What is it about?
This paper provides the most recent update on trends in contraceptive use in Ireland and its co-prescribing practices with important interacting medications, including antiepileptic drugs.
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Why is it important?
Combined oral contraceptive (COC) use remains highly prevalent compared to the more effective long-acting reversible contraceptives. The are also highly susceptible to metabolic drug interactions, capable of altering therapeutic levels and reducing clinical effectiveness of both hormonal contraceptives and important interacting medications. It is vital to maintain good pharmacological knowledge of such possible drug interactions to ensure optimal co-prescribing practices. This is especially true of antiepileptic medications. 94% of patients on enzyme-inducing antiepiletic medications were co-prescribed ineffective contraception. Third and fourth generation combined oral contraceptives, which carry a higher risk of venous thromboembolism (VTE) compared with second generation COCs, were most frequently co-prescribed enzyme inhibitors, potentiating their VTE risk further.
Perspectives
This paper highlights the importance of maintaining optimal pharmacological knowledge of important metabolic drug interactions involving hormonal contraceptives. Due to their clinical and cost effectiveness, we should endeavour to address the barriers to the low uptake of long acting reversible contraceptives.
Dr Laura O'Mahony
Read the Original
This page is a summary of: Hormonal contraceptive use in Ireland: trends and co-prescribing practices, British Journal of Clinical Pharmacology, October 2015, Wiley,
DOI: 10.1111/bcp.12755.
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