A combined oral contraceptive (COC) pill containing a low-dose synthetic estrogen (Ethinyl Estradiol) and a third-generation progestin (Desogestrel). It is a monophasic, fixed-dose combination primarily used for pregnancy prevention by inhibiting ovulation, thickening cervical mucus, and altering the endometrium. It is one of the most commonly prescribed COCs in India due to its favorable side effect profile and high efficacy.
Adult: One tablet (0.03mg EE + 0.15mg Desogestrel) orally once daily, at approximately the same time each day. Follow a 21-day active pill/7-day placebo or pill-free interval regimen (for 28-day packs) or a 21-day active pill only regimen.
Note: Start on Day 1 of menstrual cycle (immediate protection) or on Sunday after period begins (backup contraception needed for first 7 days). Take with or without food. If vomiting/diarrhea occurs within 3-4 hours of intake, consider it a missed pill. For 21-day packs, take one pill daily for 21 days, then a 7-day break, starting a new pack on day 8.
The primary mechanism is suppression of the hypothalamic-pituitary-ovarian axis. Ethinyl Estradiol and Desogestrel act synergistically. The negative feedback inhibits the secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus and follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary. This prevents follicular development, ovulation, and corpus luteum formation.
Pregnancy: Pregnancy Category X. Contraindicated. Discontinue immediately if pregnancy is confirmed. No known teratogenic risk from inadvertent use in early pregnancy.
Driving: No known effects. However, if dizziness, migraine, or visual disturbances occur, caution is advised.
| Enzyme Inducers (e.g., Rifampicin, Rifabutin, Carbamazepine, Phenytoin, Phenobarbital, Primidone, Topiramate, Modafinil, St. John's Wort) | Significantly reduces contraceptive efficacy, leading to breakthrough bleeding and increased risk of pregnancy. | Major |
| Antibiotics (e.g., Griseofulvin, broad-spectrum penicillins, tetracyclines) | May reduce efficacy via gut flora alteration affecting enterohepatic recirculation of EE. Evidence is controversial but backup contraception is advised. | Moderate |
| HIV Protease Inhibitors (e.g., Ritonavir, Nelfinavir) & Non-Nucleoside Reverse Transcriptase Inhibitors (e.g., Nevirapine) | May alter contraceptive hormone levels (increase or decrease). | Major |
| Lamotrigine | Ethinyl Estradiol significantly reduces lamotrigine plasma levels, increasing risk of seizures. | Major |
| Tizanidine | Ethinyl Estradiol can increase tizanidine levels and toxicity. | Major |
| Selegiline, Theophylline | Metabolism may be inhibited, increasing their plasma levels. | Moderate |
| Ascorbic Acid (Vitamin C), Atorvastatin | May increase Ethinyl Estradiol plasma levels. | Minor |
| Warfarin, other anticoagulants | Contraceptive may reduce or increase anticoagulant effect; monitor INR closely. | Major |
Same composition (Ethinyl Estradiol (0.03mg) + Desogestrel (0.15mg)), different brands: