Dienogest Estradiol valerate Brand Name– Natazia
What is Dienogest Estradiol valerate
Dienogest estradiol valerate is a combination, four-phasic combined oral contraceptive (COC) used for routine contraception.
Estradiol valerate is a synthetic prodrug of the estrogen 17-beta-estradiol.
Dienogest is a fourth generation progestin that exhibits properties of progesterone derivatives; it is devoid of estrogenic, androgenic, glucocorticoid and mineralocorticoid activities.
The quadriphasic dosing strategy, which provides early estrogen dominance, is thought to allow for initial endometrial proliferation and sensitivity to progestogen, followed by the potent effects of dienogest during the middle and late part of the cycle to ensure endometrial stroma stability and bleeding control.
This COC combination has been shown to be beneficial for women with heavy menstrual bleeding by reducing menstrual flow and blood loss.
Combined hormonal contraceptives can be used in female patients from menarche to over the age of 40 years up until the time of menopause with proper selection of products.
The choice of a routine hormonal contraceptive for any given patient is based on the individual’s contraceptive needs, underlying medical conditions or risk factors for adverse effects, and individual preferences for use.
All combined oral contraceptives (COCs) have risks related to venous and arterial thromboembolism, particularly in women who smoke; all combined hormonal contraceptive labels contain a boxed warning about tobacco smoking.
The Centers for Disease Control’s U.S. Medical Eligibility Criteria describe considerations for risk vs. benefits, including medical conditions or attributes that contraindicate use; these criteria can help prescribing practitioners in product selection for individual patients.
The use of estradiol in an oral contraceptive may be less likely to affect clotting proteins versus the use of ethinyl estradiol; however, postmarketing studies are needed to establish if the pharmacologic effect will translate into a reduced risk for thromboembolism in clinical practice.
The FDA approved dienogest; estradiol valerate as a routine contraceptive in May 2010.
Indications
- contraception
- endometriosis
- menorrhagia
For routine contraception
Side Effects
- abdominal pain
- acne vulgaris
- alopecia
- amenorrhea
- anaphylactoid reactions
- angioedema
- anorexia
- anxiety
- appetite stimulation
- arthralgia
- asthenia
- back pain
- bowel ischemia
- breakthrough bleeding
- breast discharge
- breast enlargement
- candidiasis
- cataracts
- cervical dysplasia
- cholecystitis
- cholelithiasis
- cholestasis
- colitis
- cystitis
- depression
- diarrhea
- diplopia
- dysmenorrhea
- dyspepsia
- edema
- elevated hepatic enzymes
- emotional lability
- erythema multiforme
- erythema nodosum
- fatigue
- fluid retention
- galactorrhea
- gingivitis
- headache
- hepatitis
- hepatoma
- hirsutism
- hyperlipidemia
- hypertension
- hypertriglyceridemia
- intracranial bleeding
- irritability
- jaundice
- lactation suppression
- leukorrhea
- libido decrease
- libido increase
- lupus-like symptoms
- maculopapular rash
- mastalgia
- melasma
- menorrhagia
- menstrual irregularity
- migraine
- musculoskeletal pain
- myalgia
- myocardial infarction
- nausea
- new primary malignancy
- optic neuritis
- pancreatitis
- papilledema
- peliosis hepatis
- pelvic pain
- photosensitivity
- porphyria
- pruritus
- pulmonary embolism
- rash
- retinal thrombosis
- rhinitis
- sinusitis
- stroke
- thromboembolism
- thrombosis
- urticaria
- vaginal discharge
- vaginal irritation
- vaginitis
- visual impairment
- vomiting
- weight gain
- weight loss
Interactions
- Acarbose
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Propoxyphene
- Acetohexamide
- Albiglutide
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-glucosidase Inhibitors
- Amikacin
- Aminoglycosides
- Amiodarone
- Amobarbital
- Amoxicillin
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amoxicillin; Clavulanic Acid
- Ampicillin
- Ampicillin; Sulbactam
- Amprenavir
- Anastrozole
- Apalutamide
- Aprepitant, Fosaprepitant
- Armodafinil
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine; Fluticasone
- Azithromycin
- Aztreonam
- Bacitracin
- Barbiturates
- Beclomethasone
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Betamethasone
- Bexarotene
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Boceprevir
- Bosentan
- Brigatinib
- Bromocriptine
- Budesonide
- Budesonide; Formoterol
- Butabarbital
- Calaspargase pegol
- Calcium
- Canagliflozin
- Canagliflozin; Metformin
- Carbamazepine
- Carbapenems
- Carbenicillin
- Cefaclor
- Cefadroxil
- Cefazolin
- Cefdinir
- Cefditoren
- Cefepime
- Cefiderocol
