Dienogest
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [1] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
| |
| Dienogest
| |
| Systematic (IUPAC) name | |
| 17a-cyanomethyl-17b-hydroxy-estra-4,9-di-ene-3-one[1] | |
| Identifiers | |
| CAS number | |
| ATC code | G03 |
| PubChem | |
| Chemical data | |
| Formula | C20H25NO2 |
| Mol. mass | 311.42 g/mol[2] |
| Physical data | |
| Density | 1.2 g/cm³ |
| Boiling point | 549 °C (1020 °F) |
| Pharmacokinetic data | |
| Bioavailability | 90%[2] |
| Protein binding | 90%[3] |
| Metabolism | Hepatic[4] |
| Half life | 6-12 hours[5] |
| Excretion | Renal |
| Therapeutic considerations | |
| Pregnancy cat. |
? |
| Legal status | |
| Routes | Oral |
Dienogest is an orally active synthetic progesterone (or progestin).[1] It is available for use as an oral contraceptive in combination with ethinylestradiol. It has antiandrogenic activity and as a result can improve androgenic symptoms.[2] It is a non-ethinylated progestin which is structurally related to testosterone.[4]
History
Dienogest was discovered in 1979 in Jena, Germany and first named STS 557. It was found that its potency was 10 times that of levonorgestrel.[6]The first product on the market to contain dienogest as a contraceptive pill Valette in 1995 made by Jenapharm. It has been little used outside of Germany. [7]
Indications
Contraception
Dienogest is used primarily as a contraceptive in combination with ethinylestradiol. It is given as a tablet containing 2mg of dienogest and 30μg of ethinylestradiol.[8]
Pharmacodynamics
Progestational Activity
Dienogest has moderate affinity for the progesterone receptor in human uterus tissue, in vitro, about 10% that of progesterone.[9]
Inhibition of Ovulation
The minimum effective dose of oral dienogest required to inhibit ovulation is 1 mg/day. [10] The inhibition of ovulation by dienogest occurs mainly via peripheral action as opposed to central action on gonadotrophin secretion.[2] Oral treatment of dienogest 2mg/day in cyclical women reduced serum progesterone levels to anovulatory levels, however serum levels of lutenising hormone and follicle-stimulating hormone are not significantly altered.[10]
Adverse effects
Adverse effects associated with dienogest are the same as those expected of a progestogen.[2] These include weight gain, increased blood pressure, breast tenderness and nausea.[11] It produces no androgenic side effects and has little effect on metabolic and lipid haemostatic parameters.
References
- ↑ 1.0 1.1 Nakamura M, Katsuki Y, Shibutani Y, Oikawa T (1999). "Dienogest, a synthetic steroid, suppresses both embryonic and tumor-cell-induced angiogenesis". European Journal of Pharmacology 386 (1): 33-40. doi:10.1016/S0014-2999(99)00765-7. PMID 10611461.
- ↑ 2.0 2.1 2.2 2.3 2.4 Foster RH, Wilde MI (1998). "Dienogest". Drugs 56 (5): 825-833. PMID 9829156.
- ↑ de Lignieres B, Dennerstein L, Backstrom T (1995). "Influence of route of administration on progesterone metabolism". Maturitas 21 (3): 251-257. doi:10.1016/0378-5122(94)00882-8. PMID 7616875.
- ↑ 4.0 4.1 Nakamura M, Katsuki Y, Shibutani Y, Oikawa T (2003). "All progestins are not created equal". Steroids 68 (10-13): 879-890. doi:10.1016/j.steroids.2003.08.003. PMID 14667980.
- ↑ Sitruk-Ware R (2004). "Pharmacological profile of progestins". Maturitas 47 (4): 277-283. doi:10.1016/j.maturitas.2004.01.001. PMID 15063480.
- ↑ Oettel M, Kurischko A (1980). "STS 557, a new orally active progestin with antiprogestational and contragestational properties in rabbits". Contraception 21 (1): 61-75. doi:10.1016/0010-7824(80)90140-7. PMID 7357870.
- ↑ Kuhl H (1998). "Dienogest. A Viewpoint by Herbert Kuhl". Drugs 56 (5): 834.
- ↑ Wiegratz I, Mittmann K, Dietrichb H, Zimmermann T, Kuhl H (2006). "Fertility after discontinuation of treatment with an oral contraceptive containing 30 μg of ethinyl estradiol and 2 mg of dienogest". Fertility and Sterility 85 (6): 1812-1819. doi:10.1016/j.fertnstert.2005.11.052. PMID 16759929.
- ↑ Oettel M, Bervoas-Martin S, Elger W, Golbs S, Hobe G, Kaufmann G, Mathieu M, Moore C, Schneider B, Puri C, Ritter P, Reddersen G, Schon R, Strauch G, Zimmermann H (1995). "A 19-norprogestin without 17α-ethinyl group II: Dienogest from a pharmacokinetic point of view". Drugs of Today 31 (7): 499-516.
- ↑ 10.0 10.1 Oettel M, Carol W, Elger W, Kaufmann G, Moore C, Romer W, Klinger G, Schneider B, Schroder J, Sobek L, Walter F, Zimmermann H (1995). "A 19-norprogestin without 17α-ethinyl group II: Dienogest from a pharmacodynamic point of view". Drugs of Today 31 (7): 517-536.
- ↑ Galbraith, Alan; Shane Bullock, Elizabeth Manias, Barry Hunt, Ann Richards (2007). Fundamentals of Pharmacology: An Applied Approach for Nursing and Health. United Kingdom: Pearson Education LTD, 632. ISBN 978-0131869011.
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
