ENDOPROST

• Brand Name: ENDOPROST

• Generic Name: Medroxyprogesterone Acetate (MPA)

• Therapeutic Class: Synthetic Progestin

• Form:

  • 150 mg/mL (1 mL vial/prefilled syringe) – Depot form (IM only)

  • 104 mg/0.65 mL (Subcutaneous option in some markets)

• Duration: 3-month contraceptive protection per dose

2. Composition

• Active Ingredient: Medroxyprogesterone Acetate (MPA)

• Vehicle:

  • Polyethylene glycol (for IM suspension)

  • Preservative-free in some formulations

• Excipients: Polysorbate 80, sodium chloride

3. Mechanism of Action

✔ Suppresses ovulation (inhibits LH surge) ✔ Thickens cervical mucus (blocks sperm entry) ✔ Atrophies endometrium (prevents implantation) ✔ Reduces FSH secretion → decreases ovarian follicular activity

4. Dosage & Administration

For Contraception

For Endometriosis/Hormonal Disorders

• 50-100 mg IM weekly (short-term use)

Key Notes:

• Shake well before injection (suspension settles)

• Do NOT give IV (risk of embolism)

• Rotate injection sites

5. Indications

✅ Contraception (long-acting reversible) ✅ Endometriosis-associated pain ✅ Abnormal uterine bleeding (hormonal control) ✅ Palliative treatment of endometrial/breast cancer

6. Storage & Stability

• Unopened: 20-25°C (avoid freezing)

• After opening: Use immediately (discard unused portions)

• Protect from light

7. Key Recommendations

✔ Baseline screening:

• Pregnancy test (if uncertain)

• BP measurement (may increase hypertension risk)

• Bone density scan (if long-term use >2 years)

✔ Return to fertility:

• Delayed by 6-12 months post-discontinuation

• Advise alternative contraception if immediate pregnancy desired

✔ Missed dose:

• If >14 weeks since last dose, rule out pregnancy before next injection

8. Important Safety Notes

⚠ Black Box Warnings:

• Bone mineral density (BMD) loss (higher risk with >2 years of use)

• Irreversible effects if used during puberty (under 18 years)

⚠ Contraindications: ❌ Active thromboembolic disorders ❌ Breast/reproductive organ cancers ❌ Unexplained vaginal bleeding ❌ Severe hepatic disease

⚠ Adverse Effects:

• Common: Weight gain, amenorrhea, headaches

• Serious:

  • Osteoporosis (long-term use)

  • Mood changes/depression

  • Increased diabetes risk

9. Comparison with Other Progestins

10. Patient Counseling

✔ Expect irregular bleeding (common in first 6 months) → usually resolves ✔ Weight management (3-5 kg gain typical) ✔ Calcium/Vitamin D supplementation (for bone health) ✔ Report:

• Severe mood changes

• Persistent leg pain (DVT risk)

• Vision changes (rare intracranial hypertension)

Conclusion

ENDOPROST is a cost-effective, long-acting contraceptive but requires bone health monitoring with prolonged use. Ideal for patients needing non-daily, discreet birth control.