Drug Guide
Hydroxyprogesterone Caproate
Classification
Therapeutic: Progestin hormone, reproductive agent
Pharmacological: Progestin
FDA Approved Indications
- Prevention of preterm birth in women with a history of spontaneous preterm birth
Mechanism of Action
Hydroxyprogesterone Caproate is a synthetic progestin that mimics the action of natural progesterone, leading to decreased uterine contractility and maintenance of pregnancy.
Dosage and Administration
Adult: 250 mg intramuscularly once a week, starting at 16-20 weeks of pregnancy and continuing until 36 weeks or delivery.
Pediatric: Not indicated for pediatric use.
Geriatric: Not applicable.
Renal Impairment: No specific dosage adjustment needed; monitor patient.
Hepatic Impairment: No specific dosage adjustment, caution advised.
Pharmacokinetics
Absorption: Administered via intramuscular injection; absorption is complete at the injection site.
Distribution: Widely distributed in body tissues, bound to plasma proteins.
Metabolism: Metabolized in the liver.
Excretion: Excreted mainly through the urine.
Half Life: Approximately 16 days after intramuscular injection.
Contraindications
- History of hypersensitivity to progesterone or progestins.
- Active thromboembolic disease.
- Pregnancy if not indicated.
Precautions
- Monitor for signs of thromboembolic events, liver dysfunction, or allergic reactions. Use caution in patients with breast cancer or persistent genital bleeding.
Adverse Reactions - Common
- Injection site reactions (pain, swelling) (Common)
- Mood changes, headache (Less common)
Adverse Reactions - Serious
- Venous thromboembolism (Rare)
- Breast cancer or other hormone-sensitive cancers (Rare)
Drug-Drug Interactions
- Enzyme inducers may reduce effectiveness.
Drug-Food Interactions
- No significant interactions noted.
Drug-Herb Interactions
- Use caution with herbal products that influence coagulation or hormone levels.
Nursing Implications
Assessment: Monitor for signs of thromboembolism, allergic reactions, and efficacy of pregnancy maintenance.
Diagnoses:
- Risk for DVT/PE
- Ineffective tissue perfusion
- Altered hormone balance
Implementation: Administer IM in the gluteal muscle, ensure proper technique, and monitor injection site.
Evaluation: Assess for pregnancy continuation, monitor for adverse reactions.
Patient/Family Teaching
- Report any signs of blood clots (leg pain, chest pain, shortness of breath).
- Understand the importance of weekly injections and adherence.
- Discuss potential side effects and when to seek medical advice.
Special Considerations
Black Box Warnings:
- Use during pregnancy should be carefully considered; fetal harm is possible if used improperly.
Genetic Factors: No specific genetic considerations documented.
Lab Test Interference: May affect certain liver function tests or hormone levels.
Overdose Management
Signs/Symptoms: N/A for overdose, but excess progestin may cause symptoms like fatigue, bloating.
Treatment: Supportive care; there’s no specific antagonist.
Storage and Handling
Storage: Store at controlled room temperature (20-25°C). Keep away from light and moisture.
Stability: Stable under recommended storage conditions.