples of the mammary glands;
• cervical erosion, dysmenorrhea, spotting;
• “vulgar” acne, hirsutism, changes in body weight;
• alopecia (hair loss).

Immediately after the injection, there may be pain, slight lumps for some time, and the color of the skin may change slightly. These manifestations are temporary.

Reception scheme

For contraceptive purposes, an intramuscular injection of 150 mg is given every three months. In order to exclude the possibility of pregnancy at the time of the first injection, it is recommended to do it within five days after the start of the next menstruation or before six weeks after childbirth.

For other purposes - for the treatment of dysfunctional uterine bleeding, endometriosis, cancer, osteoporosis - tablets are prescribed. The dosage regimen and dosage are determined by the doctor individually.

Other things to consider

When planning to resort to this method of contraception, it is important to remember the following points:

• It is prohibited to injure the injection site in any way. The area should not be rubbed, combed or massaged. It is better to spend the first hours after the injection relaxing, in a calm environment.
• You should not lose vigilance at the initial stage of using such contraception. In the next two weeks after the first administration of the drug, it is necessary to protect yourself by using an additional method of protection against pregnancy, for example a condom. It is contraindicated to take hormonal substances.
• If you miss the deadline for your next injection, you must make sure that you are not pregnant. Only if you are sure of this is it permissible to take a contraceptive injection again. After it, as at the very beginning of using the method, you need to use additional protection for two weeks.
• It should be borne in mind that the purpose of Depo-Provera is only to prevent conception, but such injections are not capable of protecting against dangerous sexually transmitted diseases. Therefore, if you are not confident in your partner, you should think about how to eliminate the risk of infection.

When planning to conceive a child, you must stop taking injections several months before.

Flaws

There are disadvantages to birth control. Depo-Provera is no different, and it's important to know both the pros and cons before making a decision.

• Planning is important and you must remember that you plan to take injections every 12 weeks. If it has been more than 13 weeks since your last shot (or 14 weeks since your last Depo-subQ 104), be sure to use a back-up birth control method because you are at risk of becoming pregnant.
• The instructions for Depo-Provera include a warning about possible bone loss: "Women who use Depo-Provera may lose significant bone mineral density." This measure measures how much calcium is stored in the bones. Depot use can cause calcium loss over time, but calcium begins to return once this method is stopped. Because of this warning, Depo-Provera is generally not recommended for teenage girls.
• Due to the possibility of bone density loss, it is also recommended not to use Depo Provera or Depo-subQ Provera 104 for more than two years.
• Many women stop using Depo-Provera within the first year of use due to spotting/irregular bleeding and/or continuous bleeding. This side effect is especially common during the first 3 months of using Depo. Unfortunately, there is no way to know in advance whether you will experience these bleeding problems.
• In a small number of cases, women experienced skin reactions in the area where the injection was given. There may also be a dimple or lump around the injection.
• Pfizer, the maker of Depo-Provera, recommends that you stop taking Depo injections a year before you want to become pregnant. It takes an average of nine to ten months (and sometimes a year or longer) to restore fertility and begin ovulation after the last shot.
• Some studies have shown weight gain with Depo-Provera. The manufacturer claims that women gain an average of 3kg in the first year and will gain 3.6kg by the end of the second year.
• Some women report mild pain associated with the Depo injection.
• Unfortunately, there is no way to stop the side effects that may occur from using Depo-Provera. There is a chance that these side effects may continue until your depot injection wears off after 12 to 14 weeks.

Fewer common side effects

During the first year of Depo, you may notice several changes as your body adjusts. Additionally, some of the less common side effects include changes in sex drive and appetite, as well as hair loss and/or increase in facial or body hair. In a few women, it may cause depression, nervousness, dizziness, nausea or headaches. You may also experience a rash or patchy darkening of the skin or chest pain.

Additional Considerations

• If you are using another hormonal method, you may want to switch to Depo-Provera. You must get your first Depo shot within seven days of the last day of your current method.
• If you are switching from combined birth control pills, arrange for your first Depo shot within seven days of taking your last active pill.
• If you switch from the Ortho Evra patch, schedule a Depo-Provera injection for seven days after removing the patch.
• If you switch from NuvaRing, schedule your first Depo shot within seven days after you remove the ring.

Protection from STIs

Depo-Provera does not protect against sexually transmitted infections. You must use a condom.

Interaction with other drugs

• Concomitant use with a hypnotic and sedative such as aminoglutethimide may reduce Depo-Provera levels in the blood plasma.
• If used simultaneously with drugs that ensure the production of microsomal enzymes in the liver, the contraceptive effect of medroxyprogesterone will also decrease.
• The duration of action of gestagens is increased by drugs such as Phenobarbital, Phenytoin, Griseofulvin, and Carbamazepine.
• Depo-Provera as a contraceptive can change in one direction or another the effectiveness of the use of drugs used for hypoglycemia.
• May enhance the absorption of the cyclic polypeptide antidepressant Cyclosporine, which will increase the risk of its toxicity.

Efficiency

Depo-Provera is 94% to 99% effective. With ideal use, less than 1 in every 100 women who use Depo-Provera will become pregnant within a year. With normal use, 3 out of every 100 women will become pregnant.

Depo-Provera is a popular option for birth control. Many women have found that several years of regular injections make birth control easier. Talk to your doctor to make sure it's right for you and be sure to ask any questions you have.

Contraindicated for whom

The effectiveness of the drug has been proven for more than one year of medical practice, and on a global scale. And, naturally, a lot of data has accumulated on situations where there are no obstacles to the use of the medicine, and when its use as a contraceptive is inappropriate and even unsafe.

