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UPLC–MS/MS assay for the simultaneous determination of ethinyl estradiol, norgestimate and 17-Desacetyl norgestimate at low pg/mL in human plasma. J Chromatogr B Analyt Technol Biomed Life Sci 2016; 1017-1018:1-9. [DOI: 10.1016/j.jchromb.2016.01.054] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 01/21/2016] [Accepted: 01/30/2016] [Indexed: 11/19/2022]
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Fels H, Steward R, Melamed A, Granat A, Stanczyk FZ, Mishell DR. Comparison of serum and cervical mucus hormone levels during hormone-free interval of 24/4 vs. 21/7 combined oral contraceptives. Contraception 2013; 87:732-7. [DOI: 10.1016/j.contraception.2012.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 11/01/2012] [Accepted: 12/07/2012] [Indexed: 11/15/2022]
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3
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Gong Z, Chandler K, Webster S, Kerley R, Buist S, McCort-Tipton M. Simple and rapid determination of norethindrone in human plasma by supported liquid extraction and ultra performance liquid chromatography with tandem mass spectrometry. Talanta 2012; 91:77-82. [DOI: 10.1016/j.talanta.2012.01.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 01/08/2012] [Accepted: 01/09/2012] [Indexed: 10/14/2022]
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Salvador A, Moretton C, Piram A, Faure R. On-line solid-phase extraction with on-support derivatization for high-sensitivity liquid chromatography tandem mass spectrometry of estrogens in influent/effluent of wastewater treatment plants. J Chromatogr A 2007; 1145:102-9. [PMID: 17291513 DOI: 10.1016/j.chroma.2007.01.055] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2006] [Revised: 01/12/2007] [Accepted: 01/15/2007] [Indexed: 11/25/2022]
Abstract
A solid-phase extraction coupled to liquid chromatography/tandem mass spectrometry for the determination of estrogens in sewage influent and effluent has been performed. The possibility of preparing estrogen derivatives directly on a solid-phase extraction bed in which the targeted analytes have been previously isolated and pre-concentrated was explored. This method uses an Oasis HLB column (2.1 mm x 20 mm i.d.) for on-line sample cleanup and derivatization support, and a Sunfire C(18) column (150 mm x 2.1 mm i.d.) with a mobile phase consisting of acetonitrile-water-formic acid for separation. After sample introduction, some matrix interferences are removed by washing up SPE column with methanol-water. Phenolic hydroxyl group of estrogens is subsequently derivatized with dansyl chloride. Reaction takes place in the on-line solid-phase extraction column. The excess of reagent and other matrix interferences are then removed by a second washing. Dansylated estrogens are further back eluted and analyzed with HPLC-MS-MS. The optimized on-line protocol is emphasized owing to a low limit of quantification (1 ng L(-1)) is achieved with only around 1 mL of sample and a low sensitive MS instrument. Developed strategy has been demonstrated to be an improvement over existing methods due to its greater sensitivity and the low volume of matrix used and the total analysis time (extraction, derivatization, analysis) is less than 17 min.
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Affiliation(s)
- Arnaud Salvador
- Université Claude Bernard Lyon 1, UMR 5180, 43 Boulevard du 11 novembre 1918, 69622 Villeurbanne cedex, France.
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Licea-Perez H, Wang S, Bowen CL, Yang E. A semi-automated 96-well plate method for the simultaneous determination of oral contraceptives concentrations in human plasma using ultra performance liquid chromatography coupled with tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2007; 852:69-76. [PMID: 17258945 DOI: 10.1016/j.jchromb.2006.12.052] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2006] [Revised: 10/30/2006] [Accepted: 12/31/2006] [Indexed: 11/18/2022]
Abstract
Two semi-automated, relatively high throughput methods using ultra performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS) were developed for the simultaneous determination of ethinyl estradiol (EE) in combination with either 19-norethindrone (NE) or levonorgestrel (LN) in human plasma. Using 300 microL plasma, the methods were validated over the concentration ranges of 0.01-2 ng/mL and 0.1-20 ng/mL for EE and NE (or LN), respectively. The existing methods for the determination of the oral contraceptives in human plasma require large volumes of plasma (> or =500 microL), and sample extraction is labor-intensive. The LC run time is at least 6 min, enabling analysis of only about 100 samples a day. In the present work the throughput was greatly improved by employing a semi-automated sample preparation process involving liquid-liquid extraction and derivatization with dansyl chloride followed by UPLC separation on a small particle size column achieving a run time of 2.7 min. The validation and actual sample analysis results show that both methods are rugged, precise, accurate, and well suitable to support pharmacokinetic studies where approximately 300 samples can be extracted and analyzed in a day.
