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Medroxyprogesterone acetate low strength oral

Updated 2 Feb 2023 | Progestogens


Tablets containing low strength medroxyprogesterone acetate.

Drugs List

  • CLIMANOR 5mg tablets
  • medroxyprogesterone 10mg tablets
  • medroxyprogesterone 2.5mg tablets
  • medroxyprogesterone 5mg tablets
  • PROVERA 10mg tablets
  • PROVERA 2.5mg tablets
  • PROVERA 5mg tablets
  • Therapeutic Indications


    Adjunct to oestrogen replacement therapy in peri and postmenopausal women
    Amenorrhoea - secondary
    Dysfunctional uterine bleeding

    Unlicensed Uses

    Hot flushes associated with androgen deprivation in prostate cancer



    Dysfunctional uterine bleeding:
    2.5mg to 10mg once a day for 5 to 10 days starting on the 16th to 21st day of the cycle, for two consecutive cycles.
    Oestrogen therapy in conjunction with medroxyprogesterone acetate may be administered when bleeding occurs from poorly developed proliferative endometrium. Dose should be started at 5mg to 10mg day for 10 or 12 days.

    Secondary amenorrhoea:
    2.5mg to 10mg once a day for 5 to 10 days starting on the 16th to 21st day of the cycle, for three consecutive cycles.
    Oestrogen therapy in conjunction with medroxyprogesterone acetate may be administered when bleeding occurs from poorly developed proliferative endometrium. Dose should be started at 5mg to 10mg day for 10 or 12 days.

    Mild to moderate endometriosis:
    10mg three times a day for 90 consecutive days beginning on the first day of the menstrual cycle. Self limiting breakthrough bleeding may occur.
    No additional hormonal therapy is recommended for the management of this bleeding.

    Hormone replacement therapy:
    Some brands suggest the following dosing in women with an intact uterus receiving oestrogen, a cyclical regimen of 10mg once a day for the last 14 days of each 28 day cycle to reduce the risk to the endometrium.

    Hot flushes associated with androgen deprivation in prostate cancer (unlicensed)
    20mg daily for 10 weeks. Assess effectiveness of therapy after initial 10 week course.


    Children under 18 years
    Abnormal liver function test
    Acute hepatic disorder
    Breast cancer
    Deep vein thrombosis
    Female genital cancer
    History of breast cancer
    History of venous thromboembolism
    Pulmonary embolism
    Recent arterial thromboembolic disorder
    Thromboembolic disorder
    Venous thromboembolism

    Precautions and Warnings

    Body mass index above 30kg per square metre
    Family history of breast cancer
    Family history of venous thromboembolism
    History of recurrent spontaneous abortion
    Predisposition to thromboembolic disease
    Prolonged immobilisation
    Recent surgery
    Recent trauma
    Risk factor for oestrogen-dependent neoplasm
    Severe headache
    Cardiac impairment
    Diabetes mellitus
    Epileptic disorder
    Glucose-galactose malabsorption syndrome
    Hepatic disorder
    Hereditary fructose intolerance
    History of acute visual disturbances
    History of depression
    History of thromboembolic disorder
    Lactose intolerance
    Renal impairment
    Systemic lupus erythematosus
    Uterine fibroids

    Assess family medical history prior to commencing treatment
    Exclude breast cancer before treatment
    Not all available brands are licensed for all indications
    Contains lactose
    Some formulations contain sucrose
    Do breast & pelvic exam. before & during treatment if clinically indicated
    Exclude pregnancy prior to initiation of treatment
    Abnormal and/or irregular bleeding should be investigated
    Monitor for signs and symptoms of glucose intolerance
    Monitor patients with a history of treatment of mental depression
    Advise patient that changes in their breasts should be reported to Dr/nurse
    Advise patient to contact a doctor if symptoms of thromboembolism develop
    May cause weight gain
    Discontinue 4 - 6 weeks before major surgery
    Discontinue at first signs of jaundice
    Discontinue if first occurrence or worsening of migraine/severe headache
    Discontinue if significant rise in blood pressure occurs
    Discontinue if sudden pain in the chest occurs
    Discontinue if venous thromboembolism develops
    Discontinue in the event of a prolonged period of immobilisation
    Pregnancy confirmed: Discontinue this medication
    Advise patient not to take St John's wort concurrently
    Delay in return to fertility can occur following treatment discontinuation
    Male & female: Use in conjunction with barrier methods of contraception

    Hormone replacement therapy (HRT) should only be considered for patients whose symptoms adversely affect quality of life. An annual careful appraisal of the risks and benefits should be undertaken. When carrying out initial medical examinations of patients, ensure that investigations (including appropriate imaging tools, e.g. mammography) are carried out in accordance with currently accepted screening practices.

    For the treatment of menopausal symptoms the benefits of short-term HRT are considered to outweigh the risks in the majority of women. In all cases, it is good practice to use the lowest effective dose for the shortest possible time and to review the need to continue treatment at least annually. For postmenopausal women over 50 years who are at an increased risk of bone fracture, HRT should be used to prevent osteoporosis only in those who are intolerant of, or contraindicated for, other osteoporosis therapies.

    Physical examination should be guided by this and a knowledge of the contraindications and precautions and warnings for use of the product. Investigations including mammography should be carried out in accordance with currently accepted screening practices, modified according to the clinical needs of the individual.

    There is an increased risk of breast cancer in women currently or recently using Hormone Replacement Therapy (HRT). The risk of breast cancer increases with the duration of treatment and returns to normal after 5 years of stopping treatment.

    Examinations to rule out endometrial abnormalities should be undertaken at regular intervals. Prolonged monotherapy with oestrogens increases the risk of endometrial hyperplasia and carcinoma in postmenopausal women unless supplemented by administration of a progestogen to protect the endometrium. Unless there is a previous diagnosis of endometriosis it is not recommended to add a progestogen in hysterectomised women.

    Pregnancy and Lactation


    Medroxyprogesterone acetate is contraindicated during pregnancy.

    The manufacturer states that the patient should be informed of the risks to the foetus if medroxyprogesterone acetate is used during pregnancy. Genital abnormalities have been associated in male and female foetuses from intrauterine exposure to progestational drugs in the first trimester of pregnancy.


    Medroxyprogesterone acetate is contraindicated during breastfeeding.

    The manufacturer advises that medroxyprogesterone acetate should not be given sooner than six weeks post-partum when the infant's enzyme system is more developed. Medroxyprogesterone acetate and its metabolites are secreted in breast milk, no adverse effect have been shown in neonates and infants exposed.

    Side Effects

    Anaphylactoid-like reaction
    Breast pain
    Breast tenderness
    Cervical discharge
    Decreased glucose tolerance
    Fluid retention
    Irregular menstruation
    Premenstrual symptoms
    Temperature disturbances
    Uterine cervical erosion
    Vaginal bleeding
    Weight changes


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: October 2019

    Reference Sources

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of product characteristics: Climanor Tablet. Resource Medical UK Ltd. Revised April 2009.

    Summary of product characteristics: Provera Tablets 2.5mg, Provera tablets 5mg, Provera tablets 10mg. Pfizer Limited. Revised February 2020.

    NAPOS. The drug database for acute porphyria.
    Available at:
    Medroxyprogesterone Last revised: 10 August 2012
    Last accessed: 14 August 2019

    NICE Evidence Services Available at: Last accessed: 15 August 2019

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