Depo Provera and levothyroxine Interactions

The risk increased with duration of use, and appeared to returnto baseline over about 5 years after stopping treatment (only the observationalstudies have substantial data on risk after stopping). In the WHI estrogen plus progestin substudy, astatistically significant 2-fold greater rate of VTE (DVT and PE) was reportedin women receiving daily CE (0.625 mg) plus MPA (2.5 mg) compared to women receivingplacebo (35 versus 17 per 10,000 women-years). Statistically significantincreases in risk for both DVT (26 versus 13 per 10,000 women-years) and PE (18versus 8 per 10,000 women-years) were also demonstrated. The increase in VTErisk was demonstrated during the first year and persisted.

Abnormal Uterine Bleeding Due To Hormonal Imbalance In

If you forget to start Provera when you’re supposed to, if you miss a dose, or if you have any questions about dosage or timing, talk to your healthcare provider or pharmacist for guidance. Healthcare providers typically prescribe the lowest effective dose and for the shortest amount of time possible. Provera may be a treatment option for certain conditions, especially if you can’t take estrogen.

There is no evidence that the use of natural estrogens results in a different endometrial risk profile than synthetic estrogens of equivalent estrogen dose.
Patients with diabetes mellitus should be monitored more closely during therapy with estrogens and/or progestogens, and adjustments made accordingly in their antidiabetic regimen.
Progestin withdrawal bleedingusually occurs within three to seven days after discontinuing PROVERA therapy.

Be sure your healthcare provider knows everything you’re taking, including over-the-counter drugs and nutritional supplements. Using the same pharmacy for all of your prescription medications can help you avoid negative drug interactions. Your healthcare provider will instruct you to take Provera on certain days during your menstrual cycle. When used to treat amenorrhea (missing periods), Provera is taken for up to 10 days during the second half of the planned menstrual cycle. The use of medroxyprogesterone in women with undiagnosed vaginal bleeding is contraindicated.

Administration of PROVERA with food increases thebioavailability of MPA.
There have not been sufficient numbers of geriatric women involved in clinical studies utilizing PROVERA alone to determine whether those over 65 years of age differ from younger subjects in their response to PROVERA alone.
This document does not contain all possible side effects and others may occur.
Therapy with parenteral medroxyprogesterone should be administered cautiously in patients with osteoporosis or chronic use of drugs that can reduce bone mass, such as anticonvulsants or corticosteroids.
There may be increased risks for hypospadias, clitoral enlargement and labial fusion in children whose mothers are exposed to PROVERA during the first trimester of pregnancy.

Breast Cancer

Specifically, thyroid-binding globulin (TBG) may be increased, resulting in elevated circulating total thyroid hormone, as measured by PBI (protein-bound iodine), T4 by column or radioimmunoassay, or T3 by radioimmunoassay. On the contrary, a decrease in TBG and, consequently, thyroxine concentration, has been reported by the manufacturers of the progestin-only (norethindrone) oral contraceptives. You should not use medroxyprogesterone if you are pregnant, or if you have liver disease, a hormone-related cancer such as breast or uterine cancer, a history of stroke or blood clot, or abnormal vaginal bleeding that has not been checked by a doctor.

Drug and food interactions

To produce an optimum secretory transformation of an endometrium that has been adequately primed with either endogenous or exogenous estrogen, 10 mg of PROVERA daily for 10 days beginning on the 16th day of the cycle is suggested. Progestin withdrawal bleeding usually occurs within three to seven days after discontinuing therapy with PROVERA. Patients with a past history of recurrent episodes of abnormal uterine bleeding may benefit from planned menstrual cycling synthroid tyrosine with PROVERA.

It can greatly increase your risk of blood clots, stroke, or heart attack while using Provera. Provera is a form of progesterone (a hormone) that is used to treat conditions such as absent or irregular menstrual periods, or abnormal uterine bleeding. Medroxyprogesterone acetate at high doses is an antifertility drug and high doses would be expected to impair fertility until the cessation of treatment. Discontinue estrogen plus progestin therapy pending examination if there is sudden partial or complete loss of vision, or a sudden onset of proptosis, diplopia or migraine.

So, getting the patients on the right dose, but maintaining them on the right dose, is also very important.
Some key points that I discuss with the patients during appointments are, one, is that this is an open conversation.
Levothyroxine is the most commonly used treatment in this setting.
MPA is rapidly absorbed from the gastrointestinal tract, and maximum MPA concentrations are obtained between 2 to 4 hours after oral administration.
An increase in relative risk wasdemonstrated in year 1, and a trend toward decreasing relative risk wasreported in years 2 through 5.

However, progestogens can increase insulin secretion and produce insulin resistance to varying degrees, depending on the agent. Patients with diabetes mellitus should be monitored more closely during therapy with estrogens and/or progestogens, and adjustments made accordingly in their antidiabetic regimen. Overdosage of estrogen plus progestin therapy may cause nausea and vomiting, breast tenderness, dizziness, abdominal pain, drowsiness/fatigue and withdrawal bleeding may occur in women.

Report Problems to the Food and Drug Administration

Treatment of overdose consists of discontinuation of CE plus MPA together with institution of appropriate symptomatic care. Overdosage of estrogen plus progestin therapy may causenausea and vomiting, breast tenderness, dizziness, abdominal pain,drowsiness/fatigue and withdrawal bleeding may occur in women. Treatment ofoverdose consists of discontinuation of CE plus MPA together with institutionof appropriate symptomatic care. There may be an increased risk of minor birth defects inchildren whose mothers are exposed to progestins during the first trimester ofpregnancy.

Provera by itself is not a contraceptive and won’t prevent pregnancy. Use another form of birth control, such as a condom, while you’re taking this drug. You may not be able to take Provera while also using hormonal birth control.

My doctor wants me to use Provera, but I’ve read it’s a synthetic hormone. Should I?

Estrogen plus progestin therapy may cause an exacerbationof asthma, diabetes mellitus, epilepsy, migraine, porphyria, systemic lupuserythematosus, and hepatic hemangiomas and should be used with caution in womenwith these conditions. Estrogen plus progestin therapy should be used withcaution in women with hypoparathyroidism as estrogen-induced hypocalcemia mayoccur. The importance of writing “Dispense as Written,” or using the state-specific language for SYNTHROID, is something I discuss with my staff as well. I go over with the patient there are treatment goals that are very important in the process. And the other is to improve the clinical symptoms that they’ve been experiencing.