Comparative in vitro study on the local tolerance and efficacy of benzalkonium chloride, myristalkonium chloride and nonoxynol-9 as active principles in vaginal contraceptives

Eur J Contracept Reprod Health Care. 2021 Aug;26(4):334-342. doi: 10.1080/13625187.2021.1900563. Epub 2021 Apr 6.

Abstract

Background: Spermicides have been identified as a potentially attractive alternative to hormonal contraceptives and/or intrauterine devices. Thus, this study aimed evaluating the efficacy and local tolerance of benzalkonium chloride (BKC) and myristalkonium chloride (MKC) contained in Pharmatex® vaginal formulations and compare them with nonoxynol-9 (N-9), the most common active ingredient in topical vaginal contraceptives.

Methods: Human normozoospermic samples were assessed for motility, viability, acrosome status and penetration ability after exposure to control, N-9 or different BKC and MKC doses for 0 and 10 minutes. Local tolerance on HeLa cells was evaluated by the Trypan-blue and MTT assays.

Results: Exposure to BKC and MKC reduced acrosome integrity while promoting total immobilisation and complete loss of sperm viability (p < .001, n = 15). Both compounds also compromised sperm penetration ability upon exposure (p < .001, n = 15). N-9 induced the same outcomes (p < .001, n = 15); nevertheless, it was more toxic to HeLa cells than BKC and MKC (p < .05, n = 14).

Conclusions: BKC and MKC present strong in vitro spermicidal activity at lower doses than N-9 and were better tolerated after immediate exposure than N-9. Available Pharmatex® galenic formulations were as effective as products based on N-9.

Keywords: Local contraceptives; human sperm; local tolerance; spermicidal activity; spermicides.

MeSH terms

  • Benzalkonium Compounds / pharmacology*
  • Chlorides
  • Contraceptive Agents / pharmacology*
  • Female
  • HeLa Cells / drug effects
  • Humans
  • Male
  • Nonoxynol / pharmacology*
  • Spermatocidal Agents / pharmacology*
  • Spermatozoa / drug effects*

Substances

  • Benzalkonium Compounds
  • Chlorides
  • Contraceptive Agents
  • Spermatocidal Agents
  • Nonoxynol