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[7] In addition, oral contraceptives have been noted to lower serum B levels, though this effect is usually clinically insignificant

Morales DR, Conover MM, You SC, Pratt N, Kostka K, Duarte-Salles T, Fernndez-Bertoln S, Aragn M, DuVall SL, Lynch K, Falconer T, van Bochove K, Sung C, Matheny ME, Lambert CG, Nyberg F, Alshammari TM, Williams AE, Park RW, Weaver J, Sena AG, Schuemie MJ, Rijnbeek PR, Williams RD, Lane JCE, Prats-Uribe A, Zhang L, Areia C, Krumholz HM , Prieto-Alhambra D, Ryan PB, Hripcsak G, Suchard MA

Slower titration and proactive side effect management significantly improve retention rates

Oral formulations work for some patients but require careful timing and may show less dramatic effects due to absorption variability