I wanted to remind women about an issue with the prescription product Angeliq, a hormone-based medicine used to relieve the symptoms of menopause. Unfortunately, we’re aware of errors where it’s been dispensed or prescribed improperly as an oral contraceptive.
Our sister organization, ISMP Canada has received two reports where a physician provided a woman with samples of Angeliq to take as birth control. Both women took Angeliq for several months until the samples were finished. The mistakes were discovered when the women took prescriptions for further supplies of Angeliq to their pharmacies and referred to them as “birth control pills.”
Angeliq has a number of similarities to birth control pills that might have played a role in the mix-up. The labeling and packaging is similar in design to birth control pills. It’s available as a 28-day blister pack like many birth control pills. “Angeliq” also sounds like a woman’s name—many birth control pills also have female-sounding names (e.g., PORTIA, YASMIN).
Neither the outer nor the inner package of the Angeliq sample pack states that the medicine is to be used for symptoms of menopause, not birth control. The hormones contained in Angeliq appear similar to the active ingredients in birth control pills - hormone components called progestin and estrogen. However, what’s important to know is the dose of progestin in Angeliq is less than that used in birth control pills, and the potency of the estrogen used in Angeliq is also different from the potency used in birth control pills.
Women using Angeliq instead of an oral contraceptive could become pregnant. And that’s exactly what happened to a woman we heard from recently through our consumer error reporting program. Her doctor had given her Angeliq for birth control after she gave birth to her first baby. Now she believes she is pregnant again. She contacted us after she searched on-line and found that the Angeliq she was taking wouldn’t protect her from a pregnancy.
We’ve alerted doctors and others who might prescribe oral contraceptives about this risk and suggested that if they have these samples they not store them anywhere near birth control pill samples. If you are being treated for menopause, Angeliq is not for you.
In an earlier blog I cautioned that when samples are provided in doctor's offices, proper labeling and certain checks that are usually provided by your pharmacy may be missed. If your doctor gives you sample medication for any reason, let your pharmacist know you are taking the medication, and why. Your pharmacist can add this information to your medication profile, and check that the sample medication does not interact with any medicines you are already taking. You should also ask your pharmacist to provide you with an information sheet about the medication, if available.
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