Comprehensive medication guide to Depo-SubQ Provera 104 including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0 copay for most patients with ACA-compliant private insurance when prescribed for contraception; standard drug benefit copay may apply for the endometriosis indication. Covered under Medicaid in most states.
Estimated Cash Pricing
$59–$100 retail per prefilled syringe (brand only — no generic available); as low as $53–$59 per injection with GoodRx or SingleCare discount coupons at participating pharmacies.
Medfinder Findability Score
55/100
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Depo-SubQ Provera 104 is the brand name for medroxyprogesterone acetate (MPA) 104 mg/0.65 mL injectable suspension, manufactured by Pfizer. It is a progestin-only hormonal medication given as a subcutaneous injection — injected just under the skin into the thigh or abdomen — every 12 to 14 weeks (approximately once every 3 months).
Depo-SubQ Provera 104 is FDA-approved for two indications: prevention of pregnancy (contraception) and management of endometriosis-associated pain. It is available only as a brand-name product — as of 2026, no FDA-approved generic version of the subcutaneous 104 mg formulation exists.
The medication comes in a single-dose, disposable pre-filled syringe packaged with a 26-gauge × 3/8-inch needle. Each syringe must be shaken vigorously before injection to ensure a uniform suspension. Administration must be performed by a licensed healthcare professional.
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Depo-SubQ Provera 104 works primarily by inhibiting the secretion of gonadotropins (LH and FSH) from the pituitary gland. This suppresses follicular maturation and prevents ovulation — the primary mechanism of its contraceptive effect. Even if ovulation occurs, MPA causes the cervical mucus to thicken, making it difficult for sperm to reach an egg, and alters the uterine lining to reduce the chance of implantation.
For endometriosis-associated pain, the mechanism is different: MPA suppresses serum estradiol levels. Since endometriosis tissue is stimulated by estrogen, lowering estradiol slows the growth and activity of endometriosis lesions and reduces the inflammatory pain response they cause.
When injected subcutaneously, MPA forms a slow-release depot under the skin that gradually releases into the bloodstream over 12–14 weeks. This prolonged-release mechanism is what allows a single injection to provide protection for an entire quarter. Importantly, the same estradiol-suppressing mechanism that helps endometriosis patients also causes the bone mineral density loss associated with long-term use — which is why the FDA recommends limiting use to 2 years.
104 mg/0.65 mL — subcutaneous injection (pre-filled syringe)
Single dose prefilled syringe administered every 12–14 weeks subcutaneously into the anterior thigh or abdomen.
As of 2026, Depo-SubQ Provera 104 is not listed on the FDA Drug Shortage Database. The national supply from Pfizer is intact. However, retail pharmacy stocking is inconsistent — particularly in rural and underserved areas where demand-based ordering leaves many pharmacies without routine inventory. Because it is a brand-only quarterly injectable, many retail pharmacies only order it when a patient presents with a prescription, causing 1–3 day delays.
Most patients who receive Depo-SubQ Provera 104 get it directly from their OB/GYN or women's health clinic, which typically keeps it in stock for in-office administration. For patients relying on retail pharmacies, the key is planning ahead — call at least 7–10 days before the injection is due to allow time for ordering.
If you're having trouble locating Depo-SubQ Provera 104 at a pharmacy near you, medfinder can contact pharmacies on your behalf to find which ones currently have it in stock — saving you the frustrating phone calls.
Depo-SubQ Provera 104 is not a controlled substance, so it can be prescribed by any licensed prescriber with prescribing authority in their state. No DEA registration or special certification is required. It is widely prescribed by a range of provider types in both outpatient and clinical settings.
OB/GYNs (Obstetrician-Gynecologists) — primary prescribers; often administer in-office
Family medicine physicians
Internal medicine physicians
Nurse practitioners (NPs) and physician assistants (PAs) — full prescribing authority in most states
Pediatricians — for post-menarchal adolescents
Reproductive endocrinologists — for endometriosis management
Telehealth providers can prescribe Depo-SubQ Provera 104 in most states since it is not a controlled substance. However, the injection itself must be administered by a healthcare professional in person. Telehealth consultations can generate a prescription that patients bring to their OB/GYN, clinic, or pharmacy.
