Combined oral contraceptive (3rd-generation progestogen)

Ethinylestradiol with desogestrel

Brand names: Marvelon, Mercilon, Gedarel

Adult dose

Dose: 1 tablet OD for 21 days then 7 days hormone-free (or tailored regimen per FSRH)

Route: Oral

Frequency: OD

Clinical pearls

MHRA Drug Safety Update: 3rd-generation progestogens (desogestrel, gestodene) carry ~2× VTE risk vs levonorgestrel — discuss with patient and document choice
FSRH supports tailored regimens (extended/continuous) to reduce hormone-free interval bleeding

Contraindications

Standard CHC contraindications
Higher VTE risk than levonorgestrel-containing COC

Side effects

Breakthrough bleeding
VTE (higher than 2nd-gen COC)
Headache
Mood change
Breast tenderness

Interactions

Enzyme inducers
Lamotrigine

Monitoring

BP
Migraine status
BMI
VTE risk factors annually

Reference: BNF; FSRH CHC guideline; UKMEC; MHRA Drug Safety Update; https://bnf.nice.org.uk/drugs/ethinylestradiol-with-desogestrel/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Ethinylestradiol with gestodene · Combined oral contraceptive (3rd-generation progestogen)

Pathways