Etonogestrel

Indications

Etonogestrel is used for: Contraception

Adult Dose

Subdermal Contraception Adult: Each implant contains 68 mg of etonogestrel: 1 implant is inserted during the 1st 5 days of the menstrual cycle; remove within 3 yr of insertion. Vaginal Contraception Adult: Each vaginal ring delivers 120 mcg of etonorgestrel and 15 mcg of ethinylestradiol daily. Insert one ring into the vagina on the 1st day of menstruation. Leave the ring in place continuously for 3 wk. Remove it after 3 wk for the 1 wk break during which breakthrough bleeding will occur. Insert a new ring 1 wk after removal of the previous ring.

Child Dose

Renal Dose

Administration

Contra Indications

Pregnancy, undiagnosed vag bleeding, severe arterial disease; liver adenoma; active liver disease; current or history of thromboembolic disorders; porphyria; after evacuation of hydatidiform mole; history of breast cancer.

Precautions

Heart disease, sex-steroid dependent cancer, history of ectopic pregnancy, malabsorption syndromes, functional ovarian cysts, recurrent cholestatic jaundice, history of jaundice in pregnancy; history of pruritus during pregnancy or of deterioration of otosclerosis; disturbances of lipid metabolism; history of CV or renal impairment, DM, asthma, epilepsy, migraine, depression; lactation. May develop bleeding irregularities. Lactation: Small amounts excreted in breast milk; may nurse after the 4th postpartum week

Pregnancy-Lactation

Interactions

Reduced efficacy with hepatic enzyme-inducing drugs; aminoglutethimide. May inhibit ciclosporin metabolism. Changes in efficacy and safety of treatment when used in combination with protease inhibitors.

Adverse Effects

Side effects of Etonogestrel : >10% Oligomenorrhea (34%),Headache (25%),Vaginitis (24.5%),Amenorrhea (22%),Menorrhagia (18%),Weight gain (14%),Acne (13.5%),Breast pain (13%),Upper resp tract infection (13%),Pharyngitis (11%),Leucorrhea (10.5%) 1-10% Back pain (7%),Depression (6%),Dizziness (7%),Dysmenorrhea (7%),Emotional lability (7%),Flu-like symptoms (8%),Insertion-site pain (9%),Nausea (6%),Nervousness (6%),Pain (6%)

Mechanism of Action

Etonogestrel is the active metabolite of desogestrel. It prevents pregnancy by suppressing ovulation, increasing viscosity of cervical mucous and inhibiting endometrial proliferation.