Once-a-month oral contraceptive could improve patient adherence

Researchers have created a new ingestible drug delivery platform that expands in the stomach and could safely deliver a contraceptive over one month when tested in pigs. The technology could one day help women adhere more easily to birth control regimens by providing an alternative to daily oral contraceptive pills. Daily birth control pills are the preferred form of contraception for a large portion of the population, largely because of their ease of use. However, many women face difficulties with adhering to daily pill schedules – a multinational survey published in 2010, after surveying women in the US, UK, France, Germany, Spain, Italy, Brazil, Australia and Russia, revealed that nearly half of women missed at least one dose over three months or reported taking their pill at the wrong time. These irregularities can reduce the effectiveness of oral pills, to the point where the chance of pregnancy in women that use them is still 9% on average each year. To address these challenges, Ameya Kirtane and colleagues developed a drug delivery system that fits within a gelatin capsule and, after being ingested, expands in the stomach, where it can reside for at least three weeks. When loaded with the contraceptive levonorgestrel and administered to pigs, the platform released the drug into the stomach over one month, and the drug remained detectable in serum for up to 29 days. In contrast, levonorgestrel from an oral immediate-release tablet (Levora) could only be detected in the serum of pigs for around two days. Kirtane et al. say that future studies should test the contraceptive efficacy of their dosage form, as well further refine their technology’s materials. They add that their platform has several features, such as the opportunity for self-administration, that could help overcome cultural and economic barriers to long-acting contraceptives in low-income countries.

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