Depo-SubQ Provera 104 Drug Interactions: What to Avoid and What to Tell Your Doctor

Depo-SubQ Provera 104 is generally well-tolerated and has a relatively clean drug interaction profile compared to many other medications. However, there are important drug-drug interactions, supplement interactions, and medical conditions that can affect how it works or how it affects your body. Here's everything you need to know — and exactly what to tell your doctor before your next injection.

The Most Important Interaction: CYP3A4 Enzyme Inducers

The most clinically significant interaction with Depo-SubQ Provera 104 involves drugs and supplements that strongly induce the CYP3A4 enzyme in the liver. Medroxyprogesterone acetate (MPA) is metabolized primarily by the liver, and CYP3A4 inducers can speed up this metabolism — potentially reducing MPA blood levels and weakening its contraceptive effect.

Medications that may reduce Depo-SubQ Provera 104 effectiveness:

Rifampin (Rifadin, Rimactane): An antibiotic used for tuberculosis; a potent CYP3A4 inducer that can significantly reduce MPA levels.

Anticonvulsants (phenytoin/Dilantin, carbamazepine/Tegretol, phenobarbital, topiramate): Seizure medications that induce CYP3A4. Patients on these medications who use Depo-SubQ Provera 104 for contraception should discuss the potential for reduced efficacy with their provider.

St. John's Wort: This herbal supplement is a well-documented CYP3A4 inducer and can reduce the effectiveness of many hormonal contraceptives, including progestins. Avoid while using Depo-SubQ Provera 104 for contraception.

Aminoglutethimide: Used in some cancer treatments; may reduce MPA levels.

Interactions That May Affect Other Medications

Depo-SubQ Provera 104 can also affect the way other medications work:

Anticoagulants (warfarin, heparin): Progestins can affect coagulation factors. If you are on blood thinners, tell your prescriber — your INR or clotting tests may need to be monitored more closely.

Diabetes medications (insulin, metformin, glipizide): Progestins can cause a decrease in glucose tolerance and potentially raise blood sugar in some patients. If you have diabetes, monitor your blood sugar more closely when starting Depo-SubQ Provera 104 and inform your diabetes care team.

Thyroid medications: MPA can affect certain thyroid hormone tests (including T3-uptake and protein-bound iodine levels). This doesn't necessarily change how your thyroid works, but it may affect lab interpretation — tell your doctor you're using Depo-SubQ Provera 104 when thyroid tests are run.

Laboratory Test Interactions (Not Drug-Drug, But Important to Know)

Depo-SubQ Provera 104 can affect laboratory test values in ways that may be misinterpreted if your doctor doesn't know you're using it. Known lab interactions include:

Coagulation factors II, VII, VIII, IX, X — may increase

T3-uptake values — may decrease

Protein-bound iodine — may increase

Liver function tests (sulfobromophthalein) — may be elevated

Lipid panels (cholesterol, triglycerides, LDL, HDL) — effects are inconsistent; both increases and decreases have been reported

Supplements to Be Cautious About

St. John's Wort (Hypericum perforatum): As mentioned above, this is a CYP3A4 inducer and may reduce contraceptive efficacy. Avoid while using Depo-SubQ Provera 104 for birth control.

Calcium and Vitamin D: These are not harmful interactions — in fact, providers may recommend calcium and vitamin D supplementation to help offset the bone mineral density loss associated with long-term use. Talk to your doctor about appropriate supplementation.

39,049+ patients found their medications in stock

39K+

Find Depo-SubQ Provera 104 In Stock Today →

Medical Conditions That Interact With Depo-SubQ Provera 104

Certain medical conditions can change how safe or effective Depo-SubQ Provera 104 is for you:

Liver disease: Significant hepatic impairment alters MPA metabolism. Depo-SubQ Provera 104 is contraindicated with significant liver disease.

Diabetes: Progestins may cause decreased glucose tolerance; diabetic patients may require medication adjustments.

Osteoporosis or low bone density: Long-term use of Depo-SubQ Provera 104 can worsen bone density. If you already have osteoporosis or low bone density, discuss the risks carefully with your provider before using this medication.

Depression or history of depression: Progestins may worsen depression in some patients. Monitor mood changes and report them to your provider.

What to Tell Every Healthcare Provider Who Treats You

Always tell any doctor, nurse practitioner, dentist, or pharmacist who treats you that you are using Depo-SubQ Provera 104. This includes informing them before:

Any lab work (including thyroid tests, lipid panels, liver function tests, or coagulation studies)

Starting a new prescription medication or supplement

Any imaging study (particularly if MRI-related — mention all hormonal medications)

For a complete review of side effects to watch for, see our guide: Depo-SubQ Provera 104 Side Effects: What to Expect and When to Call Your Doctor.

If you need help finding Depo-SubQ Provera 104 in stock near you, medfinder can locate available pharmacies by contacting them on your behalf.