Description

This pill contains a small amount of female sex hormone, the progestogen desogestrel. For this reason this pill is called a progestogen-only-pill (POP), or a minipill. Contrary the combined pill, desogestrel does not contain an oestrogen hormone next to the progestogen. Most minipills work primarily by preventing the sperm cells from entering the womb but do not always prevent the egg cell from ripening, which is the primary action of combined pills. This pill is distinct from other mini-pills in having a dose that in most cases is high enough to prevent the egg cell from ripening. As a result, this pill provides high contraceptive efficacy. In contrast to the combined pill, this pill can be used by women who do not tolerate estrogens and by women who are breast feeding. A disadvantage is that vaginal bleeding may occur at irregular intervals during the use of this pill and also may not have any bleeding at all.

Enzyme-inducing drugs may result in increased clearance and lead to breakthrough bleeding and contraceptive failure. This may be seen with hydantoins, barbiturates, primidone, carbamazepine, rifampicin, oxcarbazepine, rifabutin, felbamate, ritonavir, griseofulvin and products containing St John's Wort. Reduced absorption of etonogestrel may be seen with medical charcoal.

Known or suspected pregnancy, active venous thromboembolic disorder, presence or history of severe hepatic disease with current abnormal liver function tests, progestogen dependent tumors, undiagnosed vaginal bleeding, hypersensitivity to ingredients.

Common: irregular bleeding, amenorrhoea, headache, weight gain, breast pain, nausea, acne, mood changes, decreased libido. Less common: Vaginitis, dysmenorrhoea, ovarian cysts, vomiting, alopecia, fatigue, difficulty wearing contact lenses. Rare: Rash, urticaria, erythema nodosum.

Not recommended for use during pregnancy. Desogestrel does not affect the production or quality of breast milk. Small amounts of the metabolite etonogestrel are excreted with the milk. Long term follow-up data are not available, however 7 month data do not indicate a risk to the nursing infant

Epidemiological studies have associated the use of combined OCs with an increased incidence of venous thromboembolism (VTE, deep venous thrombosis and pulmonary embolism). It is unclear whether desogestrel used alone carries the same risk. Discontinue in the event of a thrombosis. Consider stopping prior to long term immobilization due to surgery or illness. Benefit/risk assessment should be made in women with liver cancer. Caution patients with a history of thromboembolic disorders. Patients with diabetes should be carefully monitored. Effects on bone density are unknown.

No serious deleterious effects have been reported from an overdose. Other symptoms may include nausea, vomiting and in young girls, slight vaginal bleeding. Treatment should be symptomatic.