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Oral Contraceptives

Are Drug Interactions of Clinical Significance?

  • Review Article
  • Drug Experience
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Summary

There is a large quantity of literature on drug interactions with oral contraceptive (OC) steroids although their incidence is not known. The potential clinical significance of some interactions makes it important for all prescribing doctors and dentists to have some knowledge of the topic.

Interactions may be divided into those in which OC effectiveness is impaired, causing breakthrough bleeding or pregnancy, those in which OC activity is enhanced by other drugs and those in which OCs interfere with the metabolism or activity of other therapeutic agents.

Consideration of their pharmacology indicates that impairment of OC effect is most likely to be due to interference with ethinylestradiol. This is because this compound is sulphated in the gut wall, hydroxylated and glucuronidated in the liver, and undergoes enterohepatic recirculation. The progestogens are only metabolised in the liver and have no significant enterohepatic recirculation. Protein binding interactions are rarely of clinical importance.

OC plasma concentrations may be reduced by induction of hepatic metabolism in the case of griseofulvin, rifampicin (rifampin) and several anticonvulsant drugs; valproic acid (sodium valproate) does not have this effect. Antibiotics may interfere with enterohepatic recirculation of ethinylestradiol and reduce plasma levels of active hormone. This is probably only of significance in a subgroup of women who may sometimes be suspected on history, but cannot be identified by any diagnostic test. Reasons for differences between case reports and formal studies of interactions with antibiotics are discussed.

Plasma concentrations of ethinylestradiol may be increased by ascorbic acid (vitamin C) and paracetamol (acetaminophen) which compete with it for sulphation in the gut wall. Theoretically, problems may arise if these agents are stopped suddenly. Imidazole antifungal agents can inhibit ethinylestradiol metabolism and increase its plasma concentrations but the clinical significance of this is unknown.

OCs have been shown to inhibit metabolism of many therapeutic drugs and increase their plasma concentrations. This may be of clinical significance in the case of benzodiazepines which are hydroxylated in the liver, but clinical effects are less certain with the other agents. OCs may induce metabolism of other drugs which are glucuronidated, including some benzodiazepines and analgesics. The clinical significance of this type of interaction is also unknown.

It is suggested that all prescribers should remember to ask about OCs when taking a drug history and to consider the possibility of interactions with other drugs.

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References

  • Abernethy DR, Greenblatt DJ. Impairment of antipyrine metabolism by low-dose oral contraceptive steroids. Clinical Pharmacology and Therapeutics 29: 106–110, 1981

    Article  PubMed  CAS  Google Scholar 

  • Abernethy DR, Greenblatt DJ, Ochs HR, Weyers D, Divoll M, et al. Lorazepam and oxazepam kinetics in women on low-dose oral contraceptives. Clinical Pharmacology and Therapeutics 33: 628–632, 1983

    Article  PubMed  CAS  Google Scholar 

  • Abernethy DR, Greenblatt DJ, Shader RI. Imipramine disposition in users of oral contraceptive steroids. Clinical Pharmacology and Therapeutics 35: 792–797, 1984

    Article  PubMed  CAS  Google Scholar 

  • Amatayakul K, Uttaravachai C, Singkamani R, Ruckphaopunt S. Vitamin metabolism and the effects of multivitamin supplementation in oral contraceptive users. Contraception 30: 179–196, 1984

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Bates M, Bowden A, Breckenridge AM, Hall MJ. The interaction of phenobarbital and other anticonvulsants with oral contraceptive steroid therapy. Contraception 22: 495–503, 1980a

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Bates M, Breckenridge AM, Hall JM, MacIver M, et al. The pharmacokinetics of levonorgestrel and ethinylestradiol in women — studies with Ovran and Ovranette. Contraception 23: 229–239, 1981a

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Breckenridge AM, Crawford FE. An investigation of the pharmacokinetics of ethinylestradiol in women using radioimmunoassay. Contraception 20: 263–273, 1979

