Gracial (Desogestrel, Ethinylestradiol)

Gracial is indicated for the prevention of pregnancy in women of reproductive age who are seeking a reliable, reversible contraceptive method.

• Prevents ovulation through combined estrogen and progestin action.
• Provides cycle control and reduces menstrual bleeding.
• Can be used as a first‑line hormonal contraceptive for women without contraindications.
• May be selected for its once‑daily oral dosing convenience.
• Suitable for women who require a combined oral contraceptive rather than a progestin‑only option.

Like other combined oral contraceptives, Gracial may cause a range of side effects, most of which are mild and transient.

Common

• Nausea or mild stomach upset.
• Breast tenderness or enlargement.
• Headache or mild migraine.
• Spotting or breakthrough bleeding between periods.
• Mood changes or irritability.
• Weight gain or fluid retention.

Serious

• Blood clots in veins or arteries, which can present as leg swelling, chest pain, or shortness of breath.
• Severe allergic reaction, including rash, itching, swelling of the face or throat, or difficulty breathing.
• Liver problems indicated by jaundice or dark urine.

Before prescribing Gracial, clinicians evaluate several health factors to ensure safe use and to minimize risk.

• History of venous or arterial thromboembolism, including deep‑vein thrombosis or pulmonary embolism.
• Current or past cardiovascular disease such as hypertension, stroke, or myocardial infarction.
• Smoking in women over 35 years of age.
• Known or suspected pregnancy, as the product is contraindicated (Category X).
• Liver disease or tumors that may affect hormone metabolism.
• Migraine with aura or other neurological conditions that increase stroke risk.
• Unexplained vaginal bleeding or abnormal uterine bleeding.

Gracial can interact with other medicines, which may alter its effectiveness or increase the risk of adverse events.

Avoid

• Strong enzyme inducers such as rifampin, carbamazepine, phenytoin, or St John’s wort, which can reduce hormone levels.
• Certain antiviral agents (e.g., efavirenz) that accelerate hormonal metabolism.
• Medications that increase the risk of clotting, such as selective estrogen receptor modulators.
• Certain antibiotics (e.g., griseofulvin) that may lower contraceptive effectiveness.

Use with caution

• Antifungal agents like ketoconazole that may increase hormone concentrations.
• Antidepressants, especially SSRIs, which can affect bleeding patterns.
• Herbal supplements such as ginseng that may interfere with contraceptive efficacy.
• Diuretics that may affect fluid balance and blood pressure, requiring monitoring.