Drospirenone associated with an increased risk of thrombembolic accidents

A new study shows that drospirenone, a progestin-based contraceptive, is associated with an increased risk of venous thromboembolic accidents (VTE) and arterial thrombotic accidents (ATE).

The fact that birth control pills increase the risk of thromboembolic accidents is not new. Birth control pills are known to predispose to blood clots and doctors should discuss with patients before prescribing these drugs. Thromboembolic accidents refers to the formation of blood clots in the veins. This can have serious complications such as pulmonary embolism which  is a medical emergency. Pulmonary embolism is manifested by intense dyspnea, cyanosis, sweating,  malaise and others. Thrombotic accidents refers to the formation of blood clots in the arteries. Complete occlusion of arteries cause acute ischemia, that is the tissue is not supplied with oxygenated blood anymore, such as in myocardial infarction.

Now researchers at Kaiser Permanente Northern California Division of Research, reported that drospirenone-containing combined hormonal contraceptives is associated with a 2-fold higher risk for ATE compared with low dose estrogen contraceptives. In addition, the use of drospirenone-containing combined hormonal contraceptives increases by 77% the risk of hospitalization for VTE. Stephen Sidney, MD, MPH, Director of Research Clinics at the Kaiser Permanente Northern California Division of Research and lead author of the study, said that although the incidence of this accidents is small yet growing number of studies show that drospirenone increases the risk of VTE. He therefore advises that physicians prescribe this drug with caution to women who want to use this method of contraception.

Researchers conducted a retrospective cohort study that evaluated 573,680 women, aged between 10 and 55 years, who first used either low-dose contraceptive estrogen or  drospirenone-containing combined hormonal contraceptives(DRSP), between 2001 -2007. Study results showed that DRSP is associated with a higher risk of ATE and VTE compared to low dose estrogen contraceptives. It is important to note that although the risk of such complications is low, however patients should receive the most appropriate drug for contraception because there is a wide range of such drugs.

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