|Depo-Provera Contraceptive Injection
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PROGESTINS For Contraceptive Use (Systemic)
Some commonly used brand names are:
In the U.S.—
Another commonly used name is norethisterone .
Progestins (proe-JES-tins) are hormones.
The low-dose progestins for contraception are used to prevent pregnancy. Other names for progestin-only oral contraceptives are minipills and progestin-only pills (POPs). Progestins can prevent fertilization by preventing a woman"s egg from fully developing.
Also, progestins cause changes at the opening of the uterus, such as thickening of the cervical mucus. This makes it hard for the partner"s sperm to reach the egg. The fertilization of the woman"s egg with her partner"s sperm is less likely to occur while she is taking, receiving, or using a progestin, but it can occur. Even so, the progestins make it harder for the fertilized egg to become attached to the walls of the uterus, making it difficult to become pregnant.
No contraceptive method is 100 percent effective. Studies show that fewer than 1 of each 100 women become pregnant during the first year of use when correctly receiving the injection on time or receiving the levonorgestrel implants. Fewer than 10 of each 100 women correctly taking progestins by mouth for contraception become pregnant during the first year of use . Methods that do not work as well include using condoms, diaphragms, or spermicides. Discuss with your health care professional what your options are for birth control.
Progestins are available only with your doctor"s prescription, in the following dosage forms:
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. If you are using progestins for contraception you should understand how their benefits and risks compare to those of other birth control methods. This is a decision you, your sexual partner, and your doctor will make. For progestins, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to progestins. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Diet—Make certain your health care professional knows if you are on any special diet, such as a low-sodium or low-sugar diet.
Pregnancy—Use of progestin-only contraceptives during pregnancy is not recommended. Doctors should be told if pregnancy is suspected. When accidently used during pregnancy, progestins used for contraception have not caused problems.
Breast-feeding—Although progestins pass into the breast milk, the low doses of progestins used for contraception have not been shown to cause problems in nursing babies. Progestins used for contraception are recommended for nursing mothers when contraception is desired.
Adolescents—Progestins have been used by teenagers and have not been shown to cause different side effects or problems than they do in adults. You must take progestin-only oral contraceptives every day in order for them to work. Progestins do not protect against sexually transmitted diseases, a risk factor for teenagers. It is not known if Depo-Provera Contraceptive Injection causes problems with bone development and growth in teenagers and young women. It is important that your doctor check you regularly for growth problems, especially if you have been using this medicine for 2 years or longer.
Older adults—This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking a progestin, it is especially important that your health care professional know if you are taking any of the following:
Other medical problems—The presence of other medical problems may affect the use of progestins. Make sure you tell your doctor if you have any other medical problems, especially:
Proper Use of This Medicine
To make the use of a progestin as safe and reliable as possible, you should understand how and when to take it and what effects may be expected. Progestins for contraception usually come with patient directions. Read them carefully before taking or using this medicine.
Progestins do not protect a woman from sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), or acquired immunodeficiency syndrome (AIDS). The use of latex (rubber) condoms or abstinence is recommended for protection from these diseases.
Take this medicine only as directed by your doctor. Do not take more of it and do not take it for a longer time than your doctor ordered . To do so may increase the chance of side effects. Try to take the medicine at the same time each day to reduce the possibility of side effects and to allow it to work better.
When using the levonorgestrel subdermal dosage form :
When using levonorgestrel tablet dosage form for emergency contraception :
When using medroxyprogesterone injection dosage form for contraception :
When using an oral progestin dosage form :
Dosing—Follow your doctor"s orders or the directions on the label . Also, follow your health care professional"s orders to schedule the proper time to remove the implants or receive an injection of progestins for contraception. You and your health care professional may choose to replace the implants sooner or begin a new method of birth control. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.
Storage—To store this medicine:
Precautions While Using This Medicine
It is very important that your health care professional check your progress at regular visits . This will allow your dosage to be adjusted to your changing needs, and will allow any unwanted effects to be detected. These visits are usually every 12 months when you are taking progestins by mouth for birth control.
Progestins may cause some people to become dizzy . Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.
Vaginal bleeding of various amounts may occur between your regular menstrual periods during the first 3 months of use. This is not unusual and does not mean you should stop the medicine. This is sometimes called spotting when the bleeding is slight, or breakthrough bleeding when it is heavier. If this occurs, continue on your regular dosing schedule. Check with your doctor :
Missed menstrual periods may occur. If you suspect a pregnancy, you should call your doctor immediately .
If you are scheduled for any laboratory tests, tell your health care professional that you are taking a progestin. Progestins can change certain test results.
The following medicines might reduce the effectiveness of progestins for contraception:
If you vomit your oral progestin-only contraceptive for any reason within hours of taking it, do not take another dose. Return to your regular dosing schedule and use an additional back-up method of birth control for 48 hours.
If you are receiving levonorgestrel tablets for emergency contraception and vomiting occurs within 1 hour of taking either dose of the medicine, contact your physician to discuss whether the dose should be repeated.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Changes in uterine bleeding (increased amounts of menstrual bleeding occurring at regular monthly periods; lighter uterine bleeding between menstrual periods; heavier uterine bleeding between regular monthly periods; or stopping of menstrual periods
Mental depression; skin rash; unexpected or increased flow of breast milk
Incidence not known—for patients taking Depo-Provera Contraceptive Injection .
Cough; decrease in height; difficulty swallowing; fast heartbeat; hives, itching, puffiness, or swelling of the eyelids or around the eyes, face, lips or tongue; pain in back, ribs, arms, or legs; shortness of breath; pain or swelling in arms or legs without any injury; skin rash; tightness in chest; wheezing
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
Abdominal pain or cramping; diarrhea; dizziness; fatigue; mild headache; mood changes; nausea; nervousness; pain or irritation at place of injection or place where implants were inserted; swelling of face, ankles, or feet; unusual tiredness or weakness; vomiting; weight gain
Acne; breast pain or tenderness; brown spots on exposed skin, possibly long-lasting; hot flashes; loss or gain of body, facial, or scalp hair; loss of sexual desire; trouble in sleeping
Not all of the side effects listed above have been reported for each of these medicines, but they have been reported for at least one of them. All of the progestins are similar, so any of the above side effects may occur with any of these medicines.
After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this period of time check with your doctor if you notice any of the following side effects:
Delayed return to fertility; stopping of menstrual periods; unusual menstrual bleeding (continuing)
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
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