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Generic Name: estradiol and medroxyprogesterone (ess tra DY ol and med ROX ee pro JESS te rone)
Brand Names: Lunelle

What is estradiol and medroxyprogesterone?

Estradiol and medroxyprogesterone contains a combination of female hormones that prevent ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical mucous and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.

Estradiol and medroxyprogesterone is used as contraception to prevent pregnancy.

Estradiol and medroxyprogesterone may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about estradiol and medroxyprogesterone?

You may need to use back-up birth control, such as condoms or a spermicide, when you first start using this medication. Follow your doctor's instructions.

Some drugs can make birth control injections less effective, which may result in pregnancy. Tell your doctor about all the prescription and over-the-counter medications you use, including vitamins, minerals and herbal products. Do not start using a new medication without telling your doctor.

What should I discuss with my healthcare provider before using estradiol and medroxyprogesterone?

• a history of a stroke or blood clot;

• circulation problems (especially if caused by diabetes);

• a hormone-related cancer such as breast or uterine cancer;

• abnormal vaginal bleeding;

• liver disease or liver cancer;

• severe high blood pressure;

• severe migraine headaches;

• a heart valve disorder; or

• a history of jaundice caused by birth control pills.

Before using this medication, tell your doctor if you have any of the following conditions. You may not be able to use the medication, or you may need a dosage adjustment or special tests during treatment.

• high blood pressure, heart disease, congestive heart failure, angina (chest pain), or a history of heart attack;

• high cholesterol or if you are overweight;

• kidney disease;

• a history of depression;

• gallbladder disease;

• diabetes;

• seizures or epilepsy;

• a history of irregular menstrual cycles; or

• a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram.

How is estradiol and medroxyprogesterone used?

This medication is given as an injection into a muscle in your upper arm, thigh, or buttocks. You will receive this injection in your doctor's office or other clinic setting. Before receiving your first injection, tell your doctor about all other forms of birth control you have used within the past 7 days.

The first injection of this medication is given during the first 5 days of a normal menstrual period, or within 5 days after undergoing a complete first-trimester abortion.

After your first injection, you will need to receive monthly injections every 28 to 30 days to assure prevention of pregnancy. Do not allow more than 33 days to pass between injections, even if your menstrual period has started later than expected.

If you need to have any type of medical tests or surgery, or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are using birth control injections.

Your doctor will need to see you on a regular basis while you are using this medication. Do not miss any appointments.

What happens if I miss a dose?

Missing a monthly injection increases your risk of becoming pregnant. Call your doctor for instructions if you miss an appointment for your injection.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine. Symptoms of an overdose may include nausea, vomiting, and vaginal bleeding.

What should I avoid while using estradiol and medroxyprogesterone?

Birth control injections will not protect you from sexually transmitted diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.

Estradiol and medroxyprogesterone side effects

• sudden numbness or weakness, especially on one side of the body;

• sudden headache, confusion, pain behind the eyes, problems with vision, speech, or balance;

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• a change in the pattern or severity of migraine headaches;

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• swelling in your hands, ankles, or feet;

• a breast lump;

• symptoms of depression (sleep problems, weakness, mood changes); or

• ongoing pain, bleeding, or other drainage where the shot was given.

Other less serious side effects are more likely to occur, such as:

• mild nausea, vomiting, bloating, stomach cramps;

• breast pain, tenderness, or swelling;

• freckles or darkening of facial skin;

• increased hair growth, loss of scalp hair;

• changes in weight or appetite;

• problems with contact lenses;

• vaginal itching or discharge;

• changes in your menstrual periods, decreased sex drive; or

• headache, nervousness, dizziness, tired feeling.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect estradiol and medroxyprogesterone?

Some drugs can make birth control hormones less effective, which may result in pregnancy. Before using birth control pills, tell your doctor if you are using any of the following drugs:

• phenylbutazone (Azolid, Butazolidin);

• prednisolone (Orapred);

• theophylline (Respbid, Theo-Dur);

• aminoglutethamide (Cytadren);

• cyclosporine (Neoral, Sandimmune, Gengraf);

• St. John's wort;

• antibiotics such as amoxicillin (Augmentin), ampicillin (Omnipen), doxycycline (Doryx, Vibramycin), griseofulvin (Grisactin, Grifulvin V, Fulvicin PG), minocycline (Minocin), penicillin (Veetids, Pen Vee K, Bicillin), rifampin (Rifadin), rifabutin (Mycobutin), tetracycline (Sumycin, Achromycin, Robitet), and others;

• seizure medicines such as phenytoin (Dilantin), carbamazepine (Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), topiramate (Topamax), or primidone (Mysoline);

• a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton); or

• HIV medicines such as amprenavir (Agenerase), atazanavir (Reyataz), tipranavir (Aptivus), indinavir (Crixivan), saquinavir (Invirase), lopinavir/ritonavir (Kaletra), fosamprenavir (Lexiva), ritonavir (Norvir), or nelfinavir (Viracept).

There may be other drugs not listed that can affect birth control hormones. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has additional information about estradiol and medroxyprogesterone written for health professionals that you may read.

What does my medication look like?

Estradiol and medroxyprogesterone is available with a prescription under the brand name Lunelle. Other brands and generic forms may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.