A current study revealed that taking piroxicam with the levonorgestrel emergency situation birth control pill significantly prevents more pregnancies than levonorgestrel alone. The research study discovered that 95% of pregnancies were prevented following combined treatment with levonorgestrel and the anti-inflammatory medication piroxicam, compared to 63% of pregnancies being prevented when levonorgestrel was taken alone. There were very little negative effects, however additional studies are needed to understand piroxicams system and its applicability to diverse populations.
According to a randomized regulated trial recently released in The Lancet, integrating the anti-inflammatory drug piroxicam, frequently recommended for arthritis discomfort, with the levonorgestrel emergency birth control pill after unprotected sexual intercourse results in less pregnancies compared to taking levonorgestrel alone.
2 types of emergency contraceptive pills– including either levonorgestrel or ulipristal acetate– are the most commonly used emergency situation birth control approach in many countries, with the levonorgestrel pill offered in more countries than the ulipristal acetate pill. Both contraceptives work by preventing or postponing ovulation and neither are effective post-ovulation.
The accepted efficiency of levonorgestrel is based upon the outcomes of a trial from 1998 in which levonorgestrel avoided 95% of expected pregnancies when taken within 24 hours of unprotected sex, 85% if taken within 25-48 hours, and 58% if taken within 49-72 hours. However, more recent research study recommends the efficacy of levonorgestrel may be lower.
” The levonorgestrel emergency situation birth control pill is one of the most popular choices of emergency birth control in numerous parts of the world, so discovering that there is a widely offered medication that increases levonorgestrels effectiveness when they are taken together is actually interesting,” said Dr. Sue Lo from the Family Planning Association of Hong Kong, a co-investigator of the study.
First author of the study Dr Raymond Li from The University of Hong Kong included, “Our research study is the first to recommend that a safe and readily available medication taken at the very same time as the levonorgestrel tablet can avoid more pregnancies than levonorgestrel alone. We hope these outcomes will cause more research and eventually changes in medical guidelines to allow females all over the world to gain access to more effective emergency situation contraception.”
The study happened at a significant neighborhood reproductive and sexual health service in Hong Kong in between August 2018 and August 2022. Women who needed levonorgestrel emergency situation contraception within 72 hours of unguarded sex were randomized to get a single supervised dosage of levonorgestrel 1.5 mg plus either piroxicam 40 mg or a placebo pill. The individuals and the attending health care specialists did not understand which group got which treatment. A follow-up visit was set up one to 2 weeks after the next expected duration. During the consultation, if a normal duration had actually not occurred by that time, a pregnancy test was carried out. The percentage of pregnancies prevented out of those anticipated was calculated based on an established design released in 1998.
Of the 836 women followed up, there was one pregnancy among the 418 ladies who took piroxicam and levonorgestrel and 7 pregnancies among the 418 females who had the placebo and levonorgestrel. The percentage of anticipated pregnancies without contraception was approximated at 4.5% (19/418) in both groups. The portion of pregnancies avoided following piroxicam-levonorgestrel co-treatment was 95% (18/19), compared with 63% (12/19) in those who took levonorgestrel and placebo.
There were no considerable differences in the rates of side impacts in between those receiving piroxicam and placebo co-treatment.
Teacher Kristina Gemzell-Danielsson from the Karolinska Institute, another co-investigator, described that “levonorgestrel avoids pregnancy by blocking or postponing the luteinizing hormone rise, which interrupts the ovulatory process. Piroxicam might work by targeting a various type of hormonal agent– prostaglandins. Prostaglandins assist in numerous reproductive processes consisting of embryo, fertilization, and ovulation implantation. Therefore, we speculate that piroxicam may offer a contraceptive result both pre-ovulation (by obstructing the ovulatory procedure) and post-ovulation (by avoiding the implantation of the embryo), nevertheless, our trial did not investigate piroxicams system of action and additional research studies are needed to validate this.”
The authors acknowledge some constraints of the research study, including the generalisability of the findings to other settings. As the study omitted females with current or existing usage of hormone birth control, in addition to those with more than one episode of vulnerable sex before taking emergency contraception, it is not particular whether the piroxicam-levonorgestrel co-treatment will be similarly reliable when used to women in those situations.
Writing in a linked Comment, Dr. Erica Cahill from Stanford University School of Medicine, who was not involved in the study, stated: “Overall, this study recommends that anybody administering levonorgestrel 1 · 5 mg as emergency situation birth control pills must think about the addition of 40 mg piroxicam orally, as it improves effectiveness with minor side-effects. These conclusions may not use to all clients, as this research study was restricted by a particular population, with participants being mainly of Asian ethnic background and weighing less than 70 kg. Given that levonorgestrel emergency contraception is less efficient in individuals with obesity, the effectiveness revealed here may not be generalizable to clients with higher BMIs.”
Reference: “Oral emergency birth control with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial” by Raymond Hang Wun Li, Sue Seen Tsing Lo, Kristina Gemzell-Danielsson, Carol Ho Yi Fong, Pak Chung Ho and Ernest Hung Yu Ng, 16 August 2023, The Lancet.DOI: 10.1016/ S0140-6736( 23 )01240-0.
This study was funded by, and carried out by scientists from, the Department of Obstetrics and Gynaecology, The University of Hong Kong.
A current study exposed that taking piroxicam with the levonorgestrel emergency situation contraceptive pill significantly avoids more pregnancies than levonorgestrel alone. The research study found that 95% of pregnancies were avoided following combined treatment with levonorgestrel and the anti-inflammatory medication piroxicam, compared to 63% of pregnancies being avoided when levonorgestrel was taken alone. Females who needed levonorgestrel emergency birth control within 72 hours of vulnerable sex were randomized to receive a single supervised dosage of levonorgestrel 1.5 mg plus either piroxicam 40 mg or a placebo pill. Of the 836 women followed up, there was one pregnancy among the 418 ladies who took piroxicam and levonorgestrel and seven pregnancies amongst the 418 females who had the placebo and levonorgestrel. The portion of pregnancies avoided following piroxicam-levonorgestrel co-treatment was 95% (18/19), compared with 63% (12/19) in those who took levonorgestrel and placebo.
