Levothyroxine and Provera Interactions

The possible risk to the male baby is hypospadias, a condition inwhich the opening of the penis is on the underside rather than the tip of thepenis. This condition occurs naturally in approximately 5 to 8 per 1000 malebirths. Enlargement of theclitoris and fusion of the labia may occur in female babies. However, a clearassociation between hypospadias, clitoral enlargement and labial fusion withuse of PROVERA has not been established.

What Drugs, Substances, or Supplements Interact with Provera?

Personally, I have had experiences where I have written for brand-name SYNTHROID and the patients have been dispensed generic levothyroxine or even another branded levothyroxine product. It’s very important to make sure that you write “Dispense as written,” or whatever state-specific language, on the prescription when you prescribe the medication. There may be increased risks for hypospadias, clitoral enlargement and labial fusion in children whose mothers are exposed to PROVERA during the first trimester of pregnancy. However, a clear association between these conditions with use of PROVERA has not been established. Provera is a prescription medication that can help regulate your menstrual cycle. It is typically taken for five to 10 days at a specific time during your menstrual cycle.

Breast Cancer

If examination reveals papilledema or retinal vascular lesions, estrogen plus progestin therapy should be permanently discontinued. All women should receive yearly breast examinations by a healthcare provider and perform monthly breast self-examinations. In addition, mammography examinations should be scheduled based on patient age, risk factors, and prior mammogram results. Avoiding MPA is especially wise because there are safer, more effective alternatives such as Prometrium, which is a widely available brand of bioidentical, prescription-strength progesterone. Unlike bioidentical progesterone, a synthetic form of progesterone such as medroxyprogesterone acetate (Provera) is also likely to worsen the mood swings, bloating, and depression you describe. If you haven’t begun bleeding after taking a prescribed course of medroxyprogesterone, talk to your healthcare provider.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. Timing of the initiation of estrogen plus progestin therapy relative to the start of menopause may affect the overall risk benefit profile. The WHI estrogen plus progestin substudy stratified by age showed in women 50 to 59 years of age a nonsignificant trend toward reduced risk in overall mortality hazard ration (HR) 0.69 (95 percent CI, 0.44–1.07).

Progestogens (applies to Provera) breast malignancy

There have not been sufficient numbers of geriatric womeninvolved in clinical studies utilizing PROVERA alone to determine whether thoseover 65 years of age differ from younger subjects in their response to PROVERAalone. Clinicalstudies have not been conducted in the pediatric population. Increase or decrease in weight; reduced carbohydratetolerance; aggravation of porphyria; edema; arthalgias; leg cramps; changes inlibido; urticaria, angioedema, anaphylactoid/anaphylactic reactions; hypocalcemia;exacerbation of asthma; increased triglycerides. Deep and superficial venous thrombosis; pulmonaryembolism; thrombophlebitis; myocardial infarction; stroke; increase in bloodpressure. Hypersensitivity reactions (for example, anaphylaxis andanaphylactoid reactions, angioedema), rash (allergic) with and withoutpruritus, change in weight (increase or decrease), pyrexia, edema/fluid retention,fatigue, decreased glucose tolerance. Sensitivity reactions consisting of urticaria, pruritus,edema and generalized rash have occurred.

• Medroxyprogesterone should not be used to prevent heart disease, stroke, or dementia.
• Consistent with the WHI clinical trial, observationalstudies have also reported an increased risk of breast cancer for estrogen plusprogestin therapy, and a smaller risk for estrogen-alone therapy, after severalyears of use.
• A levothyroxine product that is not therapeutically equivalent with SYNTHROID might not have the exact same effect on the patient’s TSH as SYNTHROID.
• Use the drop-down menu below to select your state and see the specific language required to prevent generic substitution.

• Tell your healthcare provider about all the medicines you take including prescription and nonprescription medicines, vitamins, and herbal supplements.
• When used to treat amenorrhea (missing periods), Provera is taken for up to 10 days during the second half of the planned menstrual cycle.
• PROVERA tablets are indicated for the treatment ofsecondary amenorrhea and abnormal uterine bleeding due to hormonal imbalance inthe absence of organic pathology, such as fibroids or uterine cancer.
• When prescribing SYNTHROID, protecting your script can ensure your patients receive SYNTHROID every time they refill their prescription.

In cases of secondary amenorrhea, therapy may be started at any time. Progestin withdrawal bleeding usually occurs within three to seven days after discontinuing PROVERA therapy. Medroxyprogesterone acetate (MPA) administered orally orparenterally in the recommended doses to women with adequate endogenousestrogen, transforms proliferative into secretory endometrium. Androgenic andanabolic effects have been noted, but the drug is apparently devoid ofsignificant estrogenic activity. While parenterally administered MPA inhibitsgonadotropin production, which in turn prevents follicular maturation andovulation, available data indicate that this does not occur when the usuallyrecommended oral dosage is given as single daily doses. PROVERA tablets may be given in dosages of 5 or 10 mgdaily for 5 to 10 days.

A dose for inducing an optimum secretory transformationof an endometrium that has been adequately primed with either endogenous orexogenous estrogen is 10 mg of PROVERA daily for 10 days. In cases of secondaryamenorrhea, therapy may be started at any time. Progestin withdrawal bleedingusually occurs within three to seven days after discontinuing PROVERA therapy.

Family history is very important when talking to these patients because there is a strong predisposition amongst family members in the primary setting to have another family member with hypothyroidism. One of the difficulties of the diagnosis of hypothyroidism is that the signs and symptoms are non-specific to the disease. So, in order to diagnose the disease accurately, given the non-specific symptoms, you must use the TSH level as a screening tool to assist in the family history and signs and symptoms that you have come across. Levothyroxine is the most commonly used treatment in this setting. Impaired glucose tolerance has been observed in some patients administered oral contraceptives and appears to be related primarily to the estrogen synthroid breakfast dose.

• There are options available to assist the patient with cost concerns.
• And a third is those that have severe, long-standing hypothyroidism.
• Probable dementia as defined in this study included Alzheimer’s disease (AD), vascular dementia (VaD) and mixed type (having features of both AD and VaD).
• Sensitivity reactions consisting of urticaria, pruritus, edema and generalized rash have occurred.
• There are 13 disease interactions with Provera (medroxyprogesterone).

Most people will have a period between three and seven days after they finish a course of treatment. Provera is used to treat menstrual cycle irregularities in people living with polycystic ovary syndrome. It regulates hormone activity to reset and restore regular periods. Treatment for PCOS is important because it’s a known risk factor for endometrial cancer. Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid.

You are encouraged to report negative side effects of prescription drugs to the FDA. Start at the lowest dose and talk to your healthcareprovider about how well that dose is working for you. You and your healthcare provider shouldtalk regularly (every 3 to 6 months) about the dose you are taking and whetheryou still need treatment with PROVERA. Tell your healthcare provider about all the medicinesyou take including prescription and nonprescription medicines, vitamins,and herbal supplements. Detectableamounts of progestin have been identified in the breast milk of nursing mothersreceiving progestins. Blood pressure should be monitored at regular intervalswith estrogen plus progestin therapy.