Drug Interaction Clinical Trial
Official title:
Pharmacokinetics and Pharmacodynamics of the Etonogestrel Contraceptive Implant When Co-administered With Efavirenz
Verified date | May 2018 |
Source | Johns Hopkins University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study evaluates whether there is an interaction between etonogestrel, the progestin hormone released by the contraceptive implant Nexplanon, and efavirenz, a common medication used to treat HIV. The endpoints measured in this study will help determine if such an interaction leads to decreased contraceptive efficacy of the contraceptive implant.
Status | Terminated |
Enrollment | 1 |
Est. completion date | April 4, 2018 |
Est. primary completion date | April 4, 2018 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Female |
Age group | 18 Years to 40 Years |
Eligibility |
Inclusion Criteria: - Healthy women aged 18-40 years who have a Nexplanon®/Implanon® in place that is palpable on exam, had the device placed between 12 and 24 months prior to enrollment, and can provide documentation of when the implant was placed - Able to speak and read English - Documented HIV-negative status within 30 days of enrollment - BMI between 18.5 and 24.9 kg/m2 - Willingness to take a two-week course of efavirenz - Willingness to comply with study visit schedule (as described below), including blood sampling, transvaginal ultrasounds, and cervical mucus assessment - Negative urine human chorionic gonadotropin pregnancy test at study entry - Normal laboratory values within 30 days of study entry, as specified below: - White blood cell count = 4500 and = 11000 cells/mm3 - Platelet count = 100,000 platelets/mm3 - Hemoglobin = 8.0 g/dL - International normalized ratio (INR) = 1.8 - Aspartate transaminase (SGOT) and alanine aminotransferase (SGPT) = 3 times the upper limit of normal (ULN) (upper limit of normal) - Creatinine = 1.5 x ULN - Serum amylase = 1.5 x ULN - Total bilirubin = 2.0 x ULN - Agree to use an additional reliable method of contraception while participating in the study. Acceptable methods include: - Abstinence - Condoms (male or female) with or without spermicide - Pre-existing sterilization of subject or her male partner - Willingness to abstain from alcohol consumption during the study period - Willingness to abstain from any grapefruit product or supplement for the duration of the study. Exclusion Criteria: - Breastfeeding - Hypersensitivity to efavirenz - History of seizure disorder - Initiated, discontinued, or changed doses of drugs that are cytochrome P450 isoenzyme 3A4 (CYP3A4) inducers or inhibitors within 30 days of study entry. |
Country | Name | City | State |
---|---|---|---|
United States | Johns Hopkins University Bayview Medical Center | Baltimore | Maryland |
Lead Sponsor | Collaborator |
---|---|
Johns Hopkins University | American College of Obstetricians and Gynecologists, The Campbell Foundation |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Serum Concentration of Etonogestrel Before and After Two Weeks of Efavirenz | We will draw a baseline serum etonogestrel immediately prior to a participant starting the 2-week course of efavirenz. Serial blood samples will subsequently be drawn over the next 6 weeks to assess for changes in serum etonogestrel concentration. We will be looking to see if the serum etonogestrel concentration decreases below the level necessary for reliable ovulation suppression. | 6 weeks | |
Secondary | Serum Efavirenz Concentrations at the Start and End of the 2-week Dosing Period | We will assess serum efavirenz concentrations at the beginning and end of the 2-week dosing period. By comparing these concentrations to historical controls, we will determine whether taking efavirenz while using the etonogestrel implant alters the serum concentration of efavirenz. | 2 weeks | |
Secondary | Serum Hormone Markers of Ovulation | We will test serial blood samples for levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, and progesterone to determine whether the etonogestrel implant is able to suppress ovulation during and after a course of efavirenz. | 6 weeks | |
Secondary | Transvaginal Ultrasound to Assess for Ovarian Follicular Development | For the entire 6 week period of the study, participants will undergo twice-weekly transvaginal ultrasound to assess for the development of ovarian follicles. This direct assessment of follicular development will be combined with serum hormone concentrations to determine if efavirenz increases the incidence of ovulation in women using the etonogestrel implant for contraception. | 6 weeks | |
Secondary | Cervical Mucus Quality | Cervical mucus quality will be assessed twice weekly throughout the study period. The etonogestrel implant exerts a secondary contraceptive effect by causing cervical mucus to become thick and sticky, and therefore less permissive to the movement of sperm through the female genital tract. We will assess whether efavirenz causes a change in cervical mucus quality that would make sperm penetration more likely, and therefore indicate a reduction in the implant's contraceptive effect. | 6 weeks |
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