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PATIENT’S NAME:
MEDICATION: medroxyprogesterone acetate (Brand names include Alti-MPA, Amen, Curretab, Cycrin,
Depo-Provera, Gen-Medroxy, Provera, and Novo-Medrone.)
WHAT IT'S USED FOR: Medroxyprogesterone acetate is to treat menstrual disorders and disorders of
the uterus.
HOW TO TAKE IT
Take drug exactly as prescribed, with or without food.
WARNINGS & PRECAUTIONS!
Review instructions that come with package before taking drug.
Stop taking drug and contact prescriber immediately if you experience symptoms of a blood clot
(such as warmth, redness, pain or swelling in your calf), chest pain, difficulty breathing or shortness
of breath, sudden vision changes or other vision disturbances, severe headache, weakness on one
side of your body, or slurred speech.
Report bloating, rash, yellowing of eyes or skin, and depression to prescriber.
Perform self-breast exams regularly, such as the first day of each month.
Keep all appointments with your prescriber.
Be sure to have annual physical exams and Pap smears while taking this drug.
Test your blood sugar as instructed.
Don’t take this drug if you are pregnant or breastfeeding.
SIDE EFFECTS
This drug may cause depression, insomnia, drowsiness, vein inflammation, blood clots (especially in
the legs, lungs, brain, and eyes), nausea, breakthrough menstrual bleeding, spotting, changes in
menstrual flow, lack of menstruation, swelling, bloating, weight changes, changes to uterine opening,
uterine secretions, yellowing of eyes or skin, fever, and allergic reactions (including hair loss, rash,
itching, hives, and a life-threatening condition anaphylaxis). Notify your prescriber of serious or
bothersome symptoms.
INTERACTIONS
Medroxyprogesterone may interact with many drugs, including bromocriptine, carbamazepine,
phenobarbital, phenytoin, and rifampin. Tell all prescribers what drugs you are taking.
Avoid alcohol use while taking this drug.
STORAGE
Store drug at controlled room temperature
ADDITIONAL POINTS:
Your initials: ______________
Date: ______________
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