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Conjugated estrogens / medroxyprogesterone Pregnancy and Breastfeeding Warnings

Conjugated estrogens / medroxyprogesterone is also known as: Premphase, Premphase 14/14, Prempro

Medically reviewed by Drugs.com. Last updated on Feb 16, 2019.

Conjugated estrogens / medroxyprogesterone Pregnancy Warnings

Animal studies have shown high doses of progestins can cause masculinization of the female fetus. Epidemiologic studies and meta-analyses have not shown exposure to combined hormonal contraceptives (estrogen and progestins) increases the risk of genital or non-genital birth defects with exposure before conception or during pregnancy. This drug is not indicated for use in females of reproductive potential. There are no controlled data in human pregnancy.

AU TGA pregnancy category D: Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

This drug is not indicated for use during pregnancy

AU TGA pregnancy category: D
US FDA pregnancy category: Not assigned

Risk Summary: This drug is not indicated for use in females of reproductive potential; there appears to be little or no increased risk of birth defects in women who have used estrogens and progestins as an oral contraceptive inadvertently during early pregnancy.

Comments:
-If pregnancy occurs, this drug should be discontinued.

See references

Conjugated estrogens / medroxyprogesterone Breastfeeding Warnings

This drug is not indicated for use in lactating females

Excreted into human milk: Yes

See references

References for pregnancy information

  1. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. Jaffe B, Harlap S, Baras M, Gordon L, Lieblich A, Magidor S, Sanchez M "Long-term effects of MPA on human progeny: intellectual development." Contraception 37 (1988): 607-19
  3. "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. Katz Z, Lancet M, Skornik J, Chemke J, Mogilner BM, Klinberg M "Teratogenicity of progestogens given during the first trimester of pregnancy." Obstet Gynecol 65 (1985): 775-80
  5. Resseguie LJ, Hick JF, Bruen JA, Noller KL, O'Fallon WM, Kurland LT "Congenital malformations among offspring exposed in utero to progestins, Olmsted County, Minnesota, 1936-1974." Fertil Steril 43 (1985): 514-9
  6. Jaffe B, Shye D, Harlap S, Baras M, Lieblich A "Aggression, physical activity levels and sex role identity in teenagers exposed in utero to MPA." Contraception 40 (1989): 351-63
  7. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  8. Pardthaisong T, Gray RH "In utero exposure to steroid contraceptives and outcome of pregnancy" Am J Epidemiol 134 (1991): 795-803
  9. Heinonen O, Slone D, Shapiro S; Kaufman DW ed. "Birth Defects and Drugs in Pregnancy." Littleton, MA: Publishing Sciences Group, Inc. (1977): 297
  10. Jordan A "Toxicology of depot medroxyprogesterone acetate." Contraception 49 (1994): 189-201
  11. Pardthaisong T, Yenchit C, Gray R "The long-term growth and development of children exposed to Depo- Provera during pregnancy or lactation." Contraception 45 (1992): 313-24
  12. Gray RH, Pardthaisong T "In utero exposure to steroid contraceptives and survival during infancy" Am J Epidemiol 134 (1991): 804-11
  13. Yovich JL, Turner SR, Draper R "Medroxyprogesterone acetate therapy in early pregnancy has no apparent fetal effects." Teratology 38 (1988): 135-44
  14. Schwallie PC "The effect of depot-medroxyprogesterone acetate on the fetus and nursing infant: a review." Contraception 23 (1981): 375-86

References for breastfeeding information

  1. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. Dahlberg K "Some effects of depo-medroxyprogesterone acetate (DMPA): observations in the nursing infant and in the long-term user." Int J Gynaecol Obstet 20 (1982): 43-8
  3. Hefnawi F, Fawzi G, Badraoui MH "Effect of some progestational steroids on lactation in Egyptian women. I. Milk yield during the first year of lactation." J Biosoc Sci 8 (1976): 45-8
  4. Jimenez J, Ochoa M, Soler MP, Portales P "Long-term follow-up of children breast-fed by mothers receiving depot- medroxyprogesterone acetate." Contraception 30 (1984): 523-33
  5. Abdel Kader MM, Abdel Aziz MT, Bahgat R, Hefnawi F, Fawzi G, Badraoui MH "Effect of some progestational steroids on lactation in Egyptian women. II. Chemical composition of milk during the first year of lactation." J Biosoc Sci 8 (1976): 49-51
  6. Committee on Drugs, 1992 to 1993 "The transfer of drugs and other chemicals into human milk." Pediatrics 93 (1994): 137-50
  7. Shaaban MM "Contraception with progestogens and progesterone during lactation." J Steroid Biochem Mol Biol 40 (1991): 705-10
  8. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  9. Schwallie PC "The effect of depot-medroxyprogesterone acetate on the fetus and nursing infant: a review." Contraception 23 (1981): 375-86
  10. Koetsawang S, Nukulkarn P, Fotherby K, Shrimanker K, Mangalam M, Towobola K "Transfer of contraceptive steroids in milk of women using long-acting gestagens." Contraception 25 (1982): 321-31

Further information

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