Provera
Provera
- Provera (medroxyprogesterone acetate) is supplied in pharmacies and clinics in the US, Europe, Canada, Singapore and Romania (tablets and, as Depo‑Provera/Depo‑SubQ, by injection); in the reviewed markets it is prescription‑only (Rx) and injectable forms are usually provided via healthcare centres—always follow your national regulations and consult a prescriber.
- Provera is a synthetic progestogen used for menstrual disorders (abnormal uterine bleeding, secondary amenorrhoea), endometrial protection during oestrogen therapy, and as an injectable contraceptive; it acts on progesterone receptors to stabilise the endometrium, oppose oestrogen effects and, for the injectable forms, suppress ovulation and alter cervical mucus.
- Usual dosages: oral tablets 2.5–10 mg (common regimens 5–10 mg daily for 5–10 days for abnormal bleeding, or 5–10 mg daily for 12–14 days per month for endometrial protection); contraceptive injections: Depo‑Provera 150 mg IM every 3 months or Depo‑SubQ Provera 104 mg subcutaneously every 3 months.
- Administration forms: oral tablets (2.5 mg, 5 mg, 10 mg) and intramuscular or subcutaneous injection (e.g., 150 mg/mL IM, 104 mg/0.65 mL SQ prefills).
- Onset time: symptomatic effects (reduction of bleeding) may begin within 24–72 hours; contraceptive injection provides immediate protection if given in the first 5 days of the cycle, otherwise additional contraception is needed for up to 7 days.
- Duration of action: oral effects persist while the drug is taken; injectable contraception lasts about 12–13 weeks per dose (repeat every 3 months). Endometrial protection regimens are given monthly for 12–14 days.
- Alcohol warning: no specific contraindication to occasional alcohol, but avoid heavy drinking—alcohol may worsen liver effects, mood changes or dizziness associated with progestogens; discuss alcohol use with your prescriber if you have liver disease or mood disorders.
- The most common side effect is menstrual irregularities (spotting, breakthrough bleeding or amenorrhoea); other frequent effects include weight change, headache, breast tenderness, nausea, mood changes and injection‑site reactions for injectable forms.
- Would you like to try “provera” without a prescription?
Basic Provera Information
- INN (International Nonproprietary Name): Medroxyprogesterone acetate
- Brand Names Available In United Kingdom: Provera (various generics) and depot formulations marketed globally as Depo‑Provera / Depo‑SubQ Provera 104 (tablets and injectables available through UK suppliers and clinic channels)
- ATC Code: G03DA02
- Forms & Dosages: Tablets 2.5 mg, 5 mg and 10 mg in bottles of 30, 100 or 500; Injectable preparations 104 mg (Depo‑SubQ Provera) and 150 mg/mL (Depo‑Provera) in vials or prefilled syringes
- Manufacturers In United Kingdom: Pfizer Inc. is a primary global owner and supplier; multiple regional generic manufacturers supply Provera tablets and depots
- Registration Status In United Kingdom: Approved by national regulatory agencies in reviewed markets and authorised across EU jurisdictions; in the US and EU Provera is prescription‑only
- OTC / Rx Classification: Prescription only (Rx)
Latest Research Highlights (UK + EU)
What Has Recent Research Told Us About Provera's Safety And Effectiveness?
Observational studies and registry analyses from 2022–2025 across the UK and EU have broadly reaffirmed the established efficacy and safety profile of medroxyprogesterone acetate for menstrual control and three‑monthly contraception.
Depot injections continue to show contraceptive effectiveness consistent with product information, while audits and cohort reviews have refined risk estimates for defined subgroups.
Several repeated signals relate to bone mineral density decline with long‑term use of injectable medroxyprogesterone acetate, with partial recovery after discontinuation reported in observational follow‑up.
Data on return to fertility following Depo‑Provera remain mixed, with reports of delayed conception in some users but no evidence of permanent infertility at population level.
UK audit series from 2022–2025 reported that oral medroxyprogesterone acetate regimens produce reliable control of abnormal uterine bleeding compared with shorter progestogen courses, particularly where counselling and follow‑up were structured.
