Co-prescription of antiepileptic drugs and contraceptives

Wang, Hao; Bos, Jens; Berg, Lolkje T. W. de Jong-van den

doi:10.1016/j.contraception.2011.04.017

Cited by 19 publications

(22 citation statements)

References 13 publications

(15 reference statements)

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“…The desirable outcome of this scenario was that the CP contacts the prescribing physician to inform him/her of the disease and drug used by the patient and discusses the implementation of safer strategies. We selected this scenario because of the high rate of concomitant AED and COC use in women of reproductive age [39,40]. …”

Section: Methodsmentioning

confidence: 99%

Use of Simulated Patients to Evaluate Combined Oral Contraceptive Dispensing Practices of Community Pharmacists

et al. 2013

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BackgroundCombined oral contraceptive (COC) use is the most commonly used reversible method of birth control. The incorrect use of COCs is frequent and one of the most common causes of unintended pregnancies. Community pharmacists (CPs) are in a strategic position to improve COC use because they are the last health professional to interact with patients before drug use.ObjectiveTo evaluate the COC dispensing practices of CPs in a developing country.MethodA cross-sectional study was conducted in community pharmacies of Assis and Ourinhos microregions, Brazil, between June 1, 2012, and October 30, 2012. Four simulated patients (SPs) (with counseled audio recording) visited community pharmacies with a prescription for Ciclo 21® (a COC containing ethinyl estradiol 30 mcg + levonorgestrel 15 mcg). The audio recording of every SP visit was listened to independently by 3 researchers to evaluate the COC dispensing practice. The percentage of CPs who performed a screening for safe use of COCs (i.e., taking of patients’ medical and family history, and measuring of blood pressure) and provided counseling, as well as the quality of the screening and counseling, were evaluated.ResultsOf the 185 CPs contacted, 41 (22.2%) agreed to participate in the study and finished the study protocol. Only 3 CPs asked the SP a question (1 question asked by each professional), and all of the questions were closed-ended, viz., “do you smoke?” (n = 2) and “what is your age?” (n = 1). None of the CPs measured the patient’s blood pressure. Six CPs provided counseling when dispensing COCs (drug dosing, 5 CPs; possible adverse effects, 2 CPs), and one CP provided counseling regarding both aspects.ConclusionThe CPs evaluated did not dispense COC appropriately and could influence in the occurrence of negatives therapeutic outcomes such as adverse effects and treatment failure.

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Section: Methodsmentioning

confidence: 99%

Use of Simulated Patients to Evaluate Combined Oral Contraceptive Dispensing Practices of Community Pharmacists

et al. 2013

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“…En un estudio realizado en el Reino Unido se informa que el 56 % de las mujeres epilépticas que utilizaban FAE y AOC, tomaban una baja dosis de estrógeno (11). Datos similares a los reportados en un estudio realizado en Holanda, donde el 65,7 % de las usuarias de FAE utilizaban el AH incorrecto; de las mujeres que utilizaban FAE en combinación con AC, más del 40 % lo hacían con AC en baja dosis (1); el estudio también encontró que a mujeres usuarias de antiepilépticos no inductores enzimáticos (FAE-NIE) se les prescribió con más frecuencia AC con 50 mcg de estrógeno, lo cual no era necesario (1).…”

Section: Discussionunclassified

“…Estos resultados son menores a los informados en otros estudios que muestran que entre un 44 a 73 % de las pacientes con FAE-IE reciben estrógenos con menos de 50 µg. Sin embargo, este porcentaje menor, pero considerable, puede asociarse a un incremento en el riesgo de una falla en el método de anticoncepción y de un embarazo no deseado y, en ambos casos, deberían explorarse las causas del uso de fármacos a concentraciones no indicadas (1,11,14).…”

Section: Discussionunclassified

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Prevalencia de prescripción conjunta incorrecta de fármacos anticonvulsivantes y anticonceptivos hormonales Colombia, 2014

Machado‐Alba¹,

Gallo-Gómez²,

Hinojosa-Millán³

2016

Rev. Colomb. Obstet. Ginecol.

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Objective: To determine the prevalence of simultaneous prescription of antiepileptic drugs and identify wrong prescriptions that may affect the effectiveness of hormonal contraceptives in a group of women covered under the Colombian General Social Security System in Health. Materials and methods: Cross-sectional study based on records of women between 15 and 45 years of age who received at least one antiepileptic drug from March 1 st to 31 st 2014, included in database of a logistic operator for medication distribution for a population belonging to the Contributory and Subsidized regimes in the Colombian social security system. The evaluation included the type of hormonal contraceptive and of the anticonvulsant medication, and the frequency of concomitant prescription and of incorrect prescription of combined use of medications. Descriptive statistics were used. Results: Out of a total number of 2092 female users of antiepileptic drugs, there were 89 (4.3%) cases identified with concomitant use of at least one anticonvulsant and one contraceptive. Incorrect prescription of contraceptive methods was identified in 48 cases (54%), including the concomitant use of enzymatic-inducing anticonvulsants and combined hormonal injectable contraceptives (20 cases) or the use of combined low-dose oestrogen oral contraceptives (16 cases) or oral progestins (10 cases) and the use of non enzyme-inducing antiepileptic drugs and combined oral contraceptives, and high-dose oestrogens (2 cases). Conclusions: An important number of female users of anticonvulsants used hormonal contraception and almost half of them had an incorrect contraceptive prescription, creating a risk of undesired pregnancies or increasing the risk of thromboembolic disease.

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“…In the liver, certain AEDs and COCs induce and are metabolized by the cytochrome P450 (CYP450) enzyme system, 5,12 more specifically by the isoenzyme cytochrome 3A4 (CYP3A4) 2,9,10,13 . The AEDs that potentiate the increased metabolism of exogenous hormones 5 through the induction of the CYP450 isoenzymes (CYP3A4) are referred to as enzyme‐inducing (EI) AEDs 2,3,6,9,10,13 . The end result of the increased metabolism by EI‐AEDs is a decrease in the serum hormone concentration 5,9,10 as much as 50% or more, which makes the hormonal drug less effective 2,3,6 .…”

Section: Interaction Between Antiepileptic Drugs and Sex Hormonesmentioning

confidence: 99%

Contraception and Antiepileptic Drugs

Guillemette¹,

Yount²

2012

J Midwife Womens Health

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Epilepsy is a neurologic condition that affects women and women's choices in many areas of their lives. Some antiepileptic drugs (AEDs) used in the treatment of epilepsy can interact with hormonal contraceptives. The result can be decreased effectiveness in the contraceptive with the possibility of unintended pregnancy, or decreased effectiveness of the AED that can result in seizure activity. This article provides information about concurrent AED and contraceptive use to assist health care providers in guiding women with epilepsy to make the best contraceptive choices based on their reproductive life plans.

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Co-prescription of antiepileptic drugs and contraceptives

Cited by 19 publications

References 13 publications

Use of Simulated Patients to Evaluate Combined Oral Contraceptive Dispensing Practices of Community Pharmacists

Use of Simulated Patients to Evaluate Combined Oral Contraceptive Dispensing Practices of Community Pharmacists

Prevalencia de prescripción conjunta incorrecta de fármacos anticonvulsivantes y anticonceptivos hormonales Colombia, 2014

Contraception and Antiepileptic Drugs

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