Impacts of GLP-1 receptor agonists on the efficacy of oral hormonal contraceptives
DOI:
https://doi.org/10.47224/revistamaster.v11i21.851Keywords:
GLP-1 receptor agonists, Oral contraceptives, Drug interactions, Pharmacokinetics, Contraceptive efficacyAbstract
The use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) has expanded significantly in the management of type 2 diabetes mellitus and obesity, raising concerns about potential interactions with oral hormonal contraceptives. This study aimed to analyze the effects of these agents on the pharmacokinetics of combined oral contraceptives, particularly ethinylestradiol and levonorgestrel, and their implications for contraceptive efficacy. An integrative literature review was conducted following PRISMA guidelines, with searches performed in PubMed, BVS, and SciELO databases, including studies published between 2010 and 2025. Six studies met the inclusion criteria and were analyzed. The findings indicated that GLP-1RAs do not reduce the overall bioavailability (AUC) of oral contraceptives and may even increase levonorgestrel exposure. However, reductions in peak plasma concentration (Cmax) and delays in time to reach peak concentration (Tmax) were observed, particularly with exenatide, likely due to delayed gastric emptying. Despite these pharmacokinetic changes, contraceptive efficacy does not appear to be significantly compromised, although this conclusion is based on indirect pharmacokinetic parameters rather than clinical outcomes. The timing of administration was identified as a relevant factor, with evidence suggesting that taking oral contraceptives prior to GLP-1RA administration may mitigate interactions. In conclusion, although no clinically significant impact has been demonstrated, important gaps remain, including the lack of studies in women of reproductive age and the absence of direct clinical endpoints, highlighting the need for further research.
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