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Desogestrel / Ethinyl Estradiol Review


Desogestrel / Ethinyl Estradiol is a combination of 2 hormones: an estrogen (ethinyl estradiol) and a progestin (desogestrel), that are used to prevent pregnancy.

Contents:

Indications for use

  • Contraception;
  • Contraception after an abortion;
  • Menorrhagia;
  • Acne vulgaris;
  • Menstrual period disorders.

Mechanism of action

Desogestrel / Ethinyl Estradiol is a combined oral contraceptive which inhibits gonadotropin synthesis and suppresses ovulation. In addition, the drug increases the viscosity of cervical mucus, which slows down the movement of spermatozoa through the cervical canal, and changes the state of the endometrium which prevents the implantation of a fertilized egg. Ethinyl estradiol is a synthetic analogue of endogenous estradiol, while desogestrel has a pronounced gestagenic and antiestrogenic action, similar to endogenous progesterone. The contraceptive has a beneficial effect on lipid metabolism: it increases the concentration of high-density lipoprotein in the blood plasma, without affecting the content of low-density lipoprotein. Against the background of the use of the drug, there is a significant decrease in the amount of monthly lost blood (with the initial menorrhagia). The preparation normalizes the menstrual period and has a favorable effect on the skin (especially with acne vulgaris).

Dosage and mode of application

Each pack of Desogestrel / Ethinyl Estradiol tablets contains 21 active pills containing ethinyl estradiol 0.03 mg and desogestrel 0.15 mg. The pack also contains 7 inert pills with no medication.

Start taking tablets on the first day of your menstrual period and take 1 tablet daily at the same time for 28 days, without interruption.

After taking the last active pill from the package, menstrual bleeding occurs due to the withdrawal of the drug. Once you have taken the last inert tablet, start taking tablets from the new package, even if your menstrual bleeding did not stop. You need t strictly follow such a regimen of taking tablets as long as you need contraception. If you observe the rules of use, the contraceptive effect is maintained even for 7 no-hormones days.

After delivery, the drug should be taken on the first day of the first menstruation. After the miscarriage or artificial abortion, the contraceptive must be taken immediately.

Side effects

Desogestrel / Ethinyl Estradiol tablets can cause the following side effects: headache, gastralgia, nausea, vomiting; soreness and engorgement of the mammary glands; increase in body weight, impaired glucose tolerance, fluid retention in the body, changes in libido, decreased mood, eyelid edema, skin rash, erythema nodosum, conjunctivitis, discomfort when wearing contact lenses, impaired perception (visual impairment, hearing loss, flies before the eyes ), thrombophlebitis, thromboembolism, generalized pruritus, cholestatic jaundice, cholelithiasis, increased blood pressure, intermenstrual bleeding, changes in vaginal secretion (development of candidiasis of the vagina).

With prolonged use and in extremely rare cases, the drug can cause chloasma and hepatocellular adenoma.

Contraindications

Desogestrel / Ethinyl Estradiol birth control pills are not used in the following cases and conditions:

  • a migraine with focal neurological symptoms (including anamnesis);
  • average or severe arterial hypertension and other expressed and / or multiple risk factors for arterial or venous thrombosis;
  • venous or arterial thromboembolism or thrombosis, including stroke, myocardial infarction, pulmonary embolism, deep vein thrombosis of the lower leg (including in the anamnesis);
  • angina pectoris, transient ischemic attack and other harbingers of thrombosis (including anamnesis);
  • pancreatitis (including anamnesis) on the background of severe hypertriglyceridemia;
  • diabetes mellitus with vascular lesions (angiopathy);
  • dyslipidemia;
  • jaundice when taking glucocorticosteroids (GCS);
  • severe liver diseases, hepatitis, cholestatic jaundice (including anamnesis);
  • gallstone disease (including anamnesis);
  • liver tumors (including anamnesis);
  • Dubin-Johnson syndrome, Gilbert’s syndrome, Rotor’s syndrome;
  • hormone-dependent malignant tumors of mammary glands and genitals or suspicion of them;
  • severe itching, otosclerosis and its progression during the previous pregnancy or on the background of receiving COCs;
  • smoking (over 15 cigarettes per day) over the age of 35;
  • vaginal bleeding of unknown etiology;
  • pregnancy;
  • breastfeeding;
  • individual intolerance to the components of the drug.

