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Makena

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Makena

SIDE EFFECTS

For the most serious adverse reactions to the use of progestins, see WARNINGS AND PRECAUTIONS.

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to the rates in the clinical trials of another drug and may not reflect the rates observed in practice.

In a vehicle (placebo)-controlled clinical trial of 463 pregnant women at risk for spontaneous preterm delivery based on obstetrical history, 310 received 250 mg of Makena and 153 received a vehicle formulation containing no drug by a weekly intramuscular injection beginning at 16 to 20 weeks of gestation and continuing until 37 weeks of gestation or delivery, whichever occurred first.1 [See Clinical Studies]

Certain pregnancy-related fetal and maternal complications or events were numerically increased in the Makena-treated subjects as compared to control subjects, including miscarriage and stillbirth, admission for preterm labor, preeclampsia or gestational hypertension, gestational diabetes, and oligohydramnios (Tables 1 and 2).

Table 1 : Selected Fetal Complications

Pregnancy Complication Makena
n/N
Control
n/N
Miscarriage ( < 20 weeks)1 5/209 0/107
Stillbirth ( ≥ 20 weeks)2 6/305 2/153
1N = Total number of subjects enrolled prior to 20 weeks 0 days
2N = Total number of subjects at risk ≥ 20 weeks

Table 2 : Selected Maternal Complications

Pregnancy Complication Makena
N=310
%
Control
N=153
%
Admission for preterm labor1 16 13.8
Preeclampsia or gestational hypertension 8.8 4.6
Gestational diabetes 5.6 4.6
Oligohydramnios 3.6 1.3
1Other than delivery admission.

Common Adverse Reactions

The most common adverse reaction was injection site pain, which was reported after at least one injection by 34.8% of the Makena group and 32.7% of the control group. Table 3 lists adverse reactions that occurred in ≥ 2% of subjects and at a higher rate in the Makena group than in the control group.

Table 3 : Adverse Reactions Occurring in ≥ 2% of Makena-Treated Subjects and at a Higher Rate than Control Subjects

Preferred Term Makena
N=310
%
Control
N=153
%
Injection site pain 34.8 32.7
Injection site swelling 17.1 7.8
Urticaria 12.3 11.1
Pruritus 7.7 5.9
Injection site pruritus 5.8 3.3
Nausea 5.8 4.6
Injection site nodule 4.5 2
Diarrhea 2.3 0.7

In the clinical trial, 2.2% of subjects receiving Makena were reported as discontinuing therapy due to adverse reactions compared to 2.6% of control subjects. The most common adverse reactions that led to discontinuation in both groups were urticaria and injection site pain/swelling (1% each).

Pulmonary embolus in one subject and injection site cellulitis in another subject were reported as serious adverse reactions in Makena-treated subjects.

Postmarketing Experience

The following adverse reactions have been identified during postapproval use of Makena. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

  • Body as a whole: Local injection site reactions (including erythema, urticaria, rash, irritation, hypersensitivity, warmth); fatigue; fever; hot flashes/flushes
  • Digestive disorders: Vomiting
  • Infections: Urinary tract infection
  • Nervous system disorders: Headache, dizziness
  • Pregnancy, puerperium and perinatal conditions: Cervical incompetence, premature rupture of membranes
  • Reproductive system and breast disorders: Cervical dilation, shortened cervix
  • Respiratory disorders: Dyspnea, chest discomfort
  • Skin: Rash

Read the Makena (hydroxyprogesterone caproate injection) Side Effects Center for a complete guide to possible side effects

DRUG INTERACTIONS

In vitro drug-drug interaction studies were conducted with Makena. [See CLINICAL PHARMACOLOGY] No in vivo drug-drug interaction studies were conducted with Makena.

REFERENCES

1 Meis 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.

Read the Makena Drug Interactions Center for a complete guide to possible interactions

Last reviewed on RxList: 9/25/2013
This monograph has been modified to include the generic and brand name in many instances.

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