DEADLY RISK OF PILL USED BY 1M WOMEN
A MILLION women who take Britain’s most popular contraceptive pills are to be told that they risk developing potentially fatal bloods clots.
All GPs have been ordered to warn patients that taking some of the best-selling brands of birth control tablets – including Yasmin, Femodene and Marvelon – means they are twice as likely to suffer blood clots compared to those who use older varieties. Scientists have found so-called third generation contraceptives caused 14 deaths a year in France – and now doctors in the UK have been ordered to alert women to the alarming dangers.
Doctors have also been told not to offer the newer types of pill to those women at highest risk.
Drugs watchdogs have written to the country’s 60,000 GPs telling them they must, for the first time, go through a checklist when prescribing the pills. The aim is to ensure they are not given to women with a higher inherent risk of developing blood
clots. And they have been told they should ‘carefully consider’ the risks when prescribing pills.
The move follows a report by the European Medicines Agency which found that synthetic hormones used in third-generation pills increased the chance of developing life-threatening deep vein thromboses (DVT) far more than previously thought.
These newer pills are prescribed around 2million times a year in the UK. They are popular because they are less likely than their predecessors to cause side-effects such as weight gain, headaches, breast tenderness and hair growth.
But GPs have now been told they must fully inform women of the risks of taking different ‘combined hormonal contraceptives’, which contain synthetic versions of the
Increased risk of strokes and lung blockages
female hormones oestrogen and progesterone.
Thousands of women in Scotland take third and fourth generation contraceptive pills, even though they are not routinely prescribed by doctors.
The Scottish Medicines Consortium has ruled that Yasmin is too expensive for general use, although it can still be prescribed after consultation between a woman and her GP. Femodene and Marvelon are increasingly common as doctors move away from more old-fashioned varieties of the Pill.
DVTs, which typically form in the leg, can travel up blood vessels causing a potentially fatal blockage in the lung called a pulmonary embolism. They can also go up to the brain, triggering a stroke.
Risk factors include being older and overweight, smoking or being prone to a type of migraine. Last night pharmaceutical giant Bayer, maker of Yasmin and Femodene, said it would make blood clot warnings more prominent on packets.
Dr Peter Swinyard, chairman of the Family Doctors’ Association, said the advice would change the way he would prescribe pills.
He said: ‘Whereas previously I would have used Yasmin or Femodene as first line because they’re more “lady friendly”, now I probably wouldn’t be as keen.’
However, he said he would still offer both to patients.
The letter from watchdogs at the Medicines and Healthcare Products Regulatory Agency (MRHA), which went out on January 22, stated that the risk of developing a serious blood clot from taking any combined pill was still ‘small’ and said that any woman who had been taking a particular pill without any problems ‘does not need to stop using it’.
The benefits ‘far outweigh the risk of serious side effects in most women,’ it went on. Being pregnant actually increases the risk of DVT far more than any pill.
But the letter warned doctors that ‘careful consideration’ should be given to each patient’s risk of developing DVT.
Doctors should ‘regularly reassess’ each woman’s risk and discuss with them the potential dangers of the pills they were prescribing. Similar letters have gone out to doctors across Europe. Taking third
‘People need to be told of the dangers’
generation contraceptives increases the risk of clots six times compared to those taking no pills at all.
The annual risk of a woman of childbearing age having a serious blood clot is one in 5,000 if she is not on a combined contraceptive pill, it said. The risk triples to about one in 1,700 a year if she is taking one of the older forms of combined pill, and taking third generation pills means the risk doubles again, to as high as one in 800.
Previous advice from 2011 suggested that the risk of clots among those taking third generation contraception was just one in 3,000.
The European review was prompted by a report from France, which found that from 2000 to 2011, 2,529 cases of serious blood clots – just over 200 a year – were down to combined contraceptives. Of those, 1,751 (146 a year) were due to third generation pills. These clots led to 20 deaths a year on average, 14 from newer versions of the pill and six from older versions.
Doctors are still trying to understand the link between the newer pills and serious blood clots – but it is thought that it is the synthetic oestrogen which increases the risk.
The hormones which appear to cause raised risks are: gestodene, desogestrel, drospirenone, etonogestrel and norelgestromin. These are present in brands including Evra Patch, Femodene, Gedarel, Katya, Marvelon, Mercilon, Millinette, Sunya, Triadene, Yasmin and Yaz. Older and apparently safer forms of progesterone are levonorgestrel, norgestimate and norethisterone.
Third generation pills were launched in the 1980s and official concerns were first raised about increased DVT risks in 1995.
Dr Sarah Branch of the MHRA said yesterday: ‘Women should continue to take their contraceptive pill. These are very safe, highly effective medicines for preventing unintended pregnancy and the benefits associated with their use far outweigh the risk of blood clots.’
Dr Asma Khalid, of Marie Stopes International, added: ‘Any method of contraception comes with benefits and possible side-effects.’