Due to a greatly increased price, a pricing controversy occurred in this country. OHPC was previously available at low cost from compounding pharmacies in the United States, but this became prohibited in 2016. Medical uses
Preterm birth
The use of OHPC in pregnancy to prevent preterm birth in women with a history of preterm delivery between 20 weeks and 36 weeks and 6 days is supported by the Society of Maternal Fetal Medicine Clinic Guidelines put out in May 2012 as Level I and III evidence, Level A recommendation. Level I evidence refers to a properly powered randomized controlled trial, and level III evidence is support from expert opinion, while a Level A recommendation confers that the recommendation is made based on good and consistent scientific evidence. OHPC 250 mg IM weekly preferably starting at 16–20 weeks until 36 weeks is recommended. In these women, if the transvaginal ultrasound cervical length shortens to <25 mm at < 24 weeks, cervical cerclage may be offered. In the 2013 study the guideline recommendation is based on, there was also a significant decrease of neonatal morbidity including lower rates of necrotizing enterocolitis (0 in the treatment group vs 4 in the control), intraventricular hemorrhage (4 in the treatment group compared with 8 in the control for a relative risk of 0.25), and need for supplemental oxygen (14% in the treatment group vs 24% in the placebo for a relative risk of 0.42). Furthermore, this study contained 463 women, 310 of whom received injection.
Research
Cyclical therapy with 150 mg OHPC by intramuscular injection was found to be effective in the treatment of 76 women with persistent, treatment-refractory acne in a preliminary study, with 84% responding to the therapy and experiencing a "good-to-excellent" improvement in symptoms.OHPC was studied by Schering for use as a progestogen-only injectable contraceptive at a dose of 250 to 500 mg once a month by intramuscular injection but produced poor cycle control at these doses and was never marketed.OHPC by itself has been found to have little or no effectiveness in the treatment of breast cancer in women. Conversely, the combination of estradiol valerate and OHPC has been found to be effective in the treatment of breast cancer in women. Initial research based on limited clinical data reported that the breast-cancer response rate with a combination of estradiol valerate and OHPC seemed to be greater than with an estrogen alone (35% vs. 50%). However, subsequent research using the related but more potent progestin gestonorone caproate found that the combination of estradiol valerate and gestonorone caproate had effectiveness that was not significantly different from that of an estrogen alone in the treatment of breast cancer in women.A novel oral formulation of OHPC (developmental code name LPCN-1107) is under development for the prevention of preterm labor. As of September 2017, it is in phase II or phase III clinical trials for this indication. See also
Estradiol valerate/hydroxyprogesterone caproate
Estradiol benzoate/hydroxyprogesterone caproate
Estradiol dipropionate/hydroxyprogesterone caproate

References


== Further reading ==