.本药所引起的类早孕反应比口服避孕药轻。
11.作为长效避孕药注射后，当发生月经改变的不良反应时，可及时按以下方法处理：
(1)经期延长：已出血较多天时，可试用口服复方炔诺酮片(避孕片一号)或复方甲地孕酮片(避孕片二号)，每天1～2片，连服4天，即可止血。在下次经前7天依同法连服4天，如此应用3个月后停用。如再出血，可依上法再用。
(2)月经后出血：每天服炔雌醇0.0125～0.025mg，直至下次注射日期为止。但若已接近下次注射日期者，不必处理。
(3)月经周期缩短：注射后10天开始加服复方炔诺酮片或复方甲地孕酮片，每天1～2片，连用4～6天。(4)注射后长期出血不止：可口服避孕片一号或二号4天。出血停止后1周，注射本药1支，于注射第11天，口服复方炔诺酮片或复方甲地孕酮片，每天1～2片，连服4天。
不良反应
1.一次注入大剂量孕激素可干扰正常月经周期的生理调节，出现子宫内膜撤退性出血、周期缩短(短于20天)或经期延长、不规则阴道出血、闭经等。
2.还可出现乳房胀痛、心悸、潮红、腰酸、腹痛、高血压等，停药后多可恢复正常。
3.个别可发生过敏反应，甚至过敏性休克。为防止过敏性休克，注射后应观察15～20min。
4.作为长效避孕药注射后，当发生月经改变的不良反应时，可及时按以下方法处理：
(1)经期延长：已出血较多日期时，可试用口服复方炔诺酮片(避孕片一号)或复方甲地孕酮片(避孕片二号)，每天1～2片，连服4天，即可止血。在下次经前7天依同法连服4天，如此应用3个月后停用。如再出血，可依上法再用。
(2)月经后出血：每天服炔雌醇0.0125～0.025mg。直至下次注射日期为止。但若已接近下次注射日期者，不必处理。
(3)月经周期缩短：注射后10天开始加服复方炔诺酮片或复方甲地孕酮片，每天1～2片，连用4～6天。
(4)注射后长期出血不止：可口服避孕片一号或二号4天。出血停止后一周，注射本药1支，于注射第11天，口服复方炔诺酮片或复方甲地孕酮片。每天1～2片，连服4天。
用法用量
肌内注射：
1.避孕：使用复方己酸羟孕酮注射剂(避孕针一号)深部肌内注射，第一次于月经来潮的第5天注射2支，以后每月1次，于月经周期第10～12天注射1支(若月经周期短，宜在月经来潮的第10天注射，即药物必须在排卵前2～3天内注射，以提高避孕效果)。必须按月注射。
2.治疗子宫内膜癌：己酸羟孕酮注射剂，隔日1次，每次0.25g，连用4周。
药物相应作用
1.酶诱导药物(如卡马西平、灰黄霉素、苯巴比妥、苯妥英钠和利福平)可提高本药的清除率，降低药效。因此二者合用时，应选择其他避孕方法。2.本药可抑制环孢素的代谢，导致血浆环孢素浓度增加，有发生药物中毒的危险。
专家点评
本药为长效孕激素类药，其孕激素活性为黄体酮的7倍，无雌激素活性。本药所引起的类早孕反应比口服避孕药轻。
Generic Name: hydroxyprogesterone caproate
Dosage Form: injection
Indications and Usage for Makena
Makena is a progestin indicated to reduce the risk of preterm birth in women with a singleton pregnancy who have a history of singleton spontaneous preterm birth. The effectiveness of Makena is based on improvement in the proportion of women who delivered <37 weeks of gestation. There are no controlled trials demonstrating a direct clinical benefit, such as improvement in neonatal mortality and morbidity.
Limitation of use: While there are many risk factors for preterm birth, safety and efficacy of Makena has been demonstrated only in women with a prior spontaneous singleton preterm birth. It is not intended for use in women with multiple gestations or other risk factors for preterm birth.
Makena Dosage and Administration
Dosing
Administer intramuscularly at a dose of 250 mg (1 mL) once weekly (every 7 days) by a healthcare provider
Begin treatment between 16 weeks, 0 days and 20 weeks, 6 days of gestation
Continue administration once weekly until week 37 (through 36 weeks, 6 days) of gestation or delivery, whichever occurs first
Preparation and Administration
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Makena is a clear, yellow solution. Do not use if solid particles appear or if the solution is cloudy.
Instructions for administration:
Clean the vial top with an alcohol swab before use.
Draw up 1 mL of drug into a 3 mL syringe with an 18 gauge needle.
Change the needle to a 21 gauge 1 1/2 inch needle.
After preparing the skin, inject in the upper outer quadrant of the gluteus maximus. The solution is viscous and oily. Slow injection (over one minute or longer) is recommended.
Applying pressure to the injection site may minimize bruising and swelling.
Discard any unused product 5 weeks after first use.
Dosage Forms and Strengths
Makena (250 mg/mL) is a sterile solution of
