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. 1987 Jan;42(1):59–64. doi: 10.1136/thx.42.1.59

Pharmacokinetics of contraceptive steroids in patients with cystic fibrosis.

R J Stead, S F Grimmer, S M Rogers, D J Back, M L Orme, M E Hodson, J C Batten
PMCID: PMC460604  PMID: 3112991

Abstract

The pharmacokinetics of the commonly used contraceptive steroids ethinyloestradiol and levonorgestrel were investigated after oral and intravenous administration in six women with cystic fibrosis. The results were compared with data obtained from healthy women of similar age. The total body clearance of ethinyloestradiol was significantly higher in the patients with cystic fibrosis (0.61 (SD 0.19) l/h/kg) than in control women (0.32 (0.16) l/h/kg; p less than 0.02). In addition, the oral bioavailability of ethinyloestradiol was greater in women with cystic fibrosis than in controls (76.9% (11.7%) compared with 47.3% (7.5%); p less than 0.001). As a result of these two changes, the area under the plasma concentration--time curve after an oral dose of ethinyloestradiol was similar in patients and controls. The pharmacokinetics of levonorgestrel did not differ significantly between patients with cystic fibrosis and healthy women. The data suggest that women with cystic fibrosis will receive similar contraceptive protection from these steroids as do healthy women.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Back D. J., Bates M., Breckenridge A. M., Hall J. M., MacIver M., Orme M. L., Park B. K., Rowe P. H. The pharmacokinetics of levonorgestrel and ethynylestradiol in women - studies with Ovran and Ovranette. Contraception. 1981 Mar;23(3):229–239. doi: 10.1016/0010-7824(81)90045-7. [DOI] [PubMed] [Google Scholar]
  2. Back D. J., Breckenbridge A. M., Cross K. J., Orme M. L., Thomas E. An antibiotic interaction with ethinyloestradiol in the rat and rabbit. J Steroid Biochem. 1982 Mar;16(3):407–413. doi: 10.1016/0022-4731(82)90053-x. [DOI] [PubMed] [Google Scholar]
  3. Back D. J., Breckenridge A. M., Crawford F. E., Cross K. J., Orme M. L., Percival A., Rowe P. H. Reduction of the enterohepatic circulation of norethisterone by antibiotics in the rat: correlation with changes in the gut flora. J Steroid Biochem. 1980 Jan;13(1):95–100. doi: 10.1016/0022-4731(80)90118-1. [DOI] [PubMed] [Google Scholar]
  4. Back D. J., Breckenridge A. M., MacIver M., Orme M., Purba H. S., Rowe P. H., Taylor I. The gut wall metabolism of ethinyloestradiol and its contribution to the pre-systemic metabolism of ethinyloestradiol in humans. Br J Clin Pharmacol. 1982 Mar;13(3):325–330. doi: 10.1111/j.1365-2125.1982.tb01382.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Boat T. F., Doershuk C. F., Stern R. C., Matthews L. W. Serum alkaline phosphatase in cystic fibrosis. Interpretation of elevated values based on electrophoretic isoenzyme analyses. Clin Pediatr (Phila) 1974 Jun;13(6):505–512. doi: 10.1177/000992287401300607. [DOI] [PubMed] [Google Scholar]
  6. Bolt H. M., Bolt M., Kappus H. Interaction of rifampicin treatment with pharmacokinetics and metabolism of ethinyloestradiol in man. Acta Endocrinol (Copenh) 1977 May;85(1):189–197. doi: 10.1530/acta.0.0850189. [DOI] [PubMed] [Google Scholar]
  7. Cohen L. F., di Sant'Agnese P. A., Friedlander J. Cystic fibrosis and pregnancy. A national survey. Lancet. 1980 Oct 18;2(8199):842–844. doi: 10.1016/s0140-6736(80)90183-x. [DOI] [PubMed] [Google Scholar]