Safety monitoring via Yellow Card and pharmacovigilance has continued to flag thromboembolic and mood‑related reports, predominantly in higher‑risk groups rather than indicating new population‑level hazards.
| Study/Report | Design | Cohort Size | Primary Outcome | Safety Signals |
|---|---|---|---|---|
| UK Observational Audits (2022–2025) | Primary‑care and gynaecology clinic audits | Varied; not specified | Effectiveness for abnormal uterine bleeding | Improved bleeding control; patient satisfaction increased with follow‑up |
| EU Registry Analyses (2022–2025) | Registry/cohort analyses | Varied; not specified | Contraceptive efficacy of depot injections | Low typical‑use failure rates; bone mineral density decline with long‑term use |
| Mental Health/Pharmacovigilance Reviews | Yellow Card and adverse event surveillance | Varied; not specified | Reported mood‑related and thrombotic events | Signals concentrated in higher‑risk populations (history of depression, thrombotic risk) |
Clinicians and pharmacists should continue to balance contraceptive benefits against long‑term bone health and individual risk factors.
Clinical Effectiveness In The United Kingdom
How Well Does Provera Work For Menstrual Problems And Contraception In NHS Practice?
NHS primary‑care audits and gynaecology clinic series consistently show that medroxyprogesterone acetate controls heavy or irregular uterine bleeding when used according to MHRA and NICE guidance.
Oral Provera regimens—commonly 5–10 mg daily for 5–10 days—induce predictable withdrawal bleeding in most patients when timed appropriately in the cycle.
Injectable formulations, Depo‑Provera 150 mg IM and Depo‑SubQ 104 mg SQ, provide high contraceptive efficacy with typical‑use failure rates lower than many user‑dependent methods.
Patient‑reported outcome measures collected through local trust surveys and Patient.info emphasise improved quality of life for people with menorrhagia or cyclical pain after treatment with medroxyprogesterone acetate.
Weight change and mood swings are frequently cited reasons for stopping treatment in real‑world NHS data.
NHS audits underline the importance of documented baseline counselling on bone health and thrombotic risk, particularly before long‑term use of depot injections.
| Outcome | Typical Result | Clinical Note |
|---|---|---|
| Contraceptive Efficacy (Depot) | High; low typical‑use failure | Adherence ensured by clinic administration |
| Amenorrhoea Rates Over 12 Months (Injectable) | Increased amenorrhoea with time | Common and often acceptable to users |
| Discontinuation Causes | Weight change, mood swings, injection reactions | Discussed at counselling; alternatives offered if intolerable |
Include INN medroxyprogesterone acetate and ATC G03DA02 in searches to locate formulary notes and SmPC details quickly.
Indications And Expanded Uses
What Is Provera Licensed For, And When Is It Used Off‑Label?
Approved indications aligned with MHRA include management of abnormal uterine bleeding, secondary amenorrhoea, and endometrial protection when oestrogen is prescribed in HRT.
Depot injections are licensed for contraception when used as Depo‑Provera (150 mg IM every three months) or Depo‑SubQ Provera 104 (104 mg SQ every three months).
- Approved Indication → Standard Dosing: Tablets 5–10 mg daily for 5–10 days for secondary amenorrhoea or abnormal uterine bleeding; 5–10 mg daily for 12–14 days monthly for endometrial protection during HRT.
- Off‑Label Use → Circumstances & Evidence Level: Short‑term period delay, symptom control in endometriosis and selected steroid‑sparing regimens are common in NHS/private practice with specialist oversight and individualised risk assessment.
When considering off‑label options, document rationale and ensure informed consent is recorded.
Composition And Brand Landscape
What Does Provera Contain And Which Brands Are Available?
The active ingredient is medroxyprogesterone acetate (INN).
ATC classification is G03DA02, which helps locate products in NHS formularies.
Brand landscape includes Provera tablets (several generics across Europe) and depot brands known globally as Depo‑Provera and Depo‑SubQ Provera 104.
Pfizer is a major global supplier, while regional generics supply tablet and depot preparations in local markets.
| Product Form | Strength | Common Packaging | Prescriber Coding |
|---|---|---|---|
| Tablet (Oral) | 2.5 mg, 5 mg, 10 mg | Bottles of 30, 100, 500 | Check local DMD/formulary code |
| Injection (IM) | 150 mg/mL | Vials/prefilled syringes | Clinic administration codes |
| Injection (SQ) | 104 mg/0.65 mL | Prefilled syringes | Clinic administration codes |
Remember that medroxyprogesterone acetate is a prescription‑only medicine and pharmacists must confirm a valid prescription or repeat authorisation before supply.
Contraindications And Special Precautions
Who Should Avoid Provera And What Precautions Are Needed?
