Special Considerations in the Management of Women With HIV, Including Management of Conception and Pregnancy
Supporting Assets
Table 1 | Table 2 | Table 3 | Table 4
Table 1. Effects of Coadministration of Antiretroviral Therapy and Combined Oral Contraceptives
| Antiretroviral Agent | Overall Effect or Recommendation |
| NRTIs | No effect |
| NNRTIs |
|
| Progestin levels markedly decreased Effectiveness of emergency contraception may be diminished Barrier method should be used in addition to this method | |
| No dose adjustment needed No additional contraceptive protection needed | |
| No dose adjustment needed No additional contraceptive protection needed | |
| No dose adjustment needed No additional contraceptive protection needed | |
| PIs |
|
| COC should contain no more than 30 µg of ethinyl estradiol No additional contraceptive protection needed | |
| Decreases in ethinyl estradiol and marked increases in drospirenone progestin Contraindicated with drospirenone-containing hormonal contraceptive due to potential for hyperkalemia Consider alternative or additional contraceptive method | |
| Ritonavir inhibits CYP3A4, which may increase contraceptive hormone levels No additional contraceptive protection needed | |
| Decreases in ethinyl estradiol and marked increases in drospirenone progestin Clinical monitoring recommended with drospirenone-containing hormonal contraceptive due to potential for hyperkalemia Consider alternative or additional contraceptive method | |
| Small decrease in progestin levels Additional or alternative method recommended | |
| Reduced amprenavir levels when fosamprenavir coadministered with ethinyl estradiol/norethindrone; may lead to loss of virologic response Use alternative contraceptive method | |
| Additional or alternative method recommended | |
| Small increases in ethinyl estradiol and progestin No additional contraceptive protection needed | |
| Decreases in ethinyl estradiol and progestin No additional contraceptive protection needed | |
| Decrease in ethinyl estradiol Additional or alternative method recommended | |
| Decrease in ethinyl estradiol Additional or alternative method recommended | |
| Decrease in ethinyl estradiol Additional or alternative method recommended | |
| Integrase Inhibitors |
|
| No additional contraceptive protection needed | |
| Ethinyl estradiol levels decreased Progestin levels increased No additional contraceptive protection needed |
| No additional contraceptive protection needed | |
| CCR5 Antagonist |
|
| No additional contraceptive protection needed |
COC, combined oral contraceptives; DMPA, depot medroxyprogesterone acetate.
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Keywords: Women