depo-subQ provera

Depo-subQ provera is a prescription hormone medication used to prevent pregnancy. It is also used to relieve pain from endometriosis.

Depo-subQ provera is in a class of medications called progestins. It works to prevent pregnancy by preventing ovulation (the release of eggs from the ovaries) and thins the lining of the uterus. 

Depo-subQ provera is available as an injection form. It is injected under the skin every 3 months. 

Common side effects include changes in your monthly periods, weight gain, and injection site reactions. 

Depo-subQ provera is used to:

• prevent pregnancy (long-acting birth control)
• relieve pain from endometriosis 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Pharmacia and Upjohn Company

Serious side effects have been reported with depo-subQ provera. See "Drug Precautions" section. 

Common side effects include:

• Changes in your monthly periods. You may not know when you will bleed, your periods may not be regular, you may have heavy bleeding, or you may have spotting. You may have more days of bleeding during the first 2 or 3 months after you start depo-subQ provera. Over time, you may have less and less bleeding. Many women stop having periods by the end of one year. Your periods will come back eventually after you stop using depo-subQ provera.
• Weight gain. In studies, women gained an average of 3 to 4 pounds during the first year they used depo-subQ provera. After 2 years of using depo-subQ provera, women gained an average of 7 to 8 pounds. Some women gained more, some gained less, some lost, and some stayed the same. Weight changes beyond 2 years of use with depo-subQ provera have not been studied. Women who used a similar birth control product for 5 years gained on average 5 pounds more than women who did not use a hormone contraceptive product.
• Skin reaction where you got the shot. Lumps, skin dimpling, or pain are usually mild and usually don't last long. Scarring is unusual, but may happen. If there is swelling or your skin gets hot, has pus or looks bruised one or more days after your shot, call your healthcare provider.
• Headache

Less common side effects include abdominal pain, acne, breast tenderness, being irritable, depression, hot flushes, insomnia, joint pain, lack of energy, less sex drive, painful periods, nausea and sleepiness.

These are not all the possible side effects of depo-subQ provera. For more information, ask your healthcare provider or pharmacist.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

No drug interactions have been evaluated by the manufacturer. Theoretically, an interaction may occur with the cancer medication, aminoglutethimide. However, you should tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Not all drug interactions are known or reported and new drug interactions are continually being reported. 

Serious side effects have been reported with depo-subQ provera including the following:

• Losing calcium from your bones. depo-subQ provera use may decrease the amount of calcium in your bones. The longer you use depo-subQ provera, the more calcium you are likely to lose. This increases the risk of your bones weakening if you use depo-subQ provera continuously for a long time (for example, if you use depo-subQ provera for more than two years). The loss of calcium may increase your risk of osteoporosis and broken bones, particularly after your menopause. Calcium is generally added to the bones during teenage years. The decrease of calcium in your bones is of most concern if you are a teenager or have the following risk factors:
  • ​Bone disease
  • Anorexia nervosa (an eating disorder)
  • A strong family history of osteoporosis
  • Drug use that can lower the amount of calcium in bones (drugs for epilepsy or steroids), or
  • Drinking a lot of alcohol or smoking a lot
• If you need a birth control method for more than two years, your healthcare provider may ask you to have a test of your bones or ask you to switch to another birth control method before continuing depo-subQ provera, especially if you have other risks for weak bones. When depo-subQ provera is stopped, the calcium in your bones begins to come back. The lost calcium may not return completely once you stop using depo-subQ provera. Your healthcare provider may tell you to take calcium and Vitamin D as this may lessen the loss of calcium from your bones.
• Abnormal or very heavy bleeding. If you start having very heavy or very long periods, tell your healthcare provider.
• Liver problems. Your healthcare provider may stop depo-subQ provera if you have liver problems. Some signs of liver problems are yellow skin or eyes, feeling like you have the flu, feeling more tired than usual, and itching. Tell your healthcare provider if you have these symptoms.
• Allergic reaction. Allergic reactions to depo-subQ provera are not common. If you have hives, problems breathing, swelling of the face, mouth, tongue or neck, or just do not feel right after your shot, call your healthcare provider or go to the Emergency Room right away.
• Serious blood clots. Call your healthcare provider immediately if you:
  • Have sharp chest pain, cough blood, or suddenly have trouble breathing
  • Have a sudden severe headache with vomiting, blindness or trouble talking, weakness, or numbness in an arm or leg, or get dizzy or faint
  • Have swelling or severe pain in your leg

There have been several studies of women who use birth control like depo-subQ provera 104.