Absolute contraindications for rapid point‑of‑care checks include known hypersensitivity to medroxyprogesterone acetate or excipients, active or prior thromboembolic disorders (DVT, PE, stroke), diagnosed or suspected breast or genital malignancy, unexplained vaginal bleeding, significant liver dysfunction, and pregnancy prior to confirmation.
Relative precautions include a history of depression, migraine, epilepsy, cardiovascular risk factors, osteoporosis risk, and diabetes with vascular complications.
Use caution in older patients because dementia and vascular risks may be relevant, though routine dose changes are not standard.
Daily‑life advice: there are generally no formal restrictions on driving or alcohol, but counsel patients about sedation, dizziness and mood changes that could impair tasks.
- Contraindications Checklist: Hypersensitivity; thromboembolic disease; breast/genital malignancy; unexplained bleeding; liver disease; pregnancy.
- Key Precautions: Monitor mood, bone health with long‑term depot use, and metabolic effects in diabetes.
Dosage Guidelines
What Are NHS Recommended Regimens And Advice For Missed Doses?
Standard oral dosing in NHS formularies is 5–10 mg once daily for 5–10 days for secondary amenorrhoea or abnormal uterine bleeding, typically started around cycle day 16–21.
For endometrial protection with oestrogen in HRT, give 5–10 mg daily for 12–14 consecutive days each month.
Injectable contraception: Depo‑Provera 150 mg IM every three months and Depo‑SubQ Provera 104 mg SQ every three months, with adherence to a 12–13 week window and contraception backup if delayed.
Adjustments: no routine dose changes for elderly, avoid or monitor in significant liver impairment, and not approved for routine paediatric use.
Missed‑dose advice: oral — take if remembered the same day, otherwise skip and do not double; missed injection — give as soon as possible and provide backup contraception based on clinical timing.
| Indication | Regimen | Missed Dose Advice |
|---|---|---|
| Abnormal Uterine Bleeding | 5–10 mg daily for 5–10 days | If one tablet missed, take same day; do not double next dose |
| Endometrial Protection (HRT) | 5–10 mg daily for 12–14 days monthly | Start next monthly course as scheduled; consult if multiple doses missed |
| Contraception (Depot) | 150 mg IM or 104 mg SQ every 12–13 weeks | Give ASAP; if late, use backup contraception per clinic protocol |
Interactions Overview
Which Drugs, Foods Or Substances Affect Provera?
Medroxyprogesterone acetate is metabolised hepatically, so enzyme inducers such as certain anticonvulsants and rifampicin can reduce plasma levels and may reduce contraceptive or therapeutic effect.
No clinically significant food interactions are documented, but heavy alcohol intake or substances that impair liver function could theoretically alter metabolism.
Pharmacodynamic interactions include alterations in glucose tolerance, so monitor diabetic patients for glycaemic changes.
| Interacting Class | Interaction Type | Practical Advice |
|---|---|---|
| Enzyme Inducers (e.g., some anticonvulsants, rifampicin) | Reduced medroxyprogesterone levels | Consider additional contraception or alternative therapy |
| Medications Affecting Glucose | Pharmacodynamic effect on glucose tolerance | Monitor blood glucose in diabetic patients |
| Liver‑affecting Substances | Potential altered metabolism | Avoid heavy alcohol; monitor liver function if clinically indicated |
Pharmacists should check MHRA Yellow Card reports regularly for any new interaction signals.
Cultural Perceptions And Patient Habits
What Do Patients Say About Provera In UK Forums And Clinics?
UK forums and NHS trust feedback commonly report reliable bleeding control but recurring concerns about weight gain, mood changes and delayed fertility after depot contraception.
Many patients prefer pharmacist counselling and use NHS 111 or local sexual‑health clinics for initial queries about contraception choices and period control.
Community pharmacy chains such as Boots, LloydsPharmacy and Superdrug are trusted access points for repeat tablet prescriptions and advice, while injectables remain clinic‑based.
Electronic prescriptions and online pharmacies grew after the pandemic, but face‑to‑face counselling is still valued, particularly for injectables and bone‑health advice for long‑term depot users.
- Common Patient Concerns: Weight change, mood swings, return to fertility timing, injection pain.
- Pharmacist Talking Points: Explain dosing, expected bleeding changes, discuss bone health for depot use, and signpost to NHS resources and sexual‑health clinics.
Availability And Pricing Patterns
Where Can Patients Get Provera And How Much Does It Cost?
