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medroxyprogesterone + Premarin (Premella / Premelle Ciclico / Premique Cycle)

✓ Approved

Pfizer, Inc. · ESR1 · 小分子

什么是 medroxyprogesterone + Premarin？

medroxyprogesterone + Premarin 是一种小分子，由Pfizer, Inc.研发。该药已获批，用于治疗相关适应症，给药途径：Oral (PO)。

药物档案

商品名Premella, Premelle Ciclico, Premique Cycle
公司Pfizer, Inc.
药物类别小分子
分子靶点ESR1, PGR
给药途径Oral (PO)
状态Approved
来源： ClinicalTrials.gov, Pfizer, Inc.

作用机制

分子靶点

medroxyprogesterone + Premarin 作用于 2 个分子靶点：

ESR1estrogen receptor 1 (ER, ESR)
PGRprogesterone receptor (NR3C3, PR)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

medroxyprogesterone + Premarin 针对 2 个适应症，涉及 2 个治疗领域。

治疗领域疾病/病症分期
Surgical and medical proceduresHormone replacement therapy✓ Approved
Musculoskeletal and connective tissue disordersOsteoporosis✓ Approved

相关研究文献

PubMedCardiology in review2026-09-04

Menopausal Hormone Therapy and Cardiovascular Risk: Current Evidence and Treatment Recommendations.

Pillai Ashwin A AA, Mehta Aryan A, Godin Shea-Lee SL, Frishman William H WH et al.

In 2025, the US Food and Drug Administration (FDA) removed its prior class-wide boxed warnings for menopausal hormone therapy (MHT), paving the way for increased clinical use. Menopause accelerates cardiovascular risk independently of chronological aging, manifesting as a 7.5% increase in carotid-femoral pulse wave velocity within 1 year and a hypertension prevalence of 66.6% in women aged 55-64 years. Risk stratification for MHT hinges on the timing of initiation and the administered formulation. The 2025 Women's Health Initiative secondary analysis suggests that in symptomatic women aged 50-59 years, combination (estrogen-progestogen) MHT maintains atherosclerotic neutrality while reducing vasomotor symptoms by 59%. Conversely, atherosclerotic risk increases in women aged 70-79 years (hazard ratio 3.22 for combined therapy). Route of administration dictates the metabolic effect: oral estrogens undergo hepatic first-pass metabolism, elevating venous thromboembolism risk and increasing triglycerides by 5-15%, whereas transdermal formulations bypass hepatic first-pass metabolism, decrease triglycerides by 5-30%, and carry a neutral thromboembolic risk profile. When concurrent progestogen therapy is required, natural micronized progesterone is favored over synthetic medroxyprogesterone acetate to preserve estrogen-mediated vascular benefits. Oral or transdermal systemic MHT can be considered for vasomotor symptom management in women <60 years or within 10 years of menopause with a 10-year atherosclerotic cardiovascular disease risk of <5% and a coronary artery calcium score of zero.

PMID 42693520
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PubMedStudies in family planning2026-09-04

Development of a Client Experience of Care Metric to Measure Person-Centered Care for Injectable Contraceptive Clients in Lilongwe, Malawi.

Felker-Kantor Erica E, Demise Eden E, Mkandawire Philip P, Rothschild Claire C et al.

The aim of this study was to develop and psychometrically assess a client-experience-of-care metric tailored for women in Lilongwe, Malawi, using self-administered or provider-administered depot medroxyprogesterone acetate subcutaneous (DMPA-SC) and to assess differences in experiences of care between the two groups. A client exit interview was administered to 400 Malawian women who had self-injected (n = 198) or received provider-administered (n = 202) DMPA-SC within the three months preceding the study. Iterative exploratory factor analysis with a polychoric matrix was performed. Cronbach's alpha was used to assess scale reliability. Bivariate and multivariate generalized linear regression models with robust standard errors were used to test for differences in client experience between self-administered and provider-administered clients. Exploratory factor analysis yielded a two-factor solution, identifying a unifying scale for client experience of care (eight items) and a subscale for empowerment (ten items). The client experience of care scale had moderate construct validity, explaining 40 percent of the variance, high criterion validity with a positive and statistically significant (p < 0.05) correlation coefficient, and low-to-moderate reliability (alpha = 0.68). In adjusted models, statistically significant differences in client experience of care were detected by injection method, with self-injecting clients reporting better experiences of care compared to provider-administered clients.

