POM-P Switches - Desogestrel Flashcards
What is the indication of Desogestrel? (1)
Contraception in women of childbearing age.
What is the licensed age of using Desogestrel? (2)
> 18 yrs
Safety + efficacy < 18 yrs not established. Lovima: benefits/risks of supply to adolescents < 16 yrs carefully considered.
What is the dose of Desogestrel? (1)
OD
Which other patient can use Desogestrel? (1)
Breastfeeding
What are the common s/e of Desogestrel? (8)
Irregular bleeding patterns.
Altered mood
Headaches
Nausea
Acne
Breast pain/tenderness
Amenorrhoea
Weight changes
What are the alarm symptoms of using Desogestrel? (4)
Severe abdominal/ chest pain
DVT
Headaches
Explain the process a starting desogestrel (New). (2)
Day 1 of period.
If days 2-5 but will need to use an additional barrier method for first 7 days .
Explain the process a starting desogestrel (After COC tablet/Patch). (2)
No break: Start next day.
After pill free period: 7 days barrier required.
Explain the process a starting desogestrel (After POP). (1)
No break: start next day.
Explain the process a starting desogestrel (Following miscarriage or abortion). (1)
ASAP or within 5 days.
After - barrier required.
Explain the process a starting desogestrel (Following childbirth). (1)
Up to 21 days after birth , >= barrier required.
Explain the process a starting desogestrel (After EHC). (2)
Levonorgestrel: Start straightaway and use an additional barrier method (e.g. condom) for 7 days.
Ulipristal: Wait 5 days after taking Ulipristal and use an additional barrier method (e.g. condom) then start desogestrel and continue using an additional barrier method for further 7 days (12 days additional barrier method use in total.)
What are the missed pill rules for < 12 hrs late? (1)
Take missed tablet ASAP and take next tablet at usual time, even if taking 2 tablets in one day.
What are the missed pill rules for > 12 hrs late? (2)
Take forgotten tablet and take the next tablet at the usual time, even if it leads to taking 2 tablets in one day.
If > 1 tablet is messed, only one of the missed tablets should be taken stat. An additional barrier method of contraception for the next 7 days.
What are the missed pill rules if vomiting occurs? (1)
If vomiting occurs within 3-4 hrs of tablet-taking then the pill should be considered as missed.
What are the c/i for taking Desogestrel? (5)
Known or suspected sex-steroid sensitive malignancies (breast, uterine and ovarian)
Active VTE
Presence or hx of severe hepatic disease as long as LFT values are not normal.
Irregular vaginal bleeding.
Hypersensitivity to active substances/excipients.
What are the GP referral symptoms for taking Desogestrel? (5)
Significant interaction (anticonvulsants, St. John’s Wort)
Hx of thrombosis/breast cancer
If person has diabetes or uncontrolled hypertension.
If person experiences serious s/e or s/s of ADR e.g. depression, thrombosis, allergy, liver disease, breast cancer or ectopic pregnancy.
If person is due to have surgery or immobile.