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Affiliation(s)
- Hermes Licea-Perez
- Worldwide Bioanalysis, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Pharmaceuticals, 709 Swedeland Road, King of Prussia, PA 19406, USA.
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Murphy PA, Kern SE, Stanczyk FZ, Westhoff CL. Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding. Contraception 2005; 71:402-8. [PMID: 15914127 DOI: 10.1016/j.contraception.2004.11.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2004] [Revised: 10/18/2004] [Accepted: 11/10/2004] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study evaluated the effect of the herbal remedy St. John's Wort on oral contraceptive (OC) therapy with respect to the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding. METHODS Sixteen healthy women were treated with a low-dose OC (Loestrin 1/20) and a placebo for two consecutive 28-day cycles in a single-blind sequential trial. Treatment with St John's Wort 300 mg three times daily was then added for two additional 28-day cycles. Outcomes compared between control and treatment cycles included the pharmacokinetics of norethindrone and ethinyl estradiol, daily bleeding diaries, follicle growth, changes in cervical mucus and progesterone levels drawn at 7- to 10-day intervals. RESULTS Treatment with St. John's Wort was associated with a significant 13-15% reduction in the dose exposure from the contraceptive. Breakthrough bleeding increased in the treatment cycles, as did evidence of follicle growth and probable ovulation. CONCLUSION St. John's Wort is associated with increased metabolism of norethindrone and ethinyl estradiol, breakthrough bleeding, follicle growth and ovulation. Women using OCs should be cautioned that St. John's Wort might interfere with contraceptive effectiveness.
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Affiliation(s)
- Patricia A Murphy
- College of Nursing, University of Utah, Salt Lake City, UT 841112-5880, USA.
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Stanczyk FZ, Ploszaj S, Gentzschein E, Qian D, Mishell DR. Effect of oral contraceptives containing 20 and 35 micrograms ethinyl estradiol on urinary prostacyclin and thromboxane metabolite levels in smokers and nonsmokers. Contraception 1999; 59:17-23. [PMID: 10342082 DOI: 10.1016/s0010-7824(98)00148-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The interaction between smoking and oral contraceptive (OC) use with respect to thrombogenesis was investigated by studying the effects of OC and smoking on urinary prostacyclin (PGI2) and thromboxane A2 (TxA2) metabolite levels in smokers and nonsmokers. Sixty healthy women, aged 19-32 years, who were not taking any hormonal treatment for at least 3 months before initiating the study, were divided into three equal groups: OC users who smoked (N = 20), OC users who did not smoke (N = 20), and a control group of 10 smokers and 10 nonsmokers. Each OC treatment group was randomized to receive either norethindrone (NET) acetate (1 mg)/ethinyl estradiol (EE2) (35 micrograms) (N = 10) or NET acetate (1 mg)/EE2 (20 micrograms) (N = 10) daily for 3 months. Overnight urine collections and fasting blood samples were obtained at baseline and at the end of the 3-month study. Serum levels of NET and EE2, as well as urinary levels of cotinine and the stable metabolites of PGI2 and TxA2, namely 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) and thromboxane (TxB2), respectively, were measured by specific immunoassays. Analysis of pre- to posttreatment changes in mean urinary 6-keto-PGF1 alpha and TxB2 levels for each subgroup, as determined by smoking status and EE2 dose, showed no statistically significant differences. Also, no significant differences were found in each subgroup with respect to changes in the 6-keto-PGF1 alpha/TxB2 ratios. Large intersubject variability in urinary 6-keto-PGF1 alpha and TxB2 levels were observed in all subgroups. The results of this study indicate that both low-estrogen-dose compounds, when used by smokers or nonsmokers, did not significantly alter the ratio of PGI2 to TXA2 metabolites, compared with pretreatment. However, the small number of subjects and the large intersubject variability in this study make it difficult to determine if there is a significant difference between the 20- and 30-microgram EE2 doses.
