Oral Piroxicam Plus Levonorgestrel Increases Efficacy of Emergency Contraception

THURSDAY, Aug. 17, 2023 (HealthDay News) -- Oral piroxicam coadministered with levonorgestrel improves the efficacy of emergency contraception (EC), according to a study published online Aug. 16 in The Lancet.

Raymond Hang Wun Li, M.D., from the University of Hong Kong, and colleagues conducted a randomized trial in a major community sexual and reproductive health service in Hong Kong. Women who required levonorgestrel EC within 72 hours of unprotected sexual intercourse were recruited and randomly assigned to a single supervised dose of levonorgestrel 1.5 mg plus piroxicam 40 mg or placebo orally (420 women in each group). The pregnancy status was noted by history or pregnancy test at follow-up one to two weeks after the next expected period.

The researchers found that one and seven (0.2 and 1.7 percent, respectively) of efficacy-eligible women in the piroxicam and placebo groups were pregnant. Levonorgestrel plus piroxicam and levonorgestrel plus placebo prevented 94.7 and 63.4 percent of expected pregnancies, respectively. In terms of the proportion of women with advancement or delay of their next period or in the adverse event profile, no significant differences were noted between the two groups.

"This randomized double-blind placebo-controlled trial showed for the first time that oral piroxicam 40 mg co-administered with levonorgestrel significantly improves EC efficacy without increasing the likelihood of adverse events," the authors write. "This can be considered where levonorgestrel EC is the option of choice."

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