Magazine article Drug Topics

Distaff Side

Magazine article Drug Topics

Distaff Side

Article excerpt

Experts share new findings on contraception, endometriosis, menopause

From emergency contraception in adolescent girls to hormone replacement therapy in postmenopausal women, thoughtprovoking therapeutic issues pertaining to the distaff segment of the population were tackled headon at the annual meeting of the American College of Clinical Pharmacy, held recently in Cincinnati.

Discussing the practical use of hormone-based emergency contraception in adolescent female patients was Maria T. Britto, M.D., M.P.H., an assistant professor in pediatrics and internal medicine at the Children's Hospital Medical Center, Cincinnati. Options so far in hormone-based emergency contraception include:

The traditional Yuzpe method, consisting of 100 mcg of ethinyl estradiol and 0.25 mg of levonorgestrel. This regimen should be initiated within 72 hours of intercourse and then repeated 12 hours later.

The recently approved Preven Kit (levonorgestrel and ethinyl estradiol tablets), containing the four required pills, a patient information book, and a pregnancy test.

A progestin-only regimen, currently under investigation.

Britto emphasized that Preven's labeling helps eliminate confusion for the patient. "The kit is clearly labeled with directions specific to emergency contraception only," she said. Other oral contraceptive (OC) products don't contain instructions pertaining to emergency contraception and can therefore be taken incorrectly. But cost is a factor, she added. Preven contains only four pills, yet costs as much as some oral contraceptive products. "If we prescribe OC products and punch out the placebo pills, then patients will have the remaining, unused portion of the pack in their possession" for a future need.

An emergency contraception regimen containing progestin only (0.75 mg of levonorgestrel) has recently been shown more effective in preventing pregnancies. It also is associated with a lower risk of side effects, compared with the Yuzpe method, Britto continued. Combined OC regimens usually produce a 50% incidence of nausea and a 20% incidence of vomiting. As a result, if vomiting occurs within two hours of OC ingestion, repeat dosing as well as administration of prophylactic antiemetic agents are often necessary Britto claimed that the incidence of nausea and vomiting was reported to be 20% and 5%, respectively, in patients who receive progestin only. …

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