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Affiliation(s)
- F Z Stanczyk
- Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA
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Sinofsky FE, Pasquale SA. The effect of fluconazole on circulating ethinyl estradiol levels in women taking oral contraceptives. Am J Obstet Gynecol 1998; 178:300-4. [PMID: 9500490 DOI: 10.1016/s0002-9378(98)80016-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This open-label, two-period, crossover study was conducted to evaluate the effect of a single 150 mg dose of fluconazole on the pharmacokinetics of ethinyl estradiol in healthy female subjects. STUDY DESIGN Ten subjects regularly taking Ortho-Novum 7/7/7 (Ortho Pharmaceutical, Raritan, N.J.) and 10 subjects regularly taking Triphasil (Wyeth-Ayerst Laboratories, Philadelphia), which contain ethinyl estradiol 35 microg and 30 microg during days 1 to 6, respectively, were randomly assigned to receive a single 150 mg dose of fluconazole 2 hours before the oral contraceptive, on pill day 6 of one of two menstrual cycles. Ethinyl estradiol serum concentrations were measured at baseline and up to 24 hours after oral contraceptive intake. No fluconazole was administered during the other menstrual cycle, which served as the control. RESULTS Mean serum concentrations of ethinyl estradiol were increased after fluconazole administration in both oral contraceptive groups. Maximum observed serum concentration and area under the concentration-time curve values were significantly (p < 0.05) greater during the fluconazole regimens (vs regimens without fluconazole) for both oral contraceptive groups and for combined values of the two oral contraceptive groups. The mean time to reach the maximum concentration was not altered by concomitant fluconazole administration. CONCLUSIONS These findings suggest that there is a potential for a clinically significant interaction between coadministration of fluconazole and ethinyl estradiol in oral contraceptives.
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Affiliation(s)
- F E Sinofsky
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08901-1977, USA
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Agasan AL, Stewart BJ, Watson TG. Development of a radioimmunoassay method for ethynylestradiol in plasma using a monoclonal antibody. J Immunol Methods 1994; 177:251-60. [PMID: 7822832 DOI: 10.1016/0022-1759(94)90163-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
An ethynylestradiol (EE2) radioimmunoassay method (RIA) using a monoclonal antibody (MAB) reagent is described. 76 plasma and 67 buffer blanks spiked with known concentrations of EE2 were used as positive samples. The steroid was extracted using dichloromethane method with an extraction efficiency of 78 +/- 2.6%. The plasma extracts were not purified. Separation of the free from bound tritiated EE2 was by centrifugation with dextran-coated charcoal suspension in phosphate-gelatin buffer. Within 95% confidence limits, the sensitivity of the assay was 10 pg/ml in buffer samples, and 43 pg/ml in unpurified plasma samples. The accuracy and precision of the method were lower for the plasma samples than for the buffer solutions but within accepted limits (i.e., 80-120% for accuracy, and up to 20% for precision). The mean recovery accuracy (R) of the method for measuring 38 pg/ml EE2 in buffer was 101 +/- 0.9% (n = 67), while for 2.39 pg/ml to 18.0 pg/ml EE2 in plasma was 97 +/- 12% (n = 76). The buffer solutions and plasma samples containing 600 pg/ml EE2 had a mean R of 102% (n = 18) and 90% (n = 16), respectively. The average interassay variation (%CV) between buffer samples was 14 +/- 1.2%, and between plasma samples was 19 +/- 8%. Plasma samples with 18 pg/ml and 2.39 pg/ml EE2, together with the blank negative plasma samples showed high interassay variations (CV > 20%). Except for the above samples, however, the precision of the method in all sample groups was within accepted limits. The intra-assay variation of replicate assays of a single plasma sample containing 1.2 ng/ml EE2 and 4 ng/ml levonorgestrel was 13% (n = 7). In the presence of very high concentration of closely related levonorgestrel, the R of the method was 106%. The increase in average variability (%CV) between results for the plasma samples (CV 19 +/- 8%) over that of the spiked buffer solutions (CV 14 +/- 1.2%) suggest some possible interference by co-extracted materials from plasma, for example lipids, which interfered in the ligand-antibody reactions. Further investigation may prove that a pre-assay purification of the sample, e.g., HPLC, would eliminate this interference. Nevertheless, the immunoassay described above completely eliminates the problem of cross-reactivity caused by the natural estrogens in plasma with the conventional polyclonal antibodies. It possesses an acceptable intra- and interassay variation with very high specificity to EE2.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- A L Agasan
- Division of Biological and Health Sciences, Deakin University, Melbourne, Victoria, Australia
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Ballagh SA, Mishell DR, Lacarra M, Shoupe D, Jackanicz TM, Eggena P. A contraceptive vaginal ring releasing norethindrone acetate and ethinyl estradiol. Contraception 1994; 50:517-33. [PMID: 7705095 DOI: 10.1016/0010-7824(94)90011-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A core design contraceptive vaginal ring (CVR) releasing 650 mcg of norethindrone acetate (NA) and 10, 20, 30 or 65 mcg of ethinyl estradiol (EE) daily was developed and tested in 99 women. The CVR inhibited ovulation well with 30 or 65 mcg EE. Vaginal bleeding was better controlled than in 23 control women using NA/EE oral contraceptives. Side effects were comparable to controls for the 20 and 30 mcg EE CVR. The 65 mcg EE CVR resulted in an unacceptably high level of nausea. The 20 and 30 mcg EE CVR caused an increase in serum HDL cholesterol and triglycerides. Total cholesterol was unchanged. Angiotensinogen and sex hormone binding globulin-binding capacity were increased in a subgroup of the 20 and 30 mcg EE CVR subjects, similar to that of 20 controls using EE/gestodene oral contraceptives. This new CVR offers an excellent contraceptive alternative with the best performance provided by the 30 mcg EE dose.
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Affiliation(s)
- S A Ballagh
- University of Southern California School of Medicine, Department of Obstetrics and Gynecology, Los Angeles
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Fernández N, García JJ, Diez MJ, Terán MT, Sierra M. Rapid high-performance liquid chromatographic assay of ethynyloestradiol in rabbit plasma. JOURNAL OF CHROMATOGRAPHY 1993; 619:143-7. [PMID: 8245154 DOI: 10.1016/0378-4347(93)80458-g] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A method for the determination of ethynyloestradiol in samples of rabbit plasma containing pentobarbital and heparin, the former used as an anaesthetic and the latter as an anticoagulant, has been developed. Quantification was carried out using a reversed-phase high-performance liquid chromatographic (HPLC) method in isocratic mode at room temperature, with electrochemical detection at an applied potential of +1 V vs. Ag/AgCl. Under these conditions, the retention time for ethynyloestradiol was ca. 2.9 min, the average recovery from plasma was 74.5%, and the limit of detection was 10 pg, corresponding to a plasma concentration of 50 pg/ml using 1 ml of plasma. Natural oestrogens, oestriol, oestradiol and oestrone showed peaks that did not interfere with ethynyloestradiol, and retention times of ca. 0.8, 2.4 and 3.4 min, respectively.
