St Johns wort is a herbal product that is used for depressive symptoms and is known to have enzyme-inducing effects on cytochrome p450 enzymes. The MHRA statement highlights that in the last quarter of 2013, two ‘Yellow Card’ reports were received relating to unplanned pregnancies, in women with progestogen-only implants, suspected to be the result of an interaction with St John’s wort.
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Following a presentation at the annual meeting of the American Academy of Ophthalmology a number of media reports have reported a possible link between use of combined oral contraception (COC) and glaucoma. There is limited data investigating combined hormonal contraceptives on glaucoma. One cohort study suggested that 5 or more years of COC use was associated with a 25% increase in the risk of glaucoma. Two UK cohort studies did not find consistent evidence of an increased risk.
FSRH CEU Statement: Strengthening of Warnings about use of Dianette and other brands of co-cyprindiol (June 2013)
Following a recent safety review, a letter has been issued to healthcare professionals from the manufacturers of Dianette® and other cyproterone acetate 2 mg/ ethinylestradiol 35 mcg (co-cyprindiol) products. The review by the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) followed concerns about the risk of thrombosis associated with co-cyprindiol. With the agreement of the EMA and Medicines and Healthcare products Regulatory Authority (MHRA), a letter has been issued to raise awareness of the thrombosis risks and the outcome of the review.
This statement provides guidance on contraceptive options for women with prolactinoma
NICE supports the use of hysteroscopic sterilisation provided that normal arrangements are in place for clinical governance and audit.