Medications not yet evaluated by P&T are considered NON-FORMULARY . . . . . Always check 2 unique patient identifiers - NAME and DATE OF BIRTH - at every step! . . . . . Please be sure to document all clinical activities daily.
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medroxyPROGESTERone

medroxyPROGESTERone
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Depo-Provera Contraceptive SUSPENSION, INTRAMUSCULAR 150 mg/mL      
Depo-SubQ Provera 104 SUSPENSION, SUBCUTANEOUS 104 mg/0.65 mL      
Provera, Amen, Curretab, Cycrin TABLET, ORAL 2.5 mg, 5 mg, 10 mg      
VIEW MORE Progestins
CLASS
683200
Comments:

Depo-Provera – not for contraceptive use

Depo-SubQ Provera 104 is non-formulary. Use for contraception purposes should be deferred to after discharge. If ordered for indications other than contraception, the physician should be asked to use the formulary product, Depo-Provera.

Reviewed: September 28, 2005 (Depo-SubQ Provera 104)

Last updated: Oct. 4, 2023
  • Black Box Warning: Cardiovascular and other risks
  • HAZ-MED: Group 2
  • Hormonal Therapy: This drug is a hormonal therapy in used in oncologic conditions. This drug may be resumed by a hospitalist or non-oncology healthcare provider without contacting an oncology pharmacy specialist or consulting an oncologist.






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