Update on risk of thromboembolism associated with combined oral contraceptives

HSA would like to update healthcare professionals on the outcome of its review on the risk of thromboembolism associated with combined oral contraceptives (COCs). Although venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is a known potential risk with the use of COCs, current evidence showed that the small absolute risk of VTE associated with COCs may differ depending on the type of progesterone present in the preparation. Based on scientific evidence to date, COCs containing levonorgestrel, norethisterone and norgestimate have the lowest VTE risk. COCs are also associated with an increased risk of arterial thromboembolism (ATE) but there is insufficient evidence to demonstrate if the ATE risk varies between different COCs. Healthcare professionals should take into consideration the latest evidence on the risk of thromboembolism associated with COCs when discussing the most suitable type of contraceptive for their patient. Careful consideration should be given to the woman’s risk factors for thromboembolism and these risk factors should be reassessed regularly. The risk of thromboembolism with a COC is higher during the first year of use, and when re-starting use after a break of 4 or more weeks. Please refer to the letter for more details.

Healthcare professional, Therapeutic Products
Published:

Dear Healthcare Professional Letters

24 Feb 2021

Only abstracts of the Dear Healthcare Professional Letters (DHCPL) are provided on this website. Details of the letters can be found on the MOH Alert System, which is accessible via the Health Professionals Portal (HPP). HPP is a one-stop portal for all healthcare professionals in Singapore. Dentists, medical doctors and pharmacists may access HPP at https://www.moh.gov.sg/hpp/, and follow the procedures below to access the MOH Alert system.

Step 1: On the top navigation ribbon of webpage, select 'For Healthcare Professionals' followed by 'Health Professionals Portal' and click on the choice of profession. User will be redirected to the specific HPP webpage for the selected profession.

Step 2: Click on the Restricted Content icon on the left panel of webpage and login via SingPass.

Step 3: Click on the MOH Alert icon under ‘Applications’ section

Step 4: Click on the Drug Alert tab to view the DHCPLs.