Levonorgestrel is a extensively used emergency contraceptive tablet
Kristoffer Tripplaar / Alamy Inventory Photograph
A extensively used morning-after tablet is way more practical when taken alongside an anti-inflammatory drug, a medical trial has discovered.
Levonorgestrel is among the most cost-effective and most generally used emergency contraceptives on the planet. However the drug solely works earlier than an egg is launched from one of many ovaries. One research discovered that the drug is barely 58 per cent efficient at stopping pregnancies when taken 49 to 72 hours after unprotected intercourse.
Anti-inflammatory medication usually work by inhibiting prostaglandins, chemical substances with hormone-like results that additionally play a task in lots of processes in copy similar to ovulation and fertilisation. Kristina Gemzell-Danielsson on the Karolinska Institute in Sweden suspected that these medication might additional cut back the probability of undesirable being pregnant.
To check this, Gemzell-Danielsson and her colleagues performed a randomised trial involving 860 girls who requested emergency contraception inside 72 hours of unprotected intercourse at a household planning clinic in Hong Kong between August 2018 and 2022. The contributors didn’t embrace any transgender or non-binary individuals.
Half the ladies got levonorgestrel and piroxicam, an anti-inflammatory drug used to deal with arthritis, whereas the opposite half acquired levonorgestrel and a placebo tablet. Neither the contributors nor the healthcare professionals knew which contributors acquired which remedy.
Only one girl grew to become pregnant within the anti-inflammatory drug group, whereas seven girls grew to become pregnant within the placebo group. There have been no variations in unintended effects between the 2 teams.
Based mostly on a mannequin of anticipated being pregnant after unprotected intercourse, 95 per cent of anticipated pregnancies have been prevented within the anti-inflammatory drug group in contrast with simply 63 per cent within the placebo group.
The trial solely included girls who weren’t on any hormonal contraceptives because the researchers needed to review the affect of the remedies on those that have been most prone to an undesirable being pregnant.
Gemzell-Danielsson says it’s unclear precisely how the anti-inflammatory drug helps to cease undesirable pregnancies. “We all know that prostaglandin is necessary for [reproductive] processes, however we have to do extra mechanistic research to know for certain what’s occurring,” she says.
She hopes that the findings have a fast affect on how healthcare professionals worldwide prescribe emergency contraceptives. Piroxicam is affordable and extensively out there, she says, and can be simple to prescribe alongside levonorgestrel.
Combining piroxicam with the opposite extensively used emergency contraceptive, ulipristal, can also be more likely to be efficient as that contraceptive works in an identical method to levonorgestrel, says Gemzell-Danielsson, however this hasn’t but been examined.
Judith Stephenson at College Faculty London says the findings might result in main modifications in medical follow, however she hopes different research will verify the consequence. “Although properly designed, it’s only one trial, so it will be reassuring to have the findings confirmed in one other research,” she says.
She additionally says it will be helpful to search out out if the drug mixture works in individuals who have missed one in all their every day contraceptive capsules.
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