Your doctor has recommended
a medication called Provera
as treatment for your illness. This page provides extra information about
your medicine, summarises possible side effects and methods to alleviate them.
What is in Provera tablets?
belongs to group of medicines called "progestogens" and is related to the
naturally occurring hormone called progesterone. The active ingredient in Provera is
called medoxyprogesterone acetate. Provera tablets are available in a number
of strengths 2.5mg, 5mg, 10 mg, 100mg, 200mg & 400mg. The lower doses tend to be used
for non-malignant conditions and the higher ones for cancers such as Breast, Uterus or
How do they work? Some tumours such as breast cancer are stimulated by the bodies
own female hormone (Oestrogen). Stopping the bodies hormones reaching the tumour can cause
the cancer cells to stop growing and in some cases shrivel up and die completely (self
destruct - apoptosis). Provera works in two main ways. Firstly
it fools the signal pathway between the brain (pituitary) and the Ovaries by
increasing the blood levels of another hormone produced in the ovaries called progesterone
so in turn the brain thinks the ovaries are producing too many hormones including
oestrogen. As a consequence the body switches off the driving signal from the brain by
itself - this results in reducing the blood level of oestrogen. Secondly
Provera has a direct effect on the tumour via its own receptors called progesterone
receptors. Stimulation of these receptors causes the cell to slow its uncontrolled growth
and become less aggressive.
How will I & the doctor know they are
In most cases there is
something the doctor can measure. This may be how you feel, a symptom related to you
cancer, something which can be felt on examination (e.g. a lump) are something seen on a
scan or xray. After 2-3 months a formal assessment of response is usually performed before
continuing the tablets indefinitely - This may well involve repeating the xrays or scans.
Possible side effects.
All tablets have side effects. These can
effect some people more than others. It its hard to predict the level and type of side
effect for each individual. Listed below are an overview of the more common side effects
you may encounter, however, you may experience none, all, or only a few of these. You may
also have a rare side effect not listed here - If you become aware of any other side
effects, please report them to your clinic.
If side effects are severe, you
may have to stop taking the drug and a different hormonal drug may be prescribed. Side
effects are more common in pre-menopausal women who may develop menopausal side effects as
a result of a reduced level of oestrogen. The commonest side effects, apart from nausea,
are hot flushes and sweats, particularly at night.
- Flushes and sweats.
are not usually prominent. Sometimes the flushes will gradually lessen over the first few
months but some women continue to have them for as long as they take megace. There are a
number of ways to help reduce or control hot flushes and sweats. Some women find it
helpful to avoid or cut down on tea, coffee, nicotine and alcohol. Evening primrose oil
has been reported to be helpful in reducing sweats but it does not work for all women and
it is expensive. There are a lot of calories in Evening Primrose Oil so it may be
fattening in some women. Some women have found complementary therapies
have helped, and your GP may be able to give you details about obtaining these on the NHS.
If you find your own therapist makes sure he or she is properly qualified and registered.
If you are having very troublesome hot flushes do not hesitate to discuss some of
these treatments with your doctor.
- Nausea and indigestion.
Feelings of sickness (nausea) and indigestion are fairly common but can
often be relieved by taking your tablet(s) with foods or milk or at night. Although mild
nausea is quite common initially it usually wears off after a few weeks. see diet and indigestion
- Weight gain. Weight
gain can be a side effect of provera and this is sometimes due to water retention but at
other times a consequence of a eating more either due to a increased appetite or mild
nausea - "to settle the stomach" . See coping with
- Ankle swelling.
- If women are prone to ankle swelling this may be worse, it is caused by fluid retention.
If one leg gets swollen tender and hot this may be a thrombosis and should be reported to
your doctor immediately.
- Change in periods.
who have not yet reached the menopause may notice their monthly periods change they
may become irregular, lighter or sometimes stop altogether. Some women also notice an
increase in vaginal discharge and vulval itching.
Less common side effects include
depression, tiredness and dizziness.
Very rare side effect of Provera include:
- Allergic reactions this may
include skin rashes
- Temporary thinning of the hair
- Headaches some people
affected by migraine have noticed a change in the pattern of their headaches
- Flaking finger nails after
several years of treatment
- Thrombosis (blood clots)
pain, warmth, swelling or tenderness in an arm or leg or any chest pain must be reported
to your doctor immediately
Before you take provera - tell
If you have had an allergic
reaction to provera in the past.
What other medications you are
If you plan to become pregnant
If you have a history of blood
There is no interaction between Provera tablets and moderate
amounts of alcohol. Provera tablets do not usually affect your ability to drive.
Provera tablets may raise your blood sugar if you are diabetic. If you notice that
your blood sugar is higher than normal consult your doctor.
This medicine is for you. Only a doctor can prescribe if for you never give this
medicine to any one else, even if they have the same symptoms as you, as it may harm them.
Further general information Your doctors and specialist nurses are in
an ideal position to give you relevant information on your disease and treatment
as they know your individual circumstances. Cancerbackup
has a help line (0808 800 1234) and a prize winning video
available in English, Italian, Urdu, Bengali,
Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk
has over 500 pages describing cancer, its management, practical tips and tool
which patients, their carers and their doctors have found helpful during the
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