What is the suitable range post-last-injection for Depo-Provera (medroxyprogesterone acetate) to be given in weeks?

From the Guidelines

Depo-Provera (depot medroxyprogesterone acetate or DMPA) should be administered every 13 weeks, but it can be given up to 15 weeks after the previous injection without requiring additional contraceptive protection, as stated in the most recent guidelines 1. The suitable range for repeat injections is between 13 to 15 weeks, allowing for a 2-week grace period while maintaining contraceptive effectiveness. Key points to consider:

• If more than 15 weeks have elapsed since the last injection, a pregnancy test should be performed before administering the next dose, and backup contraception should be used for 7 days following the delayed injection.
• The 15-week outer limit provides a reasonable safety margin while ensuring continuous contraceptive coverage.
• Patients should be encouraged to adhere to the regular 13-week schedule whenever possible to maintain optimal contraceptive effectiveness, as supported by the guidelines 1. The recommendation is based on the pharmacokinetics of DMPA, which maintains therapeutic levels for contraception beyond the standard 13-week interval, and is consistent with the guidelines from reputable sources, including the CDC 1 and other studies 1.

From the FDA Drug Label

The recommended dose is 150 mg of Medroxyprogesterone Acetate Injectable Suspension, USP every 3 months (13 weeks) If the time interval between injections is greater than 13 weeks, the physician should determine that the patient is not pregnant before administering the drug.

The suitable range post-last-injection for Depoprovera to be given is up to 13 weeks.

• If more than 13 weeks have passed, the patient should be determined not to be pregnant before administering the next dose 2.

From the Research

Suitable Range Post-Last-Injection for Depoprovera

The suitable range post-last-injection for Depoprovera to be given is not explicitly stated in the provided studies. However, the studies provide information on the effectiveness and safety of Depoprovera (DMPA) as a contraceptive method.

• The studies 3, 4, 5 discuss the use of DMPA as a contraceptive option, its potential impact on bone mineral density, and its safety profile in various populations, including women with medical problems.
• Study 4 mentions that DMPA can be used safely in women with select conditions and characteristics, including age, obesity, endometriosis, or HIV.
• Study 6 compares the contraceptive effectiveness of DMPA injectable with the levonorgestrel implant in women living with HIV on efavirenz, but does not provide information on the suitable range post-last-injection for Depoprovera.

Key Findings

• DMPA is a cost-effective contraceptive option that can be used safely in various populations 3, 4.
• The use of DMPA is associated with a slight decrease in bone mineral density, which is largely reversible 3.
• DMPA can be used in women with medical problems, such as chronic hypertension, cardiac disease, thrombotic disorders, diabetes, epilepsy, and lupus erythematosus 5.

Limitations

• The studies do not provide explicit information on the suitable range post-last-injection for Depoprovera.
• The studies have varying sample sizes, populations, and study designs, which may limit the generalizability of the findings.