Estradiol Cypionate Medroxyprogesterone Brand Name– Lunelle
What is Estradiol Cypionate Medroxyprogesterone
Estradiol cypionate and medroxyprogesterone acetate were used in combination as an injectable depot contraceptive.
A single injection provided contraceptive efficacy for roughly 30 days. In Phase III clinical trials worldwide, annual pregnancy rates were roughly 0.2%.
This medication combination was developed to provide an option to depot-medroxyprogesterone acetate (DMPA) contraceptive injections, and to eliminate the need for daily compliance with oral hormonal contraceptives (OCs).
The MPA/E2C injection is administered monthly and causes a lower incidence of amenorrhea than DMPA. In the first year, 60% of women receiving MPA/E2C experience a regular menstrual cycle versus only 6—9% of DMPA users.
Also, the return to fertility after MPA/E2C discontinuation is typically shorter (i.e., 2 cycles) than with DMPA (i.e., average, 9 cycles).
Side effects and precautions were similar to the oral hormonal combination contraceptives. This product has been available under the brand name Cyclofem in Asia, Europe and South America; estradiol cypionate; medroxyprogesterone acetate injection (Lunelle) was approved by the FDA on October 5, 2000.
NOTE: This drug is discontinued in the US. Due to market influences and other factors, the manufacture of Lunelle was halted in late 2004.
Indications
- contraception
For contraception
for initiating contraception in female patients currently on oral hormonal contraceptives or who are not currently on hormonal contraception
Side Effects
- abdominal pain
- acne vulgaris
- acneiform rash
- alopecia
- amenorrhea
- anaphylactoid reactions
- angioedema
- anorexia
- anxiety
- appetite stimulation
- bowel ischemia
- breakthrough bleeding
- breast discharge
- breast enlargement
- candidiasis
- cervical dysplasia
- cholecystitis
- cholelithiasis
- cholestasis
- colitis
- depression
- diarrhea
- diplopia
- dysmenorrhea
- dyspepsia
- edema
- elevated hepatic enzymes
- emotional lability
- erythema nodosum
- fatigue
- fluid retention
- galactorrhea
- gingivitis
- headache
- hepatoma
- hyperlipidemia
- hypertension
- irritability
- jaundice
- lactation suppression
- libido decrease
- libido increase
- maculopapular rash
- mastalgia
- melasma
- menorrhagia
- menstrual irregularity
- migraine
- myocardial infarction
- nausea
- new primary malignancy
- optic neuritis
- pancreatitis
- papilledema
- peliosis hepatis
- photosensitivity
- pulmonary embolism
- retinal thrombosis
- stroke
- thromboembolism
- thrombosis
- urticaria
- vaginal bleeding
- vaginitis
- visual impairment
- vomiting
- weight gain
- weight loss
Monitoring Parameters
- pap smear
- pelvic exam
Contraindications
- acquired immunodeficiency syndrome (AIDS)
- breast cancer
- breast-feeding
- cerebrovascular disease
- cervical cancer
- children
- chloasma
- cholestasis
- contact lenses
- coronary artery disease
- coronary thrombosis
- depression
- diabetes mellitus
- endometrial cancer
- gallbladder disease
- headache
- hepatic disease
- hepatocellular cancer
- human immunodeficiency virus (HIV) infection
- hypercalcemia
- hypercholesterolemia
- hyperlipidemia
- hypertension
- hypertriglyceridemia
- hypothyroidism
- intravenous administration
- jaundice
- menstrual irregularity
- migraine
- myocardial infarction
- obesity
- obstetric delivery
- ocular disease
- osteoporosis
- ovarian cancer
- paraben hypersensitivity
- porphyria
- pregnancy
- renal disease
- stroke
- surgery
- systemic lupus erythematosus (SLE)
- thromboembolic disease
- thrombophlebitis
- thyroid disease
- tobacco smoking
- uterine cancer
- vaginal bleeding
- vaginal cancer
- valvular heart disease
Interactions
- Acarbose
- Acebutolol
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Propoxyphene
- Acetohexamide
- Acitretin
- Albiglutide
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Aliskiren; Valsartan
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-blockers
- Alpha-glucosidase Inhibitors
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Amiodarone
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Anastrozole
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Apalutamide
- Aprepitant, Fosaprepitant
- Armodafinil
- Artemether; Lumefantrine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atazanavir
- Atazanavir; Cobicistat
- Atenolol
- Atenolol; Chlorthalidone
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine; Fluticasone
- Azilsartan
- Azilsartan; Chlorthalidone
- Barbiturates
- Beclomethasone
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benazepril
- Benazepril; Hydrochlorothiazide, HCTZ
