A Systematic Review and Meta-analysis of the Adverse Effects of Levonorgestrel Emergency Oral Contraceptive

Leelakanok, Nattawut; Methaneethorn, Janthima

doi:10.1007/s40261-020-00901-x

Cited by 24 publications

(27 citation statements)

References 120 publications

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“…Fewer than 10% suspected DRAEs were reported, which is consistent with previous studies within the national setting [14]. These were mainly menstrual delay, dizziness, and general malaise, unlike other studies that reported a higher number of cases related to nausea, vomiting, and headache, described in other studies [7,8].…”

Section: Discussionsupporting

confidence: 88%

“…Uncommon adverse reactions identified include anorexia, ectopic pregnancy, exanthema, miscarriage, and weight gain. Multiple serious adverse events, including convulsion, ectopic pregnancy, febrile neutropenia, stroke, abdominal hernia, anaphylaxis, cancer, ovarian cyst rupture, serious infections, and suicidal ideation, have been reported [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Characterization of the Use of Emergency Contraception from Sentinel Pharmacies in a Region of Southern Europe

Jambrina

Rius²,

Gascón

et al. 2021

JCM

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Numerous studies have been published suggesting that emergency contraception (EC) is used repeatedly, but a lack of information regarding the profile of users makes it difficult to evaluate actual consumer habits. The aim of this study was to obtain information regarding the profile of users who obtain EC and other factors that might play a role, and to provide criteria to evaluate and improve the strategies of current contraceptive programs. This was an observational one-year study based on surveillance data on the provision of EC to women of reproductive age in 60 community pharmacies in Catalonia, Spain. In total, 941 notifications of dispensation of EC in Catalonia were received. A total of 44.2% of users said it was not the first time that they had taken the medication (repeat user). The percentage of users who used condoms was lower in repeat users compared to first-time users (56.7% vs. 64.4%, p < 0.05). A total of 25.7% of users stated that they did not use any barrier contraceptive method. The use of natural methods in repeat users was 53.8% in the subgroup who requested the medication after 48 h, significantly higher than in users who obtained the medication within the first 24 h (p < 0.05). A high percentage of repeat users with risky sexual behaviors were detected, suggesting that new measures must be implemented to provide information for this method, together with educational and preventive strategies.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Characterization of the Use of Emergency Contraception from Sentinel Pharmacies in a Region of Southern Europe

Jambrina

Rius²,

Gascón

et al. 2021

JCM

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“…Studies with a total score of 1-3, 4-6, and 7-10 were classified as "good," "fair," and "poor" quality, respectively. 20…”

Section: Risk Of Biasmentioning

confidence: 99%

Association between polypharmacy and depression: a systematic review and meta‐analysis

Palapinyo

Methaneethorn

Leelakanok

2021

Pharmacy Practice and Res

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Aims: Polypharmacy is associated with multiple adverse health outcomes. The objective of this systematic review and meta-analysis was to explore the association between polypharmacy and depression. Methods and results: A systematic literature review was conducted by searching MEDLINE, Scopus, Science Direct, and CINAHL Complete to identify studies assessing the association between polypharmacy and depression published until November 2020. A meta-analysis was performed using random effect models. Heterogeneity was assessed using the I 2 -statistic. Nineteen studies were included in the meta-analysis. We found that an increase in the number of drugs was associated with an increased risk of depression (OR = 1.55 [95% CI: 1.01, 2.36; I 2 = 62%, n = 2]). Further, polypharmacy defined as the concurrent use of five or more medications was associated with an increased risk of depression (OR = 1.73 [95% CI: 1.39, 2.14], I 2 = 83%, n = 8). Conclusion: This meta-analysis revealed that polypharmacy, both discretely and categorically defined, was associated with an increased risk of depression.

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“… 13 , 14 Bleeding as an adverse reaction of LN has been reported only for the gynecological system until now at a percentage of 31%. 15 Even more severe adverse effects, as well as susceptibility to the development of serious diseases, have also been documented, albeit rarely. According to Conz et al, 16 a higher risk of breast cancer has been associated with utilization of levonorgestrel as a contraceptive intrauterine device.…”

Section: Discussionmentioning

confidence: 99%

Diffuse Alveolar Hemorrhage after Receiving Oral Levonorgerstrel for Emergency Contraception: A Case Report

Georgopoulou

Papadopoulou

Moyseos

et al. 2021

Clin Med Insights Case Rep

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Introduction: Drug-induced diffuse alveolar hemorrhage (DAH) has been associated with the administration of various medications, among which levonorgestrel (LN) has not been reported until now. Case Presentation: This case study describes a 42-year-old woman who presented with hemoptysis, hypoxemia, and radiological depiction of ground glass opacities, 3 days after she had received emergency contraceptive medication containing levonorgestrel. Emergent bronchoscopy was performed, and BAL was diagnostic of diffuse alveolar hemorrhage (DAH). A thorough diagnostic approach was followed, in order to detect the underlying pathological condition that induced DAH. The absence of other identifiable pathological conditions in this patient raised suspicion of LN’s potential causative role. Conclusion: DAH has not been reported as an adverse effect of LN until now. However, LN has been found to exert immunomodulatory effects and to present potential for manifestations of vasculitis as well as severe hypersensitivity reactions. These mechanisms may have been implicated in the development of DAH in our patient, who presented no other pathological conditions.

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A Systematic Review and Meta-analysis of the Adverse Effects of Levonorgestrel Emergency Oral Contraceptive

Cited by 24 publications

References 120 publications

Characterization of the Use of Emergency Contraception from Sentinel Pharmacies in a Region of Southern Europe

Characterization of the Use of Emergency Contraception from Sentinel Pharmacies in a Region of Southern Europe

Association between polypharmacy and depression: a systematic review and meta‐analysis

Diffuse Alveolar Hemorrhage after Receiving Oral Levonorgerstrel for Emergency Contraception: A Case Report

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