Q&A 63.4

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

Date prepared: 4thOctober 2013

Background

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

Answer

All licensed oral contraceptives currently available on prescription contain lactose (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:

  1. Barrier methods of contraception (e.g. condoms).
  2. Intra-uterine devices (IUDs) or Mirena, an intra-uterine system (IUS) (4).
  3. Evra transdermal patch, a topical combined contraceptive (5).
  4. Injectable progestogen-only contraceptives such as Depo-Proveraor Sayana Press (but seeSummaries of Product Characteristics[SPCs] for advice on adverse effects on bone) or Nexplanon subdermal implant (6-8).
  5. NuvaRing, a vaginal delivery system (9).

The following oral contraceptives CONTAIN lactose: Aizea, BiNovum, Brevinor, Cerelle, Cerazette, Cilest, Cimizt, Elevin, Femodene, Femodene ED, Femodette, Gedarel 20/150, Gedarel 30/150, Katya 30/75, Levest, Lizinna, Loestrin 20, Loestrin 30, Logynon, Logynon ED, Marvelon, Mercilon, Microgynon 30, Microgynon 30 ED, Micronor, Millinette 20/75, Millinette 30/75, Nacrez, Norgeston, Noriday, Norimin, Norinyl1, Ovranette, Ovysmen, Qlaira, Rigevidon, Sunya 20/75, Synphase, Triadene, TriNovum, TriRegol, Yasmin, Zelleta, Zoely (1,2).

Limitations

Generic products may also be available but have not been considered. Individual SPCs 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.

References

(1)Summaries of Product Characteristics for oral contraceptives other than those listed in reference 2 below. Accessed via on 04/10/2013.

(2)Summaries of Product Characteristics for Cimizt, Elevin, Katya30/75, Levest, Lizinna, Nacrez, Sunya20/75, Zelleta. Accessed via on 04/10/2013.

(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 4/10/2013. SPC last updated on eMC on 11/06/2013.

(5)Summary of Product Characteristics – Evra Transdermal Patch. Janssen-Cilag Ltd. Accessed via on 4/10/2013. SPC last updated on the eMC on 21/03/2013.

(6)Summary of Product Characteristics - Depo-Provera 150mg/ml injection. Pfizer Ltd. Accessed via on 4/10/2013. SPC last updated on the eMC on 18/09/2012.

(7)Summary of Product Characteristics – Sayana Press 104mg/0.65ml suspension for injection. Pfizer Ltd. Accessed via on 4/10/2013. SPC last updated on eMC on 10/06/2013.

(8)Summary of Product Characteristics – Nexplanon 68mg implant for subdermal use. Merck Sharp and Dohme Ltd. Accessed via on 4/10/2013. SPC last updated on the eMC on 23/10/2012.

(9)Summary of Product Characteristics – NuvaRing. Merck Sharp and Dohme Ltd. Accessed via on 04/10/2013. SPC last updated on eMC on 23/09/2013.

Quality Assurance

Prepared by

Sue Gough, Critical Evaluation Pharmacist (based on earlier work by Dr Simon Wills), Wessex Drug and Medicines Information Centre, University Hospital Southampton NHS Foundation Trust

Date Prepared

4th October 2013

Checked by

Kate Pickett (based on the Q&A originally checked by Jonathan Hall), Medicines Q&A Pharmacist, Wessex Drug and Medicines Information Centre, University Hospital Southampton NHS Foundation Trust.

Date of check

10th October 2013

Search strategy

Product / Listed in / Source of SPC
Aizea / BNF / eMC
BiNovum / BNF / eMC
Brevinor / BNF / eMC
Cerelle / BNF / eMC
Cerazette / BNF / eMC
Cilest / BNF / eMC
Cimizt / MIMS / MHRA
Elevin / MIMS / MHRA
Femodene / BNF / eMC
Femodene ED / BNF / eMC
Femodette / BNF / eMC
Gedarel 20/150 / BNF / eMC
Gedarel 30/150 / BNF / eMC
Katya 30/75 / BNF / MHRA
Levest / BNF / MHRA
Lizinna / MIMS / MHRA
Loestrin 20 / BNF / eMC
Loestrin 30 / BNF / eMC
Logynon / BNF / eMC
Logynon ED / BNF / eMC
Marvelon / BNF / eMC
Mercilon / BNF / eMC
Microgynon 30 / BNF / eMC
Microgynon 30 ED / BNF / eMC
Micronor / BNF / eMC
Millinette 20/75 / BNF / eMC
Millinette 30/75 / BNF / eMC
Nacrez / BNF / MHRA
Norgeston / BNF / eMC
Noriday / BNF / eMC
Norimin / BNF / eMC
Norinyl-1 / BNF / eMC
Ovranette / BNF / eMC
Ovysmen / BNF / eMC
Qlaira / BNF / eMC
Rigevidon / BNF / eMC
Sunya 20/75 / BNF / MHRA
Synphase / BNF / eMC
Triadene / BNF / eMC
TriNovum / BNF / eMC
TriRegol / BNF / eMC
Yasmin / BNF / eMC
Zelleta / MIMS / MHRA
Zoely / BNF / eMC

1

Available through NICE Evidence Search at