Depo Flashcards
IM Dose
150mg/1ml
SQ dose
104mg/0.65ml
Frequency
every 13 weeks
Effectiveness
6% unintended pregnancy rate
Mechanism of Action
inhibits gonadotropin secretion, there inhibiting follicular maturation and ovulation. Changes in cervical mucus and tubal motility inhibit fertilization
Contraindications
BCA; severe cirrhosis, hepatocellular adenoma, diabetes with nephrosis or vascular complications, HTN, ischemic heart disease or multiple RFs for atherosclerotic disease; some forms of lupus; LT corticosteroid use; current use of aminoglutethimide
Administration
Shake vial vigorously; IM (gluteal or deltoid muscle); SQ anterior thigh or abdomen (can be given in the upper arm if preferred)
Initiation: First day of menses
Ideal to start within 1st 7 days of menses to prevent ovulation so that BUC isn’t needed
Quick start initiation (after negative UPT)
If > 7 days from 1st day of LMP & she has had unprotected sex: use EC if w/i 120 hours, use BUC for 7 days; repeat UPT in 2-3 weeks
Switching from another method
D/C other method 7 days after DMPA INJ
Switching from IUD
Remove 7 days after INJ or abstain from sex (use condom) for 7 days prior to IUD removal and DMPA INJ; use EC at the time of removal
If late for repeat IM IMJ
If > 2 weeks, UPT is needed and BUC for 7 days
Return to fertility
May be delayed 10-18 months
Switching from DPMA to another method
can start new method anytime but ideally NLT 14-15 weeks after previous INJ
Menopause evaluation
DMPA lowers FSH. To evaluate menopause status it should be measured immediately before next INJ is due and if in the menopausal range on 2 consecutive occasions she can be considered menopausal.
