Desogestrel is used for contraceptive purposes in women who wish to prevent pregnancy. It is a highly effective oral contraceptive option and is suitable for women who cannot tolerate estrogen-containing hormones, as well as for those who are breastfeeding or lactating.

This tablet contains a small amount of the female sex hormone progestogen, desogestrel. Therefore, it is classified as a progestogen-only pill (POP) or mini-pill. Unlike combined oral contraceptive pills, desogestrel does not contain estrogen in addition to progestogen. Most mini-pills mainly prevent sperm from reaching the uterus but may not consistently prevent ovulation, which is the primary mechanism of combined pills. However, desogestrel is different from other mini-pills as its dose is usually sufficient to inhibit ovulation. As a result, it provides a high level of contraceptive effectiveness. Unlike combined pills, desogestrel can be used by women who cannot tolerate estrogen and by breastfeeding mothers. A possible disadvantage is irregular vaginal bleeding during use, or in some cases, absence of menstrual bleeding altogether.

One tablet at the same time each day, taken continuously without a break. Tablets should be taken within 3 hours of the same time each day.

When and how to take the tablets: Each strip of Desogestrel contains 28 tablets. Arrows are printed on the front side of the strip, between the tablets. If you turn the strip over, next to each tablet is printed the day of the week each tablet should be taken. Take your tablet at about the same time each day. Swallow each tablet whole with water. Each time you start a new strip of Desogestrel, take a tablet in the top row. For example, if you start on Wednesday, you should take the tablet from the top row marked that particular day. You should continue to take one tablet a day until the strip is empty, always follow the direction indicated by the arrows. In this way you can easily check whether you have taken your daily tablet. You may have some bleeding during the use of Desogestrel but you must continue to take your tablets as normal. When a strip is empty, you must start with a new pack of Desogestrel on the next day without interruption and without waiting for a bleed. You can stop taking Desogestrel whenever you want. From the day you stop, you are no longer protected against pregnancy.

Starting first pack of Desogestrel: If you are not using hormonal contraception at present (or in the past month), wait for your period to begin. On the first day of your period take the first Desogestrel tablet. If you take your first tablet on days 2 to 5 of your period, use an additional barrier method of contraception for the first 7 days of tablet taking.

When change from a combined pill: Start Desogestrel on the day after the last active tablet of the combined pill; in this case additional contraceptive precautions are not necessary.

When change from a mini-pill, injection, implant or hormonal IUD: Switch on any day from another mini pill. Start Desogestrel the day an implant or IUD is removed or the day your next injection would be due; additional contraceptive precautions are not necessary.

If you have a baby or abortion: Start immediately after first trimester abortion; additional contraceptive precautions are not necessary. After delivery or second trimester abortion, start before periods return. If more than 21 days have elapsed, pregnancy must be ruled out and an additional barrier method of contraception should be used for the first 7 days.

If you forget to take one or more tablets:

• If you are more than 12 hours late: Take a tablet as soon as you remember and take the next one at the usual time. This may mean taking two tablets in one day. This is not harmful. If you have forgotten more than one tablet you do not need to take the earlier missed ones. You are not protected against pregnancy. Continue to take your tablets as usual but use an extra method, such as a condom, for the next seven days. If you are more than 12 hours late and have had sex, emergency contraception may be required.
• If you are less than 12 hours late: Take the tablet as soon as you remember, and take the next tablet at the usual time. The contraceptive action of Desogestrel is maintained. If you missed one or more tablets in the first week and had intercourse in the week before missing the tablets, there is a possibility of pregnancy. The more consecutive tablets missed, the higher the risk of reduced contraceptive efficacy.

If you vomit or use medical charcoal: If vomiting or medical charcoal is used within 3–4 hours after taking Desogestrel, the active ingredient may not be fully absorbed. Follow the advice for missed tablets.

Enzyme-inducing medicines may increase the clearance of desogestrel, which can lead to breakthrough bleeding and contraceptive failure. Such interactions may occur with hydantoins, barbiturates, primidone, carbamazepine, rifampicin, oxcarbazepine, rifabutin, felbamate, ritonavir, griseofulvin, and herbal products containing St. John’s Wort. Reduced absorption of etonogestrel may occur when used with medicinal charcoal.

Contraindicated in suspected or confirmed pregnancy, active venous thromboembolic disease, severe liver disease with abnormal liver function tests, progestogen-dependent tumors, unexplained vaginal bleeding, and hypersensitivity to any component of the product.

Common: irregular bleeding, amenorrhoea, headache, weight gain, breast pain, nausea, acne, mood changes, decreased libido. Less common: vaginitis, dysmenorrhoea, ovarian cysts, vomiting, alopecia, fatigue, difficulty wearing contact lenses.
Rare: rash, urticaria, erythema nodosum.

Use during pregnancy is not recommended. Desogestrel does not affect breast milk production or quality. Small amounts of its active metabolite etonogestrel are excreted in breast milk. Long-term safety data are limited, but short-term data (up to 7 months) show no known risk to the breastfed infant.

Epidemiological studies suggest that combined oral contraceptives may increase the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism). It is not fully established whether desogestrel alone carries the same risk. The drug should be discontinued if thrombosis occurs. It should be stopped before long-term immobilization such as surgery or prolonged illness. Risk–benefit assessment is required in patients with liver cancer. Caution is advised in patients with a history of thromboembolic disorders. Diabetic patients should be closely monitored. The effect on bone mineral density is not clearly established.

No serious toxic effects have been reported. Possible symptoms include nausea, vomiting, and mild vaginal bleeding in young girls. Treatment is symptomatic and supportive.

Store below 30°C at room temperature. Do not use after the expiry date.

Oral contraceptive preparations