Serum levonorgestrel concentration and cervical mucus viscosity after six months of monoplant® implantation

Gunardi, Eka Rusdianto; Affandi, Biran

doi:10.13181/mji.v23i1.685

Cited by 4 publications

(9 citation statements)

References 22 publications

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“…A similar trend was observed in a macaque efficacy study [53]. At the levels of LNG achieved in serum, contraceptive efficacy has been reported [65] in women. However it should be noted that Dusterberg et al, [73] reported inter-species related variations in (%) bioavailabilities and plasma half-lives of three different progestogens including LNG.…”

Section: 0 Discussionsupporting

confidence: 84%

“…No LNG was detected in the MZC IVR group, as expected. The average LNG levels from the MZCL IVRs on the last day (d23) of use were 355 ± 88 pg/mL, level associated with contraceptive activity [64, 65]. Based on the PK profile, other PK parameters were computed as follows: AUC 48h - ∞ was 8.07 ng.d.…”

Section: 0 Resultsmentioning

confidence: 99%

“…The LNG dose for a human IVR was scaled down for a macaque IVR [69]. The target release values for the microbicides are at least 1000 times their reported EC 50 values and for LNG, 10,000 times above its reported minimum effective level, 200 pg/mL [65]. …”

Section: 0 Discussionmentioning

confidence: 99%

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A novel intravaginal ring to prevent HIV-1, HSV-2, HPV, and unintended pregnancy

Ugaonkar

Wesenberg

Jolanta

et al. 2015

Journal of Controlled Release

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Women urgently need a self-initiated, multipurpose prevention technology (MPT) that simultaneously reduces their risk of acquiring HIV-1, HSV-2, and HPV (latter two associated with increased risk of HIV-1 acquisition) and prevents unintended pregnancy. Here, we describe a novel core-matrix intravaginal ring (IVR), the MZCL IVR, which effectively delivered the MZC combination microbicide and a contraceptive. The MZCL IVR contains four active pharmaceutical ingredients (APIs): MIV-150 (targets HIV), zinc acetate (ZA; targets HIV and HSV-2), carrageenan (CG; targets HPV and HSV-2), and levonorgestrel (LNG; targets unintended pregnancy). The elastomeric IVR body (matrix) was produced by hot melt extrusion of the non-water swellable elastomer, ethylene vinyl acetate (EVA-28), containing the hydrophobic small molecules, MIV-150 and LNG. The solid hydrophilic core, embedded within the IVR by compression, contained the small molecule ZA and the macromolecule CG. Hydrated ZA/CG from the core was released by diffusion via a pore on the IVR while the MIV-150/LNG diffused from the matrix continuously for 94 days (d) in vitro and up to 28d (study period) in macaques. The APIs released in vitro and in vivo were active against HIV-1ADA-M, HSV-2, and HPV16 PsV in cell-based assays. Serum LNG was at levels associated with local contraceptive effects. The results demonstrate proof-of-concept of a novel core-matrix IVR for sustained and simultaneous delivery of diverse molecules for the prevention of HIV, HSV-2 and HPV acquisition, as well as unintended pregnancy.

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Section: 0 Discussionsupporting

confidence: 84%

Section: 0 Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A novel intravaginal ring to prevent HIV-1, HSV-2, HPV, and unintended pregnancy

Ugaonkar

Wesenberg

Jolanta

et al. 2015

Journal of Controlled Release

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“…In emergency contraception, studies have shown that levonorgestrel works by preventing or delaying ovulation and impairing luteal function [ 13 – 15 ]. LNG may also increase the thickness of the cervical mucus or affect sperm migration and function in the genital tract, thereby preventing fertilization of an egg [ 16 ]. Some studies have found no effect of levonorgestrel on the endometrium, the quality of cervical mucus, nor the penetration of spermatozoa in the uterine cavity [ 17 – 19 ].…”

Section: Resultsmentioning

confidence: 99%

Clinical Pharmacology of Hormonal Emergency Contraceptive Pills

Matyanga

Dzingirai

2018

International Journal of Reproductive Medicine

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Emergency contraceptives play a major role in preventing unwanted pregnancy. The use of emergency contraceptives is characterized by myths and lack of knowledge by both health professionals and users. The main objective of this paper is to summarize the clinical pharmacology of hormonal methods of emergency contraception. A literature review was done to describe in detail the mechanism of action, efficacy, pharmacokinetics, safety profile, and drug interactions of hormonal emergency contraceptive pills. This information is useful to healthcare professionals and users to fully understand how hormonal emergency contraceptive methods work.

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“…e most commonly reported side effect is irregular menstrual bleeding which often causes users to discontinue implant use [14][15][16][17]. Changes in menstrual patterns such as amenorrhea, spotting, and prolonged menstruation are often complained of by implant users [18][19][20][21]. Other factors affecting menstrual patterns include breastfeeding and body mass index.…”

Section: Introductionmentioning

confidence: 99%

Menstrual Pattern and Characteristics of One-Rod and Two-Rod Levonorgestrel Implant Users

Gunardi

Susilo

2021

Obstetrics and Gynecology International

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Introduction. The maternal mortality ratio (MMR) in Indonesia reaches 359 per 100,000 live births. The long-acting reversible contraceptive (LARC) method is an effective contraceptive choice for reducing MMR. The contraceptive implant is one of the LARCs that has low usage due to lack of education about the side effects. This study aims to compare the menstrual pattern and characteristics between one-rod and two-rod levonorgestrel implant users. Methods. A prospective cohort study was performed in patients at Cipto Mangunkusumo Hospital (RSCM) from March 2016 to May 2018. Subject recruitment was done by consecutive sampling. This study was conducted from March 2016 until May 2019. Statistical analysis was performed on the data using the chi-square test to determine the relationship between menstrual pattern and characteristics, and the use of one-rod or two-rod levonorgestrel implants. Results. A total of 140 subjects participated in the study, comprising 70 (50%) one-rod users and 70 (50%) two-rod users. In the first month, 32.9% one-rod users experienced amenorrhea, 22.9% experienced shortened menstrual period, 30% experienced normal menstrual period, and 14,2 % experienced lengthened menstrual period. In comparison, in the first month, 41.4% two-rod users experienced amenorrhea, 15.7% experienced shortened menstrual period, 32.9% experienced normal menstrual period, and 10% experienced lengthened menstrual period. There was no significant difference in menstrual patterns and characteristics between one-rod and two-rod levonorgestrel implant users. Conclusion. There was no significant difference in menstrual patterns and characteristics between one-rod and two-rod levonorgestrel implant users. Implications. Menstrual patterns and characteristics from levonorgestrel implants user can help clinicians to reduce discontinuation rate from the acceptors. Further research should be conducted to know other side effects aside from menstrual bleeding patterns.

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Serum levonorgestrel concentration and cervical mucus viscosity after six months of monoplant® implantation

Cited by 4 publications

References 22 publications

A novel intravaginal ring to prevent HIV-1, HSV-2, HPV, and unintended pregnancy

A novel intravaginal ring to prevent HIV-1, HSV-2, HPV, and unintended pregnancy

Clinical Pharmacology of Hormonal Emergency Contraceptive Pills

Menstrual Pattern and Characteristics of One-Rod and Two-Rod Levonorgestrel Implant Users

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