Gracial (Desogestrel, Ethinylestradiol)

Gracial is indicated for specific reproductive health purposes in women of childbearing age who require reliable contraception and may benefit from cycle regulation.

• Prevention of pregnancy as a combined oral contraceptive.
• Regulation of menstrual cycle length and flow.
• Management of dysmenorrhea associated with hormonal fluctuations.
• Treatment of acne that improves with estrogen–progestogen therapy (off‑label in some regions).
• Reduction of the risk of ovarian cyst formation in women with functional cysts.

Like other combined oral contraceptives, Gracial may cause a range of side effects that vary in frequency and severity.

Common

• Nausea or mild stomach upset, often transient during the first weeks.
• Breast tenderness or enlargement, which usually diminishes with continued use.
• Headache, including tension‑type or mild migraine‑like symptoms.
• Spotting or breakthrough bleeding, especially during the initial cycles.
• Mood changes or mild depressive symptoms that may improve over time.
• Weight gain or fluid retention, typically modest and reversible.

Serious

• Deep vein thrombosis, pulmonary embolism, or other thromboembolic events.
• Severe hypertension, stroke, or other cardiovascular complications.

Before prescribing Gracial, clinicians evaluate several safety considerations to minimize risks for each patient.

• History of thromboembolic disorders, cardiovascular disease, or uncontrolled hypertension.
• Smoking in women over 35 years of age.
• Known or suspected pregnancy, as the product is not indicated for use during gestation.
• Liver disease or impaired hepatic function.
• Migraine with aura or other neurologic conditions that increase stroke risk.
• Breast cancer or estrogen‑dependent tumors.
• Concomitant use of medications that increase clotting risk.

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

Avoid

• Enzyme‑inducing anticonvulsants (e.g., carbamazepine, phenytoin, phenobarbital).
• Rifampicin or other potent CYP3A4 inducers.
• Certain antiretrovirals (e.g., efavirenz) that lower hormone levels.
• Antiepileptic drug oxcarbazepine, which can diminish contraceptive efficacy.

Use with caution

• Antifungal agents such as ketoconazole that may increase hormone concentrations.
• St. John’s wort, a mild CYP3A4 inducer, which may reduce contraceptive effectiveness.
• Certain antibiotics (e.g., clarithromycin) that can alter plasma levels.
• Selective serotonin reuptake inhibitors (SSRIs) that may affect bleeding patterns.