Microgestin

Generic name:

Ethinyl estradiol and norethindrone

Drug class:

Combination oral contraceptive (estrogen-progestin)

Dosage form:

Oral tablets (monophasic)

Root of administration:

Oral

Dose:

Typical: one active tablet containing ethinyl estradiol 20 mcg and norethindrone 1 mg daily for 21 days, followed by 7 days of inactive (iron-containing or placebo) tablets.

Variations: formulations with ethinyl estradiol 35 mcg; extended-cycle regimens; continuous dosing as per prescriber.

Mechanism of action:

Combined ethinyl estradiol and norethindrone suppress ovarian ovulation by inhibiting gonadotropin release, thicken cervical mucus to impede sperm penetration, and alter endometrial lining to prevent implantation.

Drug usage cases:

• Prevention of pregnancy
• Regulation of menstrual cycles
• Treatment of acne vulgaris (off-label)
• Management of premenstrual dysphoric disorder (off-label)
• Treatment of dysmenorrhea
• Management of hirsutism (off-label)

Drug contra indications:

• Thrombophlebitis or thromboembolic disorders (current or history of deep vein thrombosis, pulmonary embolism)
• Cerebrovascular or coronary artery disease
• Known or suspected breast cancer or estrogen-dependent neoplasia
• Undiagnosed abnormal uterine bleeding
• Severe liver dysfunction or disease
• Pregnancy
• Hypersensitivity to any component
• Hypertension with vascular disease
• Headache with focal neurological symptoms (e.g., migraines with aura)
• Smokers over age 35

Side effects:

• Nausea and vomiting
• Headache, migraine
• Breast tenderness or enlargement
• Weight gain or fluid retention
• Irregular uterine bleeding or spotting
• Changes in libido
• Abdominal cramps or bloating
• Mood changes, depression
• Hypertension
• Thromboembolic events (deep vein thrombosis, pulmonary embolism)
• Gallbladder disease
• Lipid metabolism alterations
• Glucose tolerance impairment
• Cholasma (hyperpigmentation)

Warnings:

• Increased risk of venous and arterial thromboembolism; risk elevated with age, smoking, obesity.
• May increase blood pressure; monitor periodically.
• Monitor for signs of liver dysfunction; discontinue if cholestatic jaundice occurs.
• May cause glucose tolerance impairment; monitor diabetic patients.
• Increased risk of gallbladder disease.
• Possible increased risk of breast and cervical cancer with long-term use.
• Use with caution in women with hypertension, hyperlipidemia, obesity, migraine, systemic lupus erythematosus.
• Not protective against HIV or other sexually transmitted infections.
• Cigarette smoking increases cardiovascular risks; contraindicated in smokers over age 35.

Use during pregnancy or breastfeeding:

Use during pregnancy: Contraindicated. If pregnancy occurs, discontinue immediately. No therapeutic benefit in pregnancy; potential risk to fetus not fully determined.

Use during breastfeeding: Not recommended. May reduce milk production and alter milk composition; small amounts of steroid pass into breast milk. Consider alternative contraception or delay until weaning.