1. Oral
contraceptives

2. Introduction
Preventing unwanted pregnancy is the important goal of contraceptive use
There are several methods of contraception
Oral contraceptives are highly effective provided they are used appropriately
Their effectiveness approaches that of surgical sterilization

3. Composition
OCs contains,
combination of synthetic estrogen and synthetic progestin or
progestin alone
The low dose combination OCs contains,
approximately one third to one fourth the estrogen and one tenths the progestin dose

4. Composition . . .
The progestin only (mini pills) contains even lower doses of progestin . Third generation OCs contain, newer progestins e.g. desogestrel, grospirenone, gestodene and norgestimate which have no estrogenic effect

5. Mechanism: Estrogens suppresses FSH, prevents development of dominant follicle stabilizes endometrial lining potentiate the action of progestin Progestin suppresses LH surge, block ovulation thicken cervical mucous causes endometrial atrophy

6. Classification
Combined pill
Progesterone only pill
Post coital pill
Once in a month pill
Male pill

7. contain 30-35 mcg of a synthetic estrogen and 0.-1mg of progesterone
Combined pills
contain mcg of a synthetic estrogen and 0.-1mg of progesterone
One pill daily given orally, for 21 days beginning of the fifth day of menstrual cycle
Not recommended for breast feeding women because they affect quality and quantity of milk

8. Combined pills . . .
Very rarely can cause stroke
blood clots in deep veins of the legs, or heart attack
women with high blood pressure and women who are age
35 or old and smokes more than 20 cigarettes per day
Eg: Mala –N, Mala-D

9. Progesterone-only pill
contains very small amounts of only one kind of hormone, a progestin 0.35mg
These are known as progestin-only pills (POPs), POCs and mini pills
recommended for breast-feeding women
Progestin-only oral contraceptives do not disrupt existing pregnancy

10. Emergency pills
After unprotected coitus, emergency oral contraception can prevent pregnancy
Also called post coital or ‘morning after’ contraception Mainly stops ovulation (release of egg from ovary) It does not disrupt existing pregnancy

11. Emergency pills . . .
Up to 72 hours after unprotected coitus, the woman should take 4 low-dose or 2 "standard-dose" combined oral contraceptives, and then take another equal dose 12 hours later
It contains either a high dose of estrogen or double dose of standard combined pills
EC kit contains 4 tablets (2 tablets/dose), each tablet contains
50mcg of ethinyl estradiol and
0.25mg of levonorgestrel or
two tablets each containing 0.75mg levonorgestrel

12. Once in a month pill
contains a long acting estrogen in combination with short acting progesterone
Male pill
contains gossypol, derivative of cottonseed oil
acts by decreasing sperm production and sperm count

13. ADRs
Myocardial infraction
thromboembolic complications
breast cancer
hyperglycemia
hypertension
jaundice
weight gain
nausea and vomiting

14. Drug interactions
Decreased effects of contraceptives: Ampicillin Anticonvulsants Griseofulvin NNRTIs PIs Rifampicin Phenytoin Pioglitazone Sulfonamides Tetracyclines Theophylline
Decreased effects of, Paracetamol Oral anticoagulants Tolbutamide Methyldopa

15. Conclusion
-OCs are the effective means of contraception -Selection of proper OCs is important -Effects of concomitant drugs on OCs must be analyzed

16. Thank you