Desogestrel

Drug Levels and Effects:




Summary of Use during Lactation:


Desogestrel is only available in the United States in combination oral contraceptive products containing 150 mcg of desogestrel and 30 mcg ofethinylestradiol. Based on the available evidence, expert opinion holds that nonhormonal methods are preferred during breastfeeding and progestin-only contraceptive are preferred over combined oral contraceptives in breastfeeding women, especially during the first 4 weeks postpartum. For further information, consult the record entitled, "Contraceptives, Oral, Combined."


Drug Levels:


Desogestrel is metabolized in the body to the active metabolite, etonogestrel.

Maternal Levels.

Ten women participating in a study of desogestrel 75 mcg daily as a progestin-only contraceptive had blood and milk samples taken multiple times after taking a single tablet at the end of 1 and 4 treatment cycles. Peak etonogestrel concentrations in milk were not significantly different: 0.2 picograms/L at 6 hours after the dose and 0.3 picograms/L at 5.2 hours after the dose at 1 and 4 months, respectively. An exclusively breastfed infant would receive an average of 15 to 22 ng/kg daily of etonogestrel, which is 1.2 to 1.7% of the maternal weight-adjusted dosage.[1]

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


A nonblinded, nonrandomized study compared oral desogestrel 75 mcg alone daily (n = 42) to an intrauterine device (IUD; n = 40) begun 28 to 56 days postpartum for contraception. No differences in infant length, weight or biparietal head circumferences were found after 1, 4, and 7 treatment cycles. Temporary breast enlargement was reported in 2 infants and increased sweating was reported in 1 infant in the desogestrel group, compared with no adverse effects reported in infants in the IUD group. The growth of some infants were again measured at 1.5 and 2.5 years; no clinically important differences were found.[1]


Possible Effects on Lactation:


A nonblinded, nonrandomized study compared oral desogestrel 75 mcg alone daily (n = 42) to an intrauterine device (n = 40) begun 28 to 56 days postpartum for contraception. During the 7-month trial period, 1 woman dropped out of the trial because of diminished lactation compared with none in the IUD group. At the end of the first and fourth treatment cycle, there were no differences in the amount of milk produced between the desogestrel and IUD groups. No differences in triglyceride, protein or lactose content of milk were found at the end of 1, 4, and 7 cycles of therapy.[1]


Alternate Drugs to Consider:


Etonogestrel,Levonorgestrel,Medroxyprogesterone Acetate,Norethindrone


References:


1. Bjarnadottir RI, Gottfredsdottir H, Sigurdardottir K et al. Comparative study of the effects of a progestogen-only pill containing desogestrel and an intrauterine contraceptive device in lactating women. BJOG. 2001;108:1174-80. PMID:11762658



Substance Identification:




Substance Name:

Desogestrel

CAS Registry Number:

54024-22-5

Drug Class:


  • Contraceptive Agents, Female

  • Contraceptives, Oral, Synthetic


  • Administrative Information:




    LactMed Record Number:


    487


    Last Revision Date:


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