What is Provera used for?

• Dysfunctional menstrual bleeding, for example heavy, painful, irregular or very frequent periods.
• Menstrual periods that have stopped (secondary amenorrhoea).
• Mild to moderate endometriosis.

How does Provera work?

• Provera 2.5mg, 5mg and 10mg tablets contain the active ingredient medroxyprogesterone acetate, which is a synthetic form of the naturally occurring female sex hormone, progesterone.
• A woman's menstrual cycle is a complex process that is controlled by at least four different hormones. The blood levels of these hormones change throughout the menstrual cycle, causing an egg to be released from the ovaries (ovulation), preparation of the womb lining for a possible pregnancy and shedding of the womb lining each month if pregnancy doesn't occur (a menstrual period). There are plenty of places that this complex process can go wrong.
• If your periods are irregular or have stopped completely and your doctor can find no obvious cause, it may be that something has upset your natural hormone levels. Medroxyprogesterone can help to restore your natural hormone levels, because it mimics the effects of your natural progesterone.
• Normally the level of progesterone in your blood increases about a week before your period. If medroxyprogesterone is taken for 5 to 10 days each month at this time (ie day 16 to 21 of your cycle) it mimics the natural rise in your progesterone levels. This can help your other hormones to behave in a more normal way. To treat irregular periods this medicine is taken in this way for two menstrual cycles. To treat periods that have stopped it is taken for three menstrual cycles. In each case, a few days after you stop taking the tablets you should get your period. At the end of the treatment regular periods should return.
• Endometriosis can also be treated by manipulating your hormones with medroxyprogesterone. In this condition, tissue resembling the womb lining grows abnormally around the ovaries, womb and bladder. This tissue is controlled by the same hormones that control your menstrual cycle, and thickens and is shed in the same way as your normal womb lining. Medroxyprogesterone is taken three times a day for 90 days, starting on the first day of your period, to control this. The medroxyprogesterone stops the abnormal tissue from thickening and then bleeding. As a result your menstrual periods are also likely to stop during the treatment as well; alternatively you might get irregular bleeding or spotting. After treatment has finished the patches of endometrial tissue may be smaller, or may have shrunk away altogether.

How do I take Provera?

• Provera tablets should be taken as directed by your doctor. The number of tablets to take and when to take them will depend on the condition being treated. The instructions should be printed on the label that your pharmacist has put on the packet of tablets. If you are unsure about anything ask your doctor or pharmacist for advice.
• The tablets can be taken either with or without food.
• If you forget to take a dose at your usual time you should take it as soon as you remember, unless it is nearly time for your next dose. In this case just leave out the missed dose and take your next dose as usual when it is due. Don't take a double dose to make up for a missed dose.

Important information about Provera

• This medicine should not be used during pregnancy. It does not provide contraception against pregnancy, because it doesn't stop you releasing an egg (ovulation). You should use a non-hormonal method of contraception such as condoms to avoid getting pregnant while you are taking this medicine. Ask your doctor for advice.
• Stop taking this medicine and inform your doctor immediately if you experience any of the following symptoms during treatment: stabbing pains or swelling in one leg; pain on breathing or coughing; coughing up blood; breathlessness; sudden chest pain; sudden numbness affecting one side or part of the body; fainting; worsening of epilepsy; migraine or severe headaches; visual disturbances; severe abdominal complaints; increased blood pressure; itching of the whole body; yellowing of the skin or eyes (jaundice); or severe depression.

Provera should not be used in

• Women with known, suspected or past history of breast cancer or cancer of the reproductive organs.
• Women with liver disease such as liver tumours, or a history of liver disease when liver function has not returned to normal.
• Women with severe disease of the arteries, eg that has caused angina or a heart attack.
• Women with a blood clot in the leg or lungs (thromboembolism, eg deep vein thrombosis or pulmonary embolism).
• Women with abnormal vaginal bleeding (not related to your period) where the cause is not known.
• Women with rare hereditary blood disorders called porphyrias.
• Pregnancy.
• Provera tablets contain lactose and sucrose and should not be taken by women with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.
• This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Provera should be used with caution in

• Women with decreased kidney or liver function.
• Women with epilepsy.
• Women who suffer from asthma.
• Women who suffer from migraines.
• Women with heart failure.
• Women with high blood pressure.
• Women with diabetes.
• Women with gallstones.
• Women with a history of jaundice or itching during pregnancy.
• Long-term condition called systemic lupus erythematosus (SLE).
• Women with a history of or increased risk of blood clots in the blood vessels (thromboembolism, eg deep vein thrombosis or pulmonary embolism).
• Women with gene mutations that are associated with breast cancer, eg BRCA1.
• Women with a history of depression.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine should not be used in pregnancy. It does not provide contraception itself. You should use a non-hormonal method of contraception such as condoms to avoid getting pregnant while taking this medicine. Seek medical advice from your doctor. Stop taking this medicine and consult your doctor if you think you could be pregnant while taking this medicine.
• This medicine passes into breast milk. However, there is no evidence to suggest that this has any harmful effects on the nursing infant if the medicine is used by breastfeeding mothers.

Possible side effects of Provera

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Breast tenderness.
• Production of breast milk.
• Bloating.
• Fluid retention.
• Weight change.
• Feeling sick.
• Indigestion.
• Headache.
• Dizziness.
• Nervousness.
• Depression.
• Difficulty sleeping (insomnia).
• Tiredness.
• Skin reactions such as rash and itch.
• Acne.
• Increased hair growth (hirsutism).
• Hair loss (alopecia).

Talk to your doctor, nurse or pharmacist if you want any more information about the possible side effects of this medicine. 

Can I take Provera with other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

The following medicines may increase the breakdown of this medicine in the body, which could make it less effective:

• aprepitant
• barbiturates
• bosentan
• carbamazepine
• crizotinib
• dabrafenib
• efavirenz
• eslicarbazepine
• griseofulvin
• modafinil
• nelfinavir
• nevirapine
• oxcarbazepine
• perampanel
• phenobarbital
• phenytoin
• primidone
• rifampicin
• rifabutin
• ritonavir
• rufinamide
• the herbal remedy St John's wort (Hypericum perforatum)
• topiramate
• vemurafenib.

Ulipristal (the active ingredient of the emergency contraceptive Ellaone and the medicine for fibroids Esmya) also has the potential to make this medicine less effective.

This medicine may oppose the blood sugar lowering effect of medicines for diabetes. If you have diabetes you should monitor your blood sugar and seek advice from your doctor or pharmacist if your blood sugar control seems to be altered after starting this medicine.

References:

http://www.medbroadcast.com/drug/getdrug/provera

http://www.netdoctor.co.uk/medicines/a7421/provera-25mg-5mg-and-10mg-tablets-medroxyprogesterone-acetate/

https://www.drugs.com/cdi/provera.html

https://www.drugs.com/mtm/provera.html

http://www.rxlist.com/provera-side-effects-drug-center.htm

http://www.medicines.ie/medicine/13192/SPC/Provera+Tablets+2.5mg,+5mg+%26+10mg+(Low+Dose)