Gracial (Desogestrel, Ethinylestradiol)

Gracial is indicated for the prevention of pregnancy in women of reproductive age who choose an oral hormonal method.

• Primary use as a combined oral contraceptive to inhibit ovulation.
• Alternative to other hormonal contraceptives for cycle regulation.
• May be prescribed for women seeking reversible contraception.
• Can be used in conjunction with counseling on barrier methods for added protection.
• Suitable for women without contraindications to estrogen‑containing contraceptives.
• Provides a predictable menstrual withdrawal bleed during the placebo interval.

Like other combined oral contraceptives, Gracial may cause a range of side effects, most of which are mild, dose‑related, and tend to improve after several cycles of use.

Common

• Nausea, vomiting, or mild gastrointestinal discomfort, especially when the tablet is taken on an empty stomach.
• Breast tenderness, swelling, or a feeling of fullness, which usually resolves with continued use.
• Headache, including tension‑type or mild migraine, that may be alleviated by taking the tablet with food.
• Spotting, breakthrough bleeding, or irregular menstrual flow during the active pill phase.

Serious

• Blood clots in the deep veins of the legs (deep vein thrombosis) or lungs (pulmonary embolism), which require immediate medical attention.
• Severe hypertension, stroke, or heart attack, particularly in women with pre‑existing cardiovascular risk factors.

Before prescribing Gracial, clinicians evaluate several health factors to ensure the medication is appropriate and safe for each patient.

• History of thromboembolic disorders, such as DVT or pulmonary embolism.
• Current or past cardiovascular disease, including 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, especially active hepatitis or liver tumors.
• Migraine with aura or other neurological conditions that increase stroke risk.

Gracial can interact with other medicines, altering its effectiveness or increasing the risk of adverse events; patients should disclose all concurrent drugs.

Avoid

• Enzyme‑inducing anticonvulsants (e.g., carbamazepine, phenytoin, phenobarbital).
• Rifampin or other potent inducers of CYP3A4.
• Certain antiretrovirals (e.g., efavirenz).

Use with caution

• Antibiotics such as clarithromycin or erythromycin that may affect hormone levels.
• St. John’s wort, a herbal CYP3A4 inducer.
• Antifungal agents like ketoconazole that inhibit metabolism.