Levonorgestrel-Containing Oral Contraceptives: Still Among the Safest of the Safe

Venous thromboembolism (VTE) is perhaps the most feared complication of estrogen-containing contraceptive use. Because various combined oral contraceptive pills (COCs) are used by more than 10 million U.S. women (Adv Data 2004; 350:1), even subtle distinctions in risk are important. COCs that contain desogestrel have been associated with higher risk for VTE than those that contain levonorgestrel; but how do newer COCs that contain drospirenone compare with levonorgestrel-containing COCs?

Data on 937,408 U.S. women (age range, 15–44) in the PharMetrics database showed that, although rates of idiopathic nonfatal VTE among users of drospirenone COCs were low (30.8 per 100,000 woman-years), they were substantially higher than VTE rates among use…