The FDA has approved the use of ulipristal acetate (ella – Watson) as an emergency contraceptive that can be taken up to 5 days after unprotected intercourse. It is available only by prescription.

The FDA has approved the antiprogestin mifepristone (Korlym – Corcept Therapeutics) for control of hyperglycemia secondary to hypercortisolism in adults with endogenous Cushing’s syndrome who have type 2 diabetes/ glucose intolerance and have not responded to, or are not candidates for, surgery. Formerly known as RU 486, mifepristone is also available in a lower strength as Mifeprex for use in terminating an early intrauterine pregnancy.

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Changes caused by one drug in the absorption, distribution, metabolism or excretion of another may lead to a pharmacokinetic adverse drug interaction (DN Juurlink et al, JAMA 2003; 289:1652). Additive drug interactions, such as vasodilation caused by both sildenafil (Viagra) and nitrates, can also have adverse effects.

The Norplant System (Wyeth-Ayerst) for subdermal delivery of the synthetic progestin levonorgestrel was recently approved by the US Food and Drug Administration for use as a long-term contraceptive.

The results of a large randomized controlled trial of estrogen plus a progestin to prevent heart disease in postmenopausal women were recently reported (Writing Group for the Women's Health Initiative Investigators, JAMA 2002; 288:321).

An oral contraceptive (Yasmin - Berlex) containing 3 mg of drospirenone and 30 mcg of ethinyl estradiol is being promoted as having a low incidence of adverse effects.

The copper T 380A (ParaGard - GynoPharma), a new intrauterine contraceptive device (IUD) soon to be marketed in the USA, will be one of only two IUDs available in this country. Progestasert (Alza), which gradually releases progesterone (Medical Letter, 18:65, 1976), is the other.

The FDA had approved an intrauterine contraceptive device that releases the synthetic progestin levonorgestrel over a period of five years. The device has been available in Europe for 10 years.

Eplerenone (e pler' en one; Inspra - Pharmacia), an aldosterone receptor antagonist similar to spironolactone (Aldactone, and others), has been approved by the FDA, but not yet marketed, for treatment of hypertension. It has also been tried for treatment of heart failure.