PMID 42695937
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PubMedThe Cochrane database of systematic reviews2026-09-04

Long-term hormone therapy for perimenopausal and postmenopausal women.

Bofill Rodriguez Magdalena M, Yong Li Ning LN, Mirkov Sanja S, Bekos Christine C et al.

Hormone therapy is widely provided to control menopausal symptoms and has been used for the management and prevention of cardiovascular disease, osteoporosis and dementia in older women. This is an updated version of a Cochrane review first published in 2005. To assess the long-term effects of prolonged use (at least one year) of hormone therapy on mortality, cardiovascular outcomes, cancer, gallbladder disease, fractures and cognition in perimenopausal and postmenopausal women. We used the Cochrane Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, three other databases and two trial registers, together with reference checking, citation searching and contact with study authors to identify the studies included in the review. The latest search date was 26 September 2024. We included randomised, double-blind trials in which peri- or postmenopausal women took hormone therapy or placebo for at least one year. We included various oestrogen formulations, with or without progestogens. We focused on studies assessing hormone therapy's effects on long-term clinical outcomes, including death, coronary events and cancer. Hormone therapy's efficacy in managing menopausal symptoms was beyond the scope of this review, and is assessed in other Cochrane reviews. Two review authors independently selected studies, assessed risk of bias and extracted data. We calculated risk ratios (RRs) for dichotomous data and mean differences (MDs) for continuous data, along with 95% confidence intervals (CIs). We assessed the certainty of the evidence using GRADE. We included 24 studies - with two newly added in this update - involving 45,660 participants. We derived nearly 70% of the data from two well-conducted studies: the Heart and Estrogen/progestin Replacement Study (HERS 1998) and the large, multi-component Women's Health Initiative research programme, which included two hormone therapy arms (WHI 1998). Across all the studies, most participants were postmenopausal American women with one or more comorbidities. The mean participant age in most studies was over 60 years. Only one included study focused on perimenopausal women. We present full results for all included studies with available data in the main review. The results presented below are drawn from WHI 1998, in which the combined hormone therapy arm and the oestrogen-only arm were run concurrently, with women assigned to the appropriate trial based on their uterus status. One study with 16,608 postmenopausal women with an intact uterus compared combined continuous hormone therapy (conjugated equine oestrogen and medroxyprogesterone acetate) to placebo, and measured outcomes at an average of 5.6 years of follow-up. Based on this study, combined continuous hormone therapy probably makes little to no difference to the risk of a coronary event (RR 1.17, 95% CI 0.95 to 1.44; moderate-certainty evidence). It may increase the risk of stroke (RR 1.39, 95% CI 1.09 to 2.09; low-certainty evidence) and venous thromboembolism (RR 2.03, 95% CI 1.55 to 6.64; low-certainty evidence). Compared to placebo, combined continuous hormone therapy probably increases the risk of breast cancer (RR 1.27, 95% CI 1.03 to 1.56; moderate-certainty evidence) and probably makes little to no difference to the risk of lung cancer (RR 1.06, 95% CI 0.77 to 1.46; moderate-certainty evidence). It may increase gallbladder disease requiring surgery (RR 1.64, 95% CI 1.30 to 2.06; 14,203 participants; low-certainty evidence), and probably reduces the risk of all clinical fractures (RR 0.78, 95% CI 0.71 to 0.86; moderate-certainty evidence). One study including 10,739 postmenopausal women who had undergone a hysterectomy compared oestrogen-only (conjugated equine oestrogen) hormone therapy to placebo, and measured outcomes at an average of seven years' follow-up. Based on this study, oestrogen-only hormone therapy probably makes little to no difference to the risk of coronary events (RR 0.94, 95% CI 0.78 to 1.13), venous thromboembolism (RR 1.32, 95% CI 1.00 to 1.74) and breast cancer (RR 0.79, 95% CI 0.61 to 1.01), all with moderate-certainty evidence. It may make little to no difference to the risk of lung cancer (RR 1.04, 95% CI 0.73 to 1.48; low-certainty evidence). Oestrogen-only hormone therapy probably increases the risk of stroke (RR 1.33, 95% CI 1.06 to 1.67) and gallbladder disease requiring surgery (RR 1.78, 95% CI 1.42 to 2.24), and probably reduces the risk of all clinical fractures (RR 0.73, 95% CI 0.65 to 0.80), all with moderate-certainty evidence. We judged most included studies to have a low risk of bias for most domains. The overall certainty of evidence for the main comparisons was moderate. The main limitation was that only about 30% of women were 50 to 59 years old at baseline, the age group most likely to consider hormone therapy for vasomotor symptoms. Long-term follow-up of women using hormone therapy suggests that the risk profiles vary between combined hormone therapy and oestrogen-only therapy. Oestrogen-only hormone therapy probably makes little to no difference to coronary events, and probably increases the risk of stroke and gallbladder disease. It probably makes little to no difference in the risk of breast cancer, and probably reduces the risk of all fractures. Combined hormone therapy may increase the risk of thromboembolism and probably increases the risk of breast cancer. These results should be interpreted with caution as they are based on one study using oral hormone therapy, which may not represent the risks of the hormone therapy currently used in clinical practice.

