Commonly Used Oral Contraceptives

Commonly Used Oral Contraceptives (See also page 241) 

Seasonale (Duramed) 91 day Seasonique (Duramed) 91 day pack Solia (Prasco) 

---

Wild RA, Demers LM, Applebaum-Bowden D, Lenker R. Hirsutism metabolic effects of two commonly used oral contraceptives and spironolactone. Contraception 1991 44(2) 113-24. 

Most of the commonly used oral contraceptives have been associated with these liver lesions. The medication time has varied between 0.5 and a total of 11 years. Some of the patients have had pregnancies in between the medication periods. 

L-Fohc acid is available as a crystalline dihydrate containing 8% water. Approximately 80% of the commercial production is consumed for feed enrichment in animal nutrition. FoHc acid is being offered by the pharmaceutical industry for therapeutic and prophylactic use (see Pharmaceuticals). Pharmacological doses of fohc acid are commonly used as a rescue dose during cancer chemotherapy, in women using oral contraceptives, and alcohoHcs. Several studies have provided evidence that multivitamins or foHc acid (0.8—4 mg/day) supplementation prevent the majority of neural tube defects (101). 

Migraine and headache are the most common complaints in women using oral contraceptives (79 Many workers (111, ... 

Drugs with endocrinological functions or side-effects are common, but oestrogenic hormones in oral contraceptives are particularly widely used. Pharmaceuticals and their metabolites eventually find their way into the environment, predominantly via excretion into sewage. ... 

Historically, the 1950s represented an important time in the control of human fertility. It was during that decade that the first combined oral contraceptives were developed. Shortly after the discovery that the exogenous administration of hormones such as progesterone successfully blocked ovulation, the use of hormonal steroids quickly became the most popular method of contraception worldwide. Specifically, combined oral contraceptives represent the most commonly used reversible form of contraception today and it is estimated that nearly 100 million women worldwide take oral contraceptives.1 Further, in the United States, it is estimated that at some time during their lives, more than 80% of women born since 1945 have used oral... 

Since the use of combined oral contraceptives may decrease the use of selected barrier contraceptive methods that do protect against STDs (e.g., latex condoms), one of the most common risks associated with the use of oral contraceptives is the risk of acquiring an STD.8... 

Ethinyl estradiol is metabolized in the liver via the cytochrome P-450 system. It is metabolized primarily via CYP450 3A4. When reviewing drug interactions of oral contraceptives, it is important to keep in mind that antibiotic administration during contraceptive use may decrease the efficacy of many combined contraceptives. Refer to Table 45-4 for a list of common drug interactions seen with oral contraceptives.1,31... 

Synthetic steroid hormones retain the common steroid nucleus, but they may contain novel substituents that affect their pharmacological activity. The two most widely used synthetic steroid estrogens are ethinyl estradiol (Estinyl) and mestranol, found in oral contraceptives. Synthetic steroids containing an ethinyl substitution are metabolized more slowly. Thus, these synthetic steroid hormones have better oral absorption properties and extended biological half-lives than the natural estrogens. 

Gabapentin does not bind to plasma proteins, is not appreciably metabolized, nor induces hepatic enzyme activity (AHFS, 2000) Consequently, it does not appear to alter the pharmacokinetics of commonly used anticonvulsant drugs or oral contraceptives (Ketter et al.,... 

The most common use of estrogen are as oral/parenteral contraceptive and for hormone replacement therapy. 

A large number of oral contraceptives containing estrogens or progestins (or both) are now available for clinical use (Table 40-3). These preparations vary chemically and pharmacologically and have many properties in common as well as definite differences important for the correct selection of the optimum agent. 

It has become apparent that reduction in the dose of the constituents of oral contraceptives has markedly reduced mild and severe adverse effects, providing a relatively safe and convenient method of contraception for many young women. Treatment with oral contraceptives has also been shown to be associated with many benefits unrelated to contraception. These include a reduced risk of ovarian cysts, ovarian and endometrial cancer, and benign breast disease. There is a lower incidence of ectopic pregnancy. Iron deficiency and rheumatoid arthritis are less common, and premenstrual symptoms, dysmenorrhea, endometriosis, acne, and hirsutism may be ameliorated with their use. 

---