Can you take varenicline (Chantix) while using the Depo-Provera (medroxyprogesterone acetate) shot?

Varenicline Use with Depo-Provera: Safety and Considerations

Yes, you can safely take varenicline (Chantix) while using the Depo-Provera contraceptive shot, as there are no known drug interactions between these medications. There is no evidence in the medical literature indicating contraindications or significant interactions between varenicline and medroxyprogesterone acetate (Depo-Provera) 1.

Mechanism and Safety Profile

Varenicline works as a partial agonist/antagonist with affinity for alpha4-beta2 nicotinic acetylcholine receptors, helping reduce smoking cravings and withdrawal symptoms 2. Meanwhile, Depo-Provera is a progestin-only contraceptive that works primarily by preventing ovulation 3.

The U.S. Medical Eligibility Criteria for Contraceptive Use does not list any interactions between smoking cessation medications and hormonal contraceptives 1. Specifically:

• No drug interactions have been reported between varenicline and hormonal contraceptives including Depo-Provera
• Depo-Provera is not metabolized through pathways that would be expected to interact with varenicline

Potential Side Effects to Monitor

While you can take these medications concurrently, be aware of the potential side effects of each:

Varenicline side effects:

• Nausea (most common, affecting 16.3%-41.9% of users) 2
• Insomnia (14.2%) 2
• Headache (14.2%) 2
• Rare but serious: seizures, cardiovascular events, neuropsychiatric events 1

Depo-Provera side effects:

• Menstrual irregularities (nearly all users initially) 3
• Weight gain (common) 3, 4
• Bone mineral density loss with long-term use 3, 5

Important Considerations

1. Smoking cessation benefits: Quitting smoking while on Depo-Provera is particularly beneficial as:

   • Smoking is a leading preventable cause of illness and premature death 6
   • Varenicline has been shown to be highly effective, with continuous abstinence rates significantly higher than placebo (OR 2.88) 6

2. Bone health: Both smoking and Depo-Provera can negatively impact bone health. The FDA recommends:

   • Adequate calcium (1300 mg/day) and vitamin D (600 IU/day) intake
   • Regular weight-bearing exercise
   • Smoking cessation 3

3. Neuropsychiatric concerns: While earlier concerns existed about varenicline and neuropsychiatric events, recent evidence from the EAGLES trial found no significant increase in these events compared to placebo or nicotine patch 1.

4. Cardiovascular safety: Recent systematic reviews have not identified a significant link between varenicline and increased risk of serious cardiovascular adverse events 1.

Follow-up Recommendations

• Continue receiving your Depo-Provera injections on schedule (every 13 weeks) 3
• Follow the standard varenicline dosing protocol, starting 7 days before your quit date 2
• Report any unusual symptoms to your healthcare provider
• Consider calcium and vitamin D supplementation to support bone health 3

Common Pitfalls to Avoid

• Missing Depo-Provera injection windows: Ensure injections are given within the 13-15 week timeframe to maintain contraceptive effectiveness 3
• Stopping varenicline prematurely: Complete the full course of treatment for best smoking cessation outcomes
• Ignoring side effects: Report persistent or severe side effects to your healthcare provider
• Overlooking bone health: Consider calcium and vitamin D supplementation while on both medications 3

Taking varenicline while using Depo-Provera represents a positive step toward improving your overall health by addressing smoking cessation while maintaining effective contraception.