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In this review, we discuss the efficacy, safety, and benefits of four new contraceptive products available in the USA, specifically Annovera, Phexxi, Slynd, and Twirla. Phexxi prescription-only vaginal gel is a user-controlled, non-hormonal, on-demand contraceptive method that represents a novel addition to the market with its additional uses as a personal lubricant and as a Ortho Options Vaginal Contraceptive microbicide for urogenital infection prevention. Slynd, a drospirenone-only pill, provides more flexibility for delayed or missed pills while maintaining efficacy and a more favorable bleeding profile compared with previously available progestin-only pills. The addition of these products expands the available options for pregnancy prevention to address unmet contraceptive needs. New contraceptive methods increase options for individuals seeking to prevent pregnancy. Contraceptive technology research can address concerns about risks, safety, or convenience of existing methods by developing new routes of administration, utilizing novel steroid hormones or different combinations of steroid hormones, and combining multiple needs into a single product e. Recent additions to the US contraceptive market include a vaginal ring releasing ethinyl estradiol EE and segesterone acetate SA that can be used cyclically for up to one year, an acid-buffering vaginal gel, a drospirenone-only pill with a wider window for dosing delays, and a transdermal patch releasing EE and levonorgestrel LNG. In this review, we discuss the efficacy, side effects, risks, benefits, and the potential role of these new products among currently Ortho Options Vaginal Contraceptive options to assist clinicians with up-to-date contraception counseling. There are several advantages to contraceptive Ortho Options Vaginal Contraceptive rings, including non-daily administration, user control, and stable Ortho Options Vaginal Contraceptive levels compared with daily oral dosing [ 1 ]. This ring is the first approved contraceptive product to incorporate SA. This progestin has a low oral bioavailability but requires only small doses to achieve progestational activity in sustained-release formulations [ 4 ]. In contrast to Nuvaring, a single Annovera ring can be re-used for 13 consecutive cycles and does not require refrigeration, offering patients increased convenience with less frequent visits to the pharmacy or clinic for refills. Annovera is a soft, flexible, silicone ring with an outer diameter of 56 mm and cross-sectional diameter of 8.

In addition, hormonal contraception can have a bidirectional interaction with some AEDs, which can result in loss of seizure control or toxicity. Several contraceptive options that do not interact with AEDs, such as barrier and long-acting forms, are available. High dosages of emergency contraception and oral regimens also may be considered. Intervention by the pharmacist can include making recommendations about contraceptive options, advising on therapeutic drug concentration monitoring, and increasing awareness among patients and prescribers. Hormonal contraception can have a bidirectional interaction with some antiepileptic drugs AEDs , which can lead to loss of seizure control or toxicity. Alternative contraception recommendations are addressed so that more effective forms of birth control can be discussed with patients and providers. Patients are likely to be prescribed these medications by providers in different disciplines, further increasing the risk of interactions. Pharmacists are in a unique position to identify and counsel patients who may be affected by these interactions and to provide patients and healthcare providers with information on alternative options, when indicated. Contraceptive failure may be responsible for up to one in four unplanned pregnancies in women with epilepsy. Pharmacokinetic interactions can lead to decreased serum concentrations of hormonal contraceptives. The metabolism of EE, the most common estrogen component of COCs, is susceptible to induction of CYP and increased glucuronidation, which leads to reduced serum concentrations. The interactions described above can diminish the effectiveness of combined hormonal contraceptives CHCs , including COCs, the combined contraceptive patch Ortho Evra , and the vaginal ring NuvaRing , as well as progesterone-only preparations such as progesterone pills, implants, and emergency contraception Plan B, My Way, Next Choice. CHCs typically contain EE 20 to 35 mcg plus a progestin.

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