What Your Pharmacist Doesn’t Know about Plan B

The folks at a major healthcare professional  education provider were scooped by Mother Jones and, prior to that, by yours truly, regarding the ineffectiveness of Plan B ONE-STEP for the bigger girls.

They had to update their not so good analysis of the morning after pills and …. it’s still not so good. If they were offering compensation, yours truly would tell them more, but this example is blogged to illustrate a single point. The public should know that their busy health care professionals are treated like mushrooms: kept in the dark and fed B.S. concerning birth control in general.

 Pharmacists have to think about a concept of steady state when asked by physicians to dose antibiotics and other drugs, or if they work in the field of drug development. Steady state is the condition during which the intake of a drug is in a sort of equilibrium with the output or the elimination of the drug. This assumes regular dosing of the drug. Steady state generally occurs after several doses and after about 5 times the half life of the drug. Ideally drug levels at steady state are high enough to be effective, and low enough to be ‘non-toxic’.

Casting about for the reason why Plan B ONE STEP doesn’t work in American women of average size or greater, the team at this Professional Education Provider, led by N B O’ Pharm.D., BCPS,wrote the following:

“The exact mechanism for the reduced efficacy seen in overweight and obese women using levonorgestrel is not known. One proposed mechanism is that in women with an increased BMI, there is a delay in time to steady state and a prolonged half-life as seen in studies with combined oral contraceptives.21″

This nonsensically applied  idea was blamed on the article below, which covered birth control hormones in general, and addressed the drugs that females take orally every day, or those which continuously supply hormone(s) to the body,  such as patches and depot injections.

Edelman AB, Cherala G, Stanczyk FZ. Metabolism and pharmacokinetics of contraceptive steroids in obese women: a review. Contraception 2010;82:314-23.

Some poor PharmD educator is talking about STEADY STATE with respect to a drug which is taken in a single dose : Plan B ONE STEP!! 

Steady State Never Happens with a single such dose!

This is just a single example but it illustrates the point.

 1) Most of your health care professionals are generally lost in the weeds regarding birth control, and don’t know what they’re talking about. That includes the ones who really SHOULD know what they’re talking about.

 Bonus) Be assured that birth control generally does not work as well in real life as the studies claim, and many factors contribute to this.

Please consider adjusting life style and reproductive planning with at least these two facts in mind.