Medroxyprogesterone acetate (Provera)

Medroxyprogesterone acetate is a type of hormonal therapy drug to treat womb, kidney, and breast cancer. It is also known as Provera.

What is medroxyprogesterone acetate?

Medroxyprogesterone acetate is a type of hormone drug. It is a treatment for:

• womb cancer
• kidney cancer (renal cancer)
• breast cancer in women who are no longer having periods (post menopausal)

You might have it if your cancer has come back after treatment, or if it has spread to another part of the body.

Medroxyprogesterone is also occasionally used as a treatment for poor appetite. Your doctor may suggest that you take it if you are losing weight because it can help to boost your appetite.

It can also help men who have hot flushes due to hormone therapy for prostate cancer treatment.

How does medroxyprogesterone acetate work?

Medroxyprogesterone acetate is a hormone drug that is from a group of medicines called progestogens. Progestogens act like progesterone, which is a sex hormone.

Hormones are natural substances made by glands in our bodies. They are carried around our body in our bloodstream and act as messengers between one part of our body and another. 

Hormones are responsible for many functions in our body, including the growth and activity of certain cells and organs. 

Some cancers use hormones to grow or develop. This means the cancer is hormone sensitive or hormone dependent.

Medroxyprogesterone acetate works by interfering with the hormone balance in the body. This means there are smaller amounts of hormones that some cancers depend on to grow. It can also interact with other hormones or have a direct effect on the cancer to stop it growing.

How do you have medroxyprogesterone acetate?

You have medroxyprogesterone acetate as tablets. You need to swallow each tablet whole with a drink of water. Take them at the same time each day.

If you accidentally take too many tablets, tell your doctor or nurse straight away.

You should take the right dose, not more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

How often do you have medroxyprogesterone acetate?

You have medroxyprogesterone acetate daily for as long as it is working, and you are not having bad side effects.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of medroxyprogesterone acetate?

Side effects can vary from person to person. They also depend on what other treatment you are having. 

When to contact your team

Your doctor, nurse, or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

Common side effects

Common side effects happen in more than 10 in 100 people (more than 10%). At the time of this review, there have been no reports of common side effects for this treatment.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

Weight changes 

You might notice your weight changes while you are taking medroxyprogesterone. Some people might put on weight. This is more likely to happen if you are taking a large amount (dose). You should be able to control this with diet and exercise. But it is often a struggle to keep an even weight when you are having hormone treatment. 

Your appetite will go back to normal when you stop the treatment, but some people need to diet to lose the extra weight.

Talk to your nurse or your dietitian about how to safely control your weight.

Dizziness

This drug might make you feel dizzy. Don’t drive or operate machinery if you have this.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Constipation

Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor or nurse if you are constipated for more than 3 days. They can prescribe a laxative.

Sweating heavily

This can happen when you are resting and not due to exercise. Some people might feel embarrassed, but the following may help:

• Wear layers of light clothing so you can take clothes off if you overheat.
• Have layers of bedclothes to remove as you need to.
• Wear natural fibres such as silk or cotton instead of man-made fabrics.

Problems with erections

Men may find it more difficult to get and keep an erection. Speak to your nurse or doctor, they can offer some advice or refer you to a specialist to help you with this.  

Tiredness and weakness (fatigue)

Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

Swelling (oedema)

You may have swelling of your hands and legs due to a build up of fluid (oedema). 

You might also have general swelling underneath the skin or mucous membranes, but this is less common. 

Headaches

Talk to your doctor or nurse if you keep having headaches. Painkillers might help with this. 

Difficulty sleeping

It can help to change a few things about how you try to sleep. Try to go to bed and get up at the same time each day and spend some time relaxing before you go to bed. Some light exercise each day may also help. 

Rare side effects

These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:

• blood clots that can be life threatening; signs are pain, redness and swelling where the clot is. Feeling breathless can be a sign of a blood clot in the lung. Contact your advice line or doctor straight away if you have any of these symptoms
• high blood sugar levels (diabetes mellitus). You may notice you are drinking and weeing a lot. You might lose weight even if you are eating your normally, you will have regular blood tests to check your blood sugar
• high levels of calcium in your blood, symptoms include feeling achy, weak or muscle cramps
• mood changes - feeling very low or sad (depression) or very happy
• diarrohea
• dry mouth
• lowered interest in sex
• spotty skin, you may notice this more on your face, back or chest
• thicker and darker hair on your face
• breast pain and tenderness
• unusual vaginal bleeding, this may be heavy, irregular or you may have spotting
• a skin rash
• a high temperature
• puffy and round looking face and increased fat on your tummy and chest, and around your neck (these are symptoms of a condition called Cushing’s syndrome)
• heart problems causing symptoms such as shortness of breath and swelling in the legs
• risk of a stroke

Other side effects

There isn't enough information to work out how often these side effects might happen. You might have one or more of them. They include:

• allergic reaction symptoms might include a skin rash, itching, swelling of the lips, face or throat, breathing difficulties, fever and chills. Contact your hospital advice line immediately if at any time you feel unwell or call 999
• confusion
• unable to concentrate
• skin reactions, symptoms include itchy and dry skin that may also look red
• problems with your eyes that might affect your eyesight
• a milky liquid leaking from a nipple
• periods stopping
• vaginal discharge
• changes in some of your blood tests, this includes liver changes, high levels of white blood cells and platelets

What else do I need to know?

Other medicines, foods and drinks 

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you're having treatment and for a few months afterwards.

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.

Loss of fertility 

Medroxyprogesterone acetate can stop menstrual periods in some people. It may take time for your periods to return after treatment. They might also be irregular for some time. This can vary from person to person. This can delay pregnancy for people of childbearing age who are trying to become pregnant.

Breastfeeding

Medroxyprogesterone acetate can come through into your breast milk. Speak to your doctor first if you are on this treatment and are planning to breastfeed.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.