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pubmed:otherAbstract |
PIP: In July 1996, seven months after the publication of evidence linking third-generation oral contraceptives (OCs) to an increased risk of venous thromboembolism, the New Zealand Ministry of Health issued guidelines for physicians on this topic. Although all combined OCs increase the odds of thromboembolic events, preparations containing desogestrel or gestodene are associated with a two-fold greater risk than first- or second-generation OCs. In 1995, the UK Committee on the Safety of Medicines advised physicians not to prescribe OCs containing desogestrel or gestodene to women with risk factors for venous thromboembolism and recommended that current users should continue with these preparations only if they could not tolerate other OCs. The New Zealand recommendations are less directive. Doctors are advised that, when initiating OC therapy, they should consider prescribing OCs containing no more than 35 mcg of ethinyl estradiol and a progestogen other than desogestrel or gestodene; it is noted, however, that third-generation OCs may have an additional therapeutic role in specific medical conditions. In New Zealand, about 75% of OC users (compared to 50% in the UK) use these new OCs and about 40 of the 50 expected cases of venous thromboembolism in New Zealand pill users per year will occur in women taking OCs containing desogestrel or gestodene.
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