Effect of other medicinal products on desogestrel
ALL medications a woman is taking, whether prescribed, OTC, herbal, etc. should be checked for potential interactions with Lovima.
Interactions can occur between desogestrel and drugs that induce liver enzymes, which can then lead to increased clearance of sex hormones such as desogestrel. Drugs that have this effect may also include some herbal medications, such as St John's wort. As a result, blood levels of desogestrel may be reduced, potentially leading to breakthrough bleeding and/or an increased risk of contraceptive failure.
The prescribing information (SmPC, British National Formulary [BNF] or Stockley's Drug Interactions) of any concomitant medications should always be consulted to identify potential interactions with Lovima. If clinically relevant interactions are identified, the woman should be referred to her doctor for further contraception advice.
Hepatic enzyme-inducing drugs may increase the clearance of contraceptive hormones such as Lovima.
Some examples include:
| Drug class | Therapy area | Examples |
| Anticonvulsants | Epilepsy |
Hydantoins (e.g. phenytoin) Barbiturates (e.g. phenobarbital) Primidone, carbamazepine, oxcarbazepine, felbamate, topiramate |
| Antibiotics and antivirals | Tuberculosis, HIV infections, hepatitis C infections or other infectious diseases | Rifampicin, rifabutin, ritonavir,* nelfinavir,* nevirapine,* boceprevir,* telaprevir,* efavirenz, griseofulvin |
| Endothelin receptor antagonists | Pulmonary arterial hypertensions | Bosentan |
| Herbal remedies | Depressive mood | St John's wort (Hypericum perforatum) |
*These agents have variable effects on clearance of contraceptive hormones and may increase or decrease plasma concentrations of progestins.
Women taking any of the above medications should not be supplied Lovima tablets and should be referred to their doctor.
Concomitant administration of strong or moderate CY3A4 inhibitors may decrease the clearance of contraceptive hormones such as Lovima and may increase the risk of an adverse event. Such agents include the following:
| Drug class | Therapy area | Examples |
| Antibiotics | Bacterial infection | Clarithromycin, erythromycin |
| Calcium channel blockers | Hypertension | Diltiazem |
| Antifungals | Fungal infections | Ketoconazole, itraconazole, fluconazole |
Note: these lists are not exhaustive, and all concomitant medicines should be checked for interactions with Lovima.
COUNSELLING TIP:
Women taking CYP3A4 inhibitors long-term should be advised to consult their GP to discuss their contraceptive options.
EFFECT OF DESOGESTREL ON OTHER MEDICINAL PRODUCTS
Desogestrel can also affect the concentration and efficacy of other medicines. ALL medicines a woman is currently taking or planning to take should be checked for interactions with Lovima.
USE AFTER EMERGENCY HORMONAL CONTRACEPTION (EHC)
With availability of a POP without a prescription from a pharmacy, a pharmacist is able to provide immediate advice and pharmacy access to contraception for women requesting EHC and improve the probability of women using effective contraception in the long term.
Ulipristal acetate
It is important to note that the effectiveness of ulipristal acetate (for emergency contraception) could be reduced if Lovima is taken in the 5 days following the ulipristal dose. Therefore, the start of Lovima should be delayed for 5 days (120 hours) after emergency contraception with ulipristal acetate. Women should be advised to use additional contraception (barrier or abstinence) during these 5 days and then for an additional 7 days after starting Lovima, until contraception becomes effective. Ulipristal may also reduce the effectiveness of Lovima and, therefore, concomitant use is not recommended.
Levonorgestrel
After use of levonorgestrel (for emergency contraception), Lovima can be started immediately, but additional contraceptive measures (abstinence or use of barrier contraceptive measures) should be taken for the first 7 days of use.