Ethinylestradiol/drospirenone
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Combination hormonal contraceptive
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Ethinylestradiol/drospirenone is a combination hormonal contraceptive used in birth control pills. It contains two active ingredients: ethinylestradiol, an estrogen, and drospirenone, a progestin. This combination is used to prevent pregnancy and is also prescribed for other medical conditions such as acne and premenstrual dysphoric disorder (PMDD).
Pharmacology
Ethinylestradiol
Ethinylestradiol is a synthetic form of estrogen that is commonly used in oral contraceptives. It works by inhibiting ovulation through suppression of the hypothalamic-pituitary-ovarian axis. Ethinylestradiol also causes changes in the cervical mucus and endometrium, making it more difficult for sperm to enter the uterus and for a fertilized egg to implant.
Drospirenone
Drospirenone is a synthetic progestin with anti-mineralocorticoid and anti-androgenic properties. It is structurally related to spironolactone, a diuretic and antihypertensive medication. Drospirenone helps to prevent ovulation and also contributes to the contraceptive effect by altering the endometrium and cervical mucus. Its anti-androgenic effects can be beneficial in treating acne and hirsutism.
Medical Uses
Ethinylestradiol/drospirenone is primarily used as a contraceptive to prevent pregnancy. It is also prescribed for the treatment of moderate acne in women who desire oral contraception, and for the management of premenstrual dysphoric disorder (PMDD). Additionally, it can be used to regulate menstrual cycles and reduce menstrual pain.
Side Effects
Common side effects of ethinylestradiol/drospirenone include nausea, headache, breast tenderness, and mood changes. Serious side effects can include an increased risk of blood clots, stroke, and heart attack, particularly in women who smoke and are over 35 years of age. It is important for patients to discuss their medical history and risk factors with their healthcare provider before starting this medication.
Contraindications
Ethinylestradiol/drospirenone is contraindicated in women with a history of thromboembolic disorders, breast cancer, liver disease, and uncontrolled hypertension. It should not be used by women who are pregnant or breastfeeding.
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Contributors: Prab R. Tumpati, MD