Desogestrel and Ethinyl Estradiol (Oral Route)

Desogestrel and Ethinyl Estradiol comes in many brand forms and works as a female contraceptive used in the prevention of pregnancy.

Overview

Desogestrel and Ethinyl Estradiol is a combination treatment used in the prevention of pregnancy. The treatment is available in a wide range of brands including the following:

  • Velivet
  • Solia
  • Reclipsen
  • Ortho-Cept
  • Mircette
  • Marvelon 28 - White Tablet
  • Marvelon 21
  • Kariva
  • Enskyce
  • Desogen
  • Cyclessa
  • Cesia
  • Caziant
  • Apri

This birth control pill contains two hormones, Desogestrel and Ethinyl Estradiol, which prevent pregnancy when taken in the correct manner. This treatment works by preventing the full maturation of the egg each month. This prevents the egg from accepting sperm and prevents fertilization from occurring.

It is important to note that this medication is not 100% effective and that no contraceptive treatment is 100% effective. This medication also offers no protection against sexually transmitted infections and diseases. This includes the HIV infection, which can be passed on through sex. This treatment will also have no effect if it is taken after pregnancy has already occurred and cannot be used as an emergency protection from unprotected sexual intercourse or contact.

You will need a prescription from your doctor in order to use this treatment.

This medication is administered as a tablet that is taken daily.

Condition treated

  • Pregnancy prevention

Type of medicine

  • Hormone contraceptive

Side Effects

In addition to preventing pregnancy when taken correctly, this medication can also cause some unwanted effects in the body. Not all side effects may occur, but in some cases where they do medical attention may be required.

You should consult your doctor immediately if you experience any of the following side effects:

  • Abdominal pains
  • Absence of menstrual periods
  • Anxiousness
  • Changed heartbeat
  • Changed skin color
  • Changed vision
  • Chest pains
  • Chills
  • Constipation
  • Coughing
  • Darkened urine
  • Diarrhea
  • Discomfort across the chest
  • Discomfort or pain in the arms, jaw, back or neck
  • Dizziness
  • Fainting
  • Feverishness
  • Hive-like swellings appearing on the:
    • Tongue
    • Throat
    • Sex organs
    • Lips
    • Legs
    • Hands
    • Feet
    • Eyelids
  • Hives
  • Irregularity of menstrual periods
  • Itching of the skin
  • Lightheadedness
  • Loss of coordination or slurring of speech
  • Missed menstrual periods
  • Nausea
  • Pains of the chest, groin, legs or calves
  • Rash
  • Severe headaches occurring suddenly
  • Shortness of breath
  • Shortness of breath occurring suddenly with no apparent reason
  • Sore, tender or swollen foot or leg
  • Stomach pain
  • Stools with a clay-like coloration
  • Sweating when cool
  • Troubled breathing
  • Unusual tiredness
  • Unusual weakness
  • Vomiting
  • Vomiting up of blood
  • Welts

Other side effects may occur that would not normally necessitate visiting a doctor. These side effects will often abate over time and are not usually a sign of serious medical conditions that may be occurring. If side effects are ongoing or bothersome, however, then you can contact your doctor for advice on how to alleviate them.

  • Bloating or feeling of fullness
  • Blotchy spots appearing on the skin
  • Enlargement or tenderness of the breasts
  • Feeling of sadness or emptiness
  • Irritability or quickness to annoyance
  • Itchiness of the vagina or skin surrounding the genitals
  • Lack of pleasure
  • Loss of interest
  • Pain experienced during sexual intercourse
  • Thick, white vaginal discharge with a curd-like appearance. May have an odor or may be odorless
  • Trouble in wearing contact lenses

Side effects may also occur that have not been listed here. If you experience any other side effects then you should get in touch with your health care provider for advice.

Dosage

Before you begin treatment with this medication you should understand the effects that this treatment may have and how to take it most effectively. This treatment will not be effective if it is taken contrary to the instructed manner.

This medication will be issued with patient instructions that should be followed closely. Ensure that you read these and discuss any questions with your doctor.

This medication will be provided in blister packs with 28 tablets. Not all tablets will be the same and some are different in color. The medication needs to be taken in the order directed on the packaging.

It takes 7 days from starting this treatment for protection from pregnancy to be effective. In this initial 7 day period the treatment will not prevent you from becoming pregnancy.

