The latest headlines trumpeting the prescribing and dispensing of oral contraceptives by
pharmacists prompted us to have a look at the reality of dispensing oral contraceptives.
It is not all positive. Oral contraception can be divided into Combined Oral Contraception
(COCs) and Progesterone Only Pills (POPs). In this edition we will be looking at COCs.
COCs
There is a huge choice and patients can be prescribed either 21-day packs, where they take
a 7 day break, or 28-day packs, without a break. Most COCS contain either 20mcg, 30mcg
or 35mcg Ethinylestradiol plus a progestogen. Most COCs are available as Monophasic tablets
i.e., the active ingredient in all tablets is the same throughout the pack, whilst a small number
are available as Multiphasic pills that provide different levels of the hormones during the cycle
of taking them depending on the brand of pill. Again, the Monophasic and Multiphasic are
available as 28-day and 21-day pack.
The available progestogens that are combined with Ethinylestradiol are Desogestrel, Drospirenone,
Gestodene, Levonorgestrel, Norethisterone, and Norgestimate. A small number of COCs are available
as Estradiol, Estetrol or Mestranol. These are then combined with either Drosperinone, Nomegestrol
or Dienogest.
This seems all very confusing which is why we have created the following table which allows you to
see the oestrogen and progestogen content of COCs together with the prices, as well as the brands.
Dispex members can see the profitability of these brands and the profitability when the COCs are
prescribed generically, within the Brand Comparisons section of the Dispex website. Click here to
read more.
