New Depo-Provera advice
Depo-Provera should only be used as first-line contraception in adolescents when all other methods have been discussed with the patient and considered to be unsuitable or unacceptable, the Committee
on Safety of Medicines now advises.
The effect of Depo-Provera in reducing bone mineral density (BMD) has
been recognised for many years, with a warning included in the prescribing
information. The change in CSM advice comes in response to new data showing
that Depo-Provera causes a loss of BMD in adolescents, at a time when
BMD is normally increasing. The effect of this loss is not known, but
it is recognised that attaining peak bone mass during adolescence is
an important factor in minimising the risk of future osteoporosis.
It is also not known whether the effect of Depo-Provera on BMD in adults
increases the risk of osteoporosis and fractures in later life. There
is some evidence that BMD starts to recover when Depo-Provera is stopped
but the extent of recovery is unknown and may be related to duration
of exposure.
In the absence of appropriate data, the CSM recommends careful re-examination
of the risks and benefits of treatment in women of all ages who wish
to continue use of Depo-Provera for more than two years. In women with
a significant risk of osteoporosis other methods of contraception should
be considered. |
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Pharmaceutical Journal
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