Segesterone Acetate and Ethinyl Estradiol

What is Segesterone Acetate and Ethinyl Estradiol

Segesterone acetate and ethinyl estradiol and used together in a combination hormonal contraceptive vaginal system (ring). Ethinyl estradiol is a potent, synthetic estrogen.

Segesterone, also known as 17alpha-hydroxy-16-methylene-19-norprogesterone or as 17alpha-deacetylnestorone, is a synthetic progestin. Segesterone has high progestational activity with negligible androgenic, glucocorticoid, or estrogenic activity in vivo.

The segesterone acetate; ethinyl estradiol vaginal ring is inserted for 3 weeks and then removed for a 1-week dose-free interval.

Brand Name

Annovera

Indications

• contraception

Side Effects

1. abdominal pain
2. acne vulgaris
3. alopecia
4. amenorrhea
5. anaphylactoid reactions
6. angioedema
7. appetite stimulation
8. bowel ischemia
9. breakthrough bleeding
10. candidiasis
11. cataracts
12. cervical dysplasia
13. chills
14. cholecystitis
15. cholelithiasis
16. cholestasis
17. colitis
18. cystitis
19. depression
20. diarrhea
21. diplopia
22. dysmenorrhea
23. dyspepsia
24. elevated hepatic enzymes
25. emotional lability
26. erythema multiforme
27. erythema nodosum
28. fever
29. fluid retention
30. galactorrhea
31. headache
32. hepatitis
33. hepatoma
34. hirsutism
35. hyperglycemia
36. hyperlipidemia
37. hypertension
38. infection
39. infertility
40. jaundice
41. lactation suppression
42. leukorrhea
43. maculopapular rash
44. mastalgia
45. melasma
46. menorrhagia
47. menstrual irregularity
48. migraine
49. myocardial infarction
50. nausea
51. new primary malignancy
52. oligomenorrhea
53. optic neuritis
54. pancreatitis
55. papilledema
56. peliosis hepatis
57. photosensitivity
58. pruritus
59. pulmonary embolism
60. rash
61. retinal thrombosis
62. spontaneous fetal abortion
63. stroke
64. thromboembolism
65. thrombosis
66. toxic-shock syndrome
67. urticaria
68. vaginal bleeding
69. vaginal discharge
70. vaginal irritation
71. vaginal pain
72. vaginitis
73. visual impairment
74. vomiting
75. weight gain

Monitoring Parameters

• pap smear
• pelvic exam

Contraindications

• acquired immunodeficiency syndrome (AIDS)
• atrial fibrillation
• breast cancer
• breast-feeding
• cerebrovascular disease
• cervical cancer
• children
• chloasma
• cholestasis
• contact lenses
• contraceptive devices
• coronary artery disease
• coronary thrombosis
• depression
• diabetes mellitus
• endocarditis
• endometrial cancer
• gallbladder disease
• geriatric
• headache
• hepatic disease
• hepatitis
• hepatitis C infection
• hepatocellular cancer
• hereditary angioedema
• history of angioedema
• human immunodeficiency virus (HIV) infection
• hypercholesterolemia
• hyperlipidemia
• hypertriglyceridemia
• hypothyroidism
• infection
• jaundice
• laboratory test interference
• menstrual irregularity
• migraine
• myocardial infarction
• obesity
• obstetric delivery
• ovarian cancer
• porphyria
• pregnancy
• protein C deficiency
• protein S deficiency
• renal disease
• sexually transmitted disease
• stroke
• surgery
• systemic lupus erythematosus (SLE)
• thromboembolic disease
• thromboembolism
• thrombophlebitis
• tobacco smoking
• uterine cancer
• vaginal bleeding
• vaginal cancer
• valvular heart disease
• visual disturbance

