BioMed Research International / 2018 / Article / Tab 1

Review Article

A Comprehensive Review of the Pharmacologic Management of Uterine Leiomyoma

Table 1

Medical management of symptomatic uterine fibroids.

DosingTx reduces leiomyoma volume?Used to treat leiomyoma in the US?

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Ibuprofen600 mg orally daily starting on the first day of menstruationNoYes
Mefenamic acid500 mg orally three times per day starting on the first day of menstruationNoYes
Naproxen500 mg by mouth twice daily starting on the first day of menstruationNoYes

Tranexamic acid1.3 g orally three times per day for 5 daysNoYes
10 mg/kg iv (maximum 600 mg/dose) every 8 hoursNoYes

Combined contraceptives
Oral, transdermalNoYes
Cyclic or noncyclic

Progestin-only therapies
Norethindrone-contraceptive pills0.35 mg by mouth dailyNoYes
Levonorgestrel releasing intrauterine device (IUD)Intrauterine placement by healthcare professional; lasts 3–5 years depending on the deviceNoYes
Medroxyprogesterone (MPA)Depo 150 mg intramuscularly every 12 weeksNoYes
2.5–10 mg orally 12–14 days/month

Aromatase inhibitors
Letrozole2.5 mg orally for 12 weeksInsufficient evidenceNo

Gonadotropin-releasing hormone (GnRH) analogs
GnRH agonists
  Leuprolide acetateDepot 7.5 mg intramuscularly every monthYes (30–65%), reversibleYes
Depot 22.5 mg intramuscularly every 3 months
Depot 30 mg IM every 4 months
Depot 45 mg IM every 6 months
Eligard: 7.5 mg subcutaneously (sq) monthly/22.5 mg sq every 3 months/30 mg every 4 months/45 mg sq every 6 monthsNo
Leuprolide acetate: 1 mg sq dailyNo

GnRH antagonists
  Cetrorelix3 mg sq every 4 daysYes, reversibleNo
Depot 60 mg sq on cycle day 2

Mifepristone5–50 mg orally daily for 3–12 monthsInsufficient evidenceNo

Selective Progesterone Receptor Modulators:
Ulipristal acetate10–20 mg po daily for 3 monthsYes (12–53%), appears to be a stable reductionNo

Approved for the presurgical treatment of symptomatic uterine leiomyoma in the European Union.