10 mg: Secondary amenorrhea: 2.5 to 10 mg daily for 5 to 10 days.
Dysfunctional Uterine Bleeding Due to Hormonal Imbalance in the Absence of Organic Pathology: 2.5 to 10 mg daily for 5 to 10 days, starting on the 16th or 21st day of the cycle. Treatment is given for 2 consecutive cycles and then discontinued to see if the dysfunction has regressed. Withdrawal bleeding usually occurs within 3-7 days after discontinuing therapy. Note: For inducing an optimum secretory transformation of an endometrium that has been adequately primed with estrogen therapy, 5-10 mg daily for 10 days starting on the 16th for dysfunctional uterine bleeding.
Endometriosis: 10 mg PROVERA TID for 90 days beginning on cycle day 1. Breakthrough bleeding, which is self-limited, may occur in 30-40% of patients treated. No additional hormonal therapy is recommended for the management of this breakthrough bleeding.
Gynecology: Use of combined estrogen/progestin therapy in postmenopausal women should be limited to the lowest effective dose and shortest duration consistent with treatment goals and risks for individual women, and should be re-evaluated periodically as clinically appropriate (for example, 3-month to 6-month intervals) to determine if treatment is still necessary. (See Warnings.)
Hepatic Insufficiency: No clinical studies have evaluated the effect of hepatic disease on the pharmacokinetics of MPA. However, MPA is almost exclusively eliminated by hepatic metabolism and steroid hormones may be poorly metabolized in patients with severe liver insufficiency, (see Contraindications).
Renal Insufficiency: No clinical studies have evaluated the effect of renal disease on the pharmacokinetics of MPA. However, since MPA is almost exclusively eliminated by hepatic metabolism, no dosage adjustment should be necessary in women with renal insufficiency.
100 mg: Recurrent endometrial and renal cancer: 200 mg to 400 mg per day.
Recurrent breast cancer in postmenopausal women: 400 to 800 mg per day.
Doses of 1000 mg daily have been given although the incidence of minor side effects, such as indigestion and weight gain, increase with the increase in dose response to hormonal therapy may not be evident until after at least 8 - 10 weeks of therapy.