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Affiliation(s)
- N Fernández
- Department of Physiology, Pharmacology and Toxicology, Veterinary Faculty, University of León, Spain
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Price TM, Dupuis RE, Carr BR, Stanczyk FZ, Lobo RA, Droegemueller W. Single- and multiple-dose pharmacokinetics of a low-dose oral contraceptive in women with chronic renal failure undergoing peritoneal dialysis. Am J Obstet Gynecol 1993; 168:1400-6. [PMID: 8498419 DOI: 10.1016/s0002-9378(11)90772-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Our purpose was to compare the pharmacokinetic parameters of oral administration of a 35 micrograms ethinyl estradiol, 1 mg norethindrone pill in peritoneal dialysis patients and normal women. STUDY DESIGN A single-dose study was performed with five patients and four controls, followed by a multiple-dose study with five subjects in each group. Pharmacokinetic parameters were calculated by noncompartmental analysis and statistical analysis performed with Mann-Whitney U testing. RESULTS There is no difference in the pharmacokinetic parameters for norethindrone in peritoneal dialysis patients compared with normal women. During multiple dosing an increased area under the concentration curve and decreased apparent oral clearance was observed for ethinyl estradiol in peritoneal dialysis patients compared with normal women. CONCLUSION Peritoneal dialysis patients have decreased apparent oral clearance of ethinyl estradiol, leading to slightly higher serum concentrations compared with women with normal renal function. The clearance of norethindrone is the same in peritoneal dialysis patients and normal women.
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Affiliation(s)
- T M Price
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill
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Zacur HA, Linkins S, Chang V, Smith B, Kimball AW, Burkman R. Ethinyl estradiol and norethindrone radioimmunoassay following Sephadex LH-20 column chromatography. Clin Chim Acta 1991; 204:209-15. [PMID: 1819463 DOI: 10.1016/0009-8981(91)90232-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- H A Zacur
- Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, MD
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Murphy AA, Zacur HA, Charache P, Burkman RT. The effect of tetracycline on levels of oral contraceptives. Am J Obstet Gynecol 1991; 164:28-33. [PMID: 1986620 DOI: 10.1016/0002-9378(91)90617-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Despite the widespread use of tetracycline for treatment of dermatologic disorders and sexually transmitted diseases, the pharmacodynamics of oral contraceptive use in the presence of tetracycline has not been studied. Seven normal women ingested an oral contraceptive containing ethinyl estradiol 35 micrograms and norethindrone 1 mg in the follicular phase of the menstrual cycle. On day 0 baseline ethinyl estradiol and norethindrone levels were obtained at 0, 1/2, 3/4, 1, 2, 4, 12, and 24 hours after oral contraceptive administration. On day 1 tetracycline 500 mg was given orally every 6 hours while the oral contraceptive was continued. Tetracycline, ethinyl estradiol, and norethindrone levels were determined at the same time intervals as on day 0. Oral contraceptive and tetracycline were continued for up to 10 days, and additional concentrations of ethinyl estradiol, norethindrone, and tetracycline were determined between days 5 and 10. Four additional normal women ingested tetracycline for 5 to 10 days. Tetracycline levels were determined at the time intervals noted above on day 1 and days 5 to 10. No significant decrease in plasma ethinyl estradiol or norethindrone concentration was seen with either short-term (24 hours) or long-term (5 to 10 days) ingestion of tetracycline. Similarly, levels of tetracycline do not significantly decrease with ingestion of a low-dose oral contraceptive.
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Affiliation(s)
- A A Murphy
- Division of Reproductive Endocrinology and Infertility, Johns Hopkins University, Baltimore, Maryland
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Stanczyk FZ, Lobo RA, Chiang ST, Woutersz TB. Pharmacokinetic comparison of two triphasic oral contraceptive formulations containing levonorgestrel and ethinylestradiol. Contraception 1990; 41:39-53. [PMID: 2105872 DOI: 10.1016/0010-7824(90)90125-f] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The pharmacokinetics of levonorgestrel (LNG) and ethinylestradiol (EE2) were determined in 24 women (aged 21 to 35 years), following the administration of a single tablet from the second phase of two different triphasic preparations (Triphasil and Trinordiol. Each tablet contained 0.075 mg of LNG and 0.040 mg of EE2. The data were compared to the pharmacokinetics of LNG and EE2 obtained following the oral administration of a hydroalcoholic solution (standard) containing the same steroids and dose. The study consisted of a randomized design in which the three formulations were administered to each of the 24 subjects in a three-period crossover pattern. Blood samples were taken at frequent intervals after dosing. Serum levels of LNG and EE2 were measured by specific radioimmunoassays. The results show that both LNG and EE2 in the Triphasil and Trinordiol tablets are bioequivalent with respect to rate and extent of absorption. Furthermore, LNG, but not EE2, in both tablet formulations was bioequivalent to the solution dose. The serum concentration-time profiles for the three formulations showed that the range of mean peak levels was 2.3-2.8 ng/ml for LNG and 116-159 pg/ml for EE2. These levels were achieved within 2 hours in the majority of subjects. The ranges of mean values calculated for the areas under the curves were 15-16 ng.hr/ml for LNG and 1053-1390 pg.hr/ml for EE2. The ranges of mean values calculated for other pharmacokinetic parameters were: volume of distribution: LNG--1.6-1.8 L/kg, EE2--7.7-9.1 L/kg; clearance: LNG--84-88 ml/hr/kg, EE2--0.67-0.99 ml/hr/kg; half-life: LNG--13-15 hr, EE2--7-12 hrs.