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Breckenridge AM, Crawford FE, MacIver M, Orme ML’E, et al. The pharmacokinetics of norethindrone in women (1): radioimmunoassay and concentrations during multiple dosing. Clinical Pharmacology and Therapeutics 24: 439–447, 1978

    PubMed  CAS  Google Scholar 

  • Back DJ, Breckenridge AM, Crawford FE, McIver M, Orme ML’E. Reduction of the enterohepatic circulation of norethisterone by antibiotics in the rat: correlation with changes in the gut flora. Journal of Steroid Biochemistry 13: 95–100, 1980b

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Breckenridge AM, Grimmer SF, Orme ML’E, Purba HS. Pharmacokinetics of oral contraceptive steroids following the administration of the antimalarial drugs primaquine and chloroquine. Contraception 30: 289–295, 1984a

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Breckenridge AM, MacIver M, Orme ML’E, Purba H, et al. Interaction of ethinyloestradiol with ascorbic acid in man. British Medical Journal 282: 1516, 1981b

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Breckenridge AM, MacIver M, Orme ML’E, Purba HS, et al. The gut wall metabolism of ethinloestradiol and its contribution to the presystemic metabolism of ethinyloestradiol in human. British Journal of Clinical Pharmacology 13: 325–330, 1982a

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Breckenridge AM, MacIver M, Orme ML’E, Rowe PH, et al. The effects of ampicillin on oral contraceptive steroids in women. British Journal of Clinical Pharmacology 14: 43–48, 1982b

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Breckenridge AM, Orme ML’E. Drug interactions involving oral contraceptive steroid therapy. In Petrie & Cluff (Eds) Clinically important adverse drug interactions, Vol. 2, pp. 305–307, Elsevier, Amsterdam, 1984b

    Google Scholar 

  • Back DJ, Grimmer SFM, Orme ML’E, Proudlove C, Mann RD, et al. Evaluation of Committee on Safety on Medicines yellow card reports on oral contraceptive-drug interactions with anticonvulsants and antibiotics. British Journal of Clinical Pharmacology 25: 527–532, 1988

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Madden S, Orme ML’E. Gastrointestinal metabolism of contraceptive steroids. American Journal of Obstetrics and Gynecology 163: 2138–2145, 1990

    PubMed  CAS  Google Scholar 

  • Back DJ, Tjia J, Martin C, Millar E, Mant T, et al. The lack of interaction between temafloxacin and combined oral contraceptive steroids. Contraception 43: 317–323, 1991a

    Article  PubMed  CAS  Google Scholar 

  • Back DJ, Tjia J, Martin C, Millar E, Salmon P, et al. The interaction between clarithromycin and combined oral-contraceptive steroids. Journal of Pharmacy and Medicine 2: 81–87, 1991b

    Google Scholar 

  • Boehm FH, DiPietro DL, Goss DA. The effect of ampicillin administration on urinary estriol and serum estradiol in the normal pregnant patient. American Journal of Obstetrics and Gynecology 119: 98–103, 1974

    PubMed  CAS  Google Scholar 

  • Boekenoogen SJ, Szefler SJ, Jusko WJ. Prednisolone disposition and protein binding in oral contraceptive users. Journal of Clinical Endocrinology and Metabolism 56: 702–709, 1983

    Article  PubMed  CAS  Google Scholar 

  • Bolt HM, Bolt M, Kappus H. Interaction of rifampicin treatment with pharmacokinetics and metabolism of ethinyloestradiol in man. Acta Endocrinologica 85: 189–197, 1977

    PubMed  CAS  Google Scholar 

  • Bolt WH, Kappus H, Bolt HM. Ring A oxidation of 17α-ethinylestraediol in man. Hormone and Metabolism Research 6: 432, 1974

    Article  CAS  Google Scholar 

  • Bowman WC, Rand MJ. Textbook of pharmacology, 2nd ed., pp. 26, Blackwell Scientific Publications, Oxford, 1980

    Google Scholar 

  • Breckwoldt M, Wieacker P, Geisthovel F. Oral contraception in disease states. American Journal of Obstetrics and Gynecology 163: 2213–2215, 1990