This medication should be taken at the same time every day. The gap between treatments being taken should not exceed 24 hours wherever this is possible. Skipping or missing a dose could lead to you becoming pregnant. If you cannot remember to take them regularly then you will need to use a different method of contraception to prevent you from becoming pregnant.

This treatment may make you feel unwell for the first few months of treatment, especially immediately after taking it. If this is ongoing then you should visit your doctor.

You should contact your doctor if you vomit or experience diarrhea within 3-4 hours of using this treatment.

This treatment should be taken as directed by your doctor. Use will differ between patients and you should follow the directions given to you by your doctor closely. The following is a guideline only.

There are two ways to start this treatment:

  • Day 1 start – Begin your dose on the first day of your menstruation.
  • Sunday start – Begin the treatment on a determined day following your menstrual cycle ending.

Once you have started treatment it is essential that you follow the schedule closely, even if you miss a dose. If you find that the schedule is not convenient for you then you should discuss changing it with your doctor, but should not do so without planning this with your doctor first. When beginning treatment on a specific day there may be a gap between doses. In this case other contraceptives will need to be used for the first 7 days of use.

You should begin your next treatment on the same day that you started the previous cycle. This means taking the treatment continuously and rolling into the next treatment.

Usual dosage instructions:

  • Adults – 1 orange tablet taken daily at the same time for 21 days. This is followed by 1 green tablet taken daily for 7 days following the menstrual pattern.
  • Children – Use and dose to be determined by the doctor.

This medication will come with a medication guide that will inform you of what to do if you miss a dose of this treatment. You should read and follow these instructions closely and discuss any questions that you have with your doctor.

If a dose is missed you should use additional contraceptive protection for 7 days to ensure you are protected from pregnancy.

If you miss your period for 2 consecutive months this could be a sign that you are pregnant. You should take a pregnancy test and inform your doctor regardless of the results.

If you change your schedule of treatment then you may miss a period for the month.

Light bleeding and spotting may occur if you miss a treatment. The more frequently you miss treatments the more likely you are to experience bleeding.

Interactions

This medication can interact with other medications in the body. In some cases they can react violently in the body and in others they may prevent the treatment from working. Before using this treatment you must inform your doctor of all medications that you are taking so that they ensure there are no interactions that will occur. When using this treatment you should also be aware of medications that should be avoided that may prevent this contraceptive from working and expose you to risks of pregnancy.

Treatment with Desogestrel and Ethinyl Estradiol should not be carried out in conjunction with the following medications. Your doctor may need to prescribe different contraceptive methods if you are taking any of the following medications:

  • Tranexamic Acid
  • Ritonavir
  • Paritaprevir
  • Ombitasvir
  • Dasabuvir

The use of Desogestrel and Ethinyl Estradiol in conjunction with any of the following medications is not normally recommended. If both treatments are prescribed together then dose or frequency of use may be altered by the doctor.

  • Ulipristal
  • Tizanidine
  • Theophylline
  • Sugammadex
  • Pitolisant
  • Pirfenidone
  • Piperaquine
  • Paclitaxel Protein-Bound
  • Paclitaxel
  • Lumacaftor
  • Lixisenatide
  • Lesinurad
  • Isotretinoin
  • Idelalisib
  • Eliglustat
  • Donepezil
  • Darunavir
  • Dabrafenib
  • Clozapine
  • Ceritinib
  • Carbamazepine
  • Bupropion
  • Boceprevir
  • Anagrelide

Desogestrel and Ethinyl Estradiol is not recommended for use with the following because there is a greater risk of exposure to certain side effects. You may still be prescribed both, but your doctor may make changes to the frequency of use or dose of one of these medications.

  • Warfarin
  • Voriconazole
  • Valdecoxib
  • Troleandomycin
  • Troglitazone
  • Topiramate
  • Tipranavir
  • Telaprevir
  • St John's Wort
  • Selegiline
  • Rufinamide
  • Rosuvastatin
  • Roflumilast
  • Ritonavir
  • Rifapentine
  • Rifampin
  • Rifabutin
  • Primidone
  • Prednisolone
  • Phenytoin
  • Phenobarbital
  • Parecoxib
  • Oxcarbazepine
  • Nelfinavir
  • Mycophenolic Acid
  • Mycophenolate Mofetil
  • Modafinil
  • Licorice
  • Lamotrigine
  • Griseofulvin
  • Ginseng
  • Fosphenytoin
  • Fosaprepitant
  • Fosamprenavir
  • Etravirine
  • Etoricoxib
  • Eslicarbazepine Acetate
  • Efavirenz
  • Delavirdine
  • Cyclosporine
  • Colesevelam
  • Clarithromycin
  • Bosentan
  • Bexarotene
  • Betamethasone
  • Bacampicillin
  • Atazanavir
  • Aprepitant
  • Amprenavir
  • Alprazolam

