What is the recommended dosage and usage of desogestrel (progestin) for contraceptive purposes?

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From the FDA Drug Label

DOSAGE AND ADMINISTRATION To achieve maximum contraceptive effectiveness, maximum contraceptive effectiveness, desogestrel and ethinyl estradiol tablets and ethinyl estradiol tablets must be taken exactly as directed and at intervals not exceeding 24 hours.

The recommended dosage of desogestrel for contraceptive purposes is not explicitly stated as 150mcg per day in the provided drug labels.

  • The dosage and administration section of the labels describes the regimen for taking desogestrel and ethinyl estradiol tablets, but it does not specify the dosage of desogestrel.
  • The labels provide instructions for a Sunday start or Day 1 start regimen, with one white to off-white tablet taken daily for 21 days, followed by inert or active tablets.
  • However, the exact dosage of desogestrel in each tablet is not mentioned in the provided text 1 1.

From the Research

Desogestrel for contraception is typically taken as a 75 microgram tablet once daily without interruption, not 150mcg as mentioned in the question. The recommended dosage is based on the study by 2, which compared the contraceptive efficacy, acceptability, and safety of desogestrel 75 micrograms/day to levonorgestrel 30 micrograms/day. Some key points to consider when taking desogestrel include:

  • The pill should be taken at approximately the same time each day to maintain effectiveness.
  • When starting desogestrel, if beginning on day 1 of menstruation, no backup contraception is needed; if starting at any other time in the cycle, use backup contraception for the first 7 days.
  • Unlike combined hormonal contraceptives, desogestrel (a progestin-only pill or "mini-pill") does not require a pill-free week.
  • If a pill is missed by more than 12 hours, take it as soon as remembered and use backup contraception for the next 7 days. Desogestrel works primarily by inhibiting ovulation and thickening cervical mucus to prevent sperm penetration, as noted in 3. It's particularly suitable for women who cannot take estrogen-containing contraceptives, such as those with certain cardiovascular risk factors, smokers over 35, or breastfeeding women, as discussed in 4. Side effects may include irregular bleeding, headaches, mood changes, and breast tenderness, though these often improve after the first few months of use. In terms of safety, progestin-only products like desogestrel do not confer any increased risk of venous or arterial thrombosis, except for progestin depot, which may double the risk of venous thrombosis, as mentioned in 4. Overall, desogestrel is a reliable and safe progestogen-only pill with a contraceptive efficacy superior to levonorgestrel 30 micrograms/day, as shown in 2.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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