Letter: Precipitate action on Pill

From Dr Robert Donnelly

Sir: Your article covering the recent Committee on Safety of Medicines advice on certain combined oral contraceptives included a table of contraceptives ("Women still haunted by the risk factor", 20 October) which categorised products according to their safety yet failed to include Cilest.

The CSM advice was based on three new studies which indicate that combined oral contraceptives containing desogestrel and gestodene were associated with increased risk of thromboembolism compared to other progestogens. An annexe page attached to the CSM advice lists the seven brands affected by this new information and states that "No change in prescribing practice is required for any other combined oral contraceptive". Since Cilest has not been shown to present an increased risk of thromboembolism it should be included as an unrestricted product in your tables.

Yours faithfully,

Robert Donnelly

Medical Director

Janssen-Cilag

High Wycombe,

Buckinghamshire

20 October