Is There a Lactose-Free Oral Contraceptive?

Q&A 63.5

Is there a lactose-free oral contraceptive?

Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

Before using this Q&A, read the disclaimer at prepared: 3rdAugust 2016

Background

For general information about lactose intolerance and medicines, see Medicines Q&A 131: “What factors need to be considered when prescribing for lactose intolerant adults?”

Answer

All licensed oral contraceptives currently available on prescription contain lactose (see Appendix 1) (1,2).

Previously Femulen®was available, but this has now been discontinued by Pfizer(3). Femulen was an oral progestogen-only contraceptive containing etynodiol diacetate.

Lactose-free options could include:

Barrier methods of contraception (e.g. condoms).
Intra-uterine devices (IUDs) orlevonorgestrel-releasing intrauterine systems (IUS), e.g. Mirena®, Levosert®, Jaydess® (4-6).
Evra® transdermal patch, a topical combined contraceptive (7).
Injectable progestogen-only contraceptives such as Depo-Provera®or Sayana Press®or Nexplanon® subdermal implant (8-10).
NuvaRing®, a vaginal delivery system (11).

Limitations

Generic products or ‘branded generics’ may also be available but mayhave not been considered. Individual SPCs/PILs should be checked before prescribing as formulations may change.It has been assumed that all information concerning lactose in manufacturers’ SPCs is complete and correct.Emergency hormonal contraception has not been considered.

References

(1)Summaries of Product Characteristics for oral contraceptives other than those listed in reference 2 below. Accessed via on 01/08/2016.

(2)Summaries of Product Characteristics for Cimizt, Elevin, Katya30/75, Levest, Lizinna, Nacrez, Sunya20/75, Zelleta. Accessed via on01/08/2016.

(3)Pfizer Ltd. Letter to healthcare professionals. Femulen (etynodiol diacetate) tablets 500microgram. 19/02/2013.

(4)Summary of Product Characteristics – Mirena. Bayer plc. Accessed via on 01/08/2016. SPC last updated on eMC on 01/07/2015

(5)Summary of Product Characteristics – Levosert 20micrograms/24 hours IDS. Allergan Ltd. Accessed via on 23/09/2016. SPC last update on eMC on 31/05/2016

(6)Summary of Product Characteristics – Jaydess 13.5mg intrauterine delivery system. Bayer plc. Accessed via on 01/08/2016. SPC last update on eMC on 12/07/2016.

(7)Summary of Product Characteristics – Evra Transdermal Patch. Janssen-Cilag Ltd. Accessed via on01/08/2016. SPC last updated on the eMC on27/05/2016.

(8)Summary of Product Characteristics - Depo-Provera 150mg/ml injection. Pfizer Ltd. Accessed via on 01/08/2016. SPC last updated on the eMC on 03/03/2016.

(9)Summary of Product Characteristics – Sayana Press 104mg/0.65ml suspension for injection. Pfizer Ltd. Accessed via on 01/08/2016. SPC last updated on eMC on 06/06/2016.

(10)Summary of Product Characteristics – Nexplanon 68mg implant for subdermal use. Merck Sharp and Dohme Ltd. Accessed via on 01/08/2016. SPC last updated on the eMC on 17/05/2016.

(11)Summary of Product Characteristics – NuvaRing. Merck Sharp and Dohme Ltd. Accessed via on 01/08/2016. SPC last updated on eMC on 21/04/2016.

Quality Assurance

Prepared by

Joshua McKie, Critical Evaluation Pharmacist (based on earlier work by Dr Simon Willsand Sue Gough, Southampton Medicines Advice Service, University Hospital Southampton NHS Foundation Trust

Date Prepared

3rd August 2016

Contact

Checked by

Samantha Owen, Principal Pharmacist Critical Evaluation, Southampton Medicines Advice Service, University Hospital Southampton NHS Foundation Trust

Date of check

23rd September 2016

Appendix 1

Search strategy and list of oral contraceptives that contain lactose

Product / Contains lactose / Listed in / Source of SPC
Acondro / Yes / MIMS / MHRA
Aidulan 20/75 / Yes / MIMS / EMC
Aidulan 30/75 / Yes / MIMS / EMC
Aizea / Yes / MIMS / EMC
Alenini / Yes / DT / EMC
Alenvona / Yes / MIMS / MHRA
Bimizza / Yes / MIMS / MHRA
Brevinor / Yes / BNF / EMC
Cerazette / Yes / MIMS / EMC
Cerelle / Yes / MIMS / EMC
Cilest / Yes / BNF / EMC
Cilique / Yes / MIMS / EMC
Cimizt / Yes / MIMS / MHRA
Cleosensa / Yes / MIMS / EMC
Daylette / Yes / MIMS / EMC
Desogestrel / Yes / MIMS / EMC
Desomono / Yes / MIMS / MHRA
Desorex / Yes / MIMS / MHRA
Dretine / Yes / MIMS / MHRA
Elevin / Yes / MIMS / MHRA
Eloine / Yes / MIMS / EMC
Erlibelle / Yes / MIMS / EMC
Feanolla / Yes / MIMS / EMC
Femodene / Yes / BNF / EMC
FemodeneED / Yes / BNF / EMC
Femodette / Yes / BNF / EMC
Gedarel 20/150 / Yes / BNF / EMC
Gedarel 30/150 / Yes / BNF / EMC
Juliperla / Yes / C+D / EMC
Katya 30/75 / Yes / BNF / MHRA
Lestramyl 20/150 / Yes / MIMS / EMC
Lestramyl 30/150 / Yes / MIMS / MHRA
Levest / Yes / BNF / MHRA
Lizinna / Yes / MIMS / MHRA
Loestrin 20 / Yes / BNF / EMC
Loestrin 30 / Yes / BNF / EMC
Logynon / Yes / BNF / EMC
Logynon ED / Yes / BNF / EMC
Lucette / Yes / MIMS / EMC
Maexeni / Yes / MIMS / EMC
Marvelon / Yes / BNF / EMC
Mercilon / Yes / BNF / EMC
Microgynon 30 / Yes / BNF / EMC
Microgynon 30 ED / Yes / BNF / EMC
Micronor / Yes / MIMS / EMC
Millinette20/75 / Yes / BNF / EMC
Millinette30/75 / Yes / BNF / EMC
Munalea 20/150 / Yes / MIMS / EMC
Munalea 30/150 / Yes / MIMS / EMC
Nacrez / Yes / MIMS / MHRA
Norgeston / Yes / MIMS / EMC
Noriday / Yes / MIMS / EMC
Norimin / Yes / BNF / EMC
Norinyl-1 / Yes / BNF / EMC
Ovranette / Yes / BNF / EMC
Qlaira / Yes / BNF / EMC
Rigevidon / Yes / BNF / EMC
Sofiperla / Yes / C+D / EMC
Sunya 20/75 / Yes / BNF / MHRA
Synphase / Yes / BNF / EMC
Triadene / Yes / BNF / EMC
TriRegol / Yes / BNF / EMC
Yacella / Yes / MIMS / MHRA
Yasmin / Yes / BNF / EMC
Zelleta / Yes / MIMS / MHRA
Zoely / Yes / BNF / EMC

Available through NICE Evidence Search at