Contraindications may include things such as

• Tendency to allergic reactions such as hives or anaphylaxis
• Digestive problems
• Dermatological problems (itching, inflammatory or acne, alopecia (baldness, not physiological, natural, but for pathological reasons.)
• For diseases of the musculoskeletal system (joint pain, muscle cramps, especially the calf muscles)
• Problems with the reproductive system, genital organs: uterine bleeding and any bleeding from the vagina outside the menstrual period; with galactorrhea; with painful sensations in the mammary glands; with anorgasmia (lack of orgasms) and decreased sexual desire; for leucorrhoea, vaginitis, pain in the lower abdomen.
• Problems with blood clotting.
• From the side of the central nervous system: insomnia or vice versa – drowsiness; excessive nervous excitability, irritability for no reason, tendency to depression; headaches and dizziness.
• In rare cases, sudden problems with vision occur: it can sharply weaken or even be lost; clearly defined double vision begins in the eyes, and pain appears behind the eyes. In these cases, the use of the drug should be stopped immediately and checked by an ophthalmologist for glaucoma; upon examination, swelling of the nipple in the optic nerve bundle and problems with the retina may be revealed. These problems are not caused by the drug - these symptoms are simply an indicator that you already have glaucoma or a similar disease.
• Strictly contraindicated during pregnancy.

Reviews

I only took one injection. I experienced cramps, dizziness, nausea and mood changes every day for 3 months. I haven't had my next shot, but I still see stomach pain, irregular periods and mood swings: I would never recommend this product. Moreover, I think it should be withdrawn from sale immediately.

I am 41 years old and I have four children. I don't want to get pregnant again, so I decided to get the injection. The first injection was on March 24, my menstruation stopped at 2 weeks. In May I started bleeding and it got worse. I am still bleeding for 4 months now. I'm afraid this is serious? Help, I can't sleep. Thank you.

I took one injection at the end of February 2021. Missed my next dose on purpose because Depo completely killed my sex drive. A week after my missed dose I had severe anxiety, had to leave work early because I had struggled with anxiety in the PAST and had learned to keep it under control very well. This time I can't stop the intrusive anxious thoughts and life has been going well so there is no reason to worry. I also had a period of depression that seemed to come and go. It's been 2 months since my missed dose and the anxiety and depression are still there. I would not recommend the drug or others like it to anyone, as I see many other types of contraception causing the same effects.

Check with your doctor

What questions should you discuss with your doctor if you are considering using Depo-Provera as a long-acting contraceptive?

• Change in body weight towards increase with long-term use of the drug
• Delay in the restoration of fertility - especially in light of the fact that there is no antidote for this remedy
• In the long term, the development of osteoporosis is possible, especially if the medicine was used uncontrolled and from adolescence (16-17 years)
• Duration of action of even a single dose (up to 12 weeks)
• Informing those wishing to use this particular contraceptive that monthly menstrual bleeding is not a mandatory attribute of a woman.
• It is possible that there will be frequent periodic acyclic mild bleeding.

Most often, women decide to use Depo-Provera for whom regular and daily use of oral contraceptives is inconvenient or even impossible due to employment or a busy business schedule. It is for this reason that they often miss the next injection - due to lack of time or forgetfulness.

But due to the residual hormonal effects of progestogens, a delay of up to 2 weeks with the next injection is not critical. And the longer the drug was used, the longer it is possible to miss the deadline (up to a month or more). So during this time, the woman will inevitably remember the next date for visiting the doctor’s office.

If there is heavy bleeding after the injection

Normally this shouldn't happen. But the mechanism of action of Depo-Provera on the uterus is such that the thickness of the inner epithelial layer, the endometrium, inevitably decreases. What to do in such a situation?

Let's understand the reasons

Heavy menstrual bleeding, if on the contrary, occurs with an excess layer due to the parallel use of estrogens, is extinguished by the introduction of additional injections of progestogens.

But in the case of Depo-Provera, this cannot be done - an additional dose of progestogen will only increase bleeding in conditions of a thin endometrium. So with such a development of the process, it is impossible to do without the use of additional estrogens; they are prescribed in an amount of 30 mcg as part of COCs (combined oral contraceptives), which will allow the endometrium to develop further. Such measures contribute to the rapid normalization of the cycle, and after 2-3 weeks the need for additional estrogen treatment disappears.

note

When processing the medical results of using Depo-Provera over the past at least a decade, evidence has emerged that long-term, over 4-6 years, use of the drug as a contraceptive may in the long term, in 20-30 years, cause a risk of developing osteoporosis.

When examining the liver, the test results for prothrombin (factor II), as well as blood clotting factors VII, VIII, IX, X, may be overestimated.

When determining the level of hormones in blood plasma, the test results may show an underestimation compared to the medical norm. The same decrease in level can occur when analyzing the level of gonadotropins, testosterone in the blood plasma, pregnanediol in the urine and in the glucose tolerance test (sugar load test).

A decrease in level will also be shown by a test for specific globulins that bind sex hormones.

Therefore, if a histological examination of any organs is prescribed, the histologist conducting it must be warned about the previous use of progestogens, including its timing, duration and dosage.

Since the contraindications indicate the possibility of Depo-Provera influencing the central nervous system, and therefore the occurrence of even slight dizziness, you need to drive motor vehicles and complex machinery in general with caution. At the first signs of spatial disorientation, driving should be avoided until the end of the drug's validity period.

Does not affect the production of mother's milk. It is excreted in microscopic quantities and, according to studies, does not have any effect on the health and development of infants.