• Women who use depo-subQ provera 104 may have a slightly increased risk of breast cancer compared to non-users.
• The risk of cancer of the ovary, liver, or cervix did not change.
• There is a decreased risk of cancer of the uterus (endometrial cancer).

Do not take depo-subQ provera if you:

• Are pregnant or might be pregnant
• Have any unexplained vaginal bleeding
• Have, or have ever had breast cancer, or think you have breast cancer
• Ever had serious blood clots, such as blood clots in your legs (deep venous thrombophlebitis), lungs (pulmonary embolism), heart (heart attack), or head (stroke)
• Have liver disease
• Are allergic to anything in depo-subQ provera

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of depo-subQ provera, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking depo-subQ provera, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• Are pregnant or might be pregnant. You should not get depo-subQ provera if you are pregnant.
• Plan to become pregnant in the next year. After you stop getting depo-subQ provera, it takes time for your body to be able to get pregnant. It can be as early as 1 week after the last shot wears off. Most likely it will take up to 1 year or longer for you to get pregnant.
• If you have, or have ever had breast cancer, or think you have breast cancer
• Have breast cancer in your family
• Have an abnormal mammogram (breast X-ray), lumps in your breast, or bleeding from your nipples
• Have irregular, light, or heavy menstrual periods
• Have or had any of the following medical problems:
  • Kidney problems
  • High blood pressure
  • Migraine headaches
  • Asthma
  • Seizures
  • Diabetes, or if it runs in your family
  • Depression
  • Heart attack, stroke, or developed blood clots
  • Bone disease
  • Anorexia nervosa (an eating disorder)
  • A strong family history of osteoporosis
  • Drug use that can lower the amount of calcium in bones (drugs for epilepsy or steroids)
  • Drinking a lot of alcohol or smoking a lot

​Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

Depo-subQ provera should not be taken during pregnancy. Tell your healthcare provider right away if you become pregnant while receiving depo-subQ provera.

Tell your healthcare provider if you are breastfeeding. 

When nursing a baby, wait at least 6 weeks after your baby is born to start depo-subQ provera. You can use depo-subQ provera if you are nursing.

• It does not lower the amount of milk you can make.
• It can pass through breast milk into your baby, but it is not harmful.

Depo-subQ provera is administered by a health care provider. 

Depo-subQ provera comes in an injection and is given under the skin (subcutaneous), on your thigh or belly, once every 3 months.

If you require depo-subQ provera for longer than two years, your healthcare provider may ask you to have a test of your bones or ask you to switch to another birth control method before continuing depo-subQ provera, especially if you have other risks for weak bones.

First Shot to prevent pregnancy:

Your healthcare provider will want to be sure that you are not pregnant before you get your first shot. Normally, you get the shot by the 5th day from the START of your menstrual period. You get it whether or not you are still bleeding.

For Endometriosis:

If you have regular periods, you get depo-subQ provera the same way as described above for birth control. If your periods have stopped or are not regular, your healthcare provider must test to make sure you are not pregnant before you get your first shot.

Blood or urine tests. depo-subQ provera may affect blood or urine test results. Tell your healthcare provider you are taking depo-subQ provera if you are going to have blood or urine tests.

If you miss a shot:

• If you miss a shot, or wait longer than 14 weeks between shots, you could get pregnant. The longer you wait, the greater the risk of getting pregnant.
• Talk with your healthcare provider to find out when to restart depo-subQ provera. You should be tested to be sure you are not pregnant.
• Use another kind of nonhormonal birth control, such as condoms, until you start depo-subQ provera again.

If you want to become pregnant:

Depo-subQ provera comes in an injection and is given under the skin (subcutaneous), once every 3 months.

Depo-subQ provera is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention. 

This medication is stored and given by a healthcare provider. 

WARNING: LOSS OF BONE MINERAL DENSITY

Women who use depo-subQ provera may lose significant bone mineral density. Bone loss is greater with increasing duration of use and may not be completely reversible.

It is unknown if use of depo-subQ provera during adolescence or early adulthood, a critical period of bone accretion, will reduce peak bone mass and increase the risk for osteoporotic fracture in later life.

depo-subQ provera should not be used as a long-term birth control method (i.e., longer than 2 years) unless other birth control methods are considered inadequate.

Patients should be counseled that this product does not protect against HIV infection (AIDS) and other sexually transmitted diseases.