Desogen is a combination hormone birth control pill which is used to prevent pregnancy. It contains 2 hormones: a progestin (desogestrel) and an estrogen (ethinyl estradiol).
Indications for use
- Oral contraception (first-line treatment).
- Functional disorders of the menstrual period, dysmenorrhea, premenstrual syndrome.
Mechanism of action
Desogen is a monophase oral contraceptive containing a combination of estrogen and progestogen. The drug contains a synthetic gestagenic and estrogenic components that are more active than natural sex hormones. They work by preventing the release of follicle-stimulating and luteinizing hormones, which hinders the process of ovulation. The effect is enhanced by increasing the viscosity of cervical mucus, which makes it difficult to penetrate the spermatozoon into the uterine cavity. A distinctive feature of the drug is the minimal content of the estrogen component, which reduces the risk of developing estrogen-dependent side effects such as nausea, mammary glands, weight gain, thromboembolic complications, etc. The progestogen content of the generation lll is associated with the absence of adverse metabolic effects, primarily carbohydrate and lipid exchanges. In general, Desogen has a minimum number of side effects and good tolerability with proper use.
Dosage and mode of application
Each 28-day pack contains 21 white round tablets each containing 0.15 mg desogestrel and 0.03 mg ethinyl estradiol. The pack also contains 7 green round tablets containing no hormones.
Start taking birth control pills on the first day of menstruation. Take 1 tablet at exactly the same time for 28 days, without any breaks. Menstrual bleeding occurs 1-2 days after you have taken the last active pill. One the pack is empty, start taking the pills from the next pack (even if the bleeding has not stopped). For your convenience, the days of the week are indicated on the blister.
When switching to Desogen after another oral contraceptive, a similar scheme is used.
The instructions for use state that the common symptoms of drug overdose are nausea and uterine bleeding. A woman feels weak, dizzy, her blood pressure drops. In the first 2-3 hours after the detection of an overdose, it is recommended to rinse the stomach and take activated charcoal. There is no specific antidote for ethinyl estradiol and desogestrel combination.
Desogen contraceptive is contraindicated in the following conditions:
- hypersensitivity to the components of the preparation;
- severe liver disease;
- congenital hyperbilirubinemia (syndromes Gilbert, Dubin-Johnson and Rotor);
- chronic colitis;
- the presence or a history of severe cardiovascular and cerebrovascular changes;
- thromboembolism and predisposition to it;
- liver tumors;
- malignant tumors, especially breast cancer or endometrium;
- severe hypertension;
- severe diabetes mellitus with vascular complications;
- sickle cell anemia;
- chronic hemolytic anemia;
- vaginal bleeding of unknown etiology;
- idiopathic jaundice in anamnesis;
- severe itching or herpes.
Adverse events occur rarely. In connection with the minimum content of the estrogen component, the risk of acyclic spotting increases. Desogen should be taken correctly to avoid side effects (regularly, at the same time of the day, without missing the tablets).
In some cases, the medication can cause the following side effects:
- nausea, vomiting,
- tension of mammary glands,
- changes in body weight and libido,
- depressed mood,
- discomfort when wearing contact lenses.
However, these phenomena are usually temporary and disappear after 2-3 month of continuous use. With a longer period of use, pigment spots on the skin can rarely occur.
Very rare side effects:
- an increase in blood pressure;
- thrombosis and thromboembolism of various locations;
- gallbladder disease;
- skin rashes;
- hair loss;
- changes in vaginal secretion;
- mycosis of the vagina;
The likelihood of these side effects increases when taking hormonal medications without consulting specialists. The risk of negative reactions with the right selection of drugs is minimal.
Desogen pills should not be used in combination with:
- inducers of hepatic microsomal oxidation, such as rifampicin, phenobarbital derivatives;
- anticonvulsants (phenytoin, carbamazepine);
- some tranquilizers, phenylbutazone, ketoconazole;
- broad-spectrum antibiotics (tetracycline, chloramphenicol, ampicillin, neomycin) because they may reduce the contraceptive effect of ethinyl estradiol and
- desogestrel combination.