PMID 42695385
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PubMedNeurosurgical focus2026-09-01

Meningioma regression following discontinuation of depot medroxyprogesterone acetate.

Gordillo Alan A, Kumar Pranav P, Gonugunta Nikita N, Torres-Trejo Alejandro A et al.

The aim of this study was to assess the clinical and radiographic changes in meningioma burden following cessation of depo-medroxyprogesterone acetate (dMPA) in patients with meningioma stabilization or shrinkage. This retrospective case series included 3 patients with meningioma who did not undergo resection at the author's institution but who discontinued dMPA during tumor surveillance (2020-2025) and experienced tumor regression. Data collection included meningioma characteristics, previous pathology reports, tumor size across various follow-up time points, and clinical course. The mean cumulative duration of dMPA was 19.7 ± 2.5 years. Tumor regression was identified as early as 14 months after cessation of dMPA and persisted beyond 68 months after cessation. Patient A, with ≥ 20 tumors, demonstrated nearly 39% reduction in overall tumor burden across 45 months. Patient B demonstrated nearly 80% decrease in tumor burden across 68 months. Patient C demonstrated a 6% decrease in tumor burden, with near-complete resolution of 1 anterior skull-base tumor, within 14 months of dMPA cessation. The authors present 3 patients with previously diagnosed meningioma who were managed with active surveillance and dMPA cessation. After 12 months of follow-up, all patients demonstrated decreases in overall tumor burden. These results highlight an evolving understanding in the management of patients with possible progestin-associated meningioma in the setting of dMPA exposure.

PMID 42679391
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PubMedArchives animal breeding2026-08-31

Reproductive and endocrine responses to short-term safflower seed supplementation in anestrous ewes synchronized with progestagen.

