Birth Control Takes New Turn with Approval of Hormonal Ring
Ritz, Jayne, Drug Topics
The effort to control unwanted pregnancies effectively and conveniently has turned a new page with the introduction of NuvaRing (Organon), a novel hormonal contraceptive vaginal device.
As the number of unwanted pregnancies is still on the rise in the United States, interest in curbing this growth is high. Pharmacists are in a leading position to assist patients in the selection of a contraceptive that takes into account the unique needs of each patient.
In clinical trials, all oral contraceptives are highly effective (> 99%) at preventing pregnancy if taken as prescribed. Unfortunately, actual pregnancy rates of 1% to 3% differ from those in clinical trials, primarily due to patient noncompliance. "Noncompliant patients who are currently taking an oral contraceptive pill may be more likely to experience breakthrough bleeding and possibly ovulation, which may lead to unwanted pregnancies," said Larry Seidman, D.O., clinical assistant professor, obstetrics and gynecology, MCP-Hahnemann School of Medicine in Philadelphia, a NuvaRing clinical investigator.
"For these patients, NuvaRing is a viable alternative hormonal contraception with increased convenience and protection," said Seidman. "Because the vaginal ring provides a month-long contraceptive protection, the patient does not have to remember to take a pill each day. The majority of the volunteers in the clinical study considered this new contraceptive method simple to use and were eager to inquire as to the eventual availability of the product."
Women can easily insert or remove the ring by pressing the sides of the circle together to gently push it into or remove it from the vagina. The correct positioning of the hoop is not critical because NuvaRing is not a barrier contraceptive. The small, flexible ethylene vinylacetate (EVA) ring is inserted on or before the fifth day of the menstrual period and designed to release a steady flow of low-dose etonogestrel-the biologically active metabolite of the progesterone desogestrel-and ethinyl estradiol (EE), the estrogen component (an average of 0.120 mg and 0.015 mg, respectively, per day) for over 21 days of use.
"Some of the noteworthy benefits of NuvaRing are the elimination of the first-pass effect with the attainment of steady-state blood levels of the hormones within three days of administration. Subsequently, this allows the use of the lowest effective dose with potentially lower adverse effects," noted Nancy Alexander, Ph.D., director of contraception medical services at Organon in West Orange, N. …