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Affiliation(s)
- F Z Stanczyk
- Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles
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Burkman RT, Zacur HA, Kimball AW, Kwiterovich P, Bell WR. Oral contraceptives and lipids and lipoproteins: Part II--Relationship to plasma steroid levels and outlier status. Contraception 1989; 40:675-89. [PMID: 2695287 DOI: 10.1016/0010-7824(89)90071-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A randomized clinical trial of oral contraceptives evaluated 67 women on 50 ug ethinyl estradiol (EE) and 1.0 mg norethindrone (NE), 61 women on 35 ug EE and 1.0 mg NE, and 64 women on 35 ug EE and 0.5 mg NE. At baseline, three, six and nine months, lipids and lipoproteins were measured as well as selected plasma determinations of the contraceptive steroids. Data was related to change in outlier status for lipids/lipoproteins (less than 10th percentile for high-density lipoprotein cholesterol and apolipoprotein A-1, greater than 90th percentile for all others). Women on the lowest dose preparation had the smallest trend towards outlier status for high-density lipoprotein cholesterol and apolipoprotein A-1. An increase over the time period of the study in the initial slope (one hour level minus zero hour level over time) of NE and a decrease in the initial slope of EE was associated with a shift to outlier status for low-density lipoprotein cholesterol. A number of other relationships were also shown. Use of the techniques described might assist in identifying sub-groups of women at risk for adverse cardiovascular sequelae associated with oral contraceptive use.
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Affiliation(s)
- R T Burkman
- Department of Gynecology-Obstetrics, Henry Ford Hospital, Detroit, Michigan 48202
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Sullivan-Nelson M, Kuller JA, Zacur HA. Clinical use of oral contraceptives administered vaginally: a case report**Supported in part by grant HD-06268 from The Population Center and by grant NO1-HD-32816 from the National Institutes of Health. Fertil Steril 1989. [DOI: 10.1016/s0015-0282(16)53055-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kuhl H, Jung-Hoffmann C, Heidt F. Serum levels of 3-keto-desogestrel and SHBG during 12 cycles of treatment with 30 micrograms ethinylestradiol and 150 micrograms desogestrel. Contraception 1988; 38:381-90. [PMID: 2971509 DOI: 10.1016/0010-7824(88)90110-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The serum concentrations of 3-keto-desogestrel (KDG) have been determined radioimmunologically in 11 female volunteers on Day 1, 10, and 21 of the 1st, 3rd, 6th, and 12th cycle of treatment with 30 micrograms ethinylestradiol and 150 micrograms desogestrel during the first 4 hours and 24 hours after intake. On the first day of each cycle the KDG levels were low, but increased thereafter until Day 21. Highest serum concentrations were measured on Day 21 of the 3rd and 6th cycle with peak levels between 1.5 and 6.2 ng/ml. Contrary to this, the KDG levels were significantly reduced during the 12th treatment cycle. The serum concentrations of SHBG rose significantly between Day 1 and Day 21 of each cycle reaching values which were 3-fold of those at the beginning of treatment. During the pill-free intervals, SHBG levels decreased but remained elevated as compared to controls. There was a significant correlation between the SHBG levels and the area under the KDG-concentration-versus-time curves (AUC) indicating a pronounced influence of the serum steroid-binding protein upon the pharmacokinetics of KDG. There were great interindividual differences in the KDG levels. The serum levels of the individual woman remain, however, in a relatively constant range throughout the treatment period of 12 months, possibly due to genetic factors.
