What is the information about the Oral Contraceptive (OC) pill?

From the Guidelines

The "O Pill" is not a recognized or standard medication in medical practice, and if you're looking for information about oral contraceptives, it's essential to consult with a healthcare provider to determine the best option based on your medical history and needs. There is no specific medication or contraceptive commonly known by this name in mainstream healthcare. If you're considering contraception, there are many different formulations available, typically containing combinations of estrogen and progestin or progestin-only options, such as combined oral contraceptive pills (COCs) which are the most popular method of hormonal contraception for adolescents, as stated in the study by 1. These medications work by preventing ovulation, thickening cervical mucus to block sperm, and thinning the uterine lining to prevent implantation.

According to the study by 1, the effectiveness of different contraceptive methods, including oral contraceptives, varies, with typical use failure rates of 9% in adults and potentially higher in adolescents. The study by 1 also notes that COCs have few contraindications in healthy female adolescents, but should not be prescribed for patients with severe and uncontrolled hypertension, ongoing hepatic dysfunction, or other specific conditions.

Some key points to consider when using oral contraceptives include:

• Starting the medication on the same day as the visit, with a backup method used for at least the first 7 days for contraceptive efficacy, as recommended by 1
• Counseling patients on strategies to promote daily adherence, such as cell phone alarms and support from a family member or partner, as suggested by 1
• Informing patients about common transient adverse effects, such as irregular bleeding, headache, and nausea, and providing recommendations for managing these effects, as discussed in 1
• Avoiding drug interactions that may decrease the effectiveness of oral contraceptives, as noted in 1

Overall, consulting with a healthcare provider is crucial to determine the best contraceptive option and to discuss potential side effects and benefits, as the most effective method will depend on individual circumstances and medical history, as emphasized by 1 and 1.

From the FDA Drug Label

In another study in Great Britain, the risk of developing cerebrovascular disease persisted for at least 6 years after discontinuation of oral contraceptives, although excess risk was very small However, current clinical practice involves the use of lower estrogen formulations combined with careful consideration of risk factors TABLE III: ANNUAL NUMBER OF BIRTH-RELATED OR METHOD-RELATED DEATHS ASSOCIATED WITH CONTROL OF FERTILITY PER 100,000 NON-STERILE WOMEN, BY FERTILITY CONTROL METHOD ACCORDING TO AGE Kariva® is contraindicated in females who currently have or have had breast cancer because breast cancer may be hormonally sensitive Epidemiology studies have not found a consistent association between use of combined oral contraceptives (COCs) and breast cancer risk Benign hepatic adenomas are associated with oral contraceptive use, although the incidence of benign tumors is rare in the United States Discontinue Kariva® prior to starting therapy with the combination drug regimen ombitasvir/paritavir/ritonavir, with or without dasabuvir Oral contraceptives should be discontinued if there is unexplained partial or complete loss of vision; onset of proptosis or diplopia; papilledema; or retinal vascular lesions Extensive epidemiologic studies have revealed no increased risk of birth defects in women who have used oral contraceptives prior to pregnancy Oral contraceptive use should be discontinued until pregnancy is ruled out

The o pill, also known as Kariva, is a form of oral contraceptive that contains ethinyl estradiol.

• Benefits: The benefits of using the o pill include effective birth control and possibly lower risk of mortality compared to other methods of birth control, especially in women under 35.
• Risks: The risks associated with the o pill include:
  • Cerebrovascular disease: The risk of developing cerebrovascular disease may persist for at least 6 years after discontinuation of oral contraceptives.
  • Breast cancer: Although epidemiology studies have not found a consistent association between use of combined oral contraceptives and breast cancer risk, Kariva is contraindicated in females who currently have or have had breast cancer.
  • Hepatic neoplasia: Benign hepatic adenomas are associated with oral contraceptive use.
  • Ocular lesions: Oral contraceptives should be discontinued if there is unexplained partial or complete loss of vision.
  • Gallbladder disease: Earlier studies have reported an increased lifetime relative risk of gallbladder surgery in users of oral contraceptives and estrogens.
• Preoming pregnancy: Extensive epidemiologic studies have revealed no increased risk of birth defects in women who have used oral contraceptives prior to pregnancy.
• Contraindications: Kariva is contraindicated in females who currently have or have had breast cancer, and should be discontinued prior to starting therapy with certain combination drug regimens. 2

From the Research

Overview of the O Pill

• The O Pill, also known as Opill, is a progestin-only oral contraceptive pill that contains norgestrel 3, 4.
• It is the first over-the-counter oral contraceptive pill approved in the United States, intended for daily use to prevent pregnancy 3, 4.
• The pill has an estimated Pearl Index of 4.4 (95% CI, 1.9-8.8), indicating its effectiveness in preventing pregnancy 4.

Mechanism of Action and Safety

• Norgestrel, the active ingredient in the O Pill, is a progestational steroid that exerts its contraceptive action at the central and peripheral levels 5.
• It is rapidly absorbed, not subjected to a "first-pass" effect, and is approximately 90% bioavailable, with a circulating half-life around 15 hours 5.
• The O Pill has an excellent safety profile, with current breast cancer as the only absolute contraindication and few relative contraindications 4.

Availability and Accessibility

• The approval of the O Pill for over-the-counter status has the potential to improve the accessibility of effective contraception for many pregnancy-capable Americans, especially those with poor access to the health care system 3, 4.
• The pill's success in reducing rates of unintended pregnancy will rely on its availability, particularly in rural communities, and affordability, especially for uninsured or underinsured individuals 4.

Comparison with Other Contraceptive Methods

• Oral contraceptive pills, including the O Pill, are the most commonly used reversible method of contraception, with a pregnancy rate of 4% to 7% per year 6.
• Long-acting methods, such as intrauterine devices and subdermal implants, have higher effectiveness and lower failure rates compared to oral contraceptive pills 6.
• The O Pill has the advantage of being available over-the-counter, making it more accessible to individuals who may have barriers to accessing prescription-required contraception 3, 4.