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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, sequential preparations
desogestrel and ethinylestradiol
G03AB05
Forms & Strengths
- Tablet: desogestrel 0.15 mg / ethinyl estradiol 0.03 mg
- Tablet: desogestrel 0.125 mg / ethinyl estradiol 0.04 mg (phasic)
- Tablet: desogestrel 0.025 mg / ethinyl estradiol 0.04 mg (phasic)
Adult Dosing
- Oral: One tablet daily taken consecutively for 21 days, followed by a 7-day pill-free interval or inactive placebo pills
- Continuous regimens: Can be used continuously to suppress menstruation per clinical guidance
Pediatric Dosing
- Post-menarcheal adolescents: 1 tablet daily as indicated for adults
- Safety and efficacy established only after menarche
Indications
- Prevention of pregnancy
- Management of moderate acne vulgaris in women who elect oral contraception
- Treatment of dysmenorrhea and heavy menstrual bleeding
Mechanism of Action
- Suppression of gonadotropins via estrogen and progestin feedback
- Inhibition of ovulation
- Alteration of cervical mucus to impede sperm penetration
- Endometrial thinning to prevent implantation
Contraindications
- Known or suspected pregnancy
- History of or current thrombophlebitis or thromboembolic disorders
- Cerebral vascular 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
- Hepatic adenomas, carcinomas, or severe active liver disease
- Hypersensitivity to any component of the product
- Smokers over the age of 35
Adverse Reactions
- Common: Breakthrough bleeding, spotting, changes in menstrual flow, amenorrhea
- Common: Headache, migraine, mood changes, depression
- Common: Nausea, abdominal cramping, breast tenderness or enlargement
- Common: Weight fluctuations, fluid retention
- Serious: Venous and arterial thromboembolism, myocardial infarction, stroke
- Serious: Hypertension, hepatic neoplasia, gallspall bladder disease
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
- Antidiabetic agents: Hormone contraceptives may impair glucose tolerance, requiring dosage adjustments
- Lamotrigine: Estrogen-containing products decrease lamotrigine serum concentrations, risking seizure control
- Bile acid sequestrants: Reduce absorption of ethinyl estradiol
Curated Content: Needs Vetting Before Put to Clinical Use