Galzote Rosanna M, Rafie Sally, Teal Rachel, Mody Sheila K
Section of Family Planning, Department of Reproductive Medicine, University of California, San Diego.
Department of Pharmacy, UC San Diego Health, San Diego, CA, USA.
Int J Womens Health. 2017 May 15;9:315-321. doi: 10.2147/IJWH.S102306. eCollection 2017.
The transdermal patch provides an effective and convenient option for hormonal contraception. The patch currently on the US market contains 150 µg norelgestromin and 35 µg ethinylestradiol (EE). The 20 cm patch is applied once weekly for 3 weeks, followed by a patch-free week, for a 21-7 cycle. Typical failure rates are similar to that of combined oral contraceptives (COCs). Transdermal delivery results in less peaks and troughs of estrogen, but a higher total estrogen exposure compared with COCs. Though studies show mixed results, the risk of developing venous thromboembolism (VTE) is about twice as high with the patch as with COCs; however, the absolute risk of VTE remains low. The side effect profile is similar to that of COCs, with slightly higher rates of breast tenderness plus a unique adverse effect of application site reactions. Two new patches have been developed, one containing gestodene and EE in Europe and another containing levonorgestrel and EE. Overall, the patch provides an alternative to COCs for women who want autonomy and the benefit of not needing to take a pill daily, with similar efficacy and tolerability.
透皮贴剂为激素避孕提供了一种有效且便捷的选择。目前美国市场上的透皮贴剂含有150微克去氧孕烯炔雌醇和35微克炔雌醇(EE)。这种20平方厘米的贴剂每周使用一次,连用3周,然后停用1周,形成21 - 7的周期。典型失败率与复方口服避孕药(COC)相似。透皮给药导致雌激素的峰谷波动较小,但与COC相比,雌激素的总暴露量更高。尽管研究结果不一,但使用透皮贴剂发生静脉血栓栓塞(VTE)的风险约为使用COC的两倍;然而,VTE的绝对风险仍然较低。副作用情况与COC相似,乳房压痛发生率略高,还有独特的贴剂应用部位不良反应。已经研发出两种新的透皮贴剂,一种在欧洲含有孕二烯酮和炔雌醇,另一种含有左炔诺孕酮和炔雌醇。总体而言,对于希望自主且受益于无需每日服药的女性来说,透皮贴剂为COC提供了一种替代选择,其疗效和耐受性相似。