Generic
Etonogestrel + Ethinylestradiol
At a glance
Etonogestrel + Ethinylestradiol — brands, prices, indication, dosage and side effects available in Bangladesh.
Description
Etonogestrel + Ethinylestradiol is a combination of two medicines available in form of a flexible vaginal ring and is used for contraception (to prevent pregnancy). It must be used as directed by the doctor. It helps to prevent release and fertilization of the egg. Etonogestrel + Ethinylestradiol comes as vaginal ring, which need to be inserted in vagina on monthly basis to avoid pregnancy. It should be taken as your doctor's advice. It is advised not to use more than one ring at one time and never forget to remove the ring at schedule time. Usually, you have to insert the ring inside vagina and have to left for the period of 3 weeks. After 3 weeks, take a break of one week before inserting the another ring. Basically, you experience monthly periods during free one week. If you forget to place another ring after more than of 7 days, then use additional method of contraception. Nausea, stomach pain, headache, breast pain, and weight gain are some commonly seen side effects of this medicine. If these bother you, or appear serious, let your doctor know. There may be ways of reducing or preventing them. You might experience spotting or bleeding between menstrual periods or missed periods. Consult with your doctor if this occurs frequently or persists longer. Inform your doctor if you notice swelling and pain in your limbs, shortness of breath, chest pain or changes in vision, as it may be a sign of blood clot. Before taking this medicine, let your doctor know if you smoke and are over 35, or if you have ever had a heart attack or have cancer of uterus/cervix, or vagina. Your doctor should also know about all other medicines you are taking as many of these may make this medicine less effective or change the way it works. Do not take the medicine if you are pregnant already or breastfeeding. Etonogestrel + Ethinylestradiol is a contraceptive vaginal ring. It works by preventing the release of egg (ovulation) and affecting sperm movement in the womb to prevent its union with the egg. It also changes the lining of the womb and renders it unsuitable for pregnancy.
Indications
• Contraception
Mechanism of action
Estradiol is the major oestrogen in pre-menopausal women. Ethinylestradiol has similar actions as oestradiol. It is responsible for the development and maintenance of female reproductive system and secondary sexual characteristics. It also inhibits anterior pituitary by negative feedback effect and causes capillary dilation, fluid retention and protein anabolism. Etonogestrel is the active metabolite of desogestrel. It prevents pregnancy by suppressing ovulation, increasing viscosity of cervical mucous and inhibiting endometrial proliferation.
Dosage
Adult Dose: Initial Treatment: Previous Contraceptive No hormonal contraceptive in past month: Insert ring on or before Day 5 (Day 1 being 1st day of menstruation); use additional form of contraception for 7 d; Combo oral contraceptive: insert ring within 7 d after last active tablet (no later than 1st day new cycle of tablets would begin); Progestin mini-pill: insert ring on any day of month, on same day as pill is discontinued; do not skip days between the last day and insertion of the ring; Progestin implant: insert ring on same day of implant removal; Progestin injection: insert ring on day next inj would be given Initial Treatment: Post-pregnancy 1st trimester abortion: insert ring within 5 d after abortion Delivery or 2nd trimester abortion: Insert ring 4 wk later; use additional form of contraception for 7 days
Administration
Use it as advised by your doctor or check the label for directions before use.
Side effects
Common: • Nausea • Stomach pain • Headache • Weight gain • Breast pain • Irregular uterine bleeding
Precautions & warnings
No interaction found/established Etonogestrel + Ethinylestradiol is a flexible ring that is inserted into the vagina on a monthly basis to help you prevent pregnancy. Etonogestrel + Ethinylestradiol should be left in place for three weeks, after which the ring should be removed followed by a one week ring-free break. During the ring-free week withdrawal bleed similar to your normal period occurs. A new ring should be inserted after seven days, even if the bleeding has not completely stopped. You may experience menstrual irregularities such as spotting or bleeding between menstrual periods or missed periods. Consult your doctor if this persists. Do not use Etonogestrel + Ethinylestradiol if you are obese, smoker, on prolonged bed rest, or have a history of heart diseases or blood clots. Stop using Etonogestrel + Ethinylestradiol and inform your doctor immediately if you notice unexplained swelling and pain in your limbs, shortness of breath, chest pain, severe headache, or changes in vision. These could be symptoms of a blood clot in a vein.
Contraindications
Documented hypersensitivity Arterial thromboembolic disease (stroke, MI), thrombophlebitis, DVT/PE, thrombogenic valvular disease Estrogen-dependent neoplasia (current or history of) Cerebrovascular disease, coronary artery disease Headaches with focal neurological symptoms Liver disease, liver tumors Undiagnosed abnormal vaginal bleeding Uncontrolled hypertension Women >35 years who smoke Major surgery with prolonged immobilization Diabetes mellitus with vascular involvement, jaundice with prior oral contraceptive use
Drug interactions
CYP1A2 and CYP3A4 inducers such as aminoglutethimide, carbamazepine, phenobarbital, and rifampin may decrease the effects of estradiol. May enhance the effects of hydrocortisone and prednisolone when used together. Altered anticoagulant effect when used with dicoumarol. Potentially Fatal: Antibiotics (ampicillin, tetracycline, sulphonamides and chloramphenicol) can cause intermenstrual bleeding or failure of contraception. Reduced efficacy of antihypertensives or hypoglycaemic drugs. 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.
Food interactions
No interaction found/established
Use in pregnancy
No interaction found/established
Use in lactation
No interaction found/established
Renal / hepatic impairment
No interaction found/established No interaction found/established