Segesterone/Ethinyl Estradiol

Mechanism :

It is a combined hormonal contraceptive (CHC). CHCs lower the risk of becoming pregnant primarily by suppressing ovulation.
Ethinyl estradiol (EE): Reduces LHRH release from hypothalamus, reduces gonadotropin release from pituitary.
Segesterone acetate (SA): Progestin; inhibits gonadotropin secretion from pituitary; prevents follicular maturation and ovulation.

Indication :

Contraceptive

Contraindications :

Hypersensitivity to segesterone, ethinyl estradiol, or any component of the formulation; current or history of breast cancer or other estrogen- or progestin-sensitive cancer; liver tumors, acute hepatitis, or severe (decompensated) cirrhosis; undiagnosed abnormal uterine bleeding; hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir.

Dosing :

Available as silicone elastomer vaginal system:

103 mg/17.4 mg.

Place one vaginal system in the vagina and it should remain in place continuously for 21 days. After 3 weeks, remove the vaginal system for 1 week for a dose-free interval, during which a withdrawal bleed usually occurs.

Adverse Effect :

Headache, migraine, nausea, vomiting, abdominal pain, vulvovaginal candidiasis, dysmenorrhea, vaginal discharge, deep vein thrombosis, psychiatric disturbance, genital pruritus, heavy menstrual bleeding, breakthrough bleeding, breast tenderness, pyelonephritis.

Interaction :

Anticoagulants: Estrogen Derivatives and progestins may diminish the anticoagulant effect of Anticoagulants.
Antihepaciviral Combination Products: Ethinyl Estradiol may enhance the hepatotoxic effect of Antihepaciviral Combination Products.
Barbiturates: May diminish the therapeutic effect of Estrogen Derivatives and progestins.
Corticosteroids: Estrogen Derivatives may increase the serum concentration of Corticosteroids.
CYP3A4 Inducers: May increase the metabolism of CYP3A4 Substrates.
CYP3A4 Inhibitors: May increase the serum concentration of Estrogen Derivatives and progestins.
Phenytoin: May diminish the therapeutic effect of Estrogen Derivatives and progestins.

Hepatic Dose :

Acute or chronic changes in liver function may require discontinuation until tests of hepatic function become normal and causation has been excluded. Use is contraindicated in patients with hepatic tumors (benign or malignant), acute hepatitis, or severe (decompensated) cirrhosis.