Other interactions with drugs may occur. This list has been compiled based on severity of interaction and is not all-inclusive. Ensure that you inform your doctor of all treatments that you are receiving before beginning use of Desogestrel and Ethinyl Estradiol.

The use of Desogestrel and Ethinyl Estradiol may also be affected by the consumption of the following common consumables:

  • Caffeine
  • Grapefruit juice

Discuss your consumption of the above with your doctor before beginning treatment.

Patients who smoke should not use this treatment as it will significantly increase the risk of blood clots occurring. Blood clots can cause serious medical conditions to occur in the body and these can even be life-threatening. Patients who smoke must inform their doctor of this fact so that alternative contraceptive medications can be prescribed.

Other unrelated medical conditions that you may suffer from can also affect the use of this treatment. Certain medications can make medical conditions that they are not treating worse and medical conditions can also prevent the effective use of certain treatment. You should inform your doctor of your full medical history and this is especially important with the following conditions:

Desogestrel and Ethinyl Estradiol should not be used in patients who suffer from the following:

  • Abnormal vaginal bleeding
  • History of blood clots
  • Known blood cancer
  • Suspected blood cancer
  • Diabetes with further damage
  • Endometrial cancer
  • History of heart attack
  • Heart disease
  • Blood vessel disease
  • Hypertension
  • Jaundice that occurred during pregnancy or as a result of hormone therapies
  • Liver disease
  • Major surgery with prolonged stasis
  • Migraine headache
  • History of stroke
  • Estrogen dependant tumors

The following conditions could be worsened by treatment with this medication:

  • History of breast cancer
  • Cervical cancer
  • History of depression
  • Edema
  • Epilepsy
  • Gallbladder disease
  • Hypertension

More serious side effects from use may occur in patients with the following conditions:

  • Diabetes
  • Hyperlipidemia
  • Hypertension
  • Kidney disease
  • History of obesity

Other medical conditions that are not listed herein may also affect the use of Desogestrel and Ethinyl Estradiol. Ensure that your doctor is aware of your full medical history before use.

Warnings

Before beginning treatment with Desogestrel and Ethinyl Estradiol you should consider the side effects, potential risk of use and other factors in relation to the benefits of use. The decision to use this treatment should be made by you and your doctor having taken the following into account:

Allergies – You should inform your doctor if you have ever had any unusual allergies or reactions to any medication. Allergies to hormone treatments in particular may prohibit use. Ensure that your doctor is also aware of any allergies you have to any foods, dyes, preservatives and other substances.

Pediatric – There are no expected pediatric specific problems to the use of this treatment to prevent pregnancy in teenagers. There have not, however, been specific studies carried out to confirm this. This treatment should not be used to prevent pregnancy before the teenager has started menstruation.

Geriatric – This treatment should not be used in elderly women. Discuss this with your doctor before use.

Pregnancy – This medication should not be used during pregnancy and is not effective as a use of emergency contraception following unprotected sex. This treatment has been demonstrated to have a harmful effect on the fetus if taken during pregnancy.

Breastfeeding – This medication will pass into the breast milk and on to the infant. This has been demonstrated to be harmful. Mothers should either cease breastfeeding during use or use alternative contraceptive methods.

Patients will need to visit their doctor at least once every 6-12 months when receiving this treatment. Some doctors may require certain patients to visit them more regularly for a check up during use. Your doctor may need to carry out tests during treatment including blood pressure checks.

If you do become pregnant during the use of this treatment you should inform your doctor straight away. This medication can be harmful to your baby if it is taken once you have become pregnant and you will need to discuss options with your doctor. You should also inform your doctor if you are starting this treatment after recently having a baby or if you are nursing an infant at the breast.

Vaginal bleeding, frequency and strength may vary during the first 3 months of use. This is referred to as spotting when light and breakthrough when a heavier flow occurs. Follow these steps if this occurs:

  • Continue with your regular dosing schedule
  • Consult your doctor if bleeding lasts for longer than a week.
  • If bleeding in this manner continues after 3 months of beginning treatment then you should consult your doctor.