    PubMed  CAS  Google Scholar 

  • Carter DE, Goldman JM, Bressler R, Huxtable RJ, Christian CD, et al. Effect of oral contraceptives on drug metabolism. Clinical Pharmacology and Therapeutics 15: 22–31, 1974

    PubMed  CAS  Google Scholar 

  • Chalmers JS, Fulli-Lemaire I, Cowen PJ. Effects of the contraceptive pill on sedative responses to clonidine and apomorphine in normal women. Psychological Medicine 15: 363–367, 1985

    Article  PubMed  CAS  Google Scholar 

  • Cockburn IT, Krupp P. An appraisal of drug interactions with Sandimmun. Transplant Proceedings 21: 3845–3850, 1989

    CAS  Google Scholar 

  • Cote J. Interaction of griseofulvin and oral contraceptives. Journal of the American Academy of Dermatology 22: 124–125, 1990

    Article  PubMed  CAS  Google Scholar 

  • Crawford FE, Back DJ, Orme ML’E, Breckenridge AM. Oral contraceptive steroid plasma concentrations in smokers and nonsmokers. British Medical Journal 282: 1829–1830, 1981

    Article  PubMed  CAS  Google Scholar 

  • Crawford P, Chadwick D, Cleland P, Tjia J, Cowie A, et al. The lack of effect of sodium valproate on the pharmacokinetics of oral contraceptive steroids. Contraception 3: 23–29, 1986

    Article  Google Scholar 

  • Crawford P, Chadwick DJ, Martin C, Tjia J, Back DJ, et al. The interaction of Phenytoin and carbamazepine with combined oral contraceptive steroids. British Journal of Clinical Pharmacology 30: 892–896, 1990

    Article  PubMed  CAS  Google Scholar 

  • Dada OA, Martens OO. Drug effects on the intestinal absorption of estrogens. Journal of Steroid Biochemistry 19: 821–825, 1983

    Article  PubMed  CAS  Google Scholar 

  • Devenport MH, Crook D, Wynn V, Lees LJ. Metabolic effects of low-dose fluconazole in healthy female users and non-users of ora. contraceptives. British Journal of Clinical Pharmacology 27: 851–859, 1989

    Article  PubMed  CAS  Google Scholar 

  • de Groot AC, Eshuis H, Stricker BH. Oral contraceptives and antibiotics in acne. British Journal of Dermatology 124: 212, 1991

    Article  PubMed  Google Scholar 

  • Dibbelt L, Knuppen R, Jütting G, Heimann S, Klipping CO, et al. Group comparison of serum ethinyl oestradiol, SHBG and CBG levels in 83 women using two low-dose combination oral contraceptives for three months. Contraception 43: 1–21, 1991

    Article  PubMed  CAS  Google Scholar 

  • Donley TG, Smith RF, Roy B. Reduced oral contraceptive effectiveness with concurrent antibiotic use: a protocol for prescribing antibiotics to women to childbearing age. Compendium Continuing Education Dentistry 11: 392–396, 1990

    CAS  Google Scholar 

  • Editorial. Starting oral contraceptives — which, when and how? Drug and Therapeutics Bulletin 30: 41–44, 1992

  • Eedy DJ, Burrows D. Minocycline-induced pigmentation occuring in two sisters. Clinical and Experimental Dermatology 16: 55–57, 1991

    Article  PubMed  CAS  Google Scholar 

  • Ellinwood EH, Easler ME, Linnoila M, Molter DW, Heatherly DG, et al. Effects of oral contraceptives on diazepam-induced psychomotor impairment. Clinical Pharmacology and Therapeutics 35: 360–366, 1984

    Article  PubMed  CAS  Google Scholar 

  • Fazio A. Caffeine, oral contraceptives, and over-the-counter drugs. Correspondence. Archives of Internal Medicine 149: 1217–1222, 1989

    Article  CAS  Google Scholar 

  • Fleischer AB, Resnick SD. The effect of antibiotics on the efficacy of oral contraceptives: a controversy revisited. Archives of Dermatology 125: 1562–1564, 1989

