Research highlights anesthesia provider knowledge gap on drug, hormonal contraceptive interactions

Editor's Note

Insufficient awareness of drug interactions with hormonal contraceptives (HCs) among anesthesia providers could lead to unintended pregnancies and preventable health consequences, according to survey published in Anesthesia & Analgesia. Physician’s Weekly covered the news February 27.

The article specifically cites sugammedex and aprepitant, both of which are widely used in perioperative care. Findings are based on 337 responses out of a total of 1,092 anethesia professionals, including attending anesthesiologists, anesthesiology residents and fellows, certified registered nurse anesthetists (CRNAs), and student registered nurse anesthetists (SRNAs).

Key findings on sugammedex awareness include:

• 88% of respondents prefer the drug for neuromuscular blockade (NMB) reversal
• 96% were aware of its interference with oral contraceptives, knowledge about interactions with other HCs varied.
• Only 61% recognized its effect on levonorgestrel intrauterine devices (IUDs),
• 70% recognized the effect on etonogestrel implants, and
• 66% recognized the effect on medroxyprogesterone injections.
• 52% identified the correct duration, despite labeling advising patients to use alternative birth control methods for seven days post-administration
• Only 49% felt adequately trained on this issue.

Aprepitant’s interactions with HCs were even less understood. Key findings include:

• 48% of respondents rarely or never used aprepitant in the past year
• Although 46.8% knew about its effect on oral contraceptives, fewer recognized its interactions with other HCs: 32% for levonorgestrel IUDs, 36% for etonogestrel implants, and 34% for medroxyprogesterone injections.
• Only 38.5% were aware of the recommended precautionary period of using alternative birth control for 28 to 31 days after administration.
• Only 11% of participants considered their training on this topic sufficient

The full report offers quotes from study authors, as well as an infographic on the value of discussing interactions with patients (a step that is “rarely part of standard practice”).

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