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This document outlines essential safety and warning information for the use of medroxyprogesterone (Depo-Provera). It is crucial to understand these details and discuss any concerns with your healthcare provider.

• Bone Health Risks: Long-term use of medroxyprogesterone can lead to significant bone loss, increasing the risk of osteoporosis and fractures. This risk is heightened with prolonged use, especially beyond two years, smoking, family history of osteoporosis, and other factors like corticosteroid use and anorexia nervosa. Bone health monitoring is advised for long-term users.

• Blood Clot Risks: There is a potential risk for blood clots with this medication. If you have a history of blood clots or related conditions, medroxyprogesterone may not be suitable for you. Seek immediate medical attention if you experience symptoms such as leg pain, chest pain, severe headaches, or difficulty breathing.

• Breast Cancer Considerations: Individuals with a history of breast cancer or a strong family history should avoid using medroxyprogesterone, as it may stimulate hormone-sensitive cancers. Regular breast self-exams are recommended, and any changes should be reported to your healthcare provider.

• Ectopic Pregnancy Risk: Though rare, medroxyprogesterone may increase the risk of ectopic pregnancy. If you experience severe pelvic pain or unusual bleeding, contact your provider. If pregnancy occurs shortly after stopping the medication, verify with your provider to exclude ectopic pregnancy.

• Menstrual Changes: Irregular periods are common with medroxyprogesterone, ranging from light to very heavy bleeding. Discuss any significant changes with your provider, especially before receiving subsequent doses.

• Allergic Reactions: Severe allergic reactions, including anaphylaxis, can occur. If you experience hives, swelling, or difficulty breathing, seek emergency medical help immediately.

• Weight Changes: Some users report weight gain, averaging 5 pounds in the first year and up to 17 pounds over six years. If this is a concern, consult your provider for guidance.

• Fertility Delays: Fertility may take time to return after stopping medroxyprogesterone, with some taking up to two years to conceive. Discuss any concerns about future fertility with your provider.

• Seizure Risk: There have been reports of seizures in users, though a direct link to the medication is unclear. If you have a history of seizures, discuss this with your provider.

• Liver Health: Notify your provider if you develop symptoms of liver issues, such as abdominal pain, fatigue, or jaundice. Treatment may be paused to conduct liver function tests.

Contraindications: Medroxyprogesterone should not be used if you are pregnant, have a history of blood clots, suspected breast cancer, severe liver problems, or unexplained vaginal bleeding. Always consult your healthcare provider to ensure this medication is appropriate for you.

When using this medication, some individuals may experience common side effects that are typically mild. These include nausea, bloating, headache, changes in appetite, tiredness, acne, hot flashes, breast tenderness, and swelling. Weight gain and dizziness can also occur, as can irregular periods or spotting, especially during the initial months. Some may notice changes at the injection site, such as pain, swelling, redness, bruising, or a hardened mass. It is not uncommon for menstrual periods to stop after about a year of use, which usually resumes post-treatment. If any common side effects persist or worsen, consulting a healthcare provider is advisable.

In some cases, more serious side effects may arise and require prompt medical attention. These include continuous nausea or vomiting, significant mental or mood changes, severe bone pain, unusual fatigue, dark urine, yellowing of the skin or eyes, seizures, and unusual vaginal bleeding. The medication may slightly increase the risk of breast cancer; thus, any breast lumps or nipple discharge should be reported to a healthcare provider immediately.

Rare but severe side effects include potential blood clot issues, which could lead to heart attack, stroke, or clotting in the lungs, legs, or eyes. Symptoms like shortness of breath, chest pain, sudden headaches, dizziness, or any unusual swelling or pain should prompt immediate medical intervention. Severe allergic reactions are also rare but require urgent care if symptoms like rash, intense itching, swelling, dizziness, or breathing difficulties occur. Always inform a healthcare provider if any unusual symptoms are observed.

Medroxyprogesterone (Depo-Provera) can interact with various medications, potentially altering their effectiveness or causing adverse effects. It is crucial to inform your doctor and pharmacist about any medications or supplements you are taking, including prescription, over-the-counter, vitamins, and herbal products.

Significant Interactions:

• Tranexamic Acid: It is advised to avoid combining Medroxyprogesterone with Tranexamic Acid. Your doctor might suggest an alternative treatment or adjust your current medications.

Interactions That Require Caution:

• Some drugs may cause hormonal birth control to become less effective by reducing hormone levels, which could lead to pregnancy. These include medications like griseofulvin, Modafinil, rifamycins (such as Rifampin and Rifabutin), Ritonavir, St. John's wort, and certain seizure medications (e.g., barbiturates, Carbamazepine, Phenytoin). Additional drugs such as apalutamide, Dexamethasone, and elvitegravir may also interact. If these are necessary, your doctor may adjust dosages or suggest using additional birth control methods.

If you experience any new symptoms like spotting or breakthrough bleeding, contact your doctor as these might indicate reduced birth control efficacy. Also, Medroxyprogesterone can interfere with specific lab tests, potentially leading to incorrect results, so ensure all healthcare providers are aware of your use of this medication.