RT Journal Article
SR Electronic
T1 Update on combined oral contraceptives: risk of venous thromboembolism. Drospirenone versus other progestins
JF European Journal of Hospital Pharmacy: Science and Practice
JO Eur J Hosp Pharm
FD British Medical Journal Publishing Group
SP 254
OP 254
DO 10.1136/ejhpharm-2012-000074.445
VO 19
IS 2
A1 C. Martí Gil
A1 A. Mulet Alberola
A1 M. Mejía Recuero
A1 D. Barreira Hernández
A1 P. Llopis Salvia
A1 D. Barreda Hernández
YR 2012
UL http://ejhp.bmj.com/content/19/2/254.2.abstract
AB Background The risk of venous thromboembolism (VTE) associated with combined oral contraceptives (COCs) is well known, but the relation with the progestin type is controversial. Purpose To describe a suspected deep vein thrombosis (DVT) associated with drospirenone (DRSP)-containing COCs. Literature review about the VTE risk of versus DRSP and other progestins. Materials and methods Medical record review. Search of PubMed (hormonal oral contraceptives, COCs, DRSP, combined DRSP and ethinyl oestradiol (EE), progestins, thromboembolism, VTE, drug toxicity.) Results Woman, 36 years old, G4 A2 V2, dysmenorrhea, ovarian cysts and fibroadenoma, non-smoker, no allergies, user of NSAIDs and COCs (2007 – March 2010: 35 mcg EE/250 mcg norgestimate, March-November 2010: 20 mcg EE/75 mcg gestodene, November 2010-August 2011: 20 mcg EE/3 mg DRSP). On August 2011, was attended in an Internal Medicine Outpatient Consultation after a previous admission in which a radiological test ruled out DVT, although D-dimers (DDs)=1220 ng/mL. She was readmitted to hospital due to persistent induration and pain in right calf (DD= 571 ng/mL). DVT was suspected again and a Doppler ultrasound was confirmatory. Low molecular weight heparin was initiated, followed by acenocoumarol. She was discharged (medium compression stockings, acenocoumarol and analgesics). The COC was stopped and she was referred to the Gynaecology Outpatient Consultation. Suspected adverse drug reaction (ADR) was reported to the regional pharmacovigilance centre. Conclusions Spontaneously reporting ADRs can improve the safety profile of drugs. Our case adds further information to the recently published epidemiological studies that suggest an increased risk of VTE associated with DRSP. View this table:CPC096 table 1 Literature review