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Affiliation(s)
- H Kuhl
- Department of Obstetrics and Gynecology, J.W. Goethe-University, Frankfurt, F.R. Germany
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Lee GJL, Oyang MH, Bautista J, Kushinsky S. Determination of Ethinylestradiol and Norethindrone in a Single Specimen of Plasma by Automated High-Performance Liquid Chromatography and Subsequent Radioimmunoassay. ACTA ACUST UNITED AC 1987. [DOI: 10.1080/01483918708068913] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Díaz-Sánchez V, Garza-Flores J, Jimenéz-Thomas S, Rudel HW. Development of a low-dose monthly injectable contraceptive system: II. Pharmacokinetic and pharmacodynamic studies. Contraception 1987; 35:57-68. [PMID: 3568660 DOI: 10.1016/0010-7824(87)90051-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A drug delivery system which provides a sustained release of norethindrone (NET) and mestranol (ME) for one month after a single intramuscular injection was assessed as a long-acting injectable contraceptive. The system is based upon well defined particle size crystals of the synthetic steroids maintained in suspension with saline solution. Eight healthy ovulating women volunteered for the study; they received a combination of 10 mg of NET plus 1 mg of ME in 1 ml of vehicle by intramuscular injection on day five of their menstrual cycle. Blood samples were drawn at 0, 1, 5, 10, 13, 17 and 21 days after drug administration. The immunoreactive serum levels of estradiol, progesterone, NET and ethinylestradiol were measured by specific radioimmunoassay procedures to assess ovarian function and the kinetic parameters of the synthetic steroids. This newly developed contraceptive system proved to be both effective, and long-lasting as well as devoid of side effects.
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Goebelsmann U, Hoffman D, Chiang S, Woutersz T. The relative bioavailability of levonorgestrel and ethinyl estradiol administered as a low-dose combination oral contraceptive. Contraception 1986; 34:341-51. [PMID: 3096634 DOI: 10.1016/0010-7824(86)90087-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The relative bioavailability of levonorgestrel (LNG) and ethinyl estradiol (EE) administered concomitantly both as an oral tablet and as a solution was assessed in a randomized two-period crossover study in 24 healthy women. Serum concentrations were monitored for 96 h after each administration. The relative bioavailability (Fr) of LNG in the tablet with respect to the solution was 107%; thus the two formulations were bioequivalent with respect to LNG. The relative bioavailability of EE, however, was significantly lower for the tablet (Fr 83%) compared to the solution. This difference may have been due to either decreased absorption or enhanced presystemic elimination of EE from the tablet formulation.
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Agasan AL, Briggs MH, Hewish DR, Stewart B. Development of a monoclonal antibody for use in radioimmunoassay of ethynylestradiol. Steroids 1986; 47:295-306. [PMID: 2438822 DOI: 10.1016/0039-128x(86)90099-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Production of monoclonal antibodies (MABs) to a 17 alpha-ethynyl-1,3,5 (10)-estratriene-3,17 beta-diol (ethynylestradiol, EE2) hapten is described. Culture antibodies generated by hybridized cells tested in enzyme-linked immunosorbent assay (ELISA) bound the 6-oxoethynyl-estradiol-6-(0-carboxymethyl) oxime-bovine serum albumin conjugate (EE2-6-0 CMO-BSA) but not BSA. On radioimmunoassay (RIA) with tritiated ethynylestradiol (3H-EE2), some of the antibodies demonstrated high binding affinity (Ka = 2.8 X 10(10) M-1) to EE2. Estradiol-17 beta, estrone and estriol did not show any displacement of 3H-EE2 from the MABs even at high concentration (1 X 10(4) ng/mL). Among the widely used progestins, norethynodrel and norethisterone exhibited considerable cross-reactivity (25.7-100% and 0.3-54.1%, respectively) but not levonor-gestrel with the MABs. The high affinity demonstrated by the MABs to EE2 3-sulfate but not to EE2 17-sulfate and EE2 3,17-disulfate suggests the dominant role of the 17 beta-hydroxyl group in immunogenicity.
