Last update: Feb. 7, 2016

Medroxyprogesterone Acetate

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Synthetic progestin similar to progesterone that is used in uterine bleeding, dysmenorrhea, infertility and contraception.
For contraception is used as a single drug or in combination with estrogen (e.g. Estradiol + Medroxyprogesterone).
For oral use or long-acting injectable administration (Intramuscular or subcutaneous).

It is excreted into breast milk in clinically non-significant amount, and, no problems have been observed in infants whose mothers who were treated with this medication. Plasma levels of these infants were undetectable or very low.
There may be increased prolactin and milk production in women who receive medroxyprogesterone.

Although it has not been shown effects on production and duration of breastfeeding when administered at any time postpartum, it is still controversial on if it really decreases milk production when progestins are used before a fully establishment of breastfeeding has occurred. Therefore, experts’ protocols by WHO and ABM advise to avoiding it until breastfeeding is fully developed (4-6 weeks).

During lactation progestin-only drugs are preferred or in combination with estrogen for birth control, but whatever, the ones with the lower doses of estrogen should be used.
For the first 6 weeks postpartum, non-hormonal methods are of choise.

Hormone containing contraceptives do not affect the composition of milk, minerals (Mg, Fe, Cu, Ca, P) fat, lactose and calories but only a few the proteins.

WHO List of Essential Medicines 2002: rates it as compatible with breastfeeding after the 6th postnatal week.

Alternatives

We do not have alternatives for Medroxyprogesterone Acetate since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Medroxyprogesterone Acetate is also known as


Medroxyprogesterone Acetate in other languages or writings:

Groups

Medroxyprogesterone Acetate belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Medroxyprogesterone Acetate in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 10 %
Molecular weight 387 daltons
Protein Binding 94 %
T1/2 14,5 hours
M/P ratio 1 -
Theoretical Dose 0,0002 mg/Kg/d
Relative Dose 0,2 %

References

  1. Phillips SJ, Tepper NK, Kapp N, Nanda K, Temmerman M, Curtis KM. Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception. 2015 Abstract Full text (link to original source) Full text (in our servers)
  2. Berens P, Labbok M; Academy of Breastfeeding Medicine. ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. Breastfeed Med. 2015 Abstract Full text (link to original source) Full text (in our servers)
  3. WHO. Department of Reproductive Health and Research World Health Organization. Medical Eligibility Criteria for Contraceptive Use. WHO/RHR/15.07. 2015 Abstract Full text (link to original source) Full text (in our servers)
  4. Berens P, Labbok M; Academy of Breastfeeding Medicine. Protocolo clínico de la ABM n.º 13: Anticoncepción durante la lactancia, revisado en 2015. Breastfeed Med. 2015 Full text (link to original source) Full text (in our servers)
  5. Jacobstein R, Polis CB. Progestin-only contraception: injectables and implants. Best Pract Res Clin Obstet Gynaecol. 2014 Abstract Full text (link to original source) Full text (in our servers)
  6. Singhal S, Sarda N, Gupta S, Goel S. Impact of injectable progestogen contraception in early puerperium on lactation and infant health. J Clin Diagn Res. 2014 Abstract Full text (link to original source) Full text (in our servers)
  7. Brownell EA, Fernandez ID, Fisher SG, Howard CR, Ternullo SR, Lawrence RA, Duckett JW, Dozier AM. The effect of immediate postpartum depot medroxyprogesterone on early breastfeeding cessation. Contraception. 2013 Abstract Full text (link to original source) Full text (in our servers)
  8. CDC. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Abstract Full text (link to original source) Full text (in our servers)
  9. Hu E, Ikeako LC, Obiora-Okafor NC. The use of depot medroxyprogesterone acetate (DMPA) injectable contraceptive in Enugu, Nigeria. Niger J Med. 2012 Abstract
  10. Brownell EA, Fernandez ID, Howard CR, Fisher SG, Ternullo SR, Buckley RJ, Dozier AM. A systematic review of early postpartum medroxyprogesterone receipt and early breastfeeding cessation: evaluating the methodological rigor of the evidence. Breastfeed Med. 2012 Abstract Full text (link to original source) Full text (in our servers)
  11. Zuppa AA, Sindico P, Orchi C, Carducci C, Cardiello V, Romagnoli C. Safety and efficacy of galactogogues: substances that induce, maintain and increase breast milk production. J Pharm Pharm Sci. 2010;13(2):162-74. Abstract Full text (link to original source) Full text (in our servers)
  12. Rodriguez MI, Kaunitz AM. An evidence-based approach to postpartum use of depot medroxyprogesterone acetate in breastfeeding women. Contraception. 2009 Abstract
  13. Omar HA, Zakharia RM, Kanungo S, Huff M, McClanahan K. Incidence of galactorrhea in young women using Depot-Medroxyprogesterone Acetate. ScientificWorldJournal. 2006 Abstract Full text (link to original source) Full text (in our servers)
  14. Aktun H, Moroy P, Cakmak P, Yalcin HR, Mollamahmutoglu L, Danisman N. Depo-Provera: use of a long-acting progestin injectable contraceptive in Turkish women. Contraception. 2005 Abstract
  15. FFPRHC: Faculty of Family Planning & Reproductive Health Care. Guidance (July 2004): Contraceptive choices for breastfeeding women. J Fam Plann Reprod Health Care. 2004 Abstract Full text (link to original source) Full text (in our servers)
  16. Truitt ST, Fraser AB, Grimes DA, Gallo MF, Schulz KF. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2003 Abstract
  17. Halderman LD, Nelson AL. Impact of early postpartum administration of progestin-only hormonal contraceptives compared with nonhormonal contraceptives on short-term breast-feeding patterns. Am J Obstet Gynecol. 2002 Abstract
  18. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  19. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  20. Ratchanon S, Taneepanichskul S. Depot medroxyprogesterone acetate and basal serum prolactin levels in lactating women. Obstet Gynecol. 2000 Abstract
  21. Danli S, Qingxiang S, Guowei S. A multicentered clinical trial of the long-acting injectable contraceptive Depo Provera in Chinese women. Contraception. 2000 Abstract
  22. Kaunitz AM. Injectable depot medroxyprogesterone acetate contraception: an update for U.S. clinicians. Int J Fertil Womens Med. 1998 Abstract
  23. Kelsey JJ. Hormonal contraception and lactation. J Hum Lact. 1996 Abstract
  24. [No authors listed] Progestogen-only contraceptives during lactation: II. Infant development. World Health Organization, Task Force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development, and Research Training in Human Reproduction. Contraception. 1994 Abstract
  25. [No authors listed] Effects of hormonal contraceptives on breast milk composition and infant growth. World Health Organization (WHO) Task Force on Oral Contraceptives. Stud Fam Plann. 1988 Abstract
  26. Schwallie PC. The effect of depot-medroxyprogesterone acetate on the fetus and nursing infant: a review. Contraception. 1981 Abstract
  27. Karim M, Ammar R, el-Mahgoub S, el-Ganzoury B, Fikri F, Abdou I. Injected progestogen and lactation. Br Med J. 1971 Abstract Full text (link to original source) Full text (in our servers)
  28. Balmer HC, Macdonald DJ. Hormonal therapy for suppressing lactation. Can Fam Physician. 1971 Abstract Full text (link to original source) Full text (in our servers)

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