As POPs are associated with fewer side effects and contraindications, there has been a decline in combined oral contraceptive pills (COCPs) while POP use has increased.⁸

In its consultation on reclassifying desogestrel as a P medicine, the MHRA noted that “risks can be managed through the product information and pharmacist training.” Particularly in desogestrel’s favour are its “well-known safety profile, its ease of use and its few contraindications for use.”¹⁶

The MHRA points out that “use of desogestrel requires little ongoing monitoring and specifically does not require blood pressure to be monitored as progesterone only pills have not been shown to affect blood pressure.”

Other features of the POM to P switch were to highlight the potential for mood changes in the patient information leaflets, with advice for the patient to contact their doctor should this occur. The checklist for pharmacists selling the OTC desogestrel preparations Lovima and Hana was strengthened to encourage the pharmacist to counsel the woman about mood changes and depression and advise them to speak to their doctor if they experience this.

The patient consultation about OTC desogestrel should also discuss sexual health and include a reminder that only barrier methods of contraception protect against sexually transmitted infections.

To ensure patient records are accurate, pharmacists are also asked to encourage patients to inform their GP that they are taking desogestrel.