Medroxyprogesterone acetate (Provera)

Medroxyprogesterone acetate is a type of hormonal therapy. You pronounce it as med-rok-see-pro-jess-ter-ohn ass-ih-tait. It is also known as Provera.

It is a treatment for cancer of the:

• womb

• kidney

• breast

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

Medroxyprogesterone acetate is also used in lower doses to help with:

• poor appetite
• hot flushes in men due to hormone therapy for prostate cancer

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 your body. They are carried around your body in the bloodstream and act as messengers between one part of your body and another. 

Hormones are responsible for many functions in your 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 take medroxyprogesterone acetate?

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

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 experiencing too many side effects.

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. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.

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 may lose or gain weight for various reasons when you are having cancer treatment.

Tell your doctor or nurse if you are losing or gaining weight. They can refer you to a dietitian for advice.

Increased appetite

This treatment can increase your appetite. Feeling hungrier can make it difficult to keep your weight down. Your appetite will go back to normal when you stop taking this medicine, but some people may need to make changes to their diet to lose the excess weight.

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

Difficulty sleeping

If you have 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. 

Headaches

Tell your healthcare team if you keep getting headaches. They can give you painkillers to help.

Dizziness

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

Shaking (tremor)

You might notice shaking or trembling movements in one or more parts of your body, such as your hands. It is something you can’t control. This can make it difficult to do everyday things depending on how severe it is.

Let your healthcare team know so they can help. 

Feeling or being sick

You may feel or be sick with this treatment. 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.

Let your healthcare team know as they can give you anti sickness medicine to help control this.

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

This drug might cause you to sweat more than usual. But there are ways to reduce sweating.

Let your healthcare team know if you are sweating much more than normal.

Erection problems

This type of hormone therapy lowers the amount of testosterone in the body. This might affect your ability to get and maintain an erection (erectile dysfunction).

Speak to your nurse or doctor for advice.

Swelling of different parts of the body

You might have swelling to different parts of the body due to fluid build up. This is called oedema.

Let your doctor or nurse know if you have any swelling.

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.

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:

• heart problems including not pumping blood around your body properly (heart failure) – this can cause symptoms such as shortness of breath, feeling faint, and swelling in the legs. Rarely it can cause a heart attack
• 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
• a condition called Cushing’s syndrome - symptoms include a swollen or puffy rounded face, stretch marks, spotty rash (acne) and increased facial hair. You might also gain weight around your tummy (abdomen)
• high blood sugar levels (diabetes mellitus) - you may notice you feel thirsty and are weeing a lot. You might lose weight even if you are eating normally. You have regular tests to check your blood sugar levels
• high levels of calcium in your blood - symptoms include feeling achy, weak, confusion or muscle cramps. Talk to your doctor or call your advice line if you have these symptoms
• mood changes - feeling very low or sad (depression) or very happy
• lowered interest in sex
• diarrhoea
• dry mouth
• spotty skin - you may notice this more on your face, back or chest
• thicker and darker hair on your face
• unexpected or unusual bleeding from the vagina . The bleeding might be heavy, light or just spotting
• breast pain
• muscle cramps or spasms
• 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:

• an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness - some allergic reactions can be life threatening. Alert your nurse if you notice any of these symptoms
• loss of vision
• a brain tumour called a meningioma that is usually non cancerous (benign)
• your periods may stop or you might have a long break between cycles
• being confused
• loss of concentration
• eye changes such as blurred, cloudy, double or loss of vision. You may see dark shapes or lines (floaters). You might be more sensitive to the light or have eye pain
• your heart may feel as though it is racing or beating very fast. It can feel like fluttering or like it is pounding or thumping 
• raised itchy bumps or puffy areas of the skin
• too much sugar in your pee (glycosuria)
• milky discharge from the breast when you are not pregnant or breastfeeding
• vaginal discharge
• liver changes that are picked up on blood tests
• high levels of white blood cells and platelets in your blood tests

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do you need to know?

Other medicines, foods and drinks 

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

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.

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 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.