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16 pages, 1109 KB

Open AccessArticle

Lacosamide Safety During Pregnancy and Breastfeeding: A Single-Centre Experience and Comprehensive Narrative Review

by Kamila Saramak, Manuela Kaml, Marina Peball, Luisa Delazer, Gerald Walser, Anna Hussl, Iris Unterberger and Alexandra Astner-Rohracher

Pharmacy 2026, 14(2), 58; https://doi.org/10.3390/pharmacy14020058 - 1 Apr 2026

Viewed by 751

Abstract

(1) Background: The management of epilepsy during pregnancy requires balancing effective seizure control against potential teratogenic effects of antiseizure medications (ASMs). Data on the safety of lacosamide (LCM), a third-generation ASM, during pregnancy and breastfeeding are limited. (2) Methods: To evaluate the safety [...] Read more.

(1) Background: The management of epilepsy during pregnancy requires balancing effective seizure control against potential teratogenic effects of antiseizure medications (ASMs). Data on the safety of lacosamide (LCM), a third-generation ASM, during pregnancy and breastfeeding are limited. (2) Methods: To evaluate the safety and efficacy of LCM during pregnancy and breastfeeding, we report a single-centre case series and provide a comprehensive narrative review of the literature. (3) Results: In total, 22 cases of maternal exposure to LCM throughout pregnancy (1 monotherapy, 21 polytherapy) were identified, resulting in 21 live births (95.5%). Congenital malformations (atrial septal defect) were observed in one offspring exposed to LCM and levetiracetam (4.8%). Twelve newborns were breastfed (57.1%) without neurodevelopmental delay after twelve months. The literature search identified 16 studies, overall reporting data on 627 pregnancies with LCM (236 monotherapy, 391 polytherapy). Among 632 available pregnancy outcomes (3 twin pregnancies and 1 triplet in the polytherapy group) the proportion of live births was 81.3% (514/632). Major congenital malformations were reported in 2.5% (6/236) with LCM monotherapy and 11.9% (47/396) with polytherapy. (4) Conclusions: According to the literature, no major safety concerns, especially in LCM monotherapy, and no specific malformations associated with LCM exposure were identified. Conclusions are limited by the heterogeneity of studies and the small number of monotherapy-exposed cases. Larger, prospective studies with longer follow-up are required. Full article

(This article belongs to the Special Issue Pharmacy Practice for Women’s/Reproductive Health)

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17 pages, 1957 KB

Open AccessArticle

Assessment of Potential Exposure to Pregnancy-Contraindicated Medications Among Women of Reproductive Age in Japan: A Retrospective Database Study

by Hiroyuki Ura and Noriko Matsuoka

Pharmacy 2026, 14(2), 51; https://doi.org/10.3390/pharmacy14020051 - 20 Mar 2026

Viewed by 638

Abstract

Preconception care is globally recognized as essential for optimizing pregnancy outcomes; however, in Japan, comprehensive data on medication-related potential exposure to pregnancy-contraindicated medications among women of reproductive age remain limited. We conducted a retrospective cross-sectional descriptive study using data from Japan’s National Database [...] Read more.

Preconception care is globally recognized as essential for optimizing pregnancy outcomes; however, in Japan, comprehensive data on medication-related potential exposure to pregnancy-contraindicated medications among women of reproductive age remain limited. We conducted a retrospective cross-sectional descriptive study using data from Japan’s National Database of Health Insurance Claims (fiscal year 2022) to assess the potential exposure to pregnancy-contraindicated medications among women of reproductive age. Outpatient prescriptions for oral medications dispensed to women aged 15–49 years were analyzed. In total, 270 medications classified as contraindicated during pregnancy were identified, of which 75 were also contraindicated for women planning pregnancy. Of these, 58 active ingredients were restricted in both phases. Notably, 212 medications were uniquely contraindicated during pregnancy, highlighting the broader contraindication profiles during fetal development than during the preconception period. Despite these contraindications, high prescription volumes were observed for medications such as loxoprofen sodium hydrate, sodium valproate, and metformin hydrochloride among women of reproductive age. These findings illustrate a high baseline utilization of pregnancy-contraindicated medications among women of reproductive age. As most women in this demographic are neither pregnant nor actively planning conception, these volumes primarily reflect standard care rather than inappropriate prescribing. In conclusion, pharmacists serve as an important supplementary safety net by routinely confirming pregnancy status to prevent inadvertent exposure. Full article

