Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Etinylestradiol

Klassificering: 2

Preparat: Abelonelle 28, Amorest 28, Anastrella 28, Cilest, Cilest®, Cilest® 28, Cleodette, Cleodette 28, Cleonita, Cleosensa, Cleosensa 28, Daylette, Desolett®, Desolett® 28, Diane, Diane®, Dienorette, Diza, Dizmine 28, Dizminelle, Eloine, Erlibelle, Estrelen, Estron, Evra®, Femistad, Leverette, Levesia, Liofora, Loette 28, Mercilon®, Mercilon® 28, Midiana, Midiana 28, Ministat, Neovletta®, Neovletta® 28, Novogyn, NuvaRing, NuvaRing®, Ornibel, Orthonett® Novum, Prionelle, Prionelle 28, Restovar®, Rigevidon, Rigevidoncont, Rosal 28, Stefaminelle, Synfase®, Synfase® 28, Synphase, Triella, Trimiron® 28, Trinordiol, Trinordiol® 28, Trinovum, Trinovum®, Trinovum® 28, Trionetta®, Trionetta® 28, Triregol, Vagiprev, Yasmin®, Yasmin® 28, Yasminelle, Yasminelle 28, Yaz, Zelle, Zellmine, Zellmine 28, Zellminelle, Zellminelle 28, Zyrona

ATC kod: G02BB01, G03AA03, G03AA05, G03AA07, G03AA09, G03AA11, G03AA12, G03AA13, G03AA16, G03AB02, G03AB03, G03AB04, G03AB05, G03HB01

Substanser: etinylestradiol, etinylestradiol betadex, etinylöstradiol

Råd till allmänheten

Kontakta läkare för diskussion innan behandling påbörjas.

För hälso- och sjukvården

Rekommendation

Risken för barnet anses vara låg vid terapeutiska doser.

Bakgrund

Passerar över till bröstmjölk i låg grad. Baserat på data från fyra kvinnor kan den relativa barndosen beräknas till 1 % (1). Inga negativa effekter har rapporterats hos 210 ammade barn (2, 3,4). Gynekomasti har rapporterats hos tre ammade barn (5-7). Kombinerade hormonella preventivmedel kan eventuellt påverka mjölkproduktionen/ mjölkkomposition och rekommenderas därför vanligen inte under det första halvåret postpartum (2-4,8-12). Om hormonell antikonception önskas, rekommenderas låg- eller mellandos gestagen (minipiller, p-stavar, hormonspiral) (12-13).

Uppdaterat: 2019-08-22

Referenser

Dokumentationsgrad: 2
  1. Nilsson S, Nygren KG, Johansson ED. Ethinyl estradiol in human milk and plasma after oral administration. Contraception 1978;17(2):131-139. PubMed
  2. Croxatto HB, Díaz S, Peralta O, Juez G, Herreros C, Casado ME et al. Fertility regulation in nursing women: IV Long-term influence of a low-dose combined oral contraceptive initiated at day 30 postpartum upon lactation and infant growth. Contraception. 1983;27(1):13-25. PubMed
  3. Nilsson S, Mellbin T, Hofvander Y, Sundelin C, Valentin J, Nygren KG. Long-term follow-up of children breast-fed by mothers using oral contraceptives. Contraception. 1986;34(5):443-57. PubMed
  4. Peralta O, Díaz S, Juez G, Herreros C, Casado ME, Salvatierra AM et al. Fertility regulation in nursing women: V Long-term influence of a low-dose combined oral contraceptive initiated at day 90 postpartum upon lactation and infant growth. Contraception. 1983;27(1):27-38. PubMed
  5. Madhavapeddi R, Ramachandran P. Side effects of oral contraceptive use in lactating women--enlargement of breast in a breast-fed child. Contraception 1985;32(5):437-443. PubMed
  6. Curtis EM. Oral-contraceptive feminization of a normal male infant: report of a case. Obstet Gynecol 1964;23:295-296. PubMed
  7. Marriq P, Oddo G. [Letter: Gynecomastia in the newborn induced by maternal milk? An unusual complication of oral contraceptives]. Nouv Presse Med 1974;3(41-43):2579. (Abstrakt) PubMed
  8. Kaern T. Effect of an oral contraceptive immediately post partum on initiation of lactation. Br Med J. 1967;3(5566):644-5. PubMed
  9. Tankeyoon M, Dusitsin N, Chalapati S, Koetsawang S, Saibiang S, Sas M et al. Effects of hormonal contraceptives on milk volume and infant growth WHO Special Programme of Research, Development and Research Training in Human Reproduction Task force on oral contraceptives. Contraception. 1984;30(6):505-22. PubMed
  10. Lonnerdal B, Forsum E, Hambraeus L. Effect of oral contraceptives on composition and volume of breast milk. Am J Clin Nutr 1980;33(4):816-824. PubMed
  11. FFPRHC Guidance (July 2004): Contraceptive choices for breastfeeding women. J Fam Plann Reprod Health Care 2004;30(3):181-9. PubMed
  12. Selected practice recommendations for contraceptive use-3rd ed. (2016). World Health Organization (WHO).
  13. Antikonception-behandlingsrekommendation. Information från Läkemedelsverket. 2014:2;14-28
  14. Progestogen-only contraceptives during lactation: I. Infant growth. World Health Organization Task force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development and Research Training in Human Reproduction. Contraception 1994;50(1):35-53. PubMed
  15. Progestogen-only contraceptives during lactation: II. Infant development. World Health Organization, Task Force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development, and Research Training in Human Reproduction. Contraception 1994;50(1):55-68. PubMed

- Författat av Klinisk farmakologi, Karolinska Universitetssjukhuset för Hälso- och sjukvårdsförvaltningen, Region Stockholm. Janusmed amning uppdateras kvartalsvis.