TAM (Treatments and Medicines) NHS Highland
Important: Therapy notes
Important: Formulation and dosage details
Formulation:
Indication:
Dosage:
- By deep intramuscular injection: 150mg within first 5 days of cycle or within first 5 days after parturition
- For long-term contraception: repeat every 13 weeks.
If interval greater than 14 weeks, rule out pregnancy before next injection and advise additional contraceptive measures for 7 days after the injection off-label
Important: Formulation and dosage details
Formulation:
- Medroxyprogesterone acetate suspension for injection 104mg/0·65mL (Sayana Press)
Indication:
- Contraception
Place in therapy:
- Suitability is assessed on a case by case basis:
- Woman must be medically suitable for medroxyprogesterone acetate as contraception.
- Woman must want to self-inject
Administration:
- Sayana Press is administered by the subcutaneous route.
- Rather than attending a clinic every 13 weeks for an injection, a woman can choose to self-administer Sayana Press at home.
- Women must be trained in the technique and supervised by an appropriately trained health care professional (HCP) administering the first dose.
Education and training:
- Demonstrate how the device works: self administration videos available online e.g. iCaSH (NHSE): Sayana Press contraception (contact details at the end).
- Supervise self-injection.
- Supply:
- Up to 3 injections to take home with review at one year.
- Written information detailing administration instructions, potential side-effects and symptoms that should prompt medical review: sayana-press-a-guide-to-self-injection.pdf.
- Sharps box
- Discuss keeping medicine and sharps box safe.
- Access to a HCP should be available if any problems arise. Advise to return if any concerns.
- Discuss remembering date for next injection: Highlight manufacturer's text reminder service:
- Patient texts 'SELF' to 83311 along with date injection given (e.g. 'SELF 24.01' for injection given on 24th January). This will arrange a reminder for 1 week before next injection due (12 weeks).
Review:
- Women will be seen once a year for review / re-supply.
- Annual assessment will be as for annual review of any method: update history, blood pressure, body mass index (BMI), review risk factors and assess ongoing contraceptive requirements and suitability of method.
- Check injection technique at review visit.
Disposal:
- Systems should be in place for the provision and disposal of sharps. See: Waste procedures 2026 v2.pdf (NHS Highland intranet access required)
- Demonstrate sharps box: Keeping lid closed, not going above fill line, locking lid when full, can be brought back to clinic or any any pharmacy for disposal
Patient information:
- Contraceptive injection | NHS inform
- Manufacturer's patient information: SAYANA Package leaflet
Dosage:
- By subcutaneous injection: 104mg within first 5 days of cycle, the second and subsequent doses should be given at 13 week intervals; for further information refer to SPC.