- Cefixime
- Cefotaxime
- Cefotetan
- Cefoxitin
- Cefpodoxime
- Cefprozil
- Ceftaroline
- Ceftazidime
- Ceftazidime; Avibactam
- Ceftibuten
- Ceftizoxime
- Ceftolozane; Tazobactam
- Ceftriaxone
- Cefuroxime
- Cenobamate
- Cephalexin
- Charcoal
- Chenodiol
- Chloramphenicol
- Chlorpropamide
- Ciclesonide
- Cimetidine
- Ciprofloxacin
- Clarithromycin
- Clindamycin
- Clobazam
- Cobicistat
- Colistimethate, Colistin, Polymyxin E
- Conivaptan
- Corticosteroids
- Cortisone
- Cosyntropin
- Cyclosporine
- Dabrafenib
- Dalbavancin
- Danazol
- Dantrolene
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Daptomycin
- Daratumumab; Hyaluronidase
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deflazacort
- Delafloxacin
- Delavirdine
- Demeclocycline
- Dexamethasone
- Dicloxacillin
- Diltiazem
- Dipeptidyl Peptidase-4 Inhibitors
- Doripenem
- Doxycycline
- Dulaglutide
- Duloxetine
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elvitegravir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enasidenib
- Encorafenib
- Enzalutamide
- Eravacycline
- Ertapenem
- Ertugliflozin
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Eslicarbazepine
- Ethotoin
- Exemestane
- Exenatide
- Felbamate
- Fidaxomicin
- Flibanserin
- Fluconazole
- Fludrocortisone
- Flunisolide
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Fosamprenavir
- Fosphenytoin
- Gemifloxacin
- Gentamicin
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Glycylcyclines
- grapefruit juice
- Griseofulvin
- Hemin
- Hyaluronidase
- Hyaluronidase, Recombinant; Immune Globulin
- Hydantoins
- Hydralazine
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrocortisone
- Icosapent ethyl
- Idelalisib
- Imatinib
- Imipenem; Cilastatin
- Imipenem; Cilastatin; Relebactam
- Incretin Mimetics
- Indinavir
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivosidenib
- Kanamycin
- Ketoconazole
- Lamotrigine
- Lefamulin
- Leflunomide
- Lenalidomide
- Lesinurad
- Lesinurad; Allopurinol
- Letrozole
- Levofloxacin
- Levothyroxine
- Levothyroxine; Liothyronine (Porcine)
- Levothyroxine; Liothyronine (Synthetic)
- Linagliptin
- Linagliptin; Metformin
- Lincomycin
- Lincosamides
- Linezolid
- Liothyronine
- Liraglutide
- Lixisenatide
- Lomitapide
- Lopinavir; Ritonavir
- Lorlatinib
- Lumacaftor; Ivacaftor
- Meglitinides
- Melatonin
- Mephobarbital
- Meropenem
- Meropenem; Vaborbactam
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methohexital
- Methylprednisolone
- Metreleptin
- Metronidazole
- Metyrapone
- Midazolam
- Mifepristone
- Miglitol
- Miltefosine
- Mineral Oil
- Minocycline
- Minoxidil
- Mivacurium
- Modafinil
- Mometasone
- Morphine
- Morphine; Naltrexone
- Moxifloxacin
- Nafcillin
- Nefazodone
- Nelfinavir
- Neomycin
- Nevirapine
- Nilotinib
- Nitrofurantoin
- Nitroprusside
- Norfloxacin
- Ofloxacin
- Omadacycline
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oritavancin
- Ospemifene
- Oxacillin
- Oxcarbazepine
- Paromomycin
- Pegaspargase
- Penicillin G
- Penicillin G Benzathine
- Penicillin G Benzathine; Penicillin G Procaine
- Penicillin G Procaine
- Penicillin V
- Pentobarbital
- Pexidartinib
- Phenobarbital
- Phentermine; Topiramate
- Phenytoin
- Piperacillin
- Piperacillin; Tazobactam
- Pitolisant
- Plazomicin
- Polymyxin B
- Polymyxins
- Posaconazole
- Pramlintide
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Prednisolone
- Prednisone
- Primidone
- Propoxyphene
- Pyrimethamine; Sulfadoxine
- Raloxifene
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifamycins
- Rifapentine
- Riluzole
- Ritonavir
- Rituximab; Hyaluronidase
- Roflumilast
- Romidepsin
- Ropinirole
- Rufinamide
- Saquinavir
- Sarecycline
- Sarilumab
- Saxagliptin
- Secobarbital
- Selegiline
- Semaglutide
- SGLT2 Inhibitors
- Siltuximab
- Simvastatin; Sitagliptin
- Sitagliptin
- Somatropin, rh-GH
- St. John’s Wort, Hypericum perforatum
- Streptogramins
- Streptomycin
- Succinylcholine
- Sugammadex
- Sulfadiazine
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfasalazine
- Sulfisoxazole
- Sulfonamides
- Sulfonylureas
- Tacrine
- Tazemetostat
- Tedizolid
- Telaprevir
- Telavancin
- Telithromycin
- Teriflunomide
- Testolactone
- Tetracycline
- Tetracyclines
- Thalidomide
- Thiazolidinediones
- Thiopental
- Thyroid hormones
- Ticarcillin
- Ticarcillin; Clavulanic Acid
- Tigecycline
- Tinidazole
- Tipranavir
- Tizanidine
- tobacco
- Tobramycin
- Tocilizumab
- Tolazamide
- Tolbutamide
- Topiramate
- Toremifene
- Trandolapril; Verapamil
- Tranexamic Acid
- Trastuzumab; Hyaluronidase
- Triamcinolone
- Tricyclic antidepressants
- Trimethoprim
- Ulipristal
- Ursodeoxycholic Acid, Ursodiol
- Valproic Acid, Divalproex Sodium
- Vancomycin
- Verapamil
- Voriconazole
- Warfarin
- Zafirlukast
