oral contraceptive , definition , before prescribing it , how to use other uses , products in the pharmacy , side effects , drug interactions , contraindications .

2.  Oral contraceptives (the pill) are hormonally
active pills which are
usually taken by women on a daily basis.
 They contain either two hormones combined
(progesterone and estrogen) or a single
hormone (progesterone).

3.  Estrogen and Progesterone causes feedback
inhibition of FSH & LH secretion from the pituitary
gland to inhibit ovulation .
 Thickening the cervical mucous to prevent the entry
of sperm .
 endometrial atrophy ( thinning the lining of the
uterus ) so it cannot support a fertilized egg.

5. Monophasic pills
Biphasic pills
Mini pills

6.  Constant Dose of both estrogen and progestin.
 in each of the hormonally active pills throughout
the entire cycle , 21 days of ingesting active
pills .

7.  contain 2 different progesterone doses.
 The progesterone dose is increased about
halfway through the cycle.

8.  contain progestin without estrogen.
 This type of pill is also called Progestin-only
pills .
 Progestin-only pills may be a good choice for
women who can’t take estrogen for health or
other reasons.

9.  The medicine is given only by prescription
from the doctor.
But some pharmacists in some pharmacies do
not stick to this.
 They give this medication as OTC drug

10.  Through our visit to various pharmacies, we
noticed that pharmacists within various
pharmacies are covered in the way they treat
patients.
 Some pharmacists ask the patient whether he
has any other diseases or is he a smoker and I
explain the correct way to give medicine and
some pharmacists only sell the medicine
without doing anything else.

11.  History & GPE .
 H/O headache, migraine
 H/O amenorrhea
 Family H/O Breast Cancer
 Breast Examination : any nodule etc.
 Pelvic Examination
 Rule out Pregnancy.
 Cervical Cytology : smear examination ; any
abnormal cells .

12.  Laboratory tests
 The use of contraceptive steroids may
influence the results of certain laboratory
tests, including biochemical parameters of
liver, thyroid, adrenal and renal function,
plasma levels of (carrier) proteins.
 Changes generally remain within the normal
laboratory range.

13.  Regulation of menstrual cycle
 Protection against iron deficiency anemia.
 Polycystic ovarian syndrome (PCOS)
 Amenorrhea
 Menstrual cramps
 Premenstrual syndromes
 Primary ovarian insufficiency (POI)

14.  Start on the 1st 5 days of the cycle regularly
every day.
 1 tab daily at same time – 21 days (21
ACTIVE PILLS)
 21 days on , 7 days off

15.  THE 21 DAY PACK
› the first seven pills in a packet inhibit ovulation
› the remaining 14 pills maintain anovulation.

16.  THE 28 DAY PACK
 1 tab daily at same time – 21 days (21
ACTIVE PILLS)
7 (INACTIVE PILLS)- iron or vitamin
preparations.

17.  One pill.
 No problem.
 Take the missed pill immediately.
 2 pills or more.
› Take the pills
› Backup methods should be used.
› Emergency contraception if sexual intercourse
was occurred in preceding 7 days.

18.  frequently referred to as
› “The Morning After Pill”
 Increased doses of Combined Oral
Contraceptive(COC) Pills
 High doses of Progestogen-only Oral
Contraceptive (POC) Pills

19.  ethinylestradiol
0.035mg
 cyproterone acetate
2mg
 Price : 4.02JD
 Drospirenone 3mg
 ethinylestradiol
0.030mg
 Price : 5.53JD

20.  levonorgestrel 0.15mg
 ethinylestradiol
0.030mg
 Price: 1.37 JD
 drospirenone
ph.Eur3mg
 ethinylestradiol
ph.EUR 0.035mg
 Price: 4.25 JD

21.  Estrogen fixed dose throughout the cycle
with doubled dose of progestin in the 2nd.
Half of the cycle.
 Progestin : low in first 10 days , higher in
next 11 days .

22.  Content :
7 Blue tab : 25mg
desogestrel , 40mg
ethinylestradiol .
15 tab : 125 mg
desogestrel , 30mg
ethinylestradiol ,

23.  One tablet is to be taken daily for 22
consecutive days, starting with the blue
tablets for 7 days, followed by the white
tablets for 15 days.

24.  Contents:
11 White tab :
2 mg estradiol
10 Pink tab :
2mg estradiol ,
1mg cyproterone

25.  indicated for the treatment of disorders
resulting from oestrogen deficiency
associated with menopause.
 It is prescribed as a hormone replacement
therapy (HRT).
 indicated for the prevention of menopause
related osteoporosis in women with
increased risk of fracture .

26.  This treatment consists of 1 tablet per day
for 21 days, to be taken without interruption
in the following order: take 1 white tablet
each day for 11 days, then 1 pink tablet each
day for the next 10 days. You will then
observe a day break in pill taking .

28.  Progestin-only pills
 No Estrogen compounds
 Suitable when breast feeding.
 Suitable when EE is contraindicated.
 Prescribed in patients having medical
disorders – hypertension , fibroid ,diabetes ,
epilepsy , smoking, h/o thromboembolism .

29.  Content desogestrel 75 microgram tab
 When you finish a pack start the next pack
straight away without having a break. This
means you'll be taking one tablet every day
all the time, including when you're having a
period.


30.  Visqnne
 Price :
 2mg dienogest
 Androcur
 Price : 5.23jd
 10mg cyproterone

31.  INCREASES THE EFFICACY
OF:
› BETA BLOCKERS
› CORTICOSTEROIDS
› DIAZEPAM
 REDUCES THE EFFICACY
OF:
› ASPIRIN
› ORAL ANTICOAGULANTS
› ORAL HYPOGLYCEMICS
 they impair absorption of
ethinyl estradiol :
› Vitamin supplements
› antibiotics
› Anti HIV drug
› Anti fungal medication
 Anti seizures drugs

32.  Minor complications :
 NAUSEA,
 VOMITING,
 HEADACHE
 LEG CRAMPS
 weight gain
› use of low dose COCs
do not cause any weight
gain.
 Mastalgia
 Breast tenderness
 Acne
 Menstrual abnormalities
 Bleeding …
› hormone levels
 Mood changes
 Missed period
 Vaginal discharge
 migraine

33.  Major complications :
 Deep vein thrombosis .. Varicose
 Heart attack
 Stroke
 Pulmonary embolism
 Cardiac problem
 Cervical cancer
 Change lipid profile
 Jaundice

34.  < 6 months postpartum if breastfeeding
 Smoker over the age of 35
› (≥ 15 cigarettes per day)
 Hypertension (systolic ≥ 160mm Hg or diastolic
≥100mm Hg)
 Current or past history of venous
thromboembolism(VTE)
 Breast cancer
 Diabetes with
retinopathy/nephropathy/neuropathy
 Severe cirrhosis