Drug Approvals
(British Approved Name, US Adopted Name, rINN)
Adverse Effects and Precautions
As for progestogens in general (see Progesterone). See also under Hormonal Contraceptives.
Breast feed ing.
Etonogestrel was found in the breast milk of 42 women given a contraceptive etonogestrel implant. Over the 4-month study, compared with a group who used an intra-uterine non-hormonal device, etonogestrel did not affect the volume or composition of breast milk, or the growth of the breast-fed infants. At 3 years of age there was no difference in growth between these 2 groups of children.
Vaginal bleeding.
Prolonged vaginal bleeding, lasting from 2 to 26 weeks, has been reported with the use of etonogestrel sub-dermal implants. Blood transfusion was needed in the management of one patient. Heavy bleeding has been described in 2 women after the implant had broken while in place.
Interactions
As for progestogens in general (see Progesterone). See also under Hormonal Contraceptives.
Pharmacokinetics
Etonogestrel is highly bound to plasma proteins about 32% is bound to sex hormone binding globulin and 66% to albumin. It is metabolised by the cytochrome P450 isoenzyme CYP3A4, and both metabolites and unchanged drug are excreted in the urine and faeces. The elimination half-life is about 25 to 30 hours. Etonogestrel is distributed into breast milk.
Uses and Administration
Etonogestrel, the active metabolite of desogestrel, is used as a hormonal contraceptive. A subdermal implant containing 68 mg of etonogestrel is used as a progestogenonly contraceptive that is effective for 3 years. Etonogestrel is also used as the progestogen component of a combined contraceptive delivered via a vaginal ring device.
The ring releases an average of 120 micrograms daily of etonogestrel and 15 micrograms daily of ethinylestradiol and remains in the vagina for 3 weeks it is then removed for a one-week break after which a new ring is inserted.
Etonogestrel is under investigation as a male contraceptive, given orally or by implant, with testosterone implants or injections.
Preparations
Proprietary Preparations
Argentina: lmplanon
Australia:: Implanon
Austria: Implanon
Belgium: Implanon
Brazil: Implanon
Chile: Implanon
Czech Republic: Implanon
Denmark: Implanon
Finland: Implanon
France: Implanon
Germany: Implanon
Greece: Implanon
Hungary: Implanon
Indonesia: Implanon
Italy: Implanon
Malaysia: Implanon
Mexico: Implanon
Norway: Implanon
Portugal: Implanon
Singapore: Implanon
Spain: Implanon
Sweden: Implanon
Switzerland: Implanon
Thailand: Implanon
Turkey: Implanon
UK: Implanon
USA: Implanon
Venezuela: Implanon
Multi-ingredient
Australia: NuvaRing
Austria: NuvaRing
Belgium: NuvaRing
Brazil: NuvaRing
Canada: NuvaRing
Chile: NuvaRing
Czech Republic: NuvaRing
Denmark: NuvaRing
Finland: NuvaRing
France: NuvaRing
Germany: NuvaRing
Greece: NuvaRing
Hungary: NuvaRing
Italy: NuvaRing
Mexico: NuvaRing
The Netherlands: NuvaRing
Norway: NuvaRing
Portugal: NuvaRing
Russia: NuvaRing
Spain: NuvaRing
Sweden: NuvaRing
Switzerland: NuvaRing
USA: NuvaRing
Jennifer is a clinical pharmacologist. She helps doctors of all medical specialties choose medications. Jennifer consults about drug dosage, interactions, and side effects.