Cerazette

Cerazette is an estrogen-free birth control pill that contains only the progestin desogestrel. It belongs to the so-called mini-pills, but differs from older mini-pills in its ability to reliably suppress ovulation.

Unlike combination pills, Cerazette contains no estrogen. This makes it suitable for women who cannot tolerate estrogen or in whom estrogen is contraindicated – for example, breastfeeding mothers, smokers over 35, or women with migraine with aura.

With a Pearl Index of about 0.4, its contraceptive reliability is comparable to that of combination pills.

Cerazette works through several mechanisms:

Prevention of ovulation: Unlike older mini-pills, desogestrel at this dose reliably inhibits ovulation. In studies, no ovulation was detected in over 97% of cycles. This is the most important contraceptive mechanism.

Thickening of cervical mucus: The progestin makes the mucus in the cervix thicker and less penetrable to sperm. This effect sets in quickly and is measurable just a few hours after intake.

Changes to the endometrium: Under the influence of the progestin, the lining of the uterus builds up less.

Advantages over combination pills: Since it contains no estrogen, Cerazette can be used by women who do not want to or must not take estrogens.

Cerazette is particularly suitable for:

• Breastfeeding mothers – desogestrel passes into breast milk only in minimal amounts
• Women with estrogen intolerance
• Smokers over 35 years of age
• Women with migraine with aura
• Women with estrogen-dependent complaints

Well suited in cases of:

• Breastfeeding (start between day 21 and day 28 after delivery)
• Estrogen-related side effects while taking a combination pill
• High blood pressure
• Overweight
• Certain cardiovascular risks

Please note before use: Cerazette is not suitable for everyone. It should not be used in cases of certain liver diseases, hormone-dependent tumors, or unexplained bleeding.

Active ingredient content:

• Desogestrel: 0.075mg (75 micrograms) per tablet

Pack sizes:

• 1 x 28 tablets (1 month)
• 3 x 28 tablets (3 months)
• 6 x 28 tablets (6 months)

Special feature: Unlike combination pills, Cerazette is taken continuously – without a break. All 28 tablets in a pack contain the active ingredient (no placebos).

Taking without a break: Cerazette is taken every day, without a 7-day break. After the last tablet of a pack, the new pack is started the next day.

Time of intake:

• Take at about the same time every day
• The intake window is 12 hours (more generous than with older mini-pills)
• Swallow with a little water

Starting intake:

• Without previous hormonal contraception: On the first day of your period, immediate protection
• After a combination pill: On the day after the last tablet or after the break
• After childbirth: Starting 21-28 days after delivery, use additional contraception during the first 7 days

Missed tablet:

• Up to 12 hours late: Take it immediately, protection is maintained
• More than 12 hours: Take it and use a condom as additional contraception for 7 days

In case of gastrointestinal problems: If vomiting or diarrhea occurs within 3-4 hours after intake, take a replacement tablet.

Cerazette must not be used in cases of:

• Active venous thromboembolism (contrary to common belief, this also applies to progestin-only preparations)
• Severe liver disease (current, or until liver values have returned to normal)
• Liver tumors
• Known or suspected breast cancer or other hormone-dependent tumors
• Unexplained vaginal bleeding
• Pregnancy
• Hypersensitivity to desogestrel or other ingredients

Caution in cases of:

• A history of venous thromboembolism (it can occur again)
• Diabetes mellitus with vascular damage
• Severe depression (including a history of depression)
• Chloasma (pigment spots) – avoid sun exposure
• Functional ovarian cysts

Advantage: For many contraindications to estrogen (smoking over 35, migraine with aura, certain cardiovascular diseases), Cerazette can be an option.

Very common (more than 10%):

• Irregular bleeding or spotting (especially in the first months)
• Absence of bleeding (amenorrhea)

Common (1-10%):

• Headache
• Mood swings, depressed mood
• Nausea
• Acne
• Breast pain
• Weight gain
• Decreased libido

Uncommon (0.1-1%):

• Ovarian cysts (usually harmless and resolve on their own)
• Fatigue
• Hair loss

Rare:

• Skin rash

Frequency not known:

• Hypersensitivity reactions including angioedema and anaphylaxis

Note on bleeding irregularities: Irregular bleeding is the most common reason for stopping Cerazette. It usually improves after 3-6 months. About 20% of women no longer have any bleeding at all – this is medically harmless.

Reduced effectiveness due to:

• Antiepileptic drugs (phenytoin, carbamazepine, phenobarbital, primidone, oxcarbazepine, topiramate)
• Rifampicin, rifabutin (tuberculosis medications)
• HIV medications (ritonavir, nelfinavir)
• St. John's wort (Hypericum)
• Griseofulvin

Recommendation in case of interactions: Use condoms as additional contraception while taking the interacting medication and for up to 28 days after stopping it.

Cerazette may affect:

• Ciclosporin (levels may rise)

No relevant interaction with:

• Most antibiotics (amoxicillin, azithromycin, etc.)
• Paracetamol
• Ibuprofen

Activated charcoal: When activated charcoal is taken (e.g., in cases of poisoning), absorption of the active ingredient may be reduced.