| drug name | Combined Oral Contraceptives (COCs) |
| classification | Hormonal Contraceptives |
| pharmacokinetics | COCs contain estrogen and progestin. Estrogen is primarily metabolized in the liver, with a variable half-life depending on the specific formulation. Progestin metabolism also occurs in the liver, and its half-life varies. The drugs exert their effects primarily by suppressing the hypothalamic-pituitary-ovarian axis, resulting in inhibition of follicle development and ovulation. Active metabolites also contribute to the effects. |
| suggested dosage | Dosage varies widely depending on the specific COC formulation. Consult a healthcare professional for personalized recommendations. Generally, COCs are taken daily, with a consistent timing. A typical regimen is 21 active pills followed by a 7-day placebo or inactive pill period. |
| indications | Primary use is for contraception. Other potential indications include: regulation of menstrual cycles, reduction in menstrual pain and bleeding, treatment of acne, hirsutism, and endometriosis. |
| safety in pregnancy | ABSOLUTELY CONTRAINDICATED if pregnancy is confirmed. COCs should be immediately discontinued if pregnancy is suspected. |
| safety in breastfeeding | COCs may affect milk production. Consult a healthcare professional to determine the best course of action. Some formulations may have less impact on milk production than others. |
| side effects | | 1 | Nausea, vomiting, breast tenderness, headache, mood changes, weight changes (often minimal). | | 2 | More serious, though less common, side effects may include blood clots, stroke, heart attack, high blood pressure, liver tumors, and severe allergic reactions. | | 3 | Some patients may experience breakthrough bleeding or spotting. | | 4 | Contact a doctor immediately for any unusual or concerning symptoms. | | 5 | Certain formulations may increase risk of certain side effects. |
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| contraindications | | 1 | History of blood clots (deep vein thrombosis, pulmonary embolism) | | 2 | History of stroke or heart attack | | 3 | Known or suspected thrombophilic disorders | | 4 | Uncontrolled hypertension | | 5 | Severe liver disease | | 6 | Breast cancer or history of breast cancer | | 7 | Migraine with aura | | 8 | Known hypersensitivity to components of COCs |
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| interactions | Some medications can interact with COCs, potentially affecting their effectiveness or increasing side effects. Inform your healthcare professional about all medications you are taking. |
| warnings and precautions | Regular check-ups with a healthcare provider are crucial while taking COCs to monitor for any potential side effects. Careful monitoring is important in individuals with risk factors for cardiovascular disease. Inform your healthcare provider about any pre-existing conditions before starting COCs. COCs do not protect against STIs. |
| additional information | Individual responses to COCs vary. A healthcare provider can help determine the most suitable formulation and dosage. Smoking significantly increases the risk of cardiovascular events associated with COCs. |
| patient specific considerations | | age | 25 years: No significant age-related alterations to consider for COC use at this time. Consult physician for individual needs. | | weight | 70 kg: Weight should be considered a factor when choosing a contraceptive method. Consultation with physician recommended for personalized advice. |
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| disclaimer | This information is for educational purposes only and does not constitute medical advice. Consult with a healthcare professional for any health concerns or before making any decisions related to your health or treatment. |
