Dienogest

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Dienogest
Dienogest.png
Clinical data
Routes of
administration
Oral
ATC code
Pharmacokinetic data
Bioavailability90%[2]
Protein binding90%[3]
MetabolismHepatic[1]
Elimination half-life6-12 hours[4]
ExcretionRenal
Identifiers
CAS Number
PubChem CID
E number{{#property:P628}}
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Chemical and physical data
FormulaC20H25NO2
Molar mass311.42 g/mol[2]
Density1.2 g/cm3
Boiling point549 °C (1,020.2 °F)

Dienogest is an orally active synthetic progesterone (or progestin).[5] 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.[1]

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. 1.0 1.1 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.
  2. 2.0 2.1 2.2 2.3 2.4 Foster RH, Wilde MI (1998). "Dienogest". Drugs. 56 (5): 825–833. PMID 9829156.
  3. 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. Sitruk-Ware R (2004). "Pharmacological profile of progestins". Maturitas. 47 (4): 277–283. doi:10.1016/j.maturitas.2004.01.001. PMID 15063480.
  5. 5.0 5.1 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. line feed character in |title= at position 62 (help)
  6. 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.
  7. Kuhl H (1998). "Dienogest. A Viewpoint by Herbert Kuhl". Drugs. 56 (5): 834.
  8. 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.
  9. 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. 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.
  11. Galbraith, Alan (2007). Fundamentals of Pharmacology: An Applied Approach for Nursing and Health. United Kingdom: Pearson Education LTD. p. 632. ISBN 978-0131869011. Unknown parameter |coauthors= ignored (help)

de: dienogest



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