Medroxyprogesterone acetate dosage

A low dosage of progestin ( mini-pill ) is used, in the form of medroxyprogesterone acetate, which is active at a very low dose. The mini-pill does not inhibit ovulation, but rather interferes with the endometrium and the cervical mucus. The use of this pill prevents most of the side effects of oral contraception, specifically nausea, water retention, and in some cases thrombophlebitis. However, a lower success rate and other frequent side effects have reduced the widespread acceptance of this preparation. Nevertheless, the mini-pill has a role to play in certain specific situations. For example, in an uncommon form of epilepsy called catamenial epilepsy, female patients will experience seizures at particular times during their menstrual cycle, reflecting the fact that seizure focus is stimulated by estrogens but inhibited by progestins. In such women, the mini-pill may afford not only birth control but also improved seizure control. 

For women with epilepsy, depot medroxyprogesterone acetate is a particularly useful contraceptive method, because it reduces seizure frequency (11). The dosage is so high that reduced efficacy due to enzyme-inducing anti-epileptic medication is not an issue. As with other hormonal contraceptives, some women tend to have headaches and mood changes. 

Treatment with low-dose medroxyprogesterone acetate (50 and 150 mg/day) for endometriosis reduces HDL cholesterol (15) confined to the HDL2 subfraction, which was lowered by as much as 58% after 24 weeks of treatment the effect was clearly dose-related in the therapeutic dosage range. 

The manufacturer states that the clearance of medroxyprogesterone acetate is approximately equal to hepatic blood flow, and as such, would not be expected to be affected by drugs that alter hepatic enzyme activity. Therefore, they say that no dosage adjustment is needed. This is in line with the FFPRHC guidance. ... 

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