Hormone/Contraceptive use in O&G

Drug
Oral
Medroxyprogeste
rone
Provera

Dose
Abnormal uterine bleeding
5-10mg OD for 5-10days. Start on D16 or D21 of menstrual cycle.
Withdrawal bleeding: 3-7days after d/c 1,2
20mg TDs for 7 days then OD for 3 weeks4
Acute
10 mg every 4 h orally (max80mg) until bleeding stops
Maintena
then every 6 h for 4 days,
nce
then every 8 h for 3 days,
then every 12 h for 2 days to 2 weeks,
then daily thereafter 5
Anovulatory 10mg/day for 10-14 days6
Ovulatory
10mg/day for 21 days6
10mg TDS for 14 days. Start on Day 127
10mg TDS for 5-10days 8
5-10mg OD for 14days. Start from 15-16days after onset of last
menstrual cycle.8
Amenorrhea,Secondary
5-10mg OD for 5-10days. Start any time.Withdrawal bleeding: 37days after d/c 1
Progestogen challenge test:10mg OD for 7-10 days9
Endometrial hyperplasia reduction
hyperplasia without atypia
Cyclic
5-10mg1 (10-20mg8) OD for 12-14days each month.
Start on D1 or D16 of cycle. Adjust, taper or d/c at 36months interval. 1
Continuous 10mg OD for 3-6 months10
Medroxyprogeste
Contraception IM 150mg q3months (q13 weeks)1
Endometrial carcinoma, recurrent or metastatic IM 400rone
1000mg/week1
Depo-Provera
Norethisterone
IM 200mg every 8 weeks for 4 doses, then every 12 weeks
thereafter3
Oral Contraceptive
Estrogen
Progestin
Packin
Emergency
Pill
g
contraception11,1
2

Regulon,Marvelon,
Desolon
Novynette, Mercilon
Oralcon, Rigevidon,
Microgynon 30,
Nordette
Loette
Gynera, Minulet
Meliane
Yaz
Yasmin

Ethinylestradiol
0.03mg
Ethinylestradiol
0.02mg
Ethinylestradiol
0.03mg

Desogestrel 0.15mg

Ethinylestradiol
0.02mg
Ethinylestradiol
0.03mcg
Ethinylestradiol
0.02mcg
Ethinylestradiol
0.02mg
Ethinylestradiol

21+7

4+4

Desogestrel 0.15mg

5+5

Levonorgestrel
0.15mg

4+4

Levonorgestrel
0.1mg
Gestodene
0.075mg
Gestodene
0.075mg
Drospirenone 3 mg

5+5

Drospirenone 3 mg

24+4

0.03mg
Noriday
Escapelle
Postinor-2

Norethisterone
0.35mg
Levonorgestrel
1.5mg
Levonorgestrel
0.75mg

28
1

Within 72H

Yuzpe regime: emergency contraception consisting of ethinyl estradiol, 100 g, and levonorgestrel, 0.5 mg, to be taken within 72 hours of
unprotected intercourse and repeated 12 hours later.
References:
1.
Lexi comp
2.
Micromedex
3.
MIMSgateway
4.
American College of Obstetricians and Gynecologists. Committee Opinion
no. 557: Management of acute abnormal uterine bleeding in nonpregnant
reproductive-aged women. Obstet Gynecol. 2013;121(4):891896.
5.
James AH, et al. Evaluation and management of acute menorrhagia in
women with and without underlying bleeding disorders: consensus from an
international expert panel. Eur J Obstet Gynecol (2011), doi:10.1016/
j.ejogrb.2011.04.025
6.
American Academy of Family Physicians. Evaluation and Management of
Abnormal Uterine Bleeding in Premenopausal Women. Am Fam Physician.
2012;85(1):35-43

7.
8.
9.

10.
11.
12.

The Johns Hopkins Manual of Gynecology and Obstetrics. Lippincott

Williams & Wilkins, 28 Mar 2012. Pg 481
Sadhana Gupta. A Comprehensive Textbook of Obstetrics and Gynecology.
JP Medical Ltd, 14 Mar 2011. Pg 140
Tarannum. Amenorrhea: Evaluation and Treatment. Am Fam Physician.
2006 Apr 15;73(8):1374-1382
David Chelmow . Acute Care and Emergency Gynecology: A Case-Based
Approach. Cambridge University Press, 2014. Pg 53
Randy Emergency Postcoital Contraception. Am Fam Physician. 2000 Nov
15;62(10):2287-2292
Emergency contraceptive Pills. South East Asia Regional Training Manual.
2015

Prepared by Drug Information Unit, Pharmacy Department, Hospital Marudi. Nov 2015