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  • Title: Contraceptive steroid concentrations in women with early active schistosomiasis: lack of effect of antischistosomal drugs.
    Author: el-Raghy I, Back DJ, Osman F, Orme ML, Fathalla M.
    Journal: Contraception; 1986 Apr; 33(4):373-7. PubMed ID: 3089682.
    Abstract:
    Plasma concentrations of the oral contraceptive steroids (OCS) ethinyloestradiol (EE2) and levonorgestrel (LNG) have been determined in women with early active schistosomiasis and compared to those obtained in healthy volunteers. Steroid concentrations following a single dose of Ovral (500 micrograms LNG, 50 micrograms EE2) or during a multiple dose regimen were unaffected by the disease. There was no significant effect of the antischistosomal drugs praziquantel (40 mg X kg-1) or metrifonate (10 mg X kg-1 X 3 at 2-week intervals) on plasma steroid concentrations. In regular users of OCS, significantly higher concentrations of LNG were observed than in women who received only a single dose. We conclude that there is no pharmacokinetic reason for withholding OCS from patients with early active schistosomiasis who are also receiving either praziquantel or metrifonate. This study was designed to determine the effects of early active schistosomiasis and treatment with antischistosomal agents on concentrations of the oral contraceptive (OC) steroids, ethinyl estradiol and levonorgestrel. Study subjects included 31 women attending rural health units in the Assiut area of Egypt, 25 of whom had proven schistosoma hematobium or schistosoma mansoni of the urinary and intestinal systems. Steroid plasma concentrations after a single dose of Ovral (500 mcg levonorgestrel, 50 mcg ethinyl estradiol) or during a multiple dose regimen did not differ significantly between cases and healthy controls. There was no significant effect of the antischistosomal drugs praziquantel or metrifonate on plasma steriod concentrations. Study participants with a history of OC use in the 6 months preceding the study had higher plasma concentrations of levonorgestrel than those given a single dose as part of the study. the finding that the elimination of OC steriods is not affected in patients displaying early manifestations of schistosomiasis complements previous research on the effects of OCs on hepatic function in women with active schistosomiasis. It is concluded that there is no pharmacokinetic indiction for withholding OCs from women with early active schistosomiasis who are concurrently receiving antischistosmal drugs.
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