Women 'not being warned' hospital drug interferes with contraceptives

Patients given a drug commonly used during surgery are not routinely being informed that it can cause contraceptive failure, a new study suggests.

A female anaesthetist holds a mask over the face of a young woman on an operating table.
Sugammadex is one several drugs available to reverse muscle relaxation suring surgery. | GETTY IMAGES

Sugammadex reverses the effects of the neuromuscular blockers rocuronium and vecuronium and is administered at the end of surgery before patients wake up. The drug is known to interact with the hormone progesterone and may reduce the effectiveness of hormonal contraceptives, including the progesterone-only pill, combined pill, vaginal ring, implants and intra-uterine devices.

Further information

View sugammadex drug record

However, new research suggests that patients are not routinely being warned of the interaction as current guidance recommends, putting them at risk of unplanned pregnancy.

Researchers from the department of anaesthesiology at University College London (UCL) hospitals NHS foundation trust questioned anaesthetists across the trust on their use of sugammadex.

Reporting their findings at Euroanaesthesia, the annual meeting of the European Society of Anaesthesiology and Intensive Care in Milan on 4-6 June, they said 94% of the 82 anaesthetists surveyed were aware of the risk of contraceptive failure associated with sugammadex, but only 30% discussed the drug with patients. 

The researchers also audited the use of sugammadex. Over a 6-week period, the drug was administered to 234 patients, of whom 65 (28%) were women of childbearing age. The researchers identified 48 women who should have been given advice on the risks of contraceptive failure, yet none had any such conversation documented in their notes. 

'It is concerning that we are so seldom informing patients of the risk of contraceptive failure following sugammadex use,' said Dr Neha Passi, one of the researchers. 'Use of sugammadex is expected to rise as it becomes cheaper in the future and ensuring that women this receiving medicine are aware it may increase their risk of unwanted pregnancy must be a priority'.

The researchers acknowledge they only studied one hospital trust but say they expect the results to be similar in elsewhere in the UK.

Current guidance on the use of sugammadex is to inform all women of childbearing age of the interaction with hormonal contraception either ahead of anticipated use, or following administration. Women taking oral hormonal contraceptives should be advised to follow the missed pill advice in the leaflet that comes with their contraceptives, and those using other types of hormonal contraceptive should be advised to use an additional non-hormonal means of contraception for seven days. 

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