Oral Contraceptives I Flashcards
Anticonvulsants interaction
Induced metabolism
Decreased efficacy
Colesevelam interaction
Reduced absorption
Decreased efficacy
Corticosteroids interaction
OCs inhibit metabolism of steroids so increased side effects
Penicillins, Tetracyclines interaction
Alters flora, reducing circulation of estrogen
Decreased efficacy and
St. John’s Wort
Induce metabolism
Decreased efficacy
Theophyline
OCs decrease clearance so increased theophylline side effects
Who should use the Minipill?
Unable to tolerate estrogen therapy
Contraindicated to estrogen therapy
Progestin only missed one dose
Take 2 tabs as soon as you remembered
Wk1: use back up
Wk2: no
Progestin only missed 2-4 doses
Take 2 tablets daily for 2 days only, then take pills as usual
Use back up if wk1/2; start over if wk 3
Traditional start for all
1st Sunday after start of menses with back up OR
1st day of menses without back up
Quick start method
Start the day of the office visit if negative urine prego test and use 7 day back up
Will delay your period
COC Missed 1 dose
Take immediately and take next dose at normal time
COC Missed 2 dose in the first 2 weeks
Take 2 for 2 days then resume regular schedule
Use backup for 7 days
COC missed 2 doses in the third week or 3 or more missed doses
Take one daily until sunday and then start a new pack
7 day back up
Common ADRs
Hair growth Breakthrough bleeding Flow changes Breast tenderness Vaginal irritation N/V/D/Constipation Cramps Appetite changes Weight gain Acne
Breakthrough bleeding
Usually resolved after 3rd/4th cycle
Breakthrough Bleeding Management
Ensure compliance
Rule out causes
Possible pharmacological adjustments (increase strength or different drug)
ACHES stands for
Ab pain Chest pain Headaches Eye probelms Severe leg pain
New Patient counseling
Written and verbal AE and ACHES No protection: STDs and HIV Quick start method Compliance and missed dose Drug interactions
Contraindications
CV Liver Heavy smoker Breast cancer Headaches
Drospirenone
Increases the risk of VTE or blood clotting but need more studies
