RESUMO
Four different implants, in the form of capsules or covered rods, that release one of the synthetic progestins levonorgestrel, etonogestrel, Nestorone, or Elcometrine and nomegestrol acetate were reviewed. Biocompatible polymers or copolymers of polydimethyl/polymethylvinyl-siloxanes or ethylvinylacetate are used to hold the steroid crystals and to control the rate of release. Once inserted under the skin, these implants release the corresponding steroid continuously over prolonged periods, a process that can be readily interrupted by implant removal. During long-term use of the implant, the released steroid circulates in blood at a fairly stable level. The physical characteristics of the implants, including drug contents and rate of release, serum levels of the progestin during use, and the duration of their effective life are described. Total steroid loads vary in the range of 50 mg to 216 mg; average release rates are in the range of 30-100 ug/day, and effective lives from 6 months to 7 years.
Assuntos
Anticoncepcionais Femininos/sangue , Congêneres da Progesterona/sangue , Congêneres da Progesterona/farmacocinética , Biodegradação Ambiental , Anticoncepcionais Femininos/química , Anticoncepcionais Femininos/farmacocinética , Implantes de Medicamento , Feminino , Humanos , Congêneres da Progesterona/químicaRESUMO
Cyclo-Provera, the original name of the combination of 25 mg medroxyprogesterone acetate and 5 mg estradiol cypionate, later known as Cyclofem and hereafter referred to MPA/E2C, has proven its use-effectiveness (pregnancy rate less than 1%) in routine service delivery conditions. Overall, the life-table discontinuation rates at 1 year ranged from 33.5% to 71.8%. Only a third of total discontinuations were attributable to the injectable contraceptive method, thus raising the importance of service delivery issues related to its continued use. The results of introductory trials in Mexico, Indonesia, Thailand, Tunisia, Jamaica and, more recently, Brazil, Colombia, Chile and Peru have demonstrated that MPA/E2C is a highly effective contraceptive that could be offered as an alternative to current fertility regulation methods for many women around the world. In addition, the results of studies were the basis for the approval of MPA/E2C by local health authorities and its inclusion in the Ministries of Health Family Planning Programs.
Assuntos
Anticoncepcionais Femininos , Países em Desenvolvimento , Estradiol/análogos & derivados , Conhecimentos, Atitudes e Prática em Saúde , Acetato de Medroxiprogesterona , Anticoncepcionais Femininos/efeitos adversos , Anticoncepcionais Femininos/química , Anticoncepcionais Orais Combinados/efeitos adversos , Anticoncepcionais Orais Combinados/química , Preparações de Ação Retardada , Combinação de Medicamentos , Estradiol/efeitos adversos , Estradiol/química , Serviços de Planejamento Familiar/métodos , Feminino , Humanos , Injeções Intramusculares , Tábuas de Vida , Acetato de Medroxiprogesterona/efeitos adversos , Acetato de Medroxiprogesterona/química , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Gravidez/estatística & dados numéricos , Estudos Prospectivos , Fatores SocioeconômicosRESUMO
Cyclo-Provera, the original name of the combination of 25 mg medroxyprogesterone acetate and 5 mg estradiol cypionate, later known as Cyclofem and hereafter referred to MPA/E2C, has proven its use- effectiveness (pregnancy rate less than 1 percent) in routine service delivery conditions. Overall, the life-table discontinuation rates at 1 year ranged from 33.5 percent to 71.8 percent. Only a third of total discontinuations were attributable to the injectable contraceptive method, thus raising the importance of service delivery issues related to its continued use. The results of introductory trials in Mexico, Indonesia, Thailand, Tunisia, Jamaica and, more recently, Brazil, Colombia, Chile and Peru have demonstrated that MPA/E2C is a highly effective contraceptive that could be offered as an alternative to current fertility regulation methods for many women around the world. In addition, the results of studies were the basis for the approval of MPA/E2C by local health authorities and its inclusion in the Ministries of Health Family Planning Programs.(Au)