COMPARISON OF ADVERSE DRUG REACTIONS OF SECOND- AND THIRD-GENERATION ORAL CONTRACEPTIVES

Kartika Citra Dps; Retnosari Andrajati; Sudibyo Supardi

doi:10.22159/ajpcr.2017.v10s5.23116

Authors

Kartika Citra Dps Department of Pharmacy, Faculty of Pharmacy, University Indonesia, Jakarta, Indonesia.
Retnosari Andrajati Institution of Health Research and Development, Ministry of Health Republic of Indonesia, Jakarta, Indonesia.
Sudibyo Supardi Institution of Health Research and Development, Ministry of Health Republic of Indonesia, Jakarta, Indonesia.

DOI:

https://doi.org/10.22159/ajpcr.2017.v10s5.23116

Keywords:

Oral contraceptive, Levonorgestrel, Desogestrel, Adverse drug reaction

Abstract

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Â Objective: Oral contraceptives are the second-most widely used contraceptives in Indonesia; however, a high percentage rate of withdrawal is seen owing to adverse drug reactions (ADRs). Only a small proportion of users have been provided information about other oral contraceptives such as newer generation progestin as an alternative option to minimize ADR. This study aimed to compare the prevalence of ADR between combined oral contraceptives containing levonorgestrel (LNG) (second generation) and desogestrel (DSG) (third generation), which was expected to have less side effects.

Methods: The study has a cross-sectional comparative design with random sampling from users in six villages in Depok City, Indonesia. Data were collected through interviews. The sample includes 60 users of LNG and 40 users of DSG.

Results: ADR complaints include intermenstrual bleeding (16.7% vs. 5%), headache (16.7% vs. 5%), nausea/vomiting (25% vs. 0%), breast tenderness (13.3% vs. 0%), impaired sexual intercourse (23.3% vs. 7.5%), weight gain (35% vs. 22.5%), acne (3.3% vs. 7.5%), and face spots/chloasma (28.3% vs. 5%). The LNG group showed significantly higher impaired sexual intercourse (odds ratio (OR): 3.75, 95% confidence interval (CI): 1.003-14.050, p=0.039) and chloasma (OR 7.51, 95% CI: 1.629-34.647, p=0.004).

Conclusion: Users' low knowledge of ADR and how to treat it could be a reason for drug withdrawal. Pharmacies must make efforts to provide counseling in this regard.

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References

Grossman Barr N. Managing adverse effects of hormonal contraceptives. Am Fam Physician 2010;82(12):1499-506.

Indonesian Statistic Center. Indonesia Demographic and Health Survey 2012. Jakarta: Indnesian Statistic Center; 2013.

Dragoman MV. The combined oral contraceptive pill -- Recent developments, risks and benefits. Best Pract Res Clin Obstet Gynaecol 2014;28(6):825-34.

Lawrie TA, Helmerhorst FM, Maitra NK, Kulier R, Bloemenkamp K, GÃ¼lmezoglu AM. Types of progestogens in combined oral contraception: Effectiveness and side-effects. Cochrane Database Syst Rev 2011;5:CD004861.

Maitra N, Kulier R, Bloemenkamp KW, Helmerhorst FM, GÃ¼lmezoglu AM. Progestogens in combined oral contraceptives for contraception review. Library (Lond) 2007;4:CD004861.

Kuhl H. Pharmacology of progestogen. J Reprod Med Endocrinol 2011;8(1):157-77.

Bitzer J, Simon JA. Current issues and available options in combined hormonal contraception. Contraception 2011;84(4):342-56.

Faculty of Sexual and Reproductive Healthcare. Statement from the Clinical Effectiveness Unit Meta-Analysis of Different Combined Oral Contraceptives and the Risk of Venous Thrombosis. London: The Royal College of Obstetricians and Gynecologist; 2013.

Foster DG, Parvataneni R, de Bocanegra HT, Lewis C, Bradsberry M, Darney P. Number of oral contraceptive pill packages dispensed, method continuation, and costs. Obstet Gynecol 2006;108(5):1107-14.

Roberts H. Combined oral contraceptive : Issues for current users. Best Pract J 2012;12:21-9.

