Case Evaluation

Depo-Provera: Depo-Provera Overview

What is Depo-Provera?

Depo-Provera is an injectable contraception used to prevent pregnancy. Part of a class of medications called "progestins", Depo-Provera works by preventing ovulation (the release of eggs from the ovaries), and by thinning the uterine lining. Depo-Provera was approved by the U.S. Food and Drug Administration (FDA) in 1992.

While Depo-Provera acts as birth control, it does not prevent the spread of the human immunodeficiency virus (HIV) or other sexually transmitted diseases (STDs).

Depo-Provera FDA Alert

In November 2004, the FDA announced that a "black box" warning would be added to the labeling of Depo-Provera Contraceptive Injection. The label warns Depo-Provera users that prolonged use may result in the loss of bone density, and that the loss may be greater the longer the drug is administered. This bone density loss may not be completely reversible after discontinuation of Depo-Provera use. The warning goes on to state that a woman should only use Depo-Provera Contraceptive Injection as a long-term birth control method (e.g., longer than two years) if other birth control methods prove inadequate.

In addition to the black box warning, Depo-Provera manufacturer Pfizer issued a "Dear Health Care Practitioner" letter regarding the effect of long-term treatment on bone mineral density, and incorporated the new information into the patient information sheet distributed with Depo-Provera. More information: 11/17/04 FDA Alert.

What Should I Know Before Using Depo-Provera?

Depo-Provera is usually administered by a health care provider in an office or clinic. You must receive your first Depo-Provera injection only at a time when there is no possibility that you are pregnant. If you have been using a different method of birth control and are switching to Depo-Provera, your health care professional will tell you when you should receive your first injection.

Your menstrual cycle will probably change while you are using Depo-Provera. At first, your periods will probably be irregular, and you may experience spotting between periods. If you continue to use Depo-Provera, your periods may stop completely. Your menstrual cycle will probably return to normal some time after you stop using Depo-Provera.

Depo-Provera is a long-acting birth control method. You might not become pregnant for some time after you receive your last injection. Talk to your healthcare professional about the effects of Depo Provera if you plan to become pregnant in the near future.

You should have a complete physical exam -- including blood pressure measurements, breast and pelvic exams, and a pap test -- at least yearly. Follow your healthcare professional's directions for self-examining your breasts; report any lumps immediately.

Before you have any laboratory tests, tell the laboratory personnel that you are using Depo-Provera.

Depo-Provera Health Risks

If you are younger than 35 years old and began to receive Depo-Provera in the last 4-5 years, you may have a slightly increased risk that you will develop breast cancer. Depo-Provera may also increase the chance that you will develop a blood clot that moves to your lungs or brain. Talk to your healthcare professional about the risks of using Depo-Provera.

Depo-Provera Side Effects

Depo-Provera may cause side effects. Tell your healthcare professional if any of these symptoms are severe or persistent:

  • changes in menstrual periods
  • weight gain
  • weakness
  • tiredness
  • nervousness
  • irritability
  • depression
  • difficulty falling asleep or staying asleep
  • hot flashes
  • breast pain, swelling, or tenderness
  • stomach cramps or bloating
  • leg cramps
  • back or joint pain
  • acne
  • loss of hair on scalp
  • swelling, redness, irritation, burning, or itching of the vagina
  • white vaginal discharge
  • changes in sexual desire
  • cold or flu symptoms
  • pain, irritation, lumps, redness or scarring in the place where the medication was injected

Some side effects can be serious. The following side effects are uncommon, but if you experience any of them, call your healthcare professional immediately:

  • sudden shortness of breath
  • sudden sharp or crushing chest pain
  • coughing up blood
  • severe headache
  • upset stomach
  • vomiting
  • dizziness or faintness
  • change or loss of vision
  • double vision
  • bulging eyes
  • difficulty speaking
  • weakness or numbness in an arm or leg
  • seizure
  • yellowing of the skin or eyes
  • extreme tiredness
  • pain, swelling, warmth, redness, or tenderness in one leg only
  • menstrual bleeding that is heavier or lasts longer than normal s
  • evere pain or tenderness just below the waist
  • rash
  • hives
  • itching
  • difficulty breathing or swallowing
  • swelling of the hands, feet, ankles, or lower legs
  • difficult, painful, or frequent urination
  • constant pain, pus, warmth, swelling, or bleeding in the place where the medication was injected

Depo-Provera Special Dietary Instructions

While taking Depo-Provera, you should eat plenty of foods that are rich in calcium and vitamin D, in order to help decrease the loss of calcium in your bones. Your healthcare professional should be able to recommend foods that are good sources of these nutrients, suggest the number of servings you need each day, and/or recommend the use of calcium or vitamin D supplements.

Depo-Provera - Getting Legal Help

While all medications have certain anticipated side effects, a drug manufacturer has a duty to make its products as reasonably safe as possible, and to inform the medical community and the public of known risks associated with its drugs. If a manufacturer fails to do so, it can be held legally responsible if patients are injured as the result of inadequate warnings or the unreasonably dangerous nature of the drug, under a legal theory called "product liability."

If you or a loved one have experienced any dangerous symptoms or unusual medical conditions while using Depo-Provera, you should first contact your doctor or other healthcare professional. You may also wish to meet with an experienced attorney to discuss your options and to protect your right to a legal remedy for any injuries caused by Depo-Provera use.

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