(This article belongs to the Special Issue Pharmacy Practice for Women’s/Reproductive Health)

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11 pages, 226 KB

Open AccessArticle

Oral Contraceptive Knowledge Among Adolescents and Young Women

by Nga-Weng (Ivy) Leong, Marie Barnard, Meagen Rosenthal and Erin Holmes

Pharmacy 2026, 14(1), 30; https://doi.org/10.3390/pharmacy14010030 - 5 Feb 2026

Viewed by 1323

Abstract

This study aims to describe oral contraceptive knowledge among adolescents and young women, and to examine individuals’ characteristics associated with oral contraceptive knowledge. A cross-sectional survey was administered using an online panel. Females aged 16 to 24 were recruited. Oral contraceptive knowledge was [...] Read more.

This study aims to describe oral contraceptive knowledge among adolescents and young women, and to examine individuals’ characteristics associated with oral contraceptive knowledge. A cross-sectional survey was administered using an online panel. Females aged 16 to 24 were recruited. Oral contraceptive knowledge was measured using nine items with six domains, including oral contraceptive use, efficacy, indication, mechanism of action, risks, and side effects. A summated score was created, with a score of 9 indicating highest level of knowledge. Multivariable regression was used to examine significant socio-demographics and clinical characteristics. Among the 700 included responses, largest proportion of respondents were White (45.43%) and were covered by public insurance (43.14%). A total of 446 (63.71%) respondents expressed at least slight interest in using over-the-counter oral contraceptives. Overall, the mean score of knowledge was 4.08 out of 9. Most did not correctly answer questions about side effects, the mechanism of action and appropriate use. Similar patterns were observed among those who were interested in over-the-counter oral contraceptives (mean = 4.11). Adolescents and young women had a low level of oral contraceptive knowledge. With a high proportion of individuals interested in over-the-counter oral contraceptives, additional information support is needed to support informed contraception choice and use. Full article

(This article belongs to the Special Issue Pharmacy Practice for Women’s/Reproductive Health)

12 pages, 319 KB

Open AccessArticle

Evaluation of Pharmacist-Developed Educational Leaflets for Women’s Health: A Pre–Post Study of Knowledge and Perceived Usefulness

by Weronika Guzenda, Zuzanna Berdzińska, Piotr Przymuszała, Olga Sierpniowska, Magdalena Jasińska-Stroschein and Magdalena Waszyk-Nowaczyk

Pharmacy 2026, 14(1), 29; https://doi.org/10.3390/pharmacy14010029 - 5 Feb 2026

Viewed by 715

Abstract

Background: Written educational materials are widely used in community pharmacies to support patient education, and available evidence suggests their effectiveness in improving short-term knowledge. However, there remains a need for well-documented, practice-oriented evaluations of pharmacist-developed materials in real-world community pharmacy settings. The aim [...] Read more.

Background: Written educational materials are widely used in community pharmacies to support patient education, and available evidence suggests their effectiveness in improving short-term knowledge. However, there remains a need for well-documented, practice-oriented evaluations of pharmacist-developed materials in real-world community pharmacy settings. The aim of this study was to evaluate the immediate impact of a pharmacist-developed educational leaflet on women’s health knowledge and its perceived usefulness, clarity, and acceptability. Methods: This study evaluated pharmacist-developed educational leaflets addressing women’s health topics using a pre–post study design. The study was conducted in Poland and involved 266 adult women. All participants completed a five-question knowledge test before and immediately after reading the educational leaflet, followed by a self-assessment of perceived usefulness, clarity, and visual appeal. Descriptive statistics were performed to summarize the results. Results: A statistically significant increase in knowledge was observed after exposure to the educational material, with mean scores rising from 2.8 ± 1.2 to 4.6 ± 0.7 (out of 5, p < 0.001). The greatest improvements were noted in topics related to sexually transmitted infection self-testing and pregnancy testing. Most participants rated the leaflet as useful, comprehensible, attractive, and engaging, with higher ratings reported among younger and better-educated respondents. Conclusions: Pharmacist-developed educational leaflets can support short-term knowledge acquisition and are perceived positively by women across age groups. These findings highlight the potential role of community pharmacies in delivering accessible written health education, while underscoring the need for future studies to assess long-term knowledge retention, behavioral outcomes, and topic-specific, targeted materials. Full article

