Malina (Desogestrel)

• Desogestrel is used as a progestin‑only oral contraceptive to prevent pregnancy.
• Contraception: provides effective prevention of pregnancy in women of reproductive age.
• Menstrual cycle control: may reduce irregular bleeding and dysmenorrhea in some users.
• Acne improvement: can help improve acne associated with hormonal fluctuations.

• Desogestrel acts as a selective progesterone receptor agonist. By binding to the progesterone receptor in the hypothalamus and pituitary, it suppresses the luteinizing hormone surge, thereby inhibiting ovulation. It also induces changes in cervical mucus, making it thicker and less permeable to sperm, and alters the endometrial lining to reduce the likelihood of implantation.

Desogestrel may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Irregular vaginal bleeding or spotting
• Headache
• Nausea or abdominal discomfort
• Breast tenderness
• Weight gain or fluid retention
• Acne or skin changes

Serious or Rare Side Effects

• Venous thromboembolism (deep vein thrombosis, pulmonary embolism)
• Severe allergic reaction (anaphylaxis, rash, swelling)
• Liver dysfunction or jaundice
• Depression or mood changes
• Hypertension or cardiovascular events
• Visual disturbances

Before prescribing Desogestrel, clinicians should evaluate patient history and risk factors.

• Pregnancy: Contraindicated in pregnancy; ensure negative pregnancy test before initiation.
• Smoking: Advise women over 35 who smoke to avoid use due to increased thrombotic risk.
• Thromboembolism: Avoid in patients with a history of venous or arterial clotting disorders.
• Liver disease: Use with caution in patients with severe hepatic impairment.
• Hypertension: Monitor blood pressure regularly in patients with pre‑existing hypertension.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Desogestrel can interact with several medicines that affect its metabolism or hormonal activity.

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampin, carbamazepine, phenytoin) – may reduce contraceptive efficacy.
• Antifungal agents like ketoconazole – can increase plasma levels, raising risk of side effects.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inducers (e.g., efavirenz, griseofulvin) – may modestly lower effectiveness.
• Certain antibiotics (e.g., ampicillin, tetracycline) – occasional reports of reduced contraceptive reliability.
• St John’s wort – may decrease hormone levels, requiring additional contraceptive measures.
• Anticonvulsants (e.g., valproate) – monitor for breakthrough bleeding.