Medroxyprogesterone acetate (Provera ®)
Medroxyprogesterone acetate is a hormonal therapy that is also often called Provera ®. It’s used to treat some types of cancer and may also be used to treat some symptoms. Throughout this section we refer to it by its more commonly used name, Provera.
The information describes Provera, how it is given and some of its possible side effects. It should ideally be read with our general information about your type of cancer.
You’ll see your doctor regularly while you have this treatment so they can monitor its effects. This information should help you discuss any queries about your treatment and its side effects with your doctor or specialist nurse.
Provera is a hormonal therapy used to treat some cancers. It is a man-made drug that's similar to the female hormone progesterone.
Hormones are substances produced naturally in the body. They act as chemical messengers and help control the activity of cells and organs.
The way Provera works is not yet fully understood, but it's thought that it interferes with the action of the female hormone oestrogen.
Many cancers rely on sex hormones, such as oestrogen, to grow. The cancer cells have proteins called receptors that sex hormones attach to.
When oestrogen comes into contact with the receptors, it fits into them and stimulates the cancer cells to divide so that the tumour grows.
Provera disrupts this process in some way. It may be that it prevents the cancer cells from maintaining the receptors, or it may have a more direct way of destroying cancer cells that has not yet been identified.
Provera is a tablet. The tablets are available in three different strengths: 100mg, 200mg and 400mg.
They are commonly taken once a day but can be prescribed in smaller doses to be taken at regular intervals. They can be taken with food or on an empty stomach. When a single daily dose is prescribed, it should be taken at approximately the same time each day. When it’s prescribed in divided doses (to be taken more than once per day,) the doses should be evenly spaced.
Provera is used to treat breast cancer
that has come back after treatment with other hormonal therapies. It can also be used to treat womb
cancers that have come back after treatment or have spread.
Provera may be given to people who have lost weight due to cancer, as it can help improve appetite.
It can also be prescribed to reduce hot flushes in women during the menopause, and in men who have hot flushes as a result of treatment for prostate cancer.
Length of treatment with Provera
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Your doctor will discuss with you the length of treatment they feel is appropriate for your situation. Provera is often given for several months or years. Treatment may continue as long as it is controlling the cancer.
Possible side effects of Provera
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Each person's reaction to any medicine is different. Some people have very few side effects while others may experience more. The side effects described here will not affect everyone. We have outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you.
Very rarely, if the side effects are severe, you may have to stop taking the drug. If this happens, a different hormonal therapy may be prescribed.
If you notice any effects that are not listed here, discuss them with your doctor or nurse.
The most commonly reported side effect is an increase in appetite, causing some people to put on weight
. Dieting may help control this, but you should consult your doctor or dietitian before making any changes to your diet.
For people who have experienced weight loss as a result of their cancer, an increased appetite can be a beneficial effect.
Feeling sick (nausea) and indigestion
Occasionally people feel sick
for the first few weeks of taking Provera, but this often disappears. If it occurs it can usually be effectively treated, so let your doctor know. It may help to take the tablets with food or milk.
Some people experience mild ankle swelling caused by fluid retention. This is not harmful but can be uncomfortable.
Vaginal bleeding in women
Occasionally women may have some light vaginal bleeding (spotting) while having treatment with Provera. Let your doctor know if this happens to you.
When you stop taking the drug you are likely to have some bleeding from the vagina, which is similar to a period.
Your breasts may feel tender and, very rarely, they may produce small amounts of milk. This is not harmful, but let your doctor know if it occurs.
Mood changes, tiredness (fatigue) and headaches
Rarely, Provera can cause nervousness, sleeplessness, drowsiness, tiredness, dizziness, low moods and headaches. Tell your doctor if these are a problem.
Always let your doctor or nurse know about any side effects you have. There are usually ways in which they can be controlled or improved.
Additional information about Provera
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Provera should not be taken during pregnancy. Even though women may find that their periods stop while taking Provera, it is still possible to get pregnant. Reliable contraception must be used during treatment.
Blood sugar levels
People with diabetes will need to monitor their blood sugar more closely and may need to adjust their anti-diabetic medication while having Provera. Contact your doctor if you have any problems controlling your diabetes.
Risk of blood clots
People who have a history of blood clots should discuss this with their doctor before taking Provera. Rarely, it increases the risk of getting a clot.
If you’re admitted to hospital for a reason not related to the cancer, it’s important to tell the doctors and nurses looking after you that you are having hormonal treatment. You should tell them the name of your cancer specialist so that they can ask for advice.
It’s a good idea to know who you should contact if you have any problems or troublesome side effects when you’re at home.
Things to remember about Provera tablets
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Provera may interact with other medicines. Tell your doctor about any medication you are taking including non-prescribed drugs such as complementary therapies and herbal drugs.
Keep the tablets in a safe place, out of the reach of children.
Keep the tablets in the original packaging and store them at room temperature, away from direct heat and sunlight.
If your doctor decides to stop the treatment, return any remaining tablets to the pharmacist. Do not flush them down the toilet or throw them away.
Don't worry if you forget to take your tablet. Do not take a double dose. The levels of the drug in your blood will not change very much, but try not to miss more than one or two tablets in a row.
Remember to get a new prescription a few weeks before you run out of tablets and make sure that you have plenty for holidays.
This information has been compiled using information from a number of reliable sources, including:
British National Formulary. 64rd edition. 2012. British Medical Association and Royal Pharmaceutical Society of Great Britain.
electronic Medicines Compendium (eMC) (accessed September 2012).
Sweetman, et al. Martindale: The Complete Drug Reference. 37th edition. 2011. Pharmaceutical Press.
With thanks to: Bruce Burnett, Teacher Practitioner in Clinical Pharmacy Practice; and the people affected by cancer who reviewed this edition. Reviewing information is just one way you could help when you join our Cancer Voices network.