(This article belongs to the Special Issue Pharmacy Practice for Women’s/Reproductive Health)

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10 pages, 227 KB

Open AccessArticle

Comparison of Subcutaneous Versus Intramuscular Estradiol Administration for Feminizing Gender-Affirming Hormone Therapy

by Abby C. Poage, Jordan M. Rowe, Mary Beth A. Dameron, Abigail M. Bavuso and Andrew J. Smith

Pharmacy 2026, 14(1), 13; https://doi.org/10.3390/pharmacy14010013 - 23 Jan 2026

Viewed by 1937

Abstract

This single health system, retrospective cohort study compared subcutaneous (SC) versus intramuscular (IM) estradiol administration in 70 adult patients with a diagnosis of gender incongruence or gender dysphoria seen in an LGBTQ Specialty Clinic within a safety-net institution between October 2018 and December [...] Read more.

This single health system, retrospective cohort study compared subcutaneous (SC) versus intramuscular (IM) estradiol administration in 70 adult patients with a diagnosis of gender incongruence or gender dysphoria seen in an LGBTQ Specialty Clinic within a safety-net institution between October 2018 and December 2024. The primary endpoint was patients who reached therapeutic estradiol levels at 6 months. Secondary endpoints included the incidence of sub- and supra-therapeutic and actual estradiol levels at months 3, 6, 9, and 12 and patients who received pharmacist-led injection technique education. At 6 months, the proportion of patients achieving therapeutic estradiol levels did not differ between IM and SC administration. In exploratory analyses of continuous estradiol concentrations, IM administration was associated with higher measured estradiol levels. Full article

(This article belongs to the Special Issue Pharmacy Practice for Women’s/Reproductive Health)

19 pages, 619 KB

Open AccessArticle

Factors, Attitudes, and Prevalence of Self-Medication Among Pregnant Women: A Cross-Sectional Study in Saudi Arabia

by Alla Alhumaid, Noha Alhumaid, Khalid Alkhurayji, Abdallah Alsuhaimi, Fawaz Modahi, Noor Almanidi, Abdullah Almutairi, Abdullah Alanazi and Nayif Modahi

Pharmacy 2025, 13(5), 138; https://doi.org/10.3390/pharmacy13050138 - 1 Oct 2025

Viewed by 2141

Abstract

Background: Self-medication (SM) among women during pregnancy poses a critical risk to maternal health, and SM is still commonly practiced in Saudi Arabia. Therefore, this study aims to assess the factors, attitudes, and prevalence of SM among pregnant women in the Ministry of [...] Read more.

Background: Self-medication (SM) among women during pregnancy poses a critical risk to maternal health, and SM is still commonly practiced in Saudi Arabia. Therefore, this study aims to assess the factors, attitudes, and prevalence of SM among pregnant women in the Ministry of Health (MOH) First Health Cluster. Methods: A cross-sectional design was used among 400 pregnant women who received care at primary, secondary, and tertiary healthcare levels. A structured tool was adopted and modified based on the literature review, expert and focus group interviews, and the experiences of the target participants. The dependent variables included history of illness, access to healthcare services, medication usage, and perception of SM, while the independent variables included socioeconomic status. Statistical Package for the Social Sciences (SPSS), Version 25 was used for analysis. Results: The prevalence of SM was 36.5%. Cough syrup and antipyretics were the most commonly used medications, while hair problems and weight loss were the most frequently reported reasons for SM. The primary sources of information guiding SM behavior were prior prescriptions and previous experience. Education level, occupation, age, number of pregnancies, and miscarriage history were all significantly associated with SM (p < 0.05). Conclusions: SM was found to be frequent among pregnant women in the First Health Cluster, highlighting the need for educational interventions and regulatory measures to reduce unsafe practices and improve maternal health. Full article

