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GENITO URINARY SYSTEM AND SEX HORMONES › SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM › HORMONAL CONTRACEPTIVES FOR SYSTEMIC USE › Progestogens and estrogens, fixed combinations
desogestrel and ethinylestradiol
G03AA09
Forms & Strengths
- Tablet: 0.15 mg desogestrel / 0.03 mg ethinylestradiol
- Tablet: 0.125 mg desogestrel / 0.03 mg ethinylestradiol
Adult Dosing
- Contraception: 1 tablet daily for 21 consecutive days, followed by a 7-day pill-free interval or 7 inert pills, repeated every 28 days
- Continuous regimens: 1 tablet daily without interruption may be used for continuous cycle suppression
Pediatric Dosing
- Post-menarchal adolescents: 1 tablet daily following the same adult schedule for contraception
- Pre-menarchal pediatric patients: Safety and efficacy not established
Indications
- Prevention of pregnancy
- Management of moderate acne vulgaris in females who desire oral contraception
- Treatment of dysmenorrhea and premenstrual symptoms
Mechanism of Action
- Suppression of gonadotropins (FSH and LH) via negative feedback, thereby inhibiting ovulation
- Alteration of cervical mucus to impede sperm penetration
- Modification of the endometrium to reduce the likelihood of implantation
Contraindications
- Known or suspected pregnancy
- History of or current thrombophlebitis, thromboembolic disorders, or deep vein thrombosis
- Active or past history of cerebral vascular disease or coronary artery disease
- Valvular heart disease with thrombogenic complications
- Known or suspected carcinoma of the breast or estrogen-dependent neoplasia
- Undiagnosed abnormal uterine bleeding
- Severe hepatic disease or liver tumors
- Hypersensitivity to any component of the product
- Smoking in women over 35 years of age
Adverse Reactions
- Venous and arterial thromboembolism
- Hypertension
- Nausea, abdominal cramping, bloating
- Headache, migraine
- Breast tenderness, enlargement, or secretion
- Breakthrough bleeding, spotting, amenorrhea
- Weight fluctuations, mood changes, libido alterations
- Melasma, hepatic adenomas
Drug Interactions
- CYP3A4 inducers (e.g., rifampin, carbamazepine, phenytoin, St. John's wort) decrease contraceptive efficacy
- CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) may increase plasma concentrations of ethinylestradiol
- Lamotrigine: Oral contraceptives decrease serum concentrations, potentially reducing seizure control
- Antidiabetic agents: Estrogens may impair glucose tolerance, requiring dosage adjustments
- Bile acid sequestrants decrease absorption of ethinylestradiol
Curated Content: Needs Vetting Before Put to Clinical Use