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Pubmed for Handhelds

PUBMED FOR HANDHELDS

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  • Title: Oral contraceptive failure secondary to dentally prescribed drugs: fact or fiction?
    Author: Kleier DJ, Tucker JE.
    Journal: J Colo Dent Assoc; 1987; 66(2):5-6. PubMed ID: 3478352.
    Abstract:
    Drug interactions likely to occur with dentally prescribed drugs and oral contraceptives include 2 broad mechanisms: reduced reabsorption of contraceptive steroids and stimulation of liver metabolism of the steroids. The antibiotics ampicillin and tetracycline are often reported to cause failure of oral contraceptives, now that pills contain such low doses. These medications destroy bacteria in the gut that normally hydrolyze conjugated steroids, re-releasing them into the circulation. Thus reduced entero-hepatic recirculation lowers active levels of the contraceptive steroids. Drugs that induce hepatic enzymes such as barbiturates and sedatives, enhance elimination of steroids. Other drugs, such as rifampin the anti-tubercular antibiotic, and barbiturates, phenobarbital meperidine, penicillin V, phenylbutazone, phenytoin sodium, sulfonamides and chloramphenicol have also been implicated in failures of the pill. Dentists should take a detailed history of drug intake, specifically mentioning oral contraceptives, and counsel patients accordingly. They are ultimately responsible for unintended pregnancy in the event of pill failure when writing prescriptions for their patients.
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