  8. Dooley R. R., Braunstein H., Osher A. B. Polypoid cervicitis in cystic fibrosis patients receiving oral contraceptives. Am J Obstet Gynecol. 1974 Apr 1;118(7):971–974. doi: 10.1016/0002-9378(74)90668-1. [DOI] [PubMed] [Google Scholar]
  9. Fitzpatrick S. B., Stokes D. C., Rosenstein B. J., Terry P., Hubbard V. S. Use of oral contraceptives in women with cystic fibrosis. Chest. 1984 Dec;86(6):863–867. doi: 10.1378/chest.86.6.863. [DOI] [PubMed] [Google Scholar]
  10. Grimmer S. F., Allen W. L., Back D. J., Breckenridge A. M., Orme M., Tjia J. The effect of cotrimoxazole on oral contraceptive steroids in women. Contraception. 1983 Jul;28(1):53–59. doi: 10.1016/s0010-7824(83)80005-5. [DOI] [PubMed] [Google Scholar]
  11. Hümpel M., Wendt H., Pommerenke G., Weiss C., Speck U. Investigations of pharmacokinetics of levonorgestrel to specific consideration of a possible first-pass effect in women. Contraception. 1978 Mar;17(3):207–220. doi: 10.1016/0010-7824(78)90012-4. [DOI] [PubMed] [Google Scholar]
  12. Isles A., Spino M., Tabachnik E., Levison H., Thiessen J., MacLeod S. Theophylline disposition in cystic fibrosis. Am Rev Respir Dis. 1983 Apr;127(4):417–421. doi: 10.1164/arrd.1983.127.4.417. [DOI] [PubMed] [Google Scholar]
  13. Joshi J. V., Joshi U. M., Sankholi G. M., Krishna U., Mandlekar A., Chowdhury V., Hazari K., Gupta K., Sheth U. K., Saxena B. N. A study of interaction of low-dose combination oral contraceptive with Ampicillin and Metronidazole. Contraception. 1980 Dec;22(6):643–652. doi: 10.1016/0010-7824(80)90089-x. [DOI] [PubMed] [Google Scholar]
  14. Kaplan E., Shwachman H., Perlmutter A. D., Rule A., Khaw K. T., Holsclaw D. S. Reproductive failure in males with cystic fibrosis. N Engl J Med. 1968 Jul 11;279(2):65–69. doi: 10.1056/NEJM196807112790203. [DOI] [PubMed] [Google Scholar]
  15. Oppenheimer E. H., Esterly J. R. Observations on cystic fibrosis of the pancreas. VI. The uterine cervix. J Pediatr. 1970 Dec;77(6):991–995. doi: 10.1016/s0022-3476(70)80082-8. [DOI] [PubMed] [Google Scholar]
  16. Palmer J., Dillon-Baker C., Tecklin J. S., Wolfson B., Rosenberg B., Burroughs B., Holsclaw D. S., Jr, Scanlin T. F., Huang N. N., Sewell E. M. Pregnancy in patients with cystic fibrosis. Ann Intern Med. 1983 Nov;99(5):596–600. doi: 10.7326/0003-4819-99-5-596. [DOI] [PubMed] [Google Scholar]
  17. Phelan P., Hey E. Cystic fibrosis mortality in England and Wales and in Victoria, Australia 1976-80. Arch Dis Child. 1984 Jan;59(1):71–73. doi: 10.1136/adc.59.1.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Spino M., Chai R. P., Isles A. F., Thiessen J. J., Tesoro A., Gold R., MacLeod S. M. Cloxacillin absorption and disposition in cystic fibrosis. J Pediatr. 1984 Nov;105(5):829–835. doi: 10.1016/s0022-3476(84)80317-0. [DOI] [PubMed] [Google Scholar]
  19. di Sant'agnese P. A., Davis P. B. Cystic fibrosis in adults. 75 cases and a review of 232 cases in the literature. Am J Med. 1979 Jan;66(1):121–132. doi: 10.1016/0002-9343(79)90491-1. [DOI] [PubMed] [Google Scholar]
  20. du Souich P., McLean A. J., Lalka D., Erill S., Gibaldi M. Pulmonary disease and drug kinetics. Clin Pharmacokinet. 1978 Jul-Aug;3(4):257–266. doi: 10.2165/00003088-197803040-00001. [DOI] [PubMed] [Google Scholar]

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