What to know about Medroxyprogesterone (Medroxy) 2.5 mg?

Medroxyprogesterone 2.5 mg: Essential Information

Medroxyprogesterone acetate 2.5 mg is primarily used to prevent endometrial hyperplasia in postmenopausal women taking estrogen therapy, and can also treat secondary amenorrhea and abnormal uterine bleeding. 1

Primary Indications

For Postmenopausal Women on Estrogen:

• The 2.5 mg dose is specifically designed for continuous combined hormone therapy to reduce the risk of endometrial cancer in women with a uterus taking estrogen. 1
• When combined with conjugated estrogens, medroxyprogesterone acetate 2.5 mg effectively reduces endometrial hyperplasia risk by counteracting estrogen's proliferative effects on the uterine lining. 2
• This dose is given daily for 12-14 consecutive days per month when used cyclically, or continuously when combined with daily estrogen. 1

For Menstrual Disorders:

• Doses of 2.5-10 mg daily for 5-10 days can treat secondary amenorrhea (absent periods) or abnormal uterine bleeding. 1
• The lower 2.5 mg dose may be sufficient for some women, though 5-10 mg is more commonly prescribed for these indications. 1

Critical Safety Information

Absolute Contraindications - Do Not Use If: 1

• Unusual vaginal bleeding (undiagnosed)
• Current or history of breast cancer or other hormone-sensitive cancers
• Active or history of blood clots, stroke, or heart attack
• Active liver disease
• Known or suspected pregnancy
• Allergy to medroxyprogesterone acetate

Important Warnings:

• Do not use estrogens with progestins to prevent heart disease, heart attacks, strokes, or dementia. 1
• Using estrogens with progestins may increase risk of heart attacks, strokes, breast cancer, blood clots, and dementia (particularly in women ≥65 years). 1
• The combination should be used at the lowest effective dose for the shortest duration necessary. 3

Dosing Considerations

Starting with Lower Doses:

• Beginning with 2.5 mg medroxyprogesterone acetate combined with lower estrogen doses (0.3-0.625 mg conjugated estrogens) produces less bleeding and fewer side effects than standard-dose regimens. 3
• Research shows that 2.5 mg effectively reduces endometrial estrogen receptor concentrations to pretreatment levels when combined with 0.3 mg or 0.625 mg conjugated estrogens. 4
• However, at higher estrogen doses (1.25 mg), the 2.5 mg dose may be insufficient; 5-10 mg doses are more effective. 4

Common Side Effects 1

Frequent Effects:

• Breakthrough bleeding or spotting
• Breast tenderness
• Headaches
• Nausea and bloating
• Weight changes
• Mood changes (nervousness, depression)

Seek Immediate Medical Attention For: 1

• New breast lumps
• Unusual vaginal bleeding
• Sudden severe headaches
• Chest pain or leg pain with shortness of breath
• Vision or speech changes
• Signs of allergic reaction (hives, difficulty breathing, facial swelling)

Important Clinical Considerations

Before Starting Treatment: 1

• Confirm you are not pregnant
• Discuss personal and family history of breast cancer, blood clots, heart disease, or stroke
• Inform your provider about conditions including asthma, epilepsy, diabetes, migraine, liver/kidney problems, or lupus
• List all medications, as drug interactions can occur

Monitoring During Treatment: 1

• Annual pelvic exam, breast exam, and mammogram (or more frequently if indicated)
• Report any vaginal bleeding promptly
• Regular discussions with your provider about whether continued treatment is necessary
• Monitor for cardiovascular risk factors (high blood pressure, cholesterol, diabetes, smoking)

Key Differences from Injectable Formulations:

• The 2.5 mg oral tablet is distinct from depot medroxyprogesterone acetate (DMPA) 150 mg IM or 104 mg subcutaneous injections used for contraception. 2
• Oral medroxyprogesterone 2.5 mg is NOT a contraceptive at this dose. 1
• Injectable DMPA has different pharmacokinetics with prolonged duration of action (3 months) compared to daily oral dosing. 5

Administration 1

• Take exactly as prescribed by your healthcare provider
• Can be taken with or without food
• If used cyclically, follow the specific schedule provided (typically 12-14 days per month)
• If used continuously, take daily without interruption
• Do not share medication with others
• Store at room temperature away from children

This medication requires ongoing medical supervision and should only be used under the guidance of a healthcare provider who can assess your individual risk-benefit profile. 1