Gracial (Desogestrel, Ethinylestradiol)

Gracial is indicated for hormonal contraception and is used to prevent unintended pregnancy in women of reproductive age.

• Prevents ovulation by suppressing the hypothalamic‑pituitary‑gonadal axis.
• Alters cervical mucus to reduce sperm penetration.
• Modifies the endometrial lining to inhibit implantation.
• Can be used in a 21‑day active tablet regimen followed by a hormone‑free interval.
• May be prescribed for cycle regulation when contraception is also required.

Side effects may vary in frequency and severity; most are mild and transient, while rare events require immediate medical attention.

Common

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

Serious

• Deep vein thrombosis or pulmonary embolism.
• Severe abdominal or pelvic pain indicating possible ovarian cyst rupture.
• Allergic reaction such as rash, itching, swelling, or difficulty breathing.
• Liver dysfunction manifested by jaundice or abnormal liver enzymes.

Before starting Gracial, certain health considerations should be reviewed to ensure safe use.

• Do not start Gracial if you have a history of thromboembolic disorders or cardiovascular disease.
• Avoid use if you are pregnant, breastfeeding, or suspect pregnancy.
• Screen for liver disease, hypertension, or diabetes before initiating therapy.
• Smoking, especially in women over 35, increases cardiovascular risk while using combined oral contraceptives.
• Inform your clinician about any history of migraines with aura.
• Regularly monitor blood pressure and lipid profile during long‑term use.

Gracial can interact with other medicines, affecting its effectiveness or safety.

Avoid

• Strong enzyme inducers such as rifampicin, carbamazepine, or phenytoin that reduce hormone levels.
• Certain antiviral protease inhibitors that may increase estrogen exposure.

Use with caution

• Antifungal agents like ketoconazole that can increase plasma concentrations.
• Antidepressants (SSRIs) that may affect hormonal metabolism.
• Herbal supplements such as St. John’s wort that can lower effectiveness.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs) may increase risk of hypertension.