175 - Hormonal Harmony: A Pharmacist’s Guide to Hormonal Contraceptives (Part 1)

HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast

Sean P. Kane, PharmD, BCPS

Health & Fitness, Medications, Rosalindfranklin, Rfums, Pharmacy, Pharmd, Pharmacist, Medicine, Drugs

5 • 644 Ratings

🗓️ 13 December 2023

⏱️ 45 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

In this two part episode, we review some of the most important clinical pearls in the pharmacotherapy and practice aspects of hormonal contraceptives with a brief focus on the very first FDA approved OTC hormonal contraceptive product (Opill).

Key Concepts (Part 1)

The effectiveness of contraceptives varies based on “ideal use” (e.g. in a clinical trial with optimal compliance) versus “typical use” (e.g. real-world effectiveness in patients who may sometimes be less adherent than in clinical trials). Oral, patch, and ring-based hormonal contraceptives (combination estrogen-progestin or progestin-only formulations) with “typical” use are about ~90% effective, meaning in one year there are ~10 unplanned pregnancies with these contraceptive options.
When using an estrogen-based oral contraceptive, the estrogen dose should be initiated at a low dose (25 mcg or less per day of ethinyl estradiol). The dose of estrogen may need to be increased if breakthrough bleeding occurs in the early/mid cycle despite being on therapy for at least 6 months.
Breakthrough bleeding later in the cycle is typically due to an inadequate progestin dose. In general, manufacturers do not provide multiple different formulations with different progestin doses; therefore, if late breakthrough does occur, an alternative formulation with a different progestin should be considered.
If a patient misses one dose of a combination oral contraceptive, they should take the missed dose as soon as possible (even taking two doses at once if they remember when the next dose is due). If two or more doses are missed, the package insert should be consulted for instructions – management depends on the timing of the cycle, recency of unprotected sex, and other factors.

References

CDC Selected Practice Recommendations for Contraceptive Use. 2016. https://www.cdc.gov/mmwr/volumes/65/rr/rr6504a1.htm?s_cid=rr6504a1_w#B-1-1_down
CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use. 2016. https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.html

Transcript

Click on a timestamp to play from that location

0:00.0	Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions.
0:11.0	This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy.
0:17.0	This podcast contains general information for educational purposes only. This is not professional
0:22.4	advice and should not be used in lieu of obtaining advice from a qualified health care provider.
0:27.2	And now on to the show. Welcome to Helix Talk, episode 175. I'm your co-host, Dr. Kane.
0:37.0	And I'm Dr. Patel. And the title of today's episode is
0:40.0	Hormonal Harmony, a Pharmacist's Guide to Hormonal Controception. And in this two-part episode, yes,
0:45.9	we have part one, part two. We're going to review some of the most important clinical pearls in
0:50.8	pharmacotherapy and all the important practice aspects of hormonal contraceptive.
0:55.9	And we're also going to discuss just a tidbit brief information about the most recently FDA
1:01.6	approved over-the-counter hormonal contraceptive product called OPEL.
1:05.7	As we said, this is a two-part episode, and we're really excited about it, especially because we are joined by two special guests today.
1:13.8	We have Dr. Nicholas Super, who is an amatory care pharmacist who works at the Women's Health Clinic at Heinz, VA.
1:20.7	He has about 13 years of experience working in women's health area.
1:24.2	And we also have Dr. Danielle Candelario with us again. She's an associate professor
1:29.2	and colleague at the College of Pharmacy who teaches hormonal contraceptive pharmacotherapy to our
1:33.8	students. She's also practicing pharmacist at the Lake County Health Department in Illinois. So
1:40.4	welcome to both of you, Dr. Super and Dr. Cand Kendallario. We're so grateful to have your expertise today.
1:46.0	Thanks for having us.
1:47.2	It's a pleasure to be here.
1:48.0	Thanks so much.
1:49.8	You know, kind of segueing on a previous episode, episode 145, we actually talked about an Illinois
	...

Please login to see the full transcript.

Previous episode | Next episode

Disclaimer: The podcast and artwork embedded on this page are from Sean P. Kane, PharmD, BCPS, and are the property of its owner and not affiliated with or endorsed by Tapesearch.

Generated transcripts are the property of Sean P. Kane, PharmD, BCPS and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.