DEPO-PROVERA Injection

Question 1

Efficacy?

Answer 1

96%

Question 2

Acne?
Weight gain?
VTE risk?

Answer 2

Yes can increase
Yes - people stop it for this reason ( 3.6 kg in 2 years)
Neutral

Question 3

Bleeding
Cycle Control?
Withdrawal Bleeindg/spotting?

Answer 3

No cycle control - unpredictable bleeding
Average is 2 days/month at 1 years of use
Amenorrhea is at 55% at 1 years and 68% at 2 years

Question 4

Adverse Effects?

Answer 4

Headache
Decreased Libido
Decreased Bone mineral Density - Pt should start taking supplement calcium and Vit D, weight bearing exercises and cessation of smoking

Question 5

Drug Interactions

Answer 5

May consider dosing at Q 10 weeks if on CYP34A4 inducer

Question 6

Additional Considerations

Answer 6

May last up to 14 weeks ( can get shot in between 10-14 weeks)
May decrease ovarian, endometrial cancer
may help with hot flashes

Question 7

Initiation and Dosing

Answer 7

150 mg IM every 12 weeks NO HFI
Use backup contraception for 7 days if not started within 5 days of menses
Injection good for 13 weeks, and probably 14 weeks

Question 8

Missed Dose si equal to what

Answer 8

over 14 weeks since last injection

Question 9

What to do if missed dose

Answer 9

test for pregnancy - only give shot if negative for pregnancy
EC if unprotected sex in last 5 days
use back up contraception for 7 days once restarted

Question 10

How to help irregular bleeding? ( 3)

Answer 10

NSAIDS for 5-7 days
COC for 1-3 months days
Exogenous estrogen for 28 days

Question 11

Return to fertility?

Answer 11

Can take up to 18 months