No. Depo-SubQ Provera 104 is not a controlled substance and is not scheduled by the DEA. It is a prescription-only medication, but it can be prescribed by any licensed prescriber with prescribing authority — including OB/GYNs, family medicine physicians, nurse practitioners, and physician assistants.
Because it is not a controlled substance, there are no special prescription restrictions such as limits on refills, requirements for in-person visits (in most states), or electronic prescribing mandates beyond those that apply to all prescription medications. Telehealth providers can prescribe Depo-SubQ Provera 104 in most states. However, the injection itself must be administered in person by a healthcare professional.
Irregular menstrual bleeding or spotting (very common in first 2–3 months)
Amenorrhea (missed periods) — many women stop having periods by the end of year 1
Weight gain (average 3–4 lbs in year 1; 7–8 lbs after 2 years)
Headache
Mood changes or depression
Decreased libido
Abdominal discomfort or bloating
Injection site reactions (dimpling, discoloration, lump at injection site)
Fluid retention
Bone mineral density loss (Black Box Warning): Significant BMD loss with increasing duration of use; may not be fully reversible. Use limited to 2 years.
Meningioma (December 2025 Warning): Possible increased risk of meningioma (benign brain tumor) with long-term use; discontinue if diagnosed.
Blood clots: DVT, PE, or stroke; discontinue if arterial or venous thrombosis develops.
Anaphylaxis: Rare but serious allergic reaction; seek emergency care immediately.
Ectopic pregnancy: Contact provider immediately if pregnancy occurs on this medication with severe abdominal pain.
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Depo-Provera CI (150 mg IM)
Intramuscular medroxyprogesterone acetate; same active ingredient, same dosing schedule, generic available — wider pharmacy access and lower cost.
Nexplanon (etonogestrel implant)
3-year subdermal progestin implant; >99% effective; no quarterly injections needed; no meningioma warning; does not treat endometriosis pain.
Mirena / Kyleena IUD (levonorgestrel)
Hormonal IUD with 5–8 year duration; localized progestin, minimal systemic exposure; no bone density or meningioma concerns.
Slynd / Norethindrone (progestin-only pill)
Daily oral progestin; no injections needed; generic norethindrone is inexpensive (~$10–$20/month); less effective if not taken consistently.
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Rifampin (Rifadin)
moderateStrong CYP3A4 inducer; may significantly reduce MPA blood levels and reduce contraceptive efficacy. Consider alternative contraception if rifampin is required.
CYP3A4-inducing anticonvulsants (phenytoin, carbamazepine, phenobarbital, topiramate)
moderateMay decrease MPA plasma concentrations and reduce contraceptive effectiveness. Discuss additional contraceptive measures with provider.
St. John's Wort (Hypericum perforatum)
moderateHerbal CYP3A4 inducer; may reduce MPA levels and contraceptive efficacy. Avoid concurrent use.
Aminoglutethimide
moderateMay decrease medroxyprogesterone acetate levels.
Warfarin / anticoagulants
minorProgestins can affect coagulation factors; monitor INR more closely if starting or stopping Depo-SubQ Provera 104 in patients on anticoagulation.
Diabetes medications (insulin, metformin)
minorProgestins may decrease glucose tolerance. Diabetic patients may require medication dose adjustment; monitor blood glucose.
Depo-SubQ Provera 104 is a highly effective, quarterly injectable contraceptive that also provides FDA-approved management of endometriosis-associated pain. Its subcutaneous delivery (versus intramuscular for Depo-Provera CI) uses a lower dose (104 mg vs. 150 mg) and may be preferred by some patients and providers. It is appropriate for use up to 2 years due to bone mineral density concerns, and following the December 2025 FDA meningioma label update, providers should ensure patients are counseled about long-term risk.
Cost-wise, most patients with ACA-compliant insurance pay $0 for this medication when prescribed for contraception. Uninsured patients can access savings through the Pfizer RxPathways patient assistance program (1-877-744-5675) or discount programs like GoodRx, which can lower the cash price to approximately $53–$59 per injection.
If you're struggling to locate Depo-SubQ Provera 104 at your pharmacy — a common issue given inconsistent retail stocking — medfinder can help. medfinder contacts pharmacies near you to find which ones have it in stock, so you don't have to make the calls yourself and can plan your next injection with confidence.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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