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Indications

Desogestrel is a progestogen (a man-made form of the hormone progesterone) used to prevent pregnancy. It is used in two kinds of contraceptive pill:

• Combined pills, where it is taken together with Ethinylestradiol.
• Progestogen-only pills (desogestrel alone), which suit many women who cannot take oestrogen, including breastfeeding mothers.

How It Works

Desogestrel mainly stops the ovaries from releasing an egg each month. It also thickens the mucus at the neck of the womb, which makes it harder for sperm to enter, and thins the lining of the womb.

Dosage and Administration

Follow the instructions in the pack and your doctor's advice.

• Combined pills: usually 1 tablet daily at the same time for 21 days, then a 7-day break (or inactive tablets) during which a period usually occurs, then the next pack.
• Progestogen-only pill (75 micrograms): 1 tablet every day at the same time with no break between packs.

Usually start on day 1 of the period. If a pill is missed, or you vomit within 3 to 4 hours of taking it or have severe diarrhoea, follow the missed-pill advice in the leaflet, use condoms until protection returns, and ask a pharmacist or doctor about emergency contraception if you had unprotected sex.

Interactions

Some medicines can make the pill less effective and lead to pregnancy, including Rifampicin, Rifabutin, Carbamazepine, Phenytoin, Phenobarbital, Topiramate, some HIV medicines (such as Efavirenz and Ritonavir), Griseofulvin and St John's wort. Combined pills can lower Lamotrigine levels. Always tell the doctor or pharmacist that you take the pill.

Contraindications

• Pregnancy or suspected pregnancy.
• Current blood clot in a vein or the lungs; for combined pills, also a past clot or a high risk of clots.
• Severe liver disease or liver tumours.
• Breast cancer or other hormone-sensitive cancer.
• Unexplained vaginal bleeding.
• Combined pills only: migraine with aura, smokers aged 35 or over, uncontrolled high blood pressure, heart disease or stroke, and diabetes with blood vessel damage.
• Allergy to any ingredient.

Side Effects

Common: irregular bleeding or spotting (especially with the progestogen-only pill), breast tenderness, headache, nausea, mood changes, acne and weight change.

Get urgent medical help if you have signs of a blood clot (pain or swelling in one leg, sudden chest pain, sudden breathlessness or coughing up blood), signs of a stroke (sudden weakness on one side, trouble speaking or a sudden severe headache), severe stomach pain, yellowing of the skin or eyes, or a new breast lump.

Pregnancy and Lactation

Not for use in pregnancy; stop taking it if you become pregnant (there is no evidence of harm if it was taken by accident early on). The progestogen-only pill can be used while breastfeeding. Combined pills may reduce milk supply and are usually avoided in the first weeks after birth; ask your doctor.

Precautions and Warnings

• The pill does not protect against sexually transmitted infections; use condoms for that.
• Smoking with combined pills increases the risk of heart attack, stroke and blood clots.
• Have your blood pressure checked regularly.
• Tell your doctor before major surgery or long periods of immobility.
• Tell your doctor if you have high blood pressure, diabetes, migraine, depression, liver or gallbladder disease.

Overdose

Taking several pills at once is not usually dangerous. It may cause nausea, vomiting or some vaginal bleeding. Seek medical advice, especially if a child swallows the tablets.

Therapeutic Class

Hormonal contraceptive (progestogen).

Storage

Store below 30°C in a dry place, away from light, in the original pack. Keep out of reach of children.