Etonogestrel
Mechanism :
Synthetic progestin, it supresses ovulation and endometrial proliferation, increases viscosity of cervical mucous and stimulates growth of mammary tissues
Indication :
Contraindications :
Breast cancer, thromboembolic disease, progestin- sensitive cancer, hepatic tumors, active hepatic disease
Dosing :
Postmenarchal females- 1 implant is inserted subdermally in the non-dominant upper arm. Change the implant after every 3 years.
In women not on any hormonal contraception - Insert between Day 1-Day 5 of menstruation.
In women taking combined oral hormonal contraceptives- Insert on the last day of active tablet.
In women using vaginal ring/transdermal patch, insert it on the day vaginal ring/transdermal patch is removed.
In women taking progestin-only pills, insert it on any day.
In case of first trimester abortion- inserted within 5 days after the event.
In case of second trimester abortion- inserted between 21 to 28 days after the event.
Post-partum- insert between 21 to 28 days if not breast feeding exclusively, otherwise in exclusively breast-fed women insert after four weeks of post-partum.
Adverse Effect :
Acne vulgaris, abdominal pain, vaginitis, headache, nausea, flu, dysmenorrhea, depression
Interaction :
Aminoglycosides- amplifies the hypocalcaemia effect of bisphosphonate derivatives
Deferasirox- amplifies the adverse/toxic effect of deferasirox
Proton pump inhibitors- can decrease the efficacy of bisphosphonate
NSAIDS- amplifies the adverse/toxic effect of bisphosphonate derivatives
Lactation :
Hormonal contraceptives can reduce the production of breast milk, otherwise no harm occurs to fetus.
Pregnanacy :
Contraindicated if pregnant