From the Guidelines
Blisovi, a combination oral contraceptive containing ethinyl estradiol and norethindrone, can potentially cause dyspnea (shortness of breath) in some users, as it increases the risk of venous thromboembolism (VTE) and cardiovascular disease (CVD) 1. The development of oral contraceptive pills (OCPs) like Blisovi has been marked by efforts to reduce the risk of adverse effects, including VTE and CVD, by modifying the doses of synthetic estrogens and progestins 1.
- Key factors that increase the risk of these complications include:
- Smoking, especially in women over 35 years old
- Certain medical conditions like high blood pressure, diabetes, or a history of heart disease
- The use of high doses of synthetic estrogens and progestins, such as norethindrone, which is a first-generation progestin 1
- Warning signs that might accompany shortness of breath include:
- Chest pain
- Coughing up blood
- Severe headache
- Vision changes
- Swelling and pain in the legs If you experience shortness of breath while taking Blisovi, it is crucial to stop taking the medication and seek emergency medical care immediately, as it could indicate a rare but dangerous complication like a blood clot in the lungs (pulmonary embolism) 1. The risk of VTE and CVD associated with OCPs like Blisovi highlights the importance of careful screening before prescribing and monitoring during use as essential safety measures 1.
From the Research
Blisovi and Dyspnea
- Blisovi, which contains ethinyl estradiol and norethindrone, may increase the risk of venous thromboembolism, including pulmonary embolism, which can cause dyspnea (shortness of breath) 2, 3, 4.
- A study found that the risk of deep vein thrombosis was higher in patients taking drospirenone/ethinyl estradiol compared to those taking norethindrone/ethinyl estradiol 3.
- Another study reported that combined oral contraceptives, including those with ethinyl estradiol, increase the risk of venous thrombosis, which can lead to dyspnea 4.
- Dyspnea can be caused by various factors, including cardiac and pulmonary disease, and can be a symptom of pulmonary embolism 5.
- Although there is no direct evidence linking Blisovi to dyspnea, the increased risk of venous thromboembolism associated with its use may indirectly contribute to the development of dyspnea 2, 3, 4.
Mechanism of Action
- The exact mechanism by which Blisovi may cause dyspnea is not fully understood, but it is thought to be related to the increased risk of venous thromboembolism associated with its use 2, 3, 4.
- Estrogen, a component of Blisovi, can increase the risk of venous thromboembolism by affecting blood clotting and fibrinolysis 2, 4.
- Progestin, another component of Blisovi, may also contribute to the increased risk of venous thromboembolism, although the exact mechanism is not fully understood 3, 4.
Clinical Implications
- Patients taking Blisovi should be aware of the potential risk of dyspnea and seek medical attention if they experience any symptoms of shortness of breath 5, 3, 4.
- Healthcare providers should carefully evaluate the risks and benefits of prescribing Blisovi to patients, particularly those with a history of venous thromboembolism or other risk factors for dyspnea 3, 4.