Review of newer oral contraceptives: Medicinewise advice for health professionals

NPS MedicineWise is advising health professionals to weigh patient needs against the possible increased risk of venous thromboembolism (VTE) when considering combined oral contraceptives (OCs) containing new generation progestogens.

In response to new data indicating that some newer (oral) contraceptives carry a higher risk of VTE than older drugs, the Therapeutic Goods Administration (TGA) has announced a review of combined OCs containing new-generation and anti-androgenic progestogens.

As the TGA monitors the risk of VTE and conducts a review of the safety information available, NPS MedicineWise clinical advisor Andrew Boyden says health professionals should consider the risks in light of their patients’ individual circumstances and educate consumers to recognise the signs and symptoms of VTE.

“It is well established that oral contraceptives carry a small risk of VTE - much lower than the risk of VTE during pregnancy and during the postpartum period,” says Dr Boyden.

“The risk will differ according to the generation of combined oral contraceptive, and increasingly evidence suggests that oral contraceptives containing newer synthetic progestogens carry a higher risk of VTE.”.

“So when choosing an oral contraceptive, or when considering Diane-35 or its generics for the treatment of acne, health professionals should weigh the risks of VTE against the clinical needs of their patients and take care especially in women with risk factors for venous or arterial thrombosis including obesity or smoking.–.”

Whilst the TGA and the European Medicines Agency (EMA) have both announced reviews of new generation combined OCs, NPS MedicineWise says at this time there is generally no need to discontinue use in patients who have not experienced any adverse medicines events,”

“Health professionals are encouraged to talk to their patients about the possible increased risk of VTE with newer oral contraceptives but says Dr Boyden.

“Educating your patients to recognise the signs and symptoms of VTE is an important step in managing the potential risks associated with oral contraceptives.

An article about the review of new-generation and anti-androgenic progestogen OCs appears in this month’s NPS Direct e-newsletter, written by NPS MedicineWise and distributed free to health professionals. To subscribe visit www.nps.org.au/nps-direct

For more information on prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and minerals) from a health professional, patients can call NPS Medicines Line on 1300 MEDICINE (1300 633 424) . Hours of operation are Monday–Friday 9am–5pm AEST (excluding public holidays).

ENDS

Independent, evidence-based and not-for-profit, NPS MedcineWise enables better decisions about medicines and medical tests. We are funded by the Australian Government Department of Health and Ageing.

Media enquiries: Stephanie Childs on 02 8217 8667, 0419 618 365 or schilds@nps.org.au