Ethynodiol/Ethinyl Estradiol
Mechanism :
Ethinyl estradiol is a synthetic derivative of the natural estrogen estradiol. Like estradiol, it promotes growth of the endometrium and thickening, stratification, and cornification of the vagina. It causes growth of the ducts of the mammary glands but inhibits lactation. It also inhibits the anterior pituitary.
Indication :
- Contraception
- Moderate acne vulgaris
- Severe dysfunctional uterine bleeding
- Dysmenorrhea
- Endometriosis
- Polycystic ovary syndrome
Contraindications :
Contraindicated in patients with a history or family history of thromboembolism, moderate to severe hyperlipoproteinemia, severe liver disease and porphyria.
Dosing :
Available as 28 day pack containing ethynodiol/ethinyl
estradiol 1 mg/50 mcg tab x 21 days and inert tab x 7 days.
Contraception, Acne vulgaris, Dysmenorrhea, Polycystic ovary syndrome:
1 tab OD PO. Start on day 1 of menstrual cycle.
Severe dysfunctional uterine bleeding:
1 tab PO every 4 hourly until bleeding subsides and then 1 tab 6 hourly for 4 days and then 1 tab 8 hourly for 3 days followed by 1 tab twice a day for 2 weeks. Subsequently maintain at 1 tab OD.
Adverse Effect :
Common Reactions: Musculoskeletal, pain, abdominal cramps/distension, dyspepsia, nausea/vomiting, constipation, cervical secretion changes, headache, fluid retention, insomnia, mood changes, vulvovaginal candidiasis, glucose intolerance, weight changes, libido changes, contact lens intolerance, vision changes, rash, melasma/chloasma, alopecia, hirsutism, breast development.Serious Reactions: Thromboembolism, hypertension, breast cancer, ovarian cancer, endometrial cancer, uterine hyperplasia, fibroid enlargement, hypercalcemia, cholestatic jaundice, gall stones, pancreatitis, hepatic hemangioma enlargement, depression, dementia, migraine, chorea exacerbation, seizure disorder exacerbation, asthma exacerbation, porphyria aggravation, SLE exacerbation, hypersensitivity reaction, anaphylaxis/anaphylactoid reaction, erythema multiforme, erythema nodosum, ischemic colitis, intestinal obstruction, vaginal erosion/ulcer.
Interaction :
Rifampicin, Phenobarbital, Carbamazepine and Phenytoin: Can lower the level of ethinylestradiol by accelerating its metabolism.
Warfarin: Ethinylestradiol may reduce the effects of anticoagulants
Insulin or Hypoglycemic Drugs: The doses may need to be adjusted due to a mild diabetogenic effect.
Theophylline: Clearance of theophylline may be reduced due to the inhibition of its metabolism.
Hepatic Dose :
Use is contraindicated with hepatic dysfunction.