    Article  PubMed  Google Scholar 

  • Fotherby K. Interactions with oral contraceptives. American Journal of Obstetrics and Gynecology 163: 2153–2159, 1990

    PubMed  CAS  Google Scholar 

  • Fotherby K. Intrasubject variability in the pharmacokinetics of ethinyloestradiol. Journal of Steroid Biochemistry 38: 733–736, 1991

    Article  CAS  Google Scholar 

  • Fraser IS, Jansen RP. Why do inadvertent pregnancies occur in oral contraceptive users? Effectiveness of oral contraceptive regimens and interfering factors. Contraception 27: 531–551, 1983

    Article  PubMed  CAS  Google Scholar 

  • Frewin DB, Leonello PP, Frewin ME. Hypertension after ingestion of trimolets. Medical Journal of Australia 2: 497–498, 1978

    PubMed  CAS  Google Scholar 

  • Friedman CI, Huneke AL, Moon KH, Powell J. The effect of ampicillin on oral contraceptive effectiveness. Obstetrics and Gynecology 55: 33–37, 1980

    PubMed  CAS  Google Scholar 

  • Goldbaum GM, Kendrick JS, Hogelin GC, Gentry EM. The relative impact of smoking and oral contraceptive use on women in the United States. Journal of the American Medical Association 258: 1339–1342, 1987

    Article  PubMed  CAS  Google Scholar 

  • Goldzieher JW. Pharmacology of contraceptive steroids: a brief review. American Journal of Obstetrics and Gynecology 160: 1260–1262, 1990

    Google Scholar 

  • Grimmer SFM, Allen WL, Breckenridge AM, Orme M. The effect of cotrimoxazole on oral contraceptive steroids in women. Contraception 28: 53–59, 1983

    Article  PubMed  CAS  Google Scholar 

  • Grimmer SFM, Back DJ, Orme ML’E, Cowie A, Gilmore I. The bioavailability of ethinyloestradiol and levonorgestrel in patients with an ileostomy. Contraception 33: 51–59, 1986a

    Article  PubMed  CAS  Google Scholar 

  • Grimmer SFM, Back DJ, Orme ML’E, Tjia J, Gilmore IT, et al. In vitro conjugation of ethinyloestradiol by coeliac mucosa and its bioavailability in coeliac patients. British Journal of Clinical Pharmacology 22: 217P–218P, 1986b

    Google Scholar 

  • Guengerich PF. Inhibition of oral contraceptive steroid-metabolizing enzymes by steroids and drugs. American Journal of Obstetrics and Gynecology 163: 2159–2163, 1990

    PubMed  CAS  Google Scholar 

  • Gugler R, von Unruh GE. Clinical pharmacokinetics of valproic acid. Clinical Pharmacokinetics 5: 67–83, 1980

    Article  PubMed  CAS  Google Scholar 

  • Hebbard GS, Smith KG, Gibson PR, Bhathal PS. Augmentin-induced jaundice with a fatal outcome. Medical Journal of Australia 156: 285–286, 1992

    PubMed  CAS  Google Scholar 

  • Herz R, Koelz HR, Haemmerli UP, Benes I, Blum AL. Inhibition of hepatic demethylation of aminopyrine by oral contraceptive steroids in humans. European Journal of Clinical Investigation 8: 27–30, 1978

    Article  PubMed  CAS  Google Scholar 

  • Hetenyi G. Possible interactions between antibiotics and oral contraceptives. Therapia Hungarica 37: 86–89, 1989

    PubMed  CAS  Google Scholar 

  • Hobbes J, Boutagy J, Shenfield GM. Interactions between ethanol and oral contraceptive steroids. Clinical Pharmacology and Therapeutics 35: 360–366, 1984

    Article  Google Scholar 

  • Hughes BR, Cunliffe WJ. Interactions between the oral contraceptive pill and antibiotics. British Journal of Dermatology 122: 177, 1990

    Google Scholar 

  • Hümpel M, Täuber U, Kuhnz W, Pfeffer M, Brill K, et al. Comparison of serum ethinyl estradiol, sex-hormone-binding globulin, corticoid-binding globulin and cortisol levels in women using two low-dose combined oral contraceptives. Hormone Research 33: 35–39, 1990