Centers for Disease Control and Prevention. U.S. Selected practice recommendations for contraceptive use, 2013: Adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd Edition. MMWR Recomm Rep 2013;62(RR- 05):1-60.

Schrager S. Abnormal uterine bleeding associated with hormonal contraception. Am Fam Physician 2002;65(10):2073-80.

Sabatini R, Cagiano R. Comparison profiles of cycle control, side effects and sexual satisfaction of three hormonal contraceptives. Contraception 2006;74(3):220-3.

Brynhildsen J. Combined hormonal contraceptives: Prescribing patterns, compliance, and benefits versus risks. Ther Adv Drug Saf 2014;5(5):201-13.

Martin VT. Ovarian hormones and pain response: A review of clinical and basic science studies. Gend Med 2009;6 Suppl 2:168-92.

Harris M, Kaneshiro B. An evidence-based approach to hormonal contraception and headaches. Contraception 2009;80(5):417-21.

Loder EW, Buse DC, Golub JR. Headache as a side effect of combination estrogen-progestin oral contraceptives: A systematic review. Am J Obstet Gynecol 2005;193(3):636-49.

Merki-Feld GS, Imthurn B, Langner R, Seifert B, Gantenbein AR. Positive effects of the progestin desogestrel 75 Î¼g on migraine frequency and use of acute medication are sustained over a treatment period of 180 days. J Headache Pain 2015;16(1):522.

Van Thiel DH, Gavaler JS, Stremple J. Lower esophageal sphincter pressure in women using sequential oral contraceptives. Gastroenterology 1976;71(2):232-4.

Liu CY, Chen LB, Liu PY, Xie DP, Wang PS. Effects of progesterone on gastric emptying and intestinal transit in male rats. World J Gastroenterol 2002;8(2):338-41.

Whitehead WE, Palsson OS. Hormones and Irritable Bowel Syndrome; 2015. Available from: http://www.med.unc.edu/IBS; https://www.med. unc.edu/ibs/files/educational-gi-handouts/IBS and Hormones.pdf.

Hirschberg AL. Sex hormones, appetite and eating behaviour in women. Maturitas 2012;71(3):248-56.

Bonny AE, Ziegler J, Harvey R, Debanne SM, Secic M, Cromer BA. Weight gain in obese and nonobese adolescent girls initiating depot medroxyprogesterone, oral contraceptive pills, or no hormonal contraceptive method. Arch Pediatr Adolesc Med 2015;160(1):40-5.

Wiebe ER, Brotto LA, MacKay J. Characteristics of women who experience mood and sexual side effects with use of hormonal contraception. J Obstet Gynaecol Can 2011;33(12):1234-40.

Wiebe E, Kaczorowski J, Mackay J. Mood and sexual side effects of hormonal contraception: Physiciansâ€™ and residentsâ€™ knowledge, attitudes, and practices. Can Fam Physician 2012;58(11):e677-83.

Shahnazi M, Farshbaf Khalili A, Ranjbar Kochaksaraei F, Asghari Jafarabadi M, Gaza Banoi K, Nahaee J, et al. A comparison of second and third generations combined oral contraceptive pillsâ€™ effect on mood. Iran Red Crescent Med J 2014;16(8):e13628.

Feskanich D, Hunter DJ, Willett WC, Spiegelman D, Stampfer MJ, Speizer FE, et al. Oral contraceptive use and risk of melanoma in premenopausal women. Br J Cancer 1999;81(5):918-23.

Ortonne JP, Arellano I, Berneburg M, Cestari T, Chan H, Grimes P, et al. A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma. J Eur Acad Dermatol Venereol 2009;23(11):1254-62.

Smith AG, Shuster S, Thody AJ, Peberdy M. Chloasma, oral contraceptives, and plasma immunoreactive beta-melanocyte-stimulating hormone. J Invest Dermatol 1977;68(4):169-70.

Wiedemann C, NÃ¤gele U, Schramm G, Berking C. Inhibitory effects of progestogens on the estrogen stimulation of melanocytes in vitro. Contraception 2009;80(3):292-8.