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Prescribing patterns of combined hormonal products containing cyproterone acetate, levonorgestrel and drospirenone in the UK
  1. Lucía Cea-Soriano1,2,
  2. Mari-Ann Wallander3,
  3. Luis Alberto García Rodríguez1
  1. 1Pharmacoepidemiologist, Spanish Centre for Pharmacoepidemiologic Research (CEIFE), Madrid, Spain
  2. 2Department of Preventive Medicine and Public Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
  3. 3Professor, Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
  1. Correspondence to Dr Lucía Cea-Soriano, Pharmacoepidemiology, Spanish Centre for Pharmacoepidemiologic Research (CEIFE), Almirante 28, Madrid 28004, Spain; luciaceife{at}


Background There are limited data to show the levels of prescribing of combined oral contraceptives (COCs) and other hormonal products containing estrogen/progestogen combinations that may be outside the product licence.

Aims To determine the diagnosis/indication recorded at the time of prescription of cyproterone acetate/ethinylestradiol (CPA/EE) and two COCs, levonorgestrel/EE (LNG/EE) and drospirenone/EE (DRSP/EE).

Design and setting Retrospective study using a primary care database, The Health Improvement Network (THIN).

Methods Women in THIN aged 12–49 years prescribed CPA/EE, LNG/EE or DRSP/EE in 2002–2010 were identified. Overall use of each product and proportion of new users each year were determined. Among new users, database codes were analysed to infer the reason for prescription.

Results The proportion of new users of each product in 2002 and 2010, respectively, were: LNG/EE, 2.03% and 2.40%; CPA/EE, 0.45% and 0.27%; and DRSP/EE, 0.27% and 0.56%. Most new users prescribed CPA/EE had a record of acne (51.0% and 79.2% in 2002 and 2010, respectively) or hirsutism (3.0% and 5.0% in 2002 and 2010, respectively); the proportion of new users with a record only for contraception decreased from 32.9% in 2002 to 8.6% in 2010. Among new users prescribed DRSP/EE or LNG/EE in 2010, 43.2% and 30.8% of women, respectively, did not have a record indicating use for contraception.

Conclusions Adherence to prescribing guidelines for CPA/EE has improved over time. A substantial proportion of women using DRSP/EE or LNG/EE had records for hormone-responsive conditions only, suggesting that many women were prescribed these therapies for non-contraceptive use.

  • hormonal contraception
  • cyproterone acetate
  • levonorgestrel
  • drospirenone
  • prescribing
  • pharmacoepidemiology
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  • Funding This study was funded by Bayer Pharma AG, Berlin, Germany.

  • Competing interests Lucía Cea-Soriano and Luis Alberto García Rodríguez are employees of CEIFE, which has received a research grant from Bayer Pharma AG for this work. Mari-Ann Wallander was an employee of AB Bayer, Solna, Sweden at the time of the study.

  • Ethics approval UK Multicentre Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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