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A pilot study on the effect of isotretinoin on serum etonogestrel concentrations in contraceptive implant users.


ABSTRACT:

Objective

To explore the pharmacokinetic interaction between isotretinoin, a cytochrome P-450 (CYP) inducer and potent teratogen, and the etonogestrel contraceptive implant.

Study design

We enrolled healthy reproductive-age women initiating isotretinoin and using an etonogestrel implant. We compared serum etonogestrel concentrations at baseline and after four and nine weeks of isotretinoin co-administration using a validated assay.

Results

Among eight implant users, all serum etonogestrel concentrations remained >90 pg/mL during isotretinoin co-administration with no significant changes from baseline (p = 0.25, Friedman's test).

Conclusion

In this exploratory study, we found that isotretinoin did not cause serum etonogestrel concentrations to fall below the threshold for ovulatory suppression (<90 pg/mL) among implant users.

Implications

Reproductive-age women treated with isotretinoin require reliable contraception to prevent pregnancies impacted by teratogenic-effects. This small study demonstrates that contraceptive implant users maintained serum etonogestrel concentrations above the threshold for consistent ovulatory suppression during isotretinoin co-administration. The contraceptive implant remains an appropriate option for patients considering isotretinoin therapy.

SUBMITTER: Lazorwitz A 

PROVIDER: S-EPMC7272275 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Publications

A pilot study on the effect of isotretinoin on serum etonogestrel concentrations in contraceptive implant users.

Lazorwitz Aaron A   Seale Rebecca R   Davis Anne A   Guiahi Maryam M  

Contraception 20200420 1


<h4>Objective</h4>To explore the pharmacokinetic interaction between isotretinoin, a cytochrome P-450 (CYP) inducer and potent teratogen, and the etonogestrel contraceptive implant.<h4>Study design</h4>We enrolled healthy reproductive-age women initiating isotretinoin and using an etonogestrel implant. We compared serum etonogestrel concentrations at baseline and after four and nine weeks of isotretinoin co-administration using a validated assay.<h4>Results</h4>Among eight implant users, all ser  ...[more]

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