Indications
Estetrol is a natural oestrogen (female hormone). It is used together with the progestogen Drospirenone as a combined oral contraceptive pill to prevent pregnancy in women.
How It Works
Estetrol is an oestrogen that is normally produced by the liver of the unborn baby during pregnancy. In the pill, Estetrol and Drospirenone work together to stop the release of an egg each month (ovulation), thicken the mucus at the neck of the womb so sperm cannot pass easily, and change the lining of the womb. Estetrol has a more selective action than older oestrogens, with less effect on the liver.
Dosage and Administration
Take one tablet every day at about the same time, following the order shown on the pack, as prescribed. A typical pack has 24 active (hormone) tablets followed by 4 inactive tablets, after which the next pack starts without a break. Your doctor or pharmacist will explain when to start and what to do if a tablet is missed or if you have vomiting or severe diarrhoea, as extra contraception may be needed.
Interactions
- Enzyme-inducing medicines such as Rifampicin, Carbamazepine, Phenytoin, some HIV medicines and St John’s wort: reduce contraceptive effect; use an additional method.
- Some hepatitis C medicines (combinations with Ombitasvir, Paritaprevir or Glecaprevir): risk of liver enzyme rises; avoid.
- Medicines that raise potassium, such as ACE inhibitors, angiotensin receptor blockers, potassium-sparing diuretics and potassium supplements: potassium levels may need checking because of Drospirenone.
- Lamotrigine: levels may fall.
Contraindications
- Current or past blood clots in the veins or arteries, or a high risk of clots (including some inherited clotting disorders).
- Heart attack, stroke, or migraine with aura.
- Smokers over 35 years.
- Severe liver disease or liver tumours.
- Severe kidney impairment or adrenal insufficiency.
- Known or suspected breast cancer or other hormone-sensitive cancer.
- Unexplained vaginal bleeding.
- Pregnancy.
Side Effects
Common side effects include irregular bleeding or spotting, headache, breast tenderness, acne, mood changes, nausea, weight changes and painful periods. Combined hormonal contraceptives slightly increase the risk of blood clots.
Get urgent medical help if you have pain or swelling in one leg, sudden chest pain or breathlessness, coughing up blood, sudden severe headache, weakness or numbness on one side of the body, difficulty speaking, sudden vision changes, yellowing of the skin or eyes, or severe stomach pain.
Pregnancy and Lactation
Do not take it if you are pregnant; stop and see your doctor if you think you may be pregnant. It is not recommended while breastfeeding, as it may reduce milk supply; ask your doctor about suitable alternatives.
Precautions and Warnings
- Do not smoke while using hormonal contraception.
- Tell your doctor about high blood pressure, diabetes, migraine, gallbladder disease, depression, high cholesterol or a family history of blood clots.
- Stop it before major surgery or long immobilisation, as advised.
- It does not protect against sexually transmitted infections.
Overdose
Taking several tablets at once is unlikely to be serious but may cause nausea, vomiting or vaginal bleeding. Contact a doctor if a large amount is taken or a child swallows tablets.
Therapeutic Class
Hormonal contraceptive, oestrogen (used in combination with a progestogen).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.