Sayana-Press self-administration

 

Prescribing information and a link to the SPC is available at the bottom of this page.

See patients annually with a once-every-13-weeks, self-administered LARC.

A highly effective, convenient contraceptive option for women:1-5

  • who have received proper instruction.
  • who have demonstrated competence in self-injection.

1. Feasible and acceptable 1,2

Cohort studies evaluating self-administration of DMPA-SC showed that with appropriate training and instruction:2-5

  1. Women were willing and able to self-inject.2
  2. Self-administration was easy and convenient for women.3,4
  3. The majority of women correctly performed the self-injection correctly.4,5
  4. Self-injections were given in a timely manner.4

2. How can self-administration benefit you?

Healthcare professional (HCP)-administered Sayana®Press or Depo-Provera® (Medroxyprogesterone acetate) can require four or more clinic visits a year for women. When women receive 12 months’ supply of Sayana-Press from a single visit, less frequent visits can result in:

  1. Reduced clinic costs.2
  2. Reduced workload.2
  3. More time for other consultations.2

Women should be re-evaluated periodically as clinically appropriate and at least every year to determine if Sayana-Press is still the best option for them.1

3. Highly effective 6

Self-administered DMPA-SC resulted in the same therapeutic levels as HCP-administered DMPA-SC2

  1. Sayana-Press is 99% effective in preventing pregnancy if used according to the product recommendations of every 13 weeks (+/-7 days).6
  2. A substantial number of overweight or obese women (>26%) took part in the trials. Efficacy was unaffected by body weight and so no dosage adjustments according to body weight are required.6

4. Who is self-administration right for?

Determining which patients are likely to be successful with self-administration is ultimately down to using your best judgment. Here are a few considerations that may help you select the right women for self-administration:

  1. Has a desire been expressed to attempt self-administration? If it hasn’t, they can still use Sayana-Press but will need to come to clinic for their injection.
  2. Confirm no physical, social or psychological inabilities exist. Discuss any anxiety or fear the patient may have about self-injecting.
  3. Demonstrate to your patient how the device works. Showing women the self-administration patient video can also help answer questions and show them how to inject properly.
  4. Perform a supervised self-injection. Women can demonstrate proficiency and their potential to be successful.

5. Contraindications 1

There are a few contraindications to be aware of with Sayana-Press. It is contra-indicated:

  1. In women with a known hypersensitivity to DMPA or any of its excipients.
  2. If pregnancy is known or suspected.
  3. In women with known or suspected malignancy of the breast or genital organs.
  4. In women with undiagnosed vaginal bleeding.
  5. In women with severe hepatic impairment.
  6. In women with metabolic bone disease.
  7. In women with active thromboembolic disease and in patients with current or past history of cerebrovascular disease.

 

6. Training

Self-administration should be first performed under the supervision of a HCP following training of the woman in proper injection technique and the schedule of administration.

If considered appropriate by the HCP, subsequent injections may be administered by the woman following suitable instruction on injection technique.


Guide to self-administering Sayana-Press

To read the full special warnings and precautions for use for Sayana-Press and see a full list of adverse events, refer to the Summary of Product Characteristics. The benefits of contraceptive options and their risks must be evaluated individually for each woman. If any of the conditions/risk factors mentioned is present, the benefits of Sayana-Press use should be weighed against the possible risks for each individual woman and discussed with the woman before she decides to start using it. In the event of aggravation, exacerbation or first appearance of any of these conditions or risk factors, the woman should contact her physician. The physician should then decide on whether Sayana-Press use should be discontinued.

Staying on track with Sayana-Press

Your patients can set a reminder helping them to remember to take their injection on time. How to register for the self-adminstration Sayana Press Text reminder service: Txt SELF and the date the injection was given to 83311 in this format DD.MM (e.g. SELF 31.07).

One week before the next injection is due a reminder text will be sent. After each injection, your patient will need to re-register for the service.

 

References

  1. Sayana Press Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/3148/smpc Last accessed September 2020
  2. Beasley A, et al. Randomized clinical trial of self versus clinical administration of subcutaneous depot medroxyprogesterone acetate. Contraception 2014;89:352–356.
  3. Prabhakaran S, Sweet A. Self-administration of subcutaneous depot medroxyprogesterone acetate for contraception: feasibility and acceptability. Contraception 2012;85: 453–457.
  4. Cameron ST, et al. Pilot study of home self-administration of subcutaneous depomedroxyprogesterone acetate for contraception. Contraception 2012;85:458–464.
  5. Williams RL, et al. Self-administration of subcutaneous depot medroxyprogesterone acetate by adolescent women. Contraception 2013;88:401–407.
  6. Jain J, et al. Contraceptive efficacy and safety of DMPA-SC. Contraception 2004;70:269-75.

Prescribing Information:

Sayana-Press:
Legal Category: POM  Basic NHS Price : £6.90

Depo-Provera (Medroxyprogesterone acetate): 
Legal Category: POM  Basic NHS Price : £6.01

PP-SAY-GBR-0185.  September 2020