(This article belongs to the Special Issue Pharmacy Practice for Women’s/Reproductive Health)

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15 pages, 218 KB

Open AccessArticle

Pharmacist Dispensing of Mifepristone: Evaluation of Knowledge and Support Before and After a Continuing Education Course

by Natalie Morris, Alexa Orosz, M. Antonia Biggs, Sally Rafie and Daniel Grossman

Pharmacy 2025, 13(5), 131; https://doi.org/10.3390/pharmacy13050131 - 15 Sep 2025

Viewed by 1249

Abstract

Medication abortion with mifepristone and misoprostol is a safe and effective method for ending a pregnancy. Pharmacy dispensing of mifepristone was approved by the U.S. Food and Drug Administration in 2023, but educational opportunities for pharmacists were nonexistent. We designed a 1 h [...] Read more.

Medication abortion with mifepristone and misoprostol is a safe and effective method for ending a pregnancy. Pharmacy dispensing of mifepristone was approved by the U.S. Food and Drug Administration in 2023, but educational opportunities for pharmacists were nonexistent. We designed a 1 h continuing education course on medication abortion for pharmacists, which was offered in a live-webinar or recorded-video format over 3 years. It included key medication abortion topics, including medications, patient counseling, relevant policies, and implementing pharmacy dispensing. Using a prepost design, we administered online surveys to participants prior to and after completing the course to assess changes in overall medication abortion knowledge score (six items, Cronbach’s alpha = 0.76) and support for pharmacist dispensing of medication abortion (one Likert-scaled item). During the study period, 279 students and pharmacists took the course, of which 148 completed both the pre- and post-course questionnaires. Adjusted regression analyses demonstrated significant increases in knowledge scores and support for pharmacist dispensing of medication abortion post-course; most thought dispensing mifepristone would be very (21.6%) or somewhat easy (38.5%) to implement, and 75% indicated a willingness to dispense mifepristone if allowed. These findings suggest that video-based education on medication abortion is an effective tool for enhancing pharmacists’ knowledge and support for medication abortion, which could increase access to reproductive health care. Full article

(This article belongs to the Special Issue Pharmacy Practice for Women’s/Reproductive Health)

17 pages, 562 KB

Open AccessArticle

Detection of Problems Related to Hormonal Contraceptives in Community Pharmacy: Application of a Structured Questionnaire in Women of Childbearing Age

by Raquel Sicilia-González, Susana Abdala-Kuri, Chaxiraxi Morales-Marrero, Adama Peña-Vera, Alexis Oliva-Martín and Sandra Dévora-Gutiérrez

Pharmacy 2025, 13(4), 112; https://doi.org/10.3390/pharmacy13040112 - 21 Aug 2025

Viewed by 2362

Abstract

The use of hormonal contraceptives is essential to ensure effective and safe contraception. However, factors such as inadequate prescription, poor adherence, or lack of information can lead to drug-related problems (DRPs) and negative outcomes associated with medication (NOMs). Methods: An observational, descriptive, cross-sectional [...] Read more.

The use of hormonal contraceptives is essential to ensure effective and safe contraception. However, factors such as inadequate prescription, poor adherence, or lack of information can lead to drug-related problems (DRPs) and negative outcomes associated with medication (NOMs). Methods: An observational, descriptive, cross-sectional study was conducted between January and June 2024 in two community pharmacies in Tenerife. It included 316 users of hormonal contraceptives over the age of 18. The main instrument was a structured questionnaire, administered through individual interviews conducted in the Personalized Care Area (PCA). Results: Combined Oral Contraceptives (COCs) were the most frequently used method (72.2%). Adverse reactions were reported by 47.2% of participants, mainly psychiatric disorders (28.1%). Emergency contraception had been used at least once by 43.8% of the respondents. Among COC users, 68.9% reported difficulties with daily adherence, and only 36.7% had adequate knowledge in case of missed doses. Conclusions: Community pharmacists may play a key role in reproductive health by providing personalized counselling, referring patients to other levels of care, and promoting the rational and safe use of hormonal contraceptives. Full article

(This article belongs to the Special Issue Pharmacy Practice for Women’s/Reproductive Health)

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