© The use of
contraception has been increased from 54% (1990) to 57.4% (2014), globally.
© In 2015, 64 per
cent of married women or those in-relationship were using some form of
contraception, worldwide.
© Contraceptive
Methods include…
Ø Hormonal
Contraceptive Methods
Ø Copper
containing Intrauterine device (IUD)
Ø Male condoms
Ø Female condoms
Ø Vasectomy (Male
sterilization)
Ø Tubal ligation
(Female sterilization)
Ø Lactational
Amenorrhea Method (LAM)
Ø Standard Days
Method or SDM
Ø Basal Body
Temperature (BBT) Method
Ø Two-day Method
Ø Sympto-thermal
Method
Ø Calendar method
or rhythm method
Ø Withdrawal
(coitus interruptus)
© Hormonal
Contraceptive Methods include…
Ø The Pill or
Combined oral contraceptives (COCs)
Ø The Minipill or
Progestogen-only pills (POPs)
Ø Implants
Ø Progestogen only
injectables
Ø Monthly
injectables or combined injectable contraceptives (CIC)
Ø Combined
contraceptive patch
Ø Combined contraceptive
vaginal ring (CVR)
Ø Emergency
contraception
Ø Levonorgestrel
containing Intrauterine device (IUD)
© Hormonal contraceptives are the preparations
containing Progesterone alone or the combination of an Estrogen and
a Progesterone.
Ø Estrogens
ü Ethinyl
estradiol (Most commonly
used)
ü Mestranol
Ø Progestins
ü Norgestrel
ü Levonorgestrel
(Most commonly used)
ü Desogestrel
ü Etonogestrel
ü Drospirenone
(Most commonly used)
ü Ethynodiol
diacetate
ü Norethindrone
ü Norgestimate
ü Medroxyprogesterone
acetate
© As the use of
contraceptives increases, the probability of Contraceptive - Drug interaction also
raises.
© Concomitant use
of Combination contraceptives (an Estrogen plus a Progestin) and Tranexamic
acid is contraindicated especially in Obese or smoking women.
© It is contraindicated to use contraceptives containing Ethinyl
estradiol and Antiviral (Hepatitis C) Drugs such as
Dasabuvir, Paritaprevir/Ritonavir and Ombitasvir, together.
© Unintended
pregnancy or breakthrough bleeding may result due to concurrent use of Hormonal
Contraceptives and CYP3A4 Inducers (Carbamazepine, Rifampin, St.John’s Wort,
Phenytoin, Griseofulvin, Phenobarbital, etc)
© Concomitant use of
Combination Contraceptives and Theophylline warrants the monitoring of
signs of theophylline toxicity (Nausea, tremors, headache, or rapid, irregular
heartbeat).
© Hypotensive and
sedative effects might be elevated by the combination of Hormonal
contraceptives and Tizanidine.
© Concurrent use
of Combination Contraceptives and Isotretinoin may decrease the
effectiveness of hormonal contraceptives.
© Monitor patients for increased adverse effects
related to Voriconazole (peripheral edema, visual disturbance) and Ethinyl estradiol/Norethindrone
(abnormal menstruation, breast tenderness, edema), when Combination
Contraceptives and Voriconazole used together.
© Before supplying
Hormonal contraceptives, the Doctor or Pharmacist should
Ø Ask women about
current and previous drug use, including prescription, OTC, herbal,
recreational drugs and dietary supplements.
Ø Provide
information about possible interactions between hormonal contraception and
other drugs.
Ø Encourage women
to consider a contraceptive method that is unaffected by the interacting drug.
Ø Educate the
women about the drugs reducing the efficacy of hormonal contraception and
advise them about additional contraceptive protection, such as condoms.
