Contraceptive patch hormonal

The manufacturing of hormonal products and medications to treat hormonal disorders is a significant segment of the pharmaceutical industry. Patients with chronic conditions, such as diabetes and hypothyroidism, are lifelong consumers. Many women take hormonal medications to deal with menopausal symptoms or dysmenorrhea (painful menstruation), and many use hormonal contraceptives (piUs, patches, or VE inal rings). In addition to hormonal products, many pharmaceuticals are designed to treat endocrine problems. These include medications to boost enei, aid in weight loss, induce sleep, and lower blood pressure. 

EE and most progestogens undergo extensive first-pass metabolism in the liver and gut wall, reducing their oral bioavailability. To avoid first-pass metabolism progestogens and EE can be absorbed transdermally via the combined contraceptive patch. Some hormones are metabolised... 

The oral contraceptives are of two main types the combined hormonal contraceptives containing both an oestrogen and a progestogen (monophasic, biphasie, triphasie, or sequential), available as tablets or a patch, and the progestogen-only contraceptives, which are available as tablets (sometimes ealled mini pills), parenteral preparations (implants, depot injections) and intrauterine devices. 

The manufacturer also points out that combined oral contraceptives (and presumably the combined hormonal contraceptive patch) must not be taken with co-cyprindiol. To do this would be analogous to doubling the ethinylestradiol dose with consequent increased risk of adverse effects. In addition, some of the progestagens in combined oral contraceptives have weak androgenic effects, which could oppose the benefits of cyproterone. 

The interaction between metronidazole and combined oral contraceptives is not established, and the whole issue of any interaction with broad-spectrum antibacterials remains very controversial. Bearing in mind the extremely wide use of both metronidazole and combined oral contraceptives, any increased incidence of contraceptive failure above that seen in general usage is clearly very low indeed. The Faculty of Family Planning and Reproductive Health Care (FFPRHC) Clinical Effectiveness Unit has issued guidance on the use of antibacterials with combined hormonal contraceptives. Although they recognise that there is poor evidence for contraceptive failure, they recommend that additional form of contraception, such as condoms, should be used for short courses of antibacterials, see Hormonal contraceptives + Antibacterials Penicillins , p.981, for more detailed information. This applies to both the oral and the patch form of the combined contraceptive. This advice has usually been applied to only broad-spectrum antibacterials that do not induce liver enzymes but the FFPRHC notes that some confusion has occurred over which antibacterials are considered to be broad-spectrum , and thus they recommend that this advice is applied to all antibacterials that do not induce liver enzymes, which would include metronidazole. ... 

On the other hand, the personal and ethical consequences of an unwanted pregnancy can be very serious. For this reason, the Faculty of Family Planning and Reproductive Health Care (FFPRHC) Clinical Effectiveness Unit recommends that women taking combined hormonal contraceptives should routinely use a second form of contraception, such as condoms, while taking a short course of less than 3 weeks of an antibacterial, and for 7 days after the antibacterial has been stopped. In addition, the FFPRHC recommends that if fewer than 7 active pills are left in the pack after the antibacterial has been stopped, the new packet should be started without a pill-free break, omitting any of the inactive tablets. For patients using the combined contraceptive patch, if the 7 days after the antibacterial has been stopped runs into the usual 7 day patch-free period, a new patch should be applied when it is due to be changed and the patch-free week delayed by 7 days. ... 

The FFPRHC advise that additional contraceptive protection is not required in established users of the combined hormonal contraceptive patch taking tetracycline. This is in line with the findings of the study cited above. 

The combined contraceptive patch may be continued in the usual manner. Using more than one patch is not recommended. Additional, non-hormonal methods of contraception, such as condoms, should also be used by patients using the combined contraceptive pateh, both when taking the liver enzyme indueers and for at least 4 weeks after stopping the drug. 

The sites of entry of toxicants into the body and their subsequent distribution have a major influence on their toxic effects. It was noted in Section 2.9.1 that the pulmonary route affords direct access of toxicants to the bloodstream and the effects of a direct-acting toxicant may be manifested very rapidly. Absorption through the skin affords similar direct access of toxicants to the blood and lymph systems. (Advantage is taken of this route through the use of skin patches worn to continuously deliver low doses of pharmaceuticals to the bloodstream, for example, a combination of norelgestro-min and ethinyl estradiol hormones that function as contraceptives.)... 

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