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Goebelsmann U, Mashchak CA, Mishell DR. Comparison of hepatic impact of oral and vaginal administration of ethinyl estradiol. Am J Obstet Gynecol 1985; 151:868-77. [PMID: 3920910 DOI: 10.1016/0002-9378(85)90664-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The pronounced hepatic impact of oral ethinyl estradiol has been attributed by some to its so-called first-pass effect through the liver as only some 40% of ingested ethinyl estradiol reaches the systemic circulation. Others believe that ethinyl estradiol exerts its hepatic effects because of its chemical composition, specifically its 17 alpha-ethinyl group. In an attempt to resolve this controversy, a study was undertaken to determine whether vaginal administration of ethinyl estradiol can selectively reduce the hepatic effects of oral ethinyl estradiol. To compare the effects of oral and vaginal ethinyl estradiol, a group of postmenopausal subjects received either 5 micrograms of oral and 20 micrograms of vaginal ethinyl estradiol or 10 micrograms of oral and 50 micrograms of vaginal ethinyl estradiol in either sequence, respectively. Oral ethinyl estradiol was four to five times more potent than vaginal ethinyl estradiol. The potency ratios of the oral-vaginal ethinyl estradiol doses required to suppress follicle-stimulating hormone and luteinizing hormone were 4.4 and 3.2 and those to raise sex hormone-binding globulin binding capacity, corticosteroid-binding globulin binding capacity, and high-density lipoprotein cholesterol as well as lower low-density lipoprotein cholesterol were 3.5, 5.0, 4.2, and 4.2, respectively. These essentially equal oral-vaginal route potency ratios for both central nervous system and hepatic effects indicate that vaginal administration of ethinyl estradiol does not selectively reduce its hepatic impact in relation to its central nervous system effects. The pronounced hepatic effects of ethinyl estradiol are therefore attributed to its chemical composition.
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Stanczyk FZ, Mroszczak EJ, Ling T, Runkel R, Henzl M, Miyakawa I, Goebelsmann U. Plasma levels and pharmacokinetics of norethindrone and ethinylestradiol administered in solution and as tablets to women. Contraception 1983; 28:241-51. [PMID: 6641224 DOI: 10.1016/0010-7824(83)90065-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Twenty-four normal adult female volunteers were dosed orally with a solution and tablet formulation containing the contraceptive combination of norethindrone (NET, 1.0 mg) and ethinylestradiol (EE2, 0.12 mg) in a crossover bioequivalence study. Blood was sampled sequentially following single oral doses and the plasma separated for analysis of NET and EE2 by specific radioimmunoassays. Comparisons of both drugs following a dose in solution and tablets were made with respect to the following parameters: (a) plasma concentrations at each sample time; (b) maximum plasma concentration (Cpmax); (c) time to maximum plasma concentration (Tmax); (d) total area under the plasma concentration vs. time curve (AUC), and (e) plasma half-life (t1/2). It was found that the tablet and solution doses were bioequivalent with respect to EE2 absorption. However, absorption of NET from solution and tablet doses exhibited significant differences with respect to plasma levels at certain time points as well as AUC (which were higher following the tablet dose), but Cpmax, Tmax and t1/2 were not significantly different. Pharmacokinetic analysis of both drugs following the tablet dose was carried out using a two-compartment open model. The absorption rate constant (ka) and peripheral to central compartment transfer rate constant (k21) were similar for NET and EE2, but statistically significant differences were observed with respect to the distribution rate constant (alpha), the central to peripheral transfer rate constant (k12), the overall elimination rate constant (ke1), and volume of distribution (V1/F). The elimination rate constant (beta) for both drugs showed a difference of borderline statistical significance.
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