Desogestrel

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Desogestrel, sold under the brand names Azalia, Cerazette, Marvelon, Mircette, Mercilon, and Novynette among others, is a progestin that is used in hormonal contraceptives. Most combined oral contraceptive pills (COCPs, or simply OCs) on the market today contain both an estrogen (usually ethinylestradiol) plus a progestin (a synthetic progesterone-like agent) such as desogestrel. Desogestrel-containing birth control pills are sometimes referred to as "third generation" oral contraceptives. In contrast, birth control pills that are considered "second generation" (Tri-Levlen, for example) contain an estrogen and a progestin, but the progestin is different, such as levonorgestrel.

Video Desogestrel

Medical uses

Desogestrel is used both alone and in combination with an estrogen such as ethinylestradiol in hormonal contraceptives.

Third-generation oral contraceptives like those containing desogestrel are suitable for use in patients with diabetes or lipid disorders because they have minimal impact on blood glucose levels and the lipid profile. Their synthetic estrogen dosage is lower than second-generation oral contraceptives, reducing the likelihood of weight gain, breast tenderness and migraine.

Maps Desogestrel

Pharmacology

Pharmacodynamics

Desogestrel is a progestogen. It behaves as a prodrug to etonogestrel (3-ketodesogestrel). It has low androgenic activity.

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Chemistry

Desogestrel, also known as 3-deketo-11-methylene-17?-ethynyl-18-methyl-19-nortestosterone or as 3-deketo-11-methylene-17?-ethynyl-18-methylestr-4-en-17?-ol-3-one, is a synthetic estrane steroid and a derivative of testosterone. It is more specifically a derivative of norethisterone (17?-ethynyl-19-nortestosterone) and is a member of the gonane (18-methylestrane) subgroup of the 19-nortestosterone family of progestins. Desogestrel is the C3 deketo and C11 methylene analogue of levonorgestrel.

Synthesis

Synthesis:

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History

Desogestrel was introduced in 1981.

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Society and culture

Generic name

Desogestrel is the generic name of the drug and its INN, USAN, BAN, DCF, DCIT, and JAN.

Brand names

Desogestrel is marketed under a variety of brand names throughout the world including Alenvona, Apri, Azalia, Azurette, Caziant, Cerazette, Cerelle, Cesia, Cyclessa, Denise, Desogen, Desirett, Diamilla, Emoquette, Feanolla, Gedarel, Gracial, Kariva, Laurina, Linessa, Marvelon, Mercilon, Mircette, Mirvala, Novynette, Ortho-Cept, Reclipsen, Regulon, Solia, Velivet, and Viorele among others.

Controversy

In February 2007, the consumer advocacy group Public Citizen released a petition requesting that the FDA ban oral contraceptives containing desogestrel, citing studies going as far back as 1995 that suggest the risk of dangerous blood clots is doubled for women on such pills in comparison to other oral contraceptives. In 2009, Public Citizen released a list of recommendations that included numerous alternative, second-generation birth control pills that women could take in place of oral contraceptives containing desogestrel. Most of those second-generation medications have been on the market longer and have been shown to be as effective in preventing unwanted pregnancy, but with a lower risk of blood clots.

Drugs cited specifically in the petition include Apri-28, Cyclessa, Desogen, Kariva, Mircette, Ortho-Cept, Reclipsen, Velivet, and some generic pills.

Drugs containing desogestrel as the only active ingredient (as opposed to being used in conjunction with estrogen, like in combined oral contraceptives) do not show an increased thrombosis risk and are therefore safer than second-generation birth-control pills in regards to thrombosis.

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References

Source of the article : Wikipedia