    Article  PubMed  Google Scholar 

  • Hurwitz A. Antacid therapy and drug kinetics. Clinical Pharmacokinetics 2: 269–287, 1977

    Article  PubMed  CAS  Google Scholar 

  • Jochemsen R, Graaf M, van der Boeijinga JP, Breimer DD. Influence of sex, menstrual cycle and oral contraception on the disposition of nitrazepam. British Journal of Clinical Pharmacology 13: 319–324, 1982

    Article  PubMed  CAS  Google Scholar 

  • Joshi JV, Joshi UM, Sankhali GM, Krishna U, Mandlekar A, et al. A study of interaction of low dose combination oral contraceptive with ampicillin and metronidazole. Contraception 22: 643–652, 1980

    Article  PubMed  CAS  Google Scholar 

  • Joshi JV, Sankolli GM, Shah RS, Joshi UM. Antacid does not reduce the bioavailability of oral contraceptive steroids in women. International Journal of Clinical Pharmacology, Therapy and Toxicology 24: 192–195, 1986

    CAS  Google Scholar 

  • Jung-Hoffman C, Kuhl H. Pharmacokinetics and pharmacodynamics of oral contraceptive steroids: factors influencing steroid metabolism. American Journal of Obstetrics and Gynecology 163: 2183–2197, 1990

    PubMed  CAS  Google Scholar 

  • Jusko WJ. Influence of cigarette smoking on drug metabolism in man. Drug and Metabolism Reviews 9: 221–236, 1979

    Article  CAS  Google Scholar 

  • Kanarkowski R, Tornatore KM, D’Ambrosio R, Gardner MJ, Jusko WJ. Pharmacokinetics of single and multiple doses of ethinyl estradiol and levonorgestrel in relation to smoking. Clinical Pharmacology and Therapeutics 43: 23–31, 1988

    Article  PubMed  CAS  Google Scholar 

  • Kendall MJ, Jack DB, Quarterman CP, Smith SR, Zaman R. β-blocker pharmacokinetics and the oral contraceptive pill. British Journal of Clinical Pharmacology 17: 87S–89S, 1984

    Article  PubMed  Google Scholar 

  • Kendall MJ, Quarterman CP, Jack DB, Beeley L. Metoprolol pharmacokinetics and the oral contraceptive pill. British Journal of Clinical Pharmacology 14: 120–122, 1982

    Article  PubMed  CAS  Google Scholar 

  • Khoo SK. Contraceptive efficacy of the Pill. Medical Journal of Australia 150: 548–549, 1989

    PubMed  CAS  Google Scholar 

  • Kovacs GT, Riddoch G, Duncombe P, Welberry L, Chick P. Inadvertent pregnancies in oral contraceptive users. Medical Journal of Australia 150: 549–551, 1989

    PubMed  CAS  Google Scholar 

  • Kuhl, H. Pharmacokinetics of progestogens. In Keller PJ & Sirtori C (Eds) Contraception into the next decade: a preview to the year 2000, pp. 25–31, Parthenon Publishing Group, Carnforth, 1988

    Google Scholar 

  • Kuhl H. Pharmacokinetics of oral contraceptive steroids and drug interactions. American Journal of Obstetrics and Gynecology 163: 2113, 1990

    PubMed  CAS  Google Scholar 

  • Kuhnz W, Back D, Power J, Schutt B, Louton T. Concentration of ethinyl estradiol in the serum of 31 young women following a treatment period of 3 months with two low-dose oral contraceptives in an intraindividual cross-over design. Hormone Research 36: 63–69, 1991

    Article  PubMed  CAS  Google Scholar 

  • Kuhnz W, Hümpel M, Schütt B, Louton T, Steinberg G, et al. Relative bioavailability of ethinyl estradiol from two different oral contraceptive formulations after single oral administration to 18 women in an intraindividual cross-over design. Hormone Research 33: 40–44, 1990

