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Precautions and Warnings With Medroxyprogesterone Intramuscular Injection

Specific Medroxyprogesterone Intramuscular Injection Precautions and Warnings

Some warnings and precautions to be aware of before receiving these injections include the following:
  • Medroxyprogesterone intramuscular injection can decrease the amount of calcium stored in your bones, which can cause bone loss (osteoporosis) and increase your risk for fractures. Your bones may not return to normal even after stopping the medication. This side effect is especially concerning for adolescents and young adults, who are at a critical age for gaining bone strength, as well as for people who are already at risk for weak bones. This may include those who:
The longer you use medroxyprogesterone intramuscular injection, the more it will affect the bones. Therefore, the medication should not be used for longer than two years unless absolutely necessary. Also, it is a good idea for everyone who uses medroxyprogesterone intramuscular injection to have an adequate intake of calcium and vitamin D through supplements or dietary means. Ask your healthcare provider if you are getting enough calcium and vitamin D to help protect your bones.
  • If you are using medroxyprogesterone intramuscular injection to prevent pregnancy, you should know that it does not protect against HIV or other sexually transmitted diseases (STDs). You will need another form of contraception to protect yourself from STDs.
  • Studies have shown that this medication can increase the risk for breast cancer. It may also increase the risk for cervical cancer. It is recommended that women with a history of breast cancer should not use hormonal contraceptives, including medroxyprogesterone intramuscular injection. Women who use this medicine should receive proper screening and monitoring, such as routine mammograms.
  • Medroxyprogesterone intramuscular injection can increase the risk for strokes and blood clots in your arms, legs, lungs, and eyes. Seek immediate medical attention if you experience signs of a stroke or blood clot, such as:
    • Changes in your vision or speech
    • Shortness of breath
    • Sudden chest pain
    • Weakness
    • Swelling
    • Pain in an arm or leg.
  • Medroxyprogesterone intramuscular injection can increase the risk for an ectopic pregnancy, which is a pregnancy that occurs outside of the uterus. An ectopic pregnancy is a serious and potentially life-threatening condition. Seek immediate medical attention if you experience unexplained vaginal bleeding or severe abdominal (stomach) or pelvic pain, which may be signs of an ectopic pregnancy.
  • This medication can cause liver problems. Contact your healthcare provider right away if you experience yellowing of the whites of the eyes or skin (jaundice), which could be signs of liver problems.
  • The majority of women who use medroxyprogesterone intramuscular injection will probably gain weight. In clinical trials, two-thirds of women gained at least five pounds in the first year of use. The average weight gain was eight pounds after two years of use.
  • There have been rare reports of seizures in people who have used this medicine, including some people who did not already have a history of a seizure disorder. Before receiving medroxyprogesterone intramuscular injection, make sure your healthcare provider knows if you have ever had a seizure.
  • Depression is a possible side effect of medroxyprogesterone intramuscular injection. If you have a history of depression, your healthcare provider may choose to monitor you more closely. If you develop depression while using medroxyprogesterone intramuscular injection, you should not receive another shot.
  • Women may notice irregular periods when they first start using medroxyprogesterone intramuscular injection. This could include spotting, periods that are lighter or heavier than normal, or irregular or unpredictable periods. The majority of women will stop having periods altogether if they continue using medroxyprogesterone intramuscular injection. Unusually heavy bleeding is not normally a side effect of this medicine, and should be reported immediately to your healthcare provider.
  • Medroxyprogesterone intramuscular injection has been reported to cause a decrease in glucose tolerance, which could be a problem for people with diabetes. If you have diabetes, your healthcare provider may recommend you test your blood sugar levels more often while using this medicine.
  • Medroxyprogesterone intramuscular injection can cause fluid retention. This can cause problems for certain people, including those with congestive heart failure (CHF), kidney problems, asthma, or migraines. Your healthcare provider may need to monitor you more closely if you have a condition that could be affected by fluid retention.
  • Because medroxyprogesterone intramuscular injection is a long-acting medicine, it can take many months before you are able to become pregnant after stopping the medication. Clinical studies suggest the average time to conception is 10 months following the last shot, with a majority of women able to get pregnant within 12 months. However, some women may not conceive for as long as 36 months after stopping medroxyprogesterone intramuscular injection.
  • It is a good idea to have an annual healthcare exam in general, and especially while using this medication. Make sure to keep all of your appointments with your healthcare provider. He or she will want to check your blood pressure, and may also recommend other tests, such as a mammogram and pelvic exam if you are a woman.
  • Medroxyprogesterone intramuscular injection passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving the drug (see Depo-Provera and Breastfeeding).
  • Medroxyprogesterone intramuscular injection is a pregnancy Category X medication. This means it should not be used in pregnant women (see Depo-Provera and Pregnancy).
Last reviewed by: Kristi Monson, PharmD
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