Effect of the British warning on contraceptive use in the General Medical Service in Ireland

In October 1995 the UK Committee of Safety of Medicine (CSM) issued a warni ng about the safety (thromboembolic disease) of the third generation oral c ontraceptive steroids (OCS) recommending a snitch to older agents except wh ere women were intolerant of first and second generation OCS. Advice by the Irish regulatory authority (Irish Medicines Board) did not recommend such a switch. This pill scare lead to some UK users stopping OCS mid-cycle and a rise subsequently in abortions and pregnancies was noted. To determine whether local or UK advice was followed we obtained data from the General Medical Service (GMS) Scheme on the use of contraceptive steroi ds prescribed before and after the CSM's warning. The results show a clear shift from usage of the third generation OCS to th e second generation OCS and norgestimate-containing OCS. We have also noted a marked fall in the overall use of the combined OCS? a trend that was not noted in the U.K. It is clear that prescribers and pill users were influenced more by advice from the UK than by Irish regulatory authority. There is now a centralised European mechanism to licence drugs in the European Union (EU). We need to develop an EU perspective to issues of drug safety, as constituent nations are no longer isolated islands.