    Article  PubMed  CAS  Google Scholar 

  • Lunell NO, Pschera H, Zador G, Carlstrom K. Evaluation of the possible interactions of the antifungal triazole SCH 39304 with oral contraceptives in normal healthy women. Gynecologic and Obstetric Investigation 32: 91–97, 1991

    Article  PubMed  CAS  Google Scholar 

  • Madden S, Back DJ, Martin CA, Orme ML’E. Metabolism of the contraceptive steroid desogestrel by the intestinal mucosa. British Journal of Clinical Pharmacology 27: 295–299, 1989

    Article  PubMed  CAS  Google Scholar 

  • Maggs JL, Grimmer SFM, Orme ML’E, Breckenridge AM, Park BK, et al. The biliary and urinary metabolites of 3-H-17α-ethinylestradiol in women. Xenobiotica 13: 421–431, 1983

    Article  PubMed  CAS  Google Scholar 

  • Meffin PJ, Wing LMH, Sallustio BC, Brooks PM. Alterations in prednisolone disposition as a result of oral contraceptive use and dose. British Journal of Clinical Pharmacology 17: 655–664, 1984

    Article  PubMed  CAS  Google Scholar 

  • Meyer B, Muller F, Wessels P, Maree J. A model to detect interactions between roxithromycin and oral contraceptives. Clinical Pharmacology and Therapeutics 47: 671–674, 1990

    Article  PubMed  CAS  Google Scholar 

  • Miners JO, Attwood J, Birkett DJ. Influence of sex and oral contraceptive steroids on paracetamol metabolism. British Journal of Clinical Pharmacology 16: 503–509, 1983

    Article  PubMed  CAS  Google Scholar 

  • Miners JO, Grgurinovich N, Whitehead AG, Robson RA, Birkett DJ. Influence of gender and oral contraceptive steroids on the metabolism of salicylic acid and acetylsalicylic acid. British Journal of Clinical Pharmacology 22: 135–142, 1986

    Article  PubMed  CAS  Google Scholar 

  • Miners JO, Robson RA, Birkett DJ. Gender and oral contraceptive steroids as determinants of drug glucuronidation: effects on clofibric acid elimination. British Journal of Clinical Pharmacology 18: 240–243, 1984

    Article  PubMed  CAS  Google Scholar 

  • Mitchell MC, Hanew T, Meredith CG, Schenker S. Effects of oral contraceptive steroids on acetaminophen metabolism and elimination. Clinical Pharmacology and Therapeutics 34: 48–53, 1983

    Article  PubMed  CAS  Google Scholar 

  • Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man. British Medical Journal 283: 503, 1981

    Article  PubMed  CAS  Google Scholar 

  • Murphy AA, Zacur HA, Charache P, Burkman RT. The effect of tetracycline on levels of oral contraceptives. American Journal of Obstetrics and Gynecology 164: 28–33, 1991

    PubMed  CAS  Google Scholar 

  • Neely JL, Abate M, Swinder M, D’Angio R. The effect of doxycline on serum levels of ethinyl estradiol, norethindrone, and endogenous progesterone. Obstetrics and Gynecology 77: 416–420, 1991

    PubMed  CAS  Google Scholar 

  • Nocke-Fink L, Breur H, Reimers D. Effects of rifampicin on the menstrual cycle and on oestrogen excretion in patients taking oral contraceptives. Deutsche Medizinische Wochenschrift 98: 1521–1523, 1973

    Article  Google Scholar 

  • Ochs HR, Greenblatt DJ, Friedman H, Burstein ES, Locniskar BS. Bromazepam pharmacokinetics: influence of age, gender, oral contraceptives, cimetidine and propranolol. Clinical Pharmacology and Therapeutics 41: 562–570, 1987

    Article  PubMed  CAS  Google Scholar 

  • Ochs HR, Greenblatt DJ, Verburg-Ochs B, Harmatz JS, Grehl H. Disposition of clotiazepam: influence of age, sex, oral contraceptives, cimetidine, isoniazid and ethanol. European Journal of Clinical Pharmacology 26: 55–59, 1984