Birth control pills should be used with caution in combination with:
- anticoagulant derivatives of coumarin or indanedione (there may be a need for changing the dose of anticoagulant);
- tricyclic antidepressants, maprotiline;
- beta-blockers (bioavailability and toxicity of these drugs may increase);
- oral antidiabetic drugs, insulin (it may be necessary to change their dose);
- bromocriptine (decreased efficacy);
- hepatotoxic drugs, especially with dantrolene (the risk of increased hepatotoxicity, especially in women over 35 years of age).
What if I miss a dose?
- If more than 36 hours have passed between taking active tablets, this is “a missed tablet”, the reliability of contraception in this period is not guaranteed;
- If you miss 1 active pill on the first or second week of the period, you need to take 2 tablets the next day and then continue taking pills according to the usual schedule;
- If you miss 2 active tablets in a row during the first or second week of the period, you need to take 2 tablets in the next 2 days, then taking pills according to the usual schedule, using additional contraceptive methods until the end of the period;
- If you miss an active pill during the third week of the period, follow the same instructions and start taking pills from a new package without taking 7 no-medication pills
- If you miss an inert pill, throw it away, then continue as scheduled.
It is important to remember that in connection with the minimal dose of estrogen, the risk of ovulation and/or bleeding is increased when the tablet is missed.
Desogen and pregnancy
The intake of oral contraceptives before pregnancy does not increase the risk of various fetal defects. Use of hormonal contraceptives in the early stages of pregnancy does not have a negative effect on the fetus. Remember that according to the FDA classification, Desogen is classified in category X according to the risk during pregnancy. The possible risk associated with taking hormonal contraceptives, in this case, is much greater than the benefit, so when pregnancy is suspected, the drug should be canceled.
Combined oral contraceptives inhibit lactation, so they are not the right contraceptive choice when breastfeeding. A small amount of active substances can be excreted in breast milk.
After delivery, Desogen can be used after 21 days (non-breastfeeding women). If a woman is breastfeeding, the medication can be started after 5 months.
Before starting the medication, general medical and gynecological examinations should be carried out (primarily blood pressure measurement, blood sugar level determination, liver function tests, mammary gland examination, cytological analysis of cervical smear) to eliminate risk-related diseases and pregnancy.
Desogen is not recommended for women who have a family history of thromboembolic disease.
Take birth control pills with caution if you have diabetes, heart disease of non-ischemic etiology, hypertension, renal dysfunction, thrombophlebitis, otosclerosis, multiple sclerosis, epilepsy, small chorea, intermittent porphyria, latent tetany, bronchial asthma.
At the time of taking the drug, medical supervision is required at least every 6 months.
After viral hepatitis suffered, the use of oral contraception is allowed no earlier than 6 months, provided that hepatic functions are normalized.
Benign or malignant liver tumors were very rarely observed against the background of the continuous use of sex hormones (more than 8 years). When you have a sharp pain in the upper abdomen, hepatomegaly and signs of intra-abdominal hemorrhage, there may be a suspicion of a liver tumor. In this case, the drug should be discontinued until the cause is determined.
In case of violations of the liver functions during the use of the drug, it is necessary to monitor the condition of the women every 2-3 months.
In the absence of menstrual bleeding, continued use of Desogen contraceptive is allowed only after exclusion of pregnancy.
If you have intermenstrual bleeding, especially in the first 2-3 months, continue taking the pills, as in most cases bleeding stops spontaneously. If intermenstrual bleeding does not disappear or recur, a medical examination is required to exclude the pathology of the internal organs.
If you have vomiting or diarrhea, continue taking tablets, but it is recommended to use an additional, mechanical method of contraception.
In women taking oral contraceptive preparations containing estrogens, the probability of developing thromboembolism of different localization may increase. This risk increases with age, mainly among smokers. In this regard, women over 30 years of age who take Desogen are advised to quit smoking.
If a woman is planning a pregnancy, the drug should be canceled at least three months before the expected conception period.
Stop taking birth control pills immediately in the following cases:
- you suffer from a migraine-like severe headache, with acute visual impairment, with a suspected thrombosis or a cerebral infarction;
- you have a sharp increase in blood pressure, jaundice or hepatitis without jaundice, generalized pruritus, frequency of epileptic seizures;
- you plan an operation, with subsequent long-term immobilization.