- Bendroflumethiazide; Nadolol
- Beta-blockers
- Betamethasone
- Betaxolol
- Bexarotene
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Bosentan
- Brigatinib
- Brimonidine; Timolol
- Bromocriptine
- Budesonide
- Budesonide; Formoterol
- Bumetanide
- Butabarbital
- Calcium
- Canagliflozin
- Canagliflozin; Metformin
- Candesartan
- Candesartan; Hydrochlorothiazide, HCTZ
- Captopril
- Captopril; Hydrochlorothiazide, HCTZ
- Carbamazepine
- Carteolol
- Carvedilol
- Cenobamate
- Central-acting adrenergic agents
- Ceritinib
- Chenodiol
- Chloramphenicol
- Chlorothiazide
- Chlorpropamide
- Chlorthalidone
- Chlorthalidone; Clonidine
- Ciclesonide
- Cimetidine
- Clarithromycin
- Clindamycin
- Clobazam
- Clonidine
- Cobicistat
- Conivaptan
- Corticosteroids
- Cortisone
- Cosyntropin
- Cyclosporine
- Danazol
- Dantrolene
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Daratumumab; Hyaluronidase
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deflazacort
- Delavirdine
- Dexamethasone
- Diltiazem
- Dipeptidyl Peptidase-4 Inhibitors
- Dirithromycin
- Dorzolamide; Timolol
- Doxazosin
- Dulaglutide
- Duloxetine
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enalapril, Enalaprilat
- Enalapril; Felodipine
- Enalapril; Hydrochlorothiazide, HCTZ
- Enzalutamide
- Eprosartan
- Eprosartan; Hydrochlorothiazide, HCTZ
- Ertugliflozin
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Esmolol
- Ethacrynic Acid
- Ethotoin
- Exemestane
- Exenatide
- Fedratinib
- Felbamate
- Felodipine
- Fluconazole
- Fludrocortisone
- Flunisolide
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol; Mometasone
- Fosamprenavir
- Fosinopril
- Fosinopril; Hydrochlorothiazide, HCTZ
- Fosphenytoin
- Furosemide
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Glycylcyclines
- grapefruit juice
- Griseofulvin
- Guanabenz
- Guanfacine
- Hemin
- Hyaluronidase
- Hyaluronidase, Recombinant; Immune Globulin
- Hydantoins
- Hydralazine
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydrocortisone
- Icosapent ethyl
- Idelalisib
- Imatinib
- Incretin Mimetics
- Indinavir
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Irbesartan
- Isotretinoin
- Isradipine
- Itraconazole
- Ivosidenib
- Ketoconazole
- Labetalol
- Lefamulin
- Lenalidomide
- Lesinurad
- Lesinurad; Allopurinol
- Letermovir
- Letrozole
- Levobetaxolol
- Levobunolol
- Levothyroxine
- Levothyroxine; Liothyronine (Porcine)
- Levothyroxine; Liothyronine (Synthetic)
- Linagliptin
- Linagliptin; Metformin
- Lincomycin
- Lincosamides
- Liothyronine
- Liraglutide
- Lisinopril
- Lixisenatide
- Loop diuretics
- Lopinavir; Ritonavir
- Lorlatinib
- Losartan
- Lumacaftor; Ivacaftor
- Mecamylamine
- Meglitinides
- Melatonin
- Mephobarbital
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methohexital
- Methyclothiazide
- Methyldopa
- Methylprednisolone
- Metolazone
- Metoprolol
- Metreleptin
- Metyrapone
- Midazolam
- Miglitol
- Mineral Oil
- Minoxidil
- Mitotane
- Modafinil
- Moexipril
- Mometasone
- Nadolol
- Nebivolol
- Nebivolol; Valsartan
- Nefazodone
- Nelfinavir
- Neomycin
- Nevirapine
- Nicardipine
- Nifedipine
- Nilotinib
- Nimodipine
- Nisoldipine
- Nitroprusside
- Olmesartan
- Ombitasvir; Paritaprevir; Ritonavir
- Ospemifene
- Oxcarbazepine
- Pegvaliase
- Penbutolol
- Pentobarbital
- Perindopril
- Perindopril; Amlodipine
- Phenobarbital
- Phenoxybenzamine
- Phentermine; Topiramate
- Phentolamine
- Phenytoin
- Pindolol
- Posaconazole
- Potassium-sparing diuretics
- Pramlintide
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Prazosin
- Prednisolone
- Prednisone
- Primidone
- Propoxyphene
- Propranolol
- Quinapril
- Raloxifene
- Ramipril
- Reserpine
- Ribociclib
- Ribociclib; Letrozole
- Rifamycins
- Ritonavir
- Rituximab; Hyaluronidase
- Romidepsin
- Ropinirole
- Sacubitril; Valsartan
- Saquinavir
- Saxagliptin
- Secobarbital
- Selegiline
- Semaglutide
- SGLT2 Inhibitors
- Simvastatin; Sitagliptin
- Sitagliptin
- Somatropin, rh-GH
- Sotalol
- Spironolactone
- St. John’s Wort, Hypericum perforatum
- Sugammadex
- Sulfonamides
- Sulfonylureas
- Tacrine
- Tamoxifen
- Tazemetostat
- Telaprevir
- Telithromycin
- Telmisartan
- Telotristat Ethyl
- Terazosin
- Testolactone
- Tetracyclines
- Thiazide diuretics
- Thiazolidinediones
- Thiopental
- Thyroid hormones
- Timolol
- Tipranavir
- tobacco
- Tolazamide
- Tolbutamide
- Topiramate
- Toremifene
- Torsemide
- Trandolapril
- Trandolapril; Verapamil
- Tranexamic Acid
- Trastuzumab; Hyaluronidase
- Triamcinolone
- Triamterene
- Tricyclic antidepressants
- Tucatinib
- Ulipristal
- Ursodeoxycholic Acid, Ursodiol
- Valproic Acid, Divalproex Sodium
- Valsartan
- Verapamil
- Voriconazole
- Warfarin
- Zafirlukast