If you miss two periods then you may be pregnant and should inform your doctor straight away. If you believe that you are pregnant you should stop treatment immediately.

Do not use this treatment if you smoke or are aged over 35. Doing so can increase the risk of blood clots that may cause a heart attack or stroke. There is also an increased risk if you suffer from diabetes as this treatment can increase the blood pressure in the patient. Overweight patients may also be advised not to use hormonal treatments.

Blood clotting problems may occur with the use of this treatment. These usually only occur when you first start using this treatment, but you need to be alert to the symptoms. Blood clots can lead to very serious and life threatening medical conditions so you should check with your doctor immediately if you experience any of the following symptoms:

  • Changes in vision
  • Difficulty breathing
  • Loss of coordination
  • Pain in the groin
  • Pain in the legs
  • Pains in the chest
  • Shortness of breath without cause
  • Sudden and severe headaches

The use of this treatment can increase the risk of the patient developing certain cancers. Patients may be more likely to develop breast cancer or cervical cancer and you should discuss this with your doctor. It is important that you check with your doctor if you experience abnormalities of your vaginal bleeding.

You may need to get your eyes checked by a doctor during treatment. This is particularly important if you notice changes in your vision during use.

Liver problems may occur during use of this treatment. You should consult your doctor as soon as possible if you experience the following symptoms:

  • Pain in the upper stomach
  • Darkened stools
  • Yellow skin
  • Yellowing of eyes

You should check with your doctor before refilling any prescription. Your doctor will need to assess your health and ensure the treatment is still right for you.

Any doctor or dentist treating you should be made aware that you are taking this medication. You may need to stop use for a period of up to 4 weeks before surgery and for a further 2 weeks after surgery.

You should not consume grapefruit juice when you are taking this medication. This can change the delivery of medication into your body and in doing so change the effects experienced.

Do not use this treatment in conjunction with any other medication without first discussing this with your doctor.

This medication dose not protect the patient against any sexually transmitted infections. This includes the HIV virus. Patients using this contraceptive must always practice safe sex so that they can prevent themselves from developing problems from sexually transmitted infections.

This contraceptive is not 100% effective and there is still a risk of becoming pregnant during use. Patients should consider using other additional contraceptives to increase protection. Other preventative measures can be more effective.

This treatment is not effective if it is not use properly and taken regularly as instructed. Missed doses will expose the patient to a risk of pregnancy.

Storage

This medication must be stored in the original blister pack at room temperature. Keep it away from heat, direct light and moisture.

Always keep this treatment out of the reach of children.

Dispose of unwanted and outdated medication safely.

Summary

Desogestrel and Ethinyl Estradiol is used to prevent pregnancy in teenagers and adults aged under 35. This treatment is a hormone pill that is taken daily on a 28 day cycle.

This hormone treatment works by preventing the egg from maturating and becoming ready for fertilization. By preventing the egg from becoming fertile, pregnancy can be prevented.

This treatment is not 100% effective at preventing pregnancy.

This treatment will not be effective unless it is taken regularly as directed by your doctor. Pills need to be taken at the same time daily to ensure the best effect and the best protection. This treatment will always be provided with a medication guide that will inform you of what to do if you miss a treatment. Ensure that you follow this guide closely and ask your doctor if you do not understand it. If you are unable to take this treatment regularly then you should seek other forms of contraception.

This treatment offers no protection against HIV nor against any other sexually transmitted infections. Patients using this treatment must follow safe sexual practices at all times and use other contraceptive protections to protect against sexually transmitted infections.

This medication will not prevent pregnancy for the first 7 days of use. If a treatment is missed or skipped then you may need to use alternative protection for 7 days to prevent pregnancy.

Before beginning use of this treatment it is important that you understand the risks of use. This treatment can increase the risk of serious medical conditions occurring. These risks include blood clots, which can cause more serious problems, and the development of certain cancers. You should discuss all of the risks of use with your doctor before you begin treatment with this medication.

This treatment should not be administered to smokers. Smoking will dramatically increase the risk of the development of blood clots in the patient and prohibits use.

Patients with certain medical conditions may also be unable to use this form of hormone therapy for contraceptive use.

Resources
Last Reviewed:
January 31, 2018
Last Updated:
February 10, 2018