Riboflavin, Self-report, and Serum Norethindrone

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Abstract
• The purpose of this study was to test the reliability of using the tablet marker, riboflavin, as an indicator of adolescent compliance with oral contraceptives, as compared with self-reports and more costly quantitative determinations of serum norethindrone levels. In a pilot study, a total of 31 urine samples were obtained from 11 subjects, aged 14 to 18 years. A follow-up study was conducted on 26 girls, aged 14 to 19 years, who were randomly selected from an ongoing study of oral contraceptive compliance. Subjects were given an oral contraceptive (Ortho-Novum 1/35), combined with 28 mg of riboflavin. In both studies, urinary fluorescence tests for riboflavin and self-reports were found to be significantly associated. In the follow-up study, both self-reports and urinary fluorescence tests were significantly associated with serum norethindrone levels. When the urinary fluorescence test agreed with self-report, compliance or noncompliance was confirmed by serum norethindrone levels in 90% of the cases. The findings suggest that riboflavin, combined with self-report, can be used as an accurate and cost-effective indicator of adolescent compliance with oral contraceptives. (AJDC 1984;138:70-73)