Interactions

• Acarbose
• Acetaminophen
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetohexamide
• Acitretin
• Albiglutide
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-glucosidase Inhibitors
• Alprazolam
• Amikacin
• Aminoglycosides
• Amiodarone
• Amitriptyline; Chlordiazepoxide
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amobarbital
• Amoxicillin
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amoxicillin; Clavulanic Acid
• Ampicillin
• Ampicillin; Sulbactam
• Amprenavir
• Anastrozole
• Apalutamide
• Aprepitant, Fosaprepitant
• Armodafinil
• Artemether; Lumefantrine
• Ascorbic Acid, Vitamin C
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Atazanavir
• Atazanavir; Cobicistat
• Atorvastatin
• Atorvastatin; Ezetimibe
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azelastine; Fluticasone
• Azithromycin
• Aztreonam
• Bacitracin
• Barbiturates
• Beclomethasone
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Bendamustine
• Benzhydrocodone; Acetaminophen
• Betamethasone
• Bexarotene
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Blinatumomab
• Boceprevir
• Bosentan
• Brigatinib
• Bromocriptine
• Budesonide
• Budesonide; Formoterol
• Butabarbital
• Cabozantinib
• Caffeine
• Caffeine; Ergotamine
• Calaspargase pegol
• Calcium
• Calcium-channel blockers
• Canagliflozin
• Canagliflozin; Metformin
• Carbamazepine
• Carbapenems
• Carbenicillin
• Carvedilol
• 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
• Ceritinib
• Charcoal
• Chenodiol
• Chloramphenicol
• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chlorpropamide
• Ciclesonide
• Cimetidine
• Ciprofloxacin
• Clarithromycin
• Clevidipine
• Clindamycin
• Clobazam
• Clonazepam
• Clorazepate
• Cobicistat
• Cobimetinib
• Colesevelam
• Colistimethate, Colistin, Polymyxin E
• Conivaptan
• Corticosteroids
• Corticotropin, ACTH
• Cortisone
• Cosyntropin
• Crizotinib
• Cyclosporine
• Dabrafenib
• Dalbavancin
• Dalfopristin; Quinupristin
• Danazol
• Dantrolene
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Daptomycin
• Daratumumab; Hyaluronidase
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Deferasirox
• Deflazacort
• Delafloxacin
• Delavirdine
• Demeclocycline
• Dexamethasone
• Diazepam
• Dicloxacillin
• Diltiazem
• Dipeptidyl Peptidase-4 Inhibitors
• Dirithromycin
• Doripenem
• Doxazosin
• Doxercalciferol
• Doxorubicin
• Doxycycline
• Dronabinol
• Dronedarone
• Dulaglutide
• Duloxetine
• Dutasteride; Tamsulosin
• Duvelisib
• 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
• Enalapril; Felodipine
• Enasidenib
• Encorafenib
• Enzalutamide
• Eravacycline
• Ertapenem
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Eslicarbazepine
• Estazolam
• Exemestane
• Exenatide
• Felbamate
• Felodipine
• Fidaxomicin
• Flibanserin
• Fluconazole
• Fludrocortisone
• Flunisolide
• Flurazepam
• Fluticasone
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Fluvoxamine
• food
• Formoterol; Mometasone
• Fosamprenavir
• Frovatriptan
• Gemifloxacin
• Gentamicin
• Glecaprevir; Pibrentasvir
• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Glycylcyclines
• grapefruit juice
• Green Tea
• 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
• Isavuconazonium
• Isoniazid, INH
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isotretinoin
• Isradipine
• Itraconazole
• Ivosidenib
• Ixabepilone
• Kanamycin
• Ketoconazole
• Lamotrigine
• Lefamulin
• Leflunomide
• Lenalidomide
• Lesinurad
• Lesinurad; Allopurinol
• Letermovir
• Letrozole
• Levofloxacin
• Levothyroxine