With caution:

  • women over the age of 35,
  • smoking,
  • a family history of thromboembolism and thrombosis,
  • obesity (body weight index above 30 kg per 1 m2),
  • patients with a migraine,
  • dyslipoproteinemia,
  • epilepsy,
  • arterial hypertension,
  • atrial fibrillation,
  • valvular heart disease,
  • extensive surgical operations,
  • severe trauma,
  • prolonged immobilization,
  • changes in biochemical parameters (hyperhomocysteinemia, deficiency of antithrombin III, resistance of activated protein C, deficiency of protein C, deficiency of anti-thrombophlebitis, or S, antiphospholipid antibodies, antibodies to cardiolipin, lupus anticoagulant), sickle cell anemia, Crohn’s disease, systemic lupus erythematosus (SLE), ulcerative olit, hypertriglyceridemia (including family history).

Interactions

Rifampicin, isoniazid, ampicillin, neomycin, penicillins, tetracycline, chloramphenicol, griseofulvin, barbiturates, carbamazepine, activated charcoal and laxative drugs decrease the effectiveness of the birth control pills and may cause “breakthrough” bleeding.

The contraceptive reduces the effectiveness of oral anticoagulants, anxiolytics (diazepam), tricyclic antidepressants, theophylline, caffeine, hypoglycemic drugs, clofibrate.

Breastfeeding and pregnancy

Desogestrel / Ethinyl Estradiol tablets are contraindicated during pregnancy. Before taking the drug, pregnancy should be excluded. If you get pregnant during the period of taking birth control pills, they should be discontinued.

The incidence of congenital malformations in children born to women taking oral contraceptives prior to pregnancy does not increase, there is no teratogenic or mutagenic effect when taking such tablets in early pregnancy.

Oral contraceptives can lead to a decrease in the amount of breast milk and change its composition. In addition, they penetrate into breast milk (there is no evidence of undesirable effects on the health of the newborn), therefore, their use in the period of breastfeeding is not recommended.

What if I miss a pill?

Missing an active tablet:

  • If you miss an active Desogestrel / Ethinyl Estradiol tablet at the scheduled time and the delay does not exceed 12 hours, you should take it immediately, as soon as you remember about your mistake and continue taking further tablets in the normal mode. If the delay is more than 12 hours (36 hours from the time of taking the previous pill), the reliability of contraception may be compromised since it is considered a miss of one dose of the drug.
  • If you missed an active tablet during the first or second week of the period, you should take 2 tablets at a time and, continuing to take the drug as usual, use additional barrier methods of contraception during this period.
  • If you missed an active tablet on the third week of the period, you should take the missed pill and continue to use the drug regularly until the end of the current blister and start taking the next one without taking 7 inert tablets. In this case, the risk of bloody discharge or conception is increased, therefore you need to use additional methods of contraception.

Vomiting or diarrhea after taking a pill can lead to inferior absorption and disrupt the contraceptive effect of the drug. If the symptoms of malaise ceased during 12 hours, you should take an additional pill and continue contraception in the prescribed schedule. With continued vomiting or diarrhea for more than 12 hours, you should use additional methods of contraception during the period of vomiting or diarrhea and for the next 7 days.

Missing an inert tablet:

  • If you missed an inert tablet, discard it and continue taking pills in your usual mode. You do not need to use additional barrier methods of contraception during this period.

Precautions

Desogestrel / Ethinyl Estradiol tablets do not protect against sexually transmitted diseases and do not guarantee 100% protection from pregnancy.

The state of women’s health must be carefully monitored. In case of worsening, exacerbation or appearance of any adverse reactions during the administration of tablets, a woman should consult a doctor. The doctor decides whether to stop using hormonal birth control pills or continue using them. In some cases, a doctor recommends other, non-hormonal methods of contraception.

Decreased contraceptive action: Contraceptive action may be reduced if you have spotting or breakthrough bleeding after several months of taking the drug. If withdrawal bleeding does not occur or there is a violation of menstrual bleeding, pregnancy is unlikely and you should continue taking the pills until the end of the next package. If bleeding cancellation does not occur at the end of the second period or bleeding disorders persist, stop taking the pills and resume them only after excluding pregnancy.

Insufficient period control: You may have irregular bleeding (spotting or breakthrough bleeding), especially during the first months of the drug use. An adaptation period lasts about 3 periods. With permanent irregular bleeding or its occurrence during regular period, nonhormonal causes should be considered and appropriate diagnostic measures be taken to exclude a malignant tumor or pregnancy, including diagnostic scraping.

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