Last update April 8, 2022

Медроксипрогестерона Ацетат

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and 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. Daily oral administration or long-acting injection (intramuscular or subcutaneous) every 3 to 6 months.

It is excreted into breast milk in clinically non-significant amount (Koetsawang 1982, Saxena 1977) and no problems have been observed in infants whose mothers who were treated with this medication (Singhal 2014, Díaz 1997, WHO 1994, Pardthaisong 1992, Zacharias 1986, Jiménez 1984, Dahlberg 1982, Karim 1971). Urinary medroxyprogesterone levels of these infants were undetectable. (Virutamasen 1996)

There may be increased prolactin and milk production in women who receive medroxyprogesterone. (Omar 2006, Ratchanon 2000).There is no evidence of its effectiveness as a galactogogue. (Zuppa 2010)

Although it has not been shown effects on production and duration of breastfeeding when administered at any time postpartum (Parker 2021, Phillips 2016, Singata 2016, Singhal 2014, Brownell 2013, Halderman 2002, Danli 2000, Hannon 1997, Karim 1971), it is still controversial on if it really decreases milk production when progestins are used before a fully establishment of breastfeeding has occurred. (Brownell 2012, Rodriguez 2009)

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During breastfeeding progestin-only contraceptives are preferable to those combined with estrogen and, in this case, those with a lower dose of estrogen. (CDC 2016, 2013 y 2010, WHO/OMS 2015, Altshuler 2015, Berens 2015, CLM 2012, FFPRHC 2004, Moretti 2000, Guiloff 1974)

For the first 4-6 weeks postpartum, non-hormonal methods are the first choice, followed by IUDs and progestogen implants. (Berens 2015, Mwalwanda 2013, Rowe 2013, CLM 2012, Kaunitz 1998)

American Academy of Pediatrics: medication usually compatible with breastfeeding.(AAP 2001)

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


See below the information of this related product:

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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

Медроксипрогестерона Ацетат is Medroxyprogesterone Acetate in Cyrillic.

Is written in other languages:

Медроксипрогестерона Ацетат is also known as

Tradenames

Main tradenames from several countries containing Медроксипрогестерона Ацетат in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. oral: < 10 %
Molecular weight 387 daltons
Protein Binding 86 - 94 %
VD 0.2 - 0.4 l/Kg
Tmax oral: 1 - 3; im. Sc: 120 - 144 hours
oral: 40-60; im. sc: 480 -1200 hours
M/P ratio 1 -
Theoretical Dose 0.0002 - 0.001 mg/Kg/d
Relative Dose 0.7 - 3.6 %

References

  1. Parker LA, Sullivan S, Cacho N, Krueger C, Mueller M. Effect of Postpartum Depo Medroxyprogesterone Acetate on Lactation in Mothers of Very Low-Birth-Weight Infants. Breastfeed Med. 2021 Oct;16(10):835-842. Abstract Full text (link to original source)
  2. Phillips SJ, Tepper NK, Kapp N, Nanda K, Temmerman M, Curtis KM. Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception. 2016;94:226-52. Abstract Full text (link to original source) Full text (in our servers)
  3. Singata-Madliki M, Hofmeyr GJ, Lawrie TA. The effect of depot medroxyprogesterone acetate on postnatal depression: a randomised controlled trial. J Fam Plann Reprod Health Care. 2016 Jul;42(3):171-6. Abstract
  4. Altshuler AL, Gaffield ME, Kiarie JN. The WHO's medical eligibility criteria for contraceptive use: 20 years of global guidance. Curr Opin Obstet Gynecol. 2015 Abstract Full text (link to original source) Full text (in our servers)
  5. 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)
  6. WHO. Department of Reproductive Health and Research World Health Organization. Medical eligibility criteria for contraceptive use: 20 years of global guidance. WHO/RHR/15.07. 2015 Abstract Full text (link to original source) Full text (in our servers)
  7. 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)
  8. 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)
  9. 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)
  10. 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)
  11. 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)
  12. 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)
  13. Rodriguez MI, Kaunitz AM. An evidence-based approach to postpartum use of depot medroxyprogesterone acetate in breastfeeding women. Contraception. 2009 Abstract
  14. 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)
  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. 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)
  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. 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)
  19. Baheiraei A, Ardsetani N, Ghazizadeh S. Effects of progestogen-only contraceptives on breast-feeding and infant growth. Int J Gynaecol Obstet. 2001 Abstract
  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. Díaz S, Zepeda A, Maturana X, Reyes MV, Miranda P, Casado ME, Peralta O, Croxatto HB. Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, Norplant implants, and Copper T 380-A intrauterine devices. Contraception. 1997 Abstract
  24. Hannon PR, Duggan AK, Serwint JR, Vogelhut JW, Witter F, DeAngelis C. The influence of medroxyprogesterone on the duration of breast-feeding in mothers in an urban community. Arch Pediatr Adolesc Med. 1997 May;151(5):490-6. Abstract
  25. Virutamasen P, Leepipatpaiboon S, Kriengsinyot R, Vichaidith P, Muia PN, Sekadde-Kigondu CB, Mati JK, Forest MG, Dikkeschei LD, Wolthers BG, d'Arcangues C. Pharmacodynamic effects of depot-medroxyprogesterone acetate (DMPA) administered to lactating women on their male infants. Contraception. 1996 Sep;54(3):153-7. Abstract
  26. WHO. 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
  27. Pardthaisong T, Yenchit C, Gray R. The long-term growth and development of children exposed to Depo-Provera during pregnancy or lactation. Contraception. 1992 Apr;45(4):313-24. Abstract
  28. World Health Organization (WHO) Task Force on Oral Contraceptives. Effects of hormonal contraceptives on breast milk composition and infant growth. Stud Fam Plann. 1988 Abstract
  29. Zacharias S, Aguilera E, Assenzo JR, Zanartu J. Effects of hormonal and nonhormonal contraceptives on lactation and incidence of pregnancy. Contraception. 1986 Mar;33(3):203-13. Abstract
  30. Jimenez J, Ochoa M, Soler MP, Portales P. Long-term follow-up of children breast-fed by mothers receiving depot-medroxyprogesterone acetate. Contraception. 1984 Dec;30(6):523-33. Abstract
  31. Dahlberg K. Some effects of depo-medroxyprogesterone acetate (DMPA): observations in the nursing infant and in the long-term user. Int J Gynaecol Obstet. 1982 Feb;20(1):43-8. Abstract
  32. Koetsawang S, Nukulkarn P, Fotherby K, Shrimanker K, Mangalam M, Towobola K. Transfer of contraceptive steroids in milk of women using long-acting gestagens. Contraception. 1982 Abstract
  33. Saxena BN, Shrimanker K, Grudzinskas JG. Levels of contraceptive seroids in breast milk and plasma of lactating women. Contraception. 1977 Abstract
  34. Zañartu J, Aguilera E, Muñoz G, Peliowsky H. Effect of a long-acting contraceptive progestogen on lactation. Obstet Gynecol. 1976 Feb;47(2):174-6. Abstract
  35. Guiloff E, Ibarra-Polo A, Zañartu J, Toscanini C, Mischler TW, Gómez-Rogers C. Effect of contraception on lactation. Am J Obstet Gynecol. 1974 Abstract
  36. 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)
  37. 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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