Oral contraceptives in systemic lupus erythematosus: side-effects and influence on the activity of SLE
Julkunen, H.A.
Scandinavian Journal of Rheumatology 20(6): 427-433
1991
ISSN/ISBN: 0300-9742 PMID: 1771400 DOI: 10.3109/03009749109096822Document Number: 317313
The pharmacology, clinical performance, and metabolic effects of the identical combined oral contraceptive Femodene (Schering) and Minulet (Wyeth), are compared with Microgynon 30, the most widely used pill in the United Kingdom. Femodene and Minulet both contain 30 mcg ethinyl estradiol and 75 mcg gestodene, while Microgynon contains 30 mcg ethinyl estradiol and 150 mcg levonorgestrel. Gestodene is active on its own, so it suppresses ovulation at a very low dose. It is a strong anti-estrogen, has low androgenic, and minimal anti-mineralocorticoid effects. Femodene/Minulet appears to cause less breakthrough bleeding, even in the 1st few cycles, than Microgynon. It raises triglycerides and phospholipids, but does not affect lipids or carbohydrates. Like many oral contraceptives, these formulations increase clotting Factor Vii, yet accelerate fibrinolysis. There have been extremely few reports of severe adverse effects: a 19-year old Femodene user died from pulmonary embolism. These formulations are 2-4 times as expensive as other popular combined oral contraceptives marketed in England.