• Levothyroxine; Liothyronine (Porcine)
• Levothyroxine; Liothyronine (Synthetic)
• Linagliptin
• Linagliptin; Metformin
• Lincomycin
• Lincosamides
• Linezolid
• Liothyronine
• Liraglutide
• Lixisenatide
• Lomitapide
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Lorazepam
• Lorlatinib
• Lumacaftor; Ivacaftor
• Mecamylamine
• Meglitinides
• Melatonin
• Mephobarbital
• Meropenem
• Meropenem; Vaborbactam
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methohexital
• Methylprednisolone
• Metreleptin
• Metronidazole
• Metyrapone
• Miconazole
• Miconazole; Petrolatum; Zinc Oxide
• Midazolam
• Mifepristone
• Miglitol
• Miltefosine
• Mineral Oil
• Minocycline
• Minoxidil
• Mitotane
• Mivacurium
• Modafinil
• Mometasone
• Morphine
• Morphine; Naltrexone
• Moxifloxacin
• Mycophenolate
• Nafcillin
• Naratriptan
• Nefazodone
• Nelfinavir
• Neomycin
• Netupitant, Fosnetupitant; Palonosetron
• Nevirapine
• Nicardipine
• Nifedipine
• Nilotinib
• Nimodipine
• Nisoldipine
• Nitrofurantoin
• Nitroprusside
• Norfloxacin
• Octreotide
• Ofloxacin
• Omadacycline
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Amoxicillin; Rifabutin
• Oritavancin
• Ospemifene
• Oxacillin
• Oxazepam
• Oxcarbazepine
• Paromomycin
• Pazopanib
• Pegaspargase
• Penicillin G
• Penicillin G Benzathine
• Penicillin G Benzathine; Penicillin G Procaine
• Penicillin G Procaine
• Penicillin V
• Pentobarbital
• Perindopril; Amlodipine
• Pexidartinib
• Phenobarbital
• Phenothiazines
• Phenoxybenzamine
• Phentermine; Topiramate
• Piperacillin
• Piperacillin; Tazobactam
• Pitolisant
• Plazomicin
• Polymyxin B
• Polymyxins
• Posaconazole
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Prazosin
• Prednisolone
• Prednisone
• Primidone
• Propafenone
• Propoxyphene
• Pyrimethamine; Sulfadoxine
• Quazepam
• Quinine
• Raloxifene
• Ramelteon
• Ranolazine
• Rasagiline
• Reserpine
• Ribociclib
• Ribociclib; Letrozole
• Rifabutin
• Rifampin
• Rifamycins
• Rifapentine
• Riluzole
• Ritonavir
• Rituximab; Hyaluronidase
• Rivaroxaban
• Roflumilast
• Romidepsin
• Ropinirole
• Rosuvastatin
• Rufinamide
• Ruxolitinib
• Sapropterin
• Saquinavir
• Sarilumab
• Saxagliptin
• Secobarbital
• Selegiline
• Semaglutide
• SGLT2 Inhibitors
• Siltuximab
• Simvastatin; Sitagliptin
• Sincalide
• Sitagliptin
• Sofosbuvir; Velpatasvir
• Sofosbuvir; Velpatasvir; Voxilaprevir
• Somatropin, rh-GH
• St. John’s Wort, Hypericum perforatum
• Streptogramins
• Streptomycin
• Succinylcholine
• Sugammadex
• Sulfadiazine
• Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
• Sulfasalazine
• Sulfisoxazole
• Sulfonamides
• Sulfonylureas
• Tacrine
• Tacrolimus
• Tamsulosin
• Tazemetostat
• Tedizolid
• Telaprevir
• Telavancin
• Telithromycin
• Telotristat Ethyl
• Temazepam
• Temsirolimus
• Terazosin
• Terbinafine
• Teriflunomide
• Testolactone
• Tetracycline
• Thalidomide
• Theophylline, Aminophylline
• Thiazolidinediones
• Thiopental
• Thyroid hormones
• Ticarcillin
• Ticarcillin; Clavulanic Acid
• Tigecycline
• Tinidazole
• Tipranavir
• Tizanidine
• tobacco
• Tobramycin
• Tocilizumab
• Tolazamide
• Tolbutamide
• Tolvaptan
• Topiramate
• Toremifene
• Trandolapril; Verapamil
• Tranexamic Acid
• Trastuzumab; Hyaluronidase
• Triamcinolone
• Triazolam
• Tricyclic antidepressants
• Trimethoprim
• Tucatinib
• Ulipristal
• Ursodeoxycholic Acid, Ursodiol
• Valdecoxib
• Valproic Acid, Divalproex Sodium
• Vancomycin
• Verapamil
• Vinblastine
• Vincristine
• Vincristine Liposomal
• Vorapaxar
• Voriconazole
• Warfarin
• Zolmitriptan
• Zonisamide