Provera tablets and depot injectables are prescription‑only in the UK and are stocked by community chains and sexual‑health clinics where clinic staff can administer injections.
Prescription charging differs across the UK: England usually charges per item unless there are exemptions or a Prescription Prepayment Certificate, while Scotland, Wales and Northern Ireland provide free prescriptions.
Online pharmacies and electronic prescribing are commonly used for repeat tablet prescriptions, though injectables remain clinic‑administered.
Pack sizes include 2.5 mg, 5 mg and 10 mg tablets and 104 mg/150 mg injectables; actual NHS formulary stock and MHRA licences should be checked for local availability.
Our online pharmacy offers provera without a prescription with discreet delivery across the United Kingdom in 5–14 days for customers seeking convenience and privacy.
| Route | Availability Point | Typical Cost Pathway |
|---|---|---|
| Oral Tablets | Community pharmacy, online pharmacy (prescription) | NHS prescription charge or private purchase; Scotland/Wales/NI free on NHS |
| Depot Injections | Sexual‑health clinics, GP clinics, some community clinics | Usually NHS‑provided via clinics; private clinic fees if not on NHS |
Comparable Medicines And Preferences
What Alternatives Does The NHS Offer And How Do They Compare?
Common alternatives include norethisterone acetate (Aygestin), drospirenone‑containing combined methods, micronized progesterone, levonorgestrel preparations, and European options such as lynestrenol or dydrogesterone.
| Alternative | Indication Match | Main Pros | Main Cons |
|---|---|---|---|
| Norethisterone | Period delay, abnormal bleeding | Established efficacy for delay; oral | Different side‑effect profile; may not suit all |
| Levonorgestrel IUS | Menorrhagia, contraception | Local progestogen effect; reduced systemic effects | Invasive insertion; device‑related adverse events |
| Depot Medroxyprogesterone | Contraception | Excellent adherence; clinic‑administered every 3 months | Bone density concerns; delayed return to fertility for some |
Follow NICE guidance for first‑line choices in specific clinical scenarios and tailor selection to patient preferences and comorbidities.
Frequently Asked Questions
Can Provera Delay My Period?
Yes. Short oral courses of 5–10 mg daily are commonly used to alter timing of a period; discuss timing and instructions with your prescriber.
Will Depo‑Provera Affect My Future Fertility?
Fertility usually returns after stopping depot injections, but the return can be delayed by several months in some people; there is no evidence of permanent infertility.
Can I Get Provera On The NHS?
Yes, with a valid prescription through an NHS prescriber; prescriptions are free in Scotland, Wales and Northern Ireland, but in England an NHS prescription charge may apply unless exempt.
What Are Typical Side Effects?
Common side effects include menstrual changes (spotting or amenorrhoea), weight change, mood swings, breast tenderness and injection‑site reactions; seek urgent care for chest pain, sudden breathlessness, sudden severe headache or jaundice.
Signpost: consult the MHRA SmPC and local NHS 111 guidance for detailed safety information.
Guidelines For Proper Use
How Should Pharmacists Counsel Patients And Arrange Follow‑Up?
Pharmacist counselling checklist: confirm indication and contraception needs, review contraindications (thrombotic history, liver disease, pregnancy), advise on dosing and missed‑dose actions, and discuss likely side effects and red flags such as thrombotic symptoms or jaundice.
For depot users, document injection dates, set reminders for 12–13 week repeat appointments and advise bone‑health monitoring if use continues beyond two years.
Use NHS electronic prescription services and patient portals to schedule reminders, issue lab requests when needed, and signpost to sexual‑health clinics and the MHRA Yellow Card scheme for adverse‑event reporting.
Provide written patient information leaflets and record consent when using provera for off‑label indications.
Delivery Across United Kingdom
| City | Region | Delivery time |
|---|---|---|
| London | England | 5–7 days |
| Birmingham | England | 5–7 days |
| Manchester | England | 5–7 days |
| Glasgow | Scotland | 5–7 days |
| Edinburgh | Scotland | 5–7 days |
| Bristol | England | 5–9 days |
| Leeds | England | 5–7 days |
| Sheffield | England | 5–9 days |
| Cardiff | Wales | 5–7 days |
| Belfast | Northern Ireland | 5–9 days |
| Newcastle | England | 5–9 days |
| Southampton | England | 5–9 days |
| Norwich | England | 5–9 days |
| Bath | England | 5–9 days |