Generic Name

Desogestrel; Ethinyl Estradiol

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Classification

FDA Approved Indications

• Prevention of pregnancy

Mechanism of Action

Inhibits ovulation through suppression of the hypothalamic-pituitary-ovarian axis, thickens cervical mucus, and alters the endometrial lining to prevent implantation.

Dosage and Administration

Adult: Typically, one tablet daily at the same time each day, starting on the first day of the menstrual cycle, with subsequent packs following sequentially.

Pediatric: Not indicated for use in children.

Geriatric: Not indicated for use in postmenopausal women.

Renal Impairment: Use with caution; no specific dosage adjustments established.

Hepatic Impairment: Contraindicated in women with significant liver disease.

Pharmacokinetics

Absorption: Rapidly absorbed from the gastrointestinal tract.

Distribution: Widely distributed; highly bound to plasma proteins.

Metabolism: Metabolized in the liver via hydroxylation and conjugation.

Excretion: Excreted mainly in urine and feces.

Half Life: Approximately 28 hours for Ethinyl Estradiol and 30-40 hours for Desogestrel.

Contraindications

• History of thromboembolic disorders
• Active or history of breast cancer
• Significant liver disease or tumors

Precautions

• Use with caution in women over 35 who smoke, women with hypertension, diabetes, or cardiovascular risk factors.

Adverse Reactions - Common

• Nausea (Common)
• Breast tenderness (Common)
• Irregular bleeding or spotting (Common)

Adverse Reactions - Serious

• Venous thromboembolism (Less common)
• Stroke or myocardial infarction (Rare)
• Liver tumors (Rare)

Drug-Drug Interactions

• Antibiotics (may reduce efficacy)
• Anticonvulsants (e.g., phenytoin, carbamazepine)
• Rifampin

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Take as directed at the same time daily.
• Use additional contraceptive methods if diarrheal or vomiting occurs.
• Report unusual symptoms like severe headache, visual changes, chest pain, or severe leg pain.

Special Considerations

Black Box Warnings:

• Smoking increases risk of cardiovascular events in women over 35 using combination hormonal contraceptives.

Genetic Factors: No specific genetic testing required.

Lab Test Interference: May affect results of thyroid and coagulation tests.

Overdose Management

Signs/Symptoms: Nausea, vomiting, vaginal bleeding.

Treatment: Supportive care, no specific antidote. In case of overdose, discontinue medication and observe.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable for the duration of the labeled shelf life when stored properly.