Oral contraceptives contraindications

Long-term use of hormone-replacement therapy and concurrent use of progestins appear to contribute to breast cancer risk.7 The use of postmenopausal estrogen-replacement therapy in women with a history of breast cancer generally is considered contraindicated. However, most experts believe that the safety and benefits of low-dose oral contraceptives currently outweigh the potential risks and that changes in the prescribing practice for the use of oral contraceptives are not warranted. Oral contraceptives are known to reduce the risk of ovarian cancer by about 40% and the risk of endometrial cancer by about 60%. 

Teriparatide can be used if bisphosphonates are not tolerated or contraindicated. Testosterone replacement therapy should be considered in men, and high-dose hormonal oral contraceptives can be considered for premenopausal women with documented hypogonadism. 

Cilest contains ethinylestradiol and norgestimate whereas Yasmin contains ethinylestradiol in combination with drospirenone. Both are combined oral contraceptives available as tablets, which have to be taken once daily for 21 days. Both are contraindicated in patients with venous thromboembolic diseases. 

Combined oral contraceptives may cause migraine and are contraindicated in such patients. Progesteronenonly contraceptives are more suitable in this case. 

Acne vulgaris (Ortho Tri-Cyclen and Estrostep only) For the treatment of moderate acne vulgaris in females 15 years of age or older who have no known contraindications to oral contraceptive therapy, desire contraception, have achieved menarche, and are unresponsive to topical antiacne medications. 

Contraindications for oral contraceptives form episodes of thrombosis or embolism and cardiovascular disease. Estrogen containing pills should not be used immediately postpartum since they can interfere with lactation. 

Results from the Oxford Family Planning Association Study showed no relation between oral contraceptive use and the incidence of multiple sclerosis (151). Conversely, multiple sclerosis is no longer considered to be a contraindication to hormonal contraceptive use. 

Combined oral contraceptives should not be used by women with the following absolute contraindications ... 

Although sickle cell disease is sometimes listed as a contraindication to oral contraceptive use, it has been suggested that this may not be justified (309). Women with sickle cell disease need highly effective contraception, because pregnancy is associated with increased morbidity... 

Mutti P, Cesarini R. Considerazioni sulle principali com-plicanze e controindicazioni dell uso dei contraccettivi orali. [Principle complications and contraindications of the use of oral contraceptives.] Minerva Ginecol 1979 31(5) 363-75. 

Ritonavir PI 600 mg bid With food. Separate dosing with didanosine by 2 hours. Nausea, diarrhea, paresthesias, hepatitis Dose-escalate over 5-10 days to improve tolerance. In combination with saquinavir (400 mg bid), use 400 mg bid ritonavir. Refrigerate capsules but not oral solution. See footnote 2 for concurrent drug contraindication s avoid concurrent oral contraceptives. 

Contraindications Oral contraceptives are contraindicated in the presence of cerebrovascular and thromboembolic disease, estrogen-dependent neoplasms, liver disease, and migraine headache. 

Copper intrauterine devices are widely used and highly effective (> 99% at one year) for 5 and some for 10 years. They are especially useful in the over-40s in whom oral contraceptives may become progressively contraindicated and for whom one lUD will last into the menopause. The lUD prevents implantation of the fertilised ovum, and has an additional antifertilisation effect enhanced by the toxic effect of copper ions on the gametes. 

Because most hot flashes resolve in 1 to 3 years, short-term use may be all that is needed, and can significantly improve quality of life. Short-term use, however, may increase the risk for cardiovascular events due to thrombogenesis and coronary heart disease, and should generally be avoided in women with preexisting cardiovascular disease, prior history of blood clots, or any condition that increases the risk for thrombotic events. With each year of use the risk for breast cancer and gallbladder disease increases. Long-term use decreases the risk for colon cancer and hip fracture. The side effects, contraindications, and drug interactions with HRT are similar to those for oral contraception (see Case 34). 

Contraindications Large doses can decrease the effect of oral anticoagulants oral contraceptives can decrease C concentration in the body smoking decreases serum levels of C. Use with caution in renal calculi (kidney stones) gout, anemia, sickle cell, sideroblastic, and thalassemia. 

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