| アブストラクト | OBJECTIVE: To estimate associations between contraceptive failures and concomitant CYP3A4-inducing medications by route of administration. STUDY DESIGN: Comparison of unintended pregnancy outcomes within U.S. Food and Drug Administration's Adverse Event Reporting System by couse of CYP3A4-inducing drugs and route of administration for levonorgestrel and etonogestrel/desogestrel. RESULTS: Among 14,504 levonorgestrel case reports, the reporting odds ratio (ROR) was increased for oral (ROR = 4.2 [3.0-5.7]), implants (ROR = 8.0 [5.8-11.0]), but not intrauterine (ROR = 0.9 [0.6-1.3]) levonorgestrel products. For 9348 etonogestrel/desogestrel case reports, oral and vaginal products were not associated with contraceptive failure. Etonogestrel containing implants (ROR = 4.9 [4.1-5.9]) were associated with increased contraceptive failure. CONCLUSION: Levonorgestrel containing combination oral products and implants containing levonorgestrel or etonogestrel were prone to CYP3A4-inducing drug-drug interactions that may increase contraceptive failures. IMPLICATIONS: The progestin components of hormonal contraceptives are susceptible to drug-drug interactions, but this susceptibility is influenced by route of administration. This study provides evidence from an Adverse Event Reporting System that CYP3A4-inducing medications increase the risk of unintended pregnancy for oral and implant contraceptives but not intrauterine or vaginal devices. |
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| ジャーナル名 | Contraception |
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| 投稿日 | 2020/12/22 |
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| 投稿者 | Sunaga, Tomiko; Cicali, Brian; Schmidt, Stephan; Brown, Joshua |
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| 組織名 | Center for Drug Evaluation and Safety, Department of Pharmaceutical Outcomes and;Policy, University of Florida College of Pharmacy, Gainesville, FL, United;States; Showa University, School of Pharmacy, Tokyo, Japan.;Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics,;University of Florida College of Pharmacy, Orlando, FL, United States.;States. Electronic address: Joshua.brown@ufl.edu. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33345974/ |
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