15 REFERENCES
1Meis PJ, Klebanoff M, Thom E, et al. Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. N Engl J Med. 2003;348(24):2379-85.

2Northen A, Norman G, Anderson K, et al. Follow-up of children exposed in utero to 17 alpha-hydroxyprogesterone caproate. Obstet & Gynecol. 2007;110:865-872.

16 HOW SUPPLIED/STORAGE AND HANDLING
Makena (NDC 64011-243-01) is supplied as 5 mL of a sterile solution in a multidose glass vial.

Each 5 mL vial contains hydroxyprogesterone caproate USP, 250 mg/mL (25% w/v), in castor oil USP (28.6% v/v) and benzyl benzoate USP (46% v/v) with the preservative benzyl alcohol NF (2% v/v).

Single unit carton: Contains one 5 mL multidose vial of Makena (250 mg/mL) containing 1250 mg of hydroxyprogesterone caproate.

Store at controlled room temperature [15°-30°C (59°-86°F)]. Use within 5 weeks after first use.

Caution: Protect vial from light. Store vial in its box. Store upright.

17 PATIENT COUNSELING INFORMATION
See FDA-approved patient labeling (Patient Information).

Counsel patients that Makena injections may cause pain, soreness, swelling, itching or bruising. Inform the patient to contact her physician if she notices increased discomfort over time, oozing of blood or fluid, or inflammatory reactions at the injection site [see Adverse Reactions (6.1)].

Patient Information

Makena (mah-KEE-na)
(hydroxyprogesterone caproate injection) 250 mg/mL

Read this Patient Information Leaflet before you receive Makena. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or treatment.

What is Makena?
Makena is a prescription hormone medicine (progestin) used in women who are pregnant and who have delivered a baby too early (preterm) in the past. Makena is used in these women to help lower the risk of having a preterm baby again.
Makena is for women who:
Are pregnant with one baby
Have had a preterm delivery of one baby in the past
How well does Makena work?
Makena was studied in women who were at risk for having a preterm baby because they had previously given birth to a preterm baby. In the main study, about 37 of 100 women who received Makena gave birth preterm (before 37 weeks of pregnancy), compared to about 55 of 100 women who did not receive Makena. Another study of Makena is going on to see whether Makena reduces the number of babies who have serious problems shortly after birth or who die.
It is not known whether Makena is safe and effective in women who have other risk factors for preterm birth.
It is not known whether Makena is safe and effective in women less than 16 years old.
Makena is not intended for use to stop active preterm labor.
Who should not receive Makena?
Makena should not be used if you:
Have now or have had a history of blood clots or other blood clotting problems
Have now or have had a history of breast cancer or other hormone-sensitive cancers
Have unusual vaginal bleeding not related to your current pregnancy
Have yellowing of your skin due to liver problems during your pregnancy
Have liver problems, including liver tumors
Have uncontrolled high blood pressure
What should I tell my healthcare provider before receiving Makena?
Before you receive Makena, tell your healthcare provider if you have:
An allergy to hydroxy