    Article  PubMed  CAS  Google Scholar 

  • Orme ML’E, Back DJ. Interactions between oral contraceptive steroids and broad-spectrum antibiotics. Clinical and Experimental Dermatology 11: 327–331, 1986

    Article  PubMed  CAS  Google Scholar 

  • Orme ML’E, Back DJ. Factors affecting the enterohepatic circulation of oral contraceptive steroids. American Journal of Obstetrics and Gynecology 163: 2146–2152, 1990

    PubMed  CAS  Google Scholar 

  • Orme M, Back DJ. Oral contraceptive steroids-pharmacological issues of interest to the prescribing physician. Advances in Contraception 7: 325–331, 1991

    Article  PubMed  CAS  Google Scholar 

  • Orme ML’E, Back DJ, Breckenridge AM. Clinical pharmacokinetics of oral contraceptive steroids. Clinical Pharmacokinetics 8: 95–136, 1983

    Article  PubMed  CAS  Google Scholar 

  • Orme M, Back DJ, Ward S, Green S. The pharmacokinetics of ethinylestradiol in the presence and absence of gestodene and desogestrel. Contraception 43: 305–316, 1991

    Article  PubMed  CAS  Google Scholar 

  • Oxley J, Hedges A, Makki KA, Monks A, Richens A. Lack of hepatic enzyme inducing effect of sodium valproate. British Journal of Clinical Pharmacology 8: 189–190, 1979

    Article  PubMed  CAS  Google Scholar 

  • Pacifici GM, Viani A, Rizzo G, Carrai M. Plasma protein binding of ethinyloestradiol: effect of disease and interaction with drugs. International Journal of Clinical Pharmacology, Therapy and Toxicology 27: 362–365, 1989

    CAS  Google Scholar 

  • Patwardhan RV, Desmond PV, Johnson RF, Schriber S. Impaired elimination of caffeine by oral contraceptive steroids. Journal of Laboratory and Clinical Medicine 95: 603–608, 1980

    PubMed  CAS  Google Scholar 

  • Rapport DJ, Calabrese JR. Interactions between carbamazepine and birth control pills. Correspondence. Psychosomatics 30: 462–464, 1989

    Article  CAS  Google Scholar 

  • Reimers D, Jezek A. Rifampicin und Andere Antituberkulostatika bei gleichzeitiger oraler Kontrazeption. Praxis Pneumologie 25: 255–262, 1971

    CAS  Google Scholar 

  • Reimers D, Nocke-Fink L, Breuer H. Rifampicin and the ‘pill’ do not go well together. Journal of the American Medical Association 277: 608, 1974

    Google Scholar 

  • Roberts RK, Desmond PV, Wilkinson GR, Schenker S. Disposition of chlordiazepoxide: sex differences and effects of oral contraceptives. Clinical Pharmacology and Therapeutics 25: 826–831, 1979

    PubMed  CAS  Google Scholar 

  • Roberts RK, Grice J, McGuffie C, Heilbronn L. Oral contraceptive steroids impair the elimination of theophylline. Journal of Laboratory and Clinical Medicine 101: 821–825, 1983

    PubMed  CAS  Google Scholar 

  • Rogers SM, Back DJ, Orme ML’E. Intestinal metabolism of ethinyloestradiol and paracetamol in vitro: studies using Ussing chambers. British Journal of Clinical Pharmacology 23: 727–734, 1987a

    Article  PubMed  CAS  Google Scholar 

  • Rogers SM, Back DJ, Stevenson PJ, Grimmer SFM, Orme ML’E. Paracetamol interaction with oral contraceptive steroids: increased plasma concentrations of ethinyloestradiol. British Journal of Clinical Pharmacology 23: 721–725, 1987b

    Article  PubMed  CAS  Google Scholar 

  • Seregely G. Our knowledge of drug interactions with oral contraceptives. Therapia Hungarica 37: 17–22, 1989

    PubMed  CAS  Google Scholar 

  • Shenfield GM. Drug interactions with oral contraceptive preparations. Medical Journal of Australia 144: 205–211, 1986