Kutlu Metehan M, Doğan Halef H

This study investigated the effects of short-term supplementation with safflower seed, a linoleic-acid-rich oilseed, on reproductive performance and endocrine responses in Hungarian Merino ewes during the non-breeding season. Forty-four clinically healthy multiparous ewes were allocated to two equal groups: a control group and a safflower group. Ewes in the safflower group ( n = 22 ) received 75 g ewe-1 d-1 of whole safflower seed in addition to the standard ration during the 7 d sponge period, whereas control ewes ( n = 22 ) received no oilseed supplementation. All ewes were treated with an intravaginal sponge containing 60 mg medroxyprogesterone acetate for 7 d during April. At sponge removal, 500 IU equine chorionic gonadotropin (eCG) was administered intramuscularly. Ewes showing estrus were mated with proven fertile Merino rams (ewe : ram ratio of 5 : 1 ). Blood samples were collected on day 0, day 7, and immediately after mating on the day of estrus to determine serum estradiol (E2) and 13,14-dihydro-15-keto prostaglandin F2 α (PGFM) concentrations. Pregnancy was diagnosed by transabdominal ultrasonography 50 d after mating, and reproductive parameters were calculated. Under the present experimental conditions, short-term safflower seed supplementation did not produce statistically detectable improvements in estrus rate, pregnancy rate, lambing rate, or litter size compared with the control group ( p > 0.05 ). Serum E2 concentrations increased, whereas PGFM concentrations decreased over time in both groups; however, no treatment effect or treatment × time interaction was detected. In conclusion, supplementation with 75 g ewe-1 d-1 of whole safflower seed during progestagen treatment was not associated with measurable improvements in reproductive outcomes or detectable changes in circulating E2 and PGFM concentrations.

PMID 42670569
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PubMedVeterinary world2026-08-24

Mid-gestational luteal insufficiency in predisposed dog breeds: Retrospective evaluation of medroxyprogesterone acetate therapy and timed-withdrawal.

Arayatham Saengtawan S, Borikappakul Panthipa P, Ruenphet Sakchai S

Hypoluteodism is an important cause of non-infectious pregnancy loss in bitches and is characterized by inadequate progesterone (P4) production by the corpus luteum. Evidence regarding breed-specific patterns of luteal insufficiency and the clinical utility of medroxyprogesterone acetate (MPA) with timed-withdrawal remains limited. This study aimed to identify the temporal pattern of luteal insufficiency in predisposed dog breeds and to evaluate the efficacy and safety of an MPA protocol combined with standardized late-gestation withdrawal. Clinical records from 29 pregnancies in 25 bitches diagnosed with hypoluteodism were retrospectively reviewed. The cohort consisted predominantly of Shetland Sheepdogs (21), together with Miniature American Shepherds (2) and Pomeranians (2). Serial serum P4 monitoring commenced during the fourth week of gestation. Hypoluteodism was diagnosed when P4 concentrations decreased below 10 ng/mL or declined by >5 ng/mL within 48-72 h. A low-dose MPA regimen (0.1 mg/kg, orally, once daily) was administered, and treatment was discontinued 24-48 h before elective cesarean section. Pregnancy outcomes and maternal and neonatal safety parameters were evaluated. A distinct mid-gestational critical window was identified, with 79.3% of cases exhibiting P4 decline during weeks 5-6 of gestation. Pregnancy was successfully maintained to term in 86.2% (25/29) of pregnancies. Reproductive failure occurred in four pregnancies (13.8%), including three abortions and one case of fetal mummification. Mean litter size was approximately 4.4 puppies, yielding 110 live-born neonates, of which 94.5% survived to weaning. Female puppies showed no evidence of virilization, and no maternal complications, including diabetes mellitus, mammary hyperplasia, mammary tumors, or agalactia, were observed. Timed-withdrawal of MPA before delivery prevented premature labor and fetal compromise. Predisposed breeds, particularly Shetland Sheepdogs, exhibit a predictable period of luteal vulnerability during weeks 5-6 of gestation. Early P4 surveillance beginning at day 28-30 post-ovulation, combined with low-dose MPA therapy and withdrawal 24-48 h before elective delivery, represents an effective clinical strategy for reducing pregnancy loss while facilitating planned cesarean section.

PMID 42634758
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