Apri

Apri is FDA-approved for use as an oral contraceptive to prevent pregnancy. It is also used off-label for the management of menstrual disorders, including dysmenorrhea (painful periods), irregular menstrual cycles, and to reduce symptoms of premenstrual syndrome (PMS). It may also be used to treat acne in women who desire oral contraception.

Apri is contraindicated in women with a history of thrombotic disorders (such as deep vein thrombosis or pulmonary embolism), stroke, or myocardial infarction. It should not be used by women with known or suspected breast cancer, liver tumors, or liver disease. Additionally, it is contraindicated in women who are pregnant or who have a history of hypersensitivity to any of the components of the medication. Smoking increases the risk of serious cardiovascular side effects from oral contraceptive use, especially in women over 35 years of age, so it is contraindicated for smokers in this age group.

Patients taking Apri should be advised to take the pill at the same time each day, without missing doses, to maintain its effectiveness. If a dose is missed, the patient should follow the instructions provided with the medication or consult their healthcare provider for guidance. Patients should also be aware of the increased risk of blood clots, particularly if they smoke or have other risk factors for cardiovascular disease. It's important to report any unusual symptoms, such as severe headaches, vision changes, or leg pain, to a healthcare provider immediately. Additionally, patients should understand that Apri does not protect against sexually transmitted infections (STIs) and should consider using barrier methods if STI protection is needed.

Common side effects of Apri include nausea, vomiting, headache, bloating, breast tenderness, and changes in weight or appetite. Some women may experience mood changes, spotting between periods, or changes in menstrual flow. Serious side effects, though rare, include the development of blood clots, stroke, or heart attack, particularly in women with risk factors such as smoking or a history of thrombotic events. Women should seek immediate medical attention if they experience symptoms such as chest pain, shortness of breath, severe headaches, or vision changes.

The use of Apri is associated with an increased risk of cardiovascular events, particularly in women who smoke or have other cardiovascular risk factors. The risk of thrombotic events is higher in women over 35 years of age, especially if they smoke. Long-term use of combined oral contraceptives may also be associated with an increased risk of breast and cervical cancer, although the overall risk remains low. Regular monitoring and discussions with a healthcare provider are recommended to assess the risks and benefits of continued use.

Apri may interact with other medications, including certain antibiotics, anticonvulsants, and herbal supplements like St. John’s Wort, which can reduce its effectiveness. Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions. Additionally, some medications may increase the risk of side effects, such as blood clots, when taken with Apri.

Alternative contraceptive options include other combined oral contraceptives, progestin-only pills (also known as the "mini-pill"), intrauterine devices (IUDs), contraceptive implants, contraceptive patches, and injectable contraceptives. Non-hormonal methods, such as condoms, diaphragms, or copper IUDs, are also available. The choice of contraceptive method should be based on the patient's individual health profile, lifestyle, and preferences.