    PubMed  CAS  Google Scholar 

  • Shenfield G, Griffin JM. Clinical pharmacokinetics of contraceptive steroids: an update. Clinical Pharmacokinetics 20: 15–37, 1991

    Article  PubMed  CAS  Google Scholar 

  • Shenfield GM, Griffin J, Lyons J, Boutagy J. Plasma hormone concentrations in women on the oral contraceptive pill. European Journal of Clinical Pharmacology 36 (Suppl.): A93, 1989

    Article  Google Scholar 

  • Sisenwine SF, Lim AL, Kimmel HB, Ruelius HW. The conversion of d-norgestrel-3-oxime-l7 acetate to d-norgestrel in female rhesus monkeys. Contraception 15: 25–37, 1977

    Article  PubMed  CAS  Google Scholar 

  • Skolnick JL, Stoler BS, Katz DG, Anderson WH. Rifampicin, oral contraceptives and pregnancy. Journal of the American Medical Association. 236: 1382, 1976

    Article  PubMed  CAS  Google Scholar 

  • Somos P. Interactions between certain psychopharmaca and low-dose oral contraceptives. Therapia Hungarica 38: 37–40, 1990

    PubMed  CAS  Google Scholar 

  • Sparrow MJ. Pill method failures. New Zealand Medical Journal 100: 102–105, 1987

    PubMed  CAS  Google Scholar 

  • Sparrow MJ. Pregnancies in reliable pill takers. New Zealand Medical Journal 102: 575–577, 1989

    PubMed  CAS  Google Scholar 

  • Stadel BV, Sternthal PM, Schlesselman JJ, Douglas IMB, Hall WD. Variation of ethinyloestradiol blood levels amoung healthy women using oral contraceptives. Fertility and Sterility 33: 257–260, 1980

    PubMed  CAS  Google Scholar 

  • Stead RJ, Grimmer SFM, Rogers SM, Back DJ, Orme ML’E. Pharmacokinetics of contraceptive steroids in patients with cystic fibrosis. Thorax 42: 59–64, 1987

    Article  PubMed  CAS  Google Scholar 

  • Stoehr GP, Kroboth PD, Juhl RP, Wender DB, Phillips JP. Effects of oral contraceptives on triazolam, temazepam, alprazolam and lorazepam kinetics. Clinical Pharmacology and Therapeutics 36: 683–690, 1984

    Article  PubMed  CAS  Google Scholar 

  • Tephly TR, Mannering GR. Inhibition of drug metabolism. V. inhibition of drug metabolism by steroids. Molecular Pharmacology 4: 10–14, 1968

    PubMed  CAS  Google Scholar 

  • Teunissen MWE, Srivastava AK, Breimer DD. Influence of sex and oral contraceptive steroids on antipyrine metabolite formation. Clinical Pharmacology and Therapeutics 32: 240–246, 1982

    Article  PubMed  CAS  Google Scholar 

  • van de Brekel AJ, de Witte MJ, Haspels AA, van Vloten WA. Reliability of oral contraceptives during long-term use of tetracycline for the treatment of acne. Nederlands Tijdschrift voor Geneeskunde 135: 749–751, 1991

    PubMed  Google Scholar 

  • van Dijek CPH, Weber JCP. Interaction between oral contraceptives and griseofulvin. British Medical Journal 288: 1125–1126, 1984

    Google Scholar 

  • Watson KJR, Ghabrial H, Mashford ML, Harman PJ, Breen KJ. Effects of sex and the oral contraceptive pill on morphine disposition. Clinical and Experimental Pharmacology and Physiology 14 (Suppl. 10): 33, 1987

    Google Scholar 

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  1. Department of Clinical Pharmacology, Royal North Shore Hospital, St Leonards, New South Wales, 2065, Australia

    Gillian M. Shenfield

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  1. Gillian M. Shenfield
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Shenfield, G.M. Oral Contraceptives. Drug-Safety 9, 21–37 (1993). https://doi.org/10.2165/00002018-199309010-00003

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  • DOI: https://doi.org/10.2165/00002018-199309010-00003

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