Formulary
Desogestrel: Indications, Dosing, Side Effects and Interactions
Desogestrel clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Desogestrel: Indications, Dosing, Side Effects and Interactions
Desogestrel clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Contraception for desogestrel**
- **Females of childbearing potential** (By mouth): 75 micrograms daily, dose to be taken at same time each day, starting on day 1 of cycle then continuously, if administration delayed for 12 hours or more it should be regarded as a 'missed pill'.
Cautions
Cardiac dysfunction; diabetes (progestogens can decrease glucose tolerance-monitor patient closely); history of breast cancer-seek specialist advice before use; history of stroke (including transient ischaemic attack); history of venous thromboembolism; ischaemic heart disease; liver tumours-seek specialist advice before use; malabsorption states; migraine with aura; multiple risk factors for cardiovascular disease; positive antiphospholipid antibodies; rheumatoid arthritis; systemic lupus erythematosus; undiagnosed vaginal bleeding
Contraindications
Acute porphyrias ; current breast cancer
Side effects
Common or very common Breast abnormalities; depressed mood; headache; libido decreased; menstrual cycle irregularities; mood altered; nausea; skin reactions; weight increased Uncommon Alopecia; contact lens intolerance; fatigue; ovarian cyst; vomiting; vulvovaginal infection Rare or very rare Erythema nodosum Frequency not known Angioedema; arterial thromboembolism; neoplasms Side-effects, further information The benefits of using progestogen-only contraceptives (POCs), such as desogestrel, should be weighed against the possible risks for each individual woman. There is a possible small increase in the risk of breast cancer in women using, or who have recently used, progestogen-only contraception. Causal association is not clearly established, and absolute risk remains very small, and is like that of current or recent use of combined hormonal contraception. The most important risk factor for breast cancer appears to be the age the contraceptive is stopped rather than the duration of use; the risk gradually disappears during the 10 years after stopping.
Interactions
**Severe interactions:**
- Pharmacodynamic interactions During clinical trials with patients treated for hepatitis C virus infections (HCV) with medicinal products containing ombitasvir/paritaprevir/ritonavir and dasabuvir...
**Other interactions (4):**
- These products include phenytoin, phenobarbital, primidone, bosentan, carbamazepine, rifampicin, rifabutin and possibly also oxcarbazepine, modafinil, topiramate, felbamate, griseofulvin, some HIV...
- For women on long-term therapy with enzyme-inducing medicinal products, an alternative method of contraception unaffected by enzyme-inducing medicinal products should be considered.
- The net effect of these changes may be clinically relevant in some cases.
- Accordingly, plasma and tissue concentrations may either increase (e.g.
Pregnancy
Not known to be harmful.
Breast feeding
Suitable for use, however, a small amount of its active metabolite etonogestrel is present in milk M (recommendation also supported by primary literature). A decrease in milk production has been reported infrequently. M
Hepatic impairment
Manufacturer advises caution; avoid in severe or active disease.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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