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Depot medroxyprogesterone acetate for contraception

INTRODUCTION

Progestin-only contraception is an option for women in whom an estrogen-containing contraceptive is either contraindicated or causes additional health concerns. Depot medroxyprogesterone acetate (DMPA) is an injectable, progestin-only contraceptive that provides highly effective, private, long-acting, reversible contraception and avoids both the need for user action daily or near the time of sexual intercourse and the need for partner cooperation.

Other types of progestin-only contraceptives include:

FORMULATIONS AND PHARMACOLOGY

DMPA is available in two formulations: 150 mg/1 mL for intramuscular injection (IM) and 104 mg/0.65 mL for subcutaneous (SC) injection. The every three-month injection schedule provides high contraceptive efficacy because low solubility of the microcrystals at the injection site allow pharmacologically active drug levels to persist for several months [1].

Following a single 150 mg IM dose of DMPA, drug levels increase for approximately three weeks, reaching a peak concentration of 1 to 7 ng/mL [2]. The levels then decrease exponentially until they become undetectable (less than 100 pg/mL) between 120 and 200 days following the injection, but considerable interindividual variability in serum levels exists.
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