• Desogest is used to prevent pregnancy.
• There are 2 main kinds of hormone contraceptive.
− The combined pill, "The Pill", which contains 2 types of female sex hormone an oestrogen and a progestogen
− The progestogen-only pill, POP, which doesn't contain an oestrogen.
• Desogest is a progestogen-only-pill (POP).
• Desogest contains a small amount of one type of female sex hormone, the progestogen desogestrel.
• Most POPs or mini-pills work primarily by preventing the sperm cells from entering the womb but they do not always prevent the egg cell from ripening,
which is the main way that combined pills work.
• Desogest is different from other mini-pills in having a dose that in most cases prevents the egg cell from ripening. As a result, Desogest is a highly effective contraceptive.
• In contrast to the combined pill, Desogest can be used by women who do not tolerate oestrogens and by women who are breast feeding.
• A disadvantage is that vaginal bleeding may occur at irregular intervals during the use of Desogest. On the other hand you may not have any
bleeding at all.

Desogest, like other hormonal contraceptives, does not protect against HIV infection (AIDS) or any other sexually transmitted disease.
2.1 Do not take Desogest
• if you are allergic to any of the ingredients of Desogest, any of the other ingredients of Desogest (listed in section 6).
• if you have a thrombosis. Thrombosis is the formation of a blood clot in a blood vessel (e.g. of the legs (deep venous thrombosis) or the lungs (pulmonary embolism).
• if you have or have had jaundice (yellowing of the skin) or severe liver disease and your liver is still not working normally.
• if you have or if you are suspected of having a cancer that grows under the influence of sex-steroids, such as certain types of breast cancer.
• if you have any unexplained vaginal bleeding.
If any of these conditions apply to you, tell your doctor before you start to use Desogest. Your doctor may advise you to use a non-hormonal method of birth control.
If any of these conditions appear for the first time while using Desogest, consult your doctor immediately.
2.2 warning and precautions
Before you start Desogest tell your doctor or Family Planning Nurse, if
• You have ever had breast cancer.
• You have liver cancer, since a possible effect of Desogest cannot be excluded.
• You have ever had a thrombosis.
• You have diabetes.
• You suffer from epilepsy (see section ‘Taking other medicines’).
• You have tuberculosis (see section ‘Taking other medicines’).
• You have high blood pressure.
• You have or have had chloasma (yellowish-brown pigmentation patches on the skin, particularly of the face); if so, avoid too much exposure to the sun or ultraviolet radiation.
When Desogest is used in the presence of any of these conditions, you may need to be kept under close observation. Your doctor can explain what to do.
2.2.1 Breast cancer
• It is important to regularly check your breasts and you should contact your doctor as soon as possible if you feel any lump in your breasts.
• Breast cancer has been found slightly more often in women who take the Pill than in women of the same age who do not take the Pill. If women stop taking the Pill, this reduces the risk, so that 10 years after stopping the Pill, the risk is the same as for women who have never taken the Pill.
Breast cancer is rare under 40 years of age but the risk increases as the woman gets older. Therefore, the extra number of breast cancers diagnosed is higher if a woman continues to take the Pill when she is older. How long she takes the Pill is less important.
• In every 10 000 women who take the Pill for up to 5 years but stop taking it by the age of 20, there would be less than 1 extra case of breast cancer
found up to 10 years after stopping, in addition to the 4 cases normally diagnosed in this age group.
• In 10 000 women who take the Pill for up to 5 years but stop taking it by the age of 30, there would be 5 extra cases in addition to the 44 cases
normally diagnosed.
• In 10 000 women who take the Pill for up to 5 years but stop taking it by the age of 40, there would be 20 extra cases in addition to the 160 cases
normally diagnosed.
The risk of breast cancer in users of progestogen-only pills like Desogest is believed to be similar to that in women who use the Pill, but the evidence is less conclusive.
Breast cancers found in women who take the Pill, seem less likely to have spread than breast cancers found in women who do not take the Pill.
It is not certain whether the Pill causes the increased risk of breast cancer. It may be that the women were examined more often, so that the breast cancer is noticed earlier.
2.2.2 Thrombosis
See your doctor immediately if you notice possible signs of a thrombosis (see also ‘Regular check-ups’).
Thrombosis is the formation of a blood clot, which may block a blood vessel.
A thrombosis sometimes occurs in the deep veins of the legs (deep venous thrombosis). If this clot breaks away from the veins where it is formed, it may reach and block the arteries of the lungs, causing a so-called “pulmonary embolism”. A pulmonary embolism can cause chest pain, breathlessness, collapse or even death.
• Deep venous thrombosis is a rare occurrence. It can develop whether or not you are taking the Pill. It can also happen if you become pregnant.
The risk is higher in Pill-users than in non-users. The risk with progestogenonly pills like Desogest is believed to be lower than in users of Pills that also contain oestrogens (combined Pills).
2.2.3 Psychiatric disorders
some women using hormonal contraceptives including desogest tablets have reported depression or depressed mood. Depression can be serious and may sometimes lead to suicidal thoughts. If you experience mood changes and depressive symptoms contact your doctor for further medical
advice as soon as possible.
2.3 Children and adolescents: No clinical data on efficacy and safety are available in adolescents below 18 years
2.4 Taking other medicines
Please tell your doctor, pharmacist, or Family Planning Nurse if you are taking or have recently taken any other medicines or herbal products, including medicines obtained without a prescription.
They can tell you if you need to take additional contraceptive precautions (for example condoms) and if so, for how long or whether the use of another medicine you need must be changed.
Some medicines:
- can have an influence on the blood levels of Desogest
- can make it less effective in preventing pregnancy.
- can cause unexpected bleeding
These include medicines used for the treatment of
• epilepsy (e.g. primidone, phenytoin, carbamazepine, oxcarbazepine, felbamate, topiramate and phenobarbital)
• tuberculosis (e.g. rifampicin, rifabutin)
• HIV infections (e.g. ritonavir, nelfinavir, nevirapine, efivirenz), or other infectious diseases (e.g. griseofulvin)
• Hepatitis C virus infection (e.g. boceprevir, telaprevir);
• high blood pressure in the blood vessels of the lungs (bosentan);
• Depressive moods (the herbal remedy St. John’s Wort).
• Certain bacterial infections (e.g. clarithromycin, erythromycin).
• Fungal infections (e.g. ketoconazole, itraconazole, fluconazole).
• High blood pressure (hypertension), angina or certain heart rhythm disorders (e.g.diltiazem).
If you are taking medicines or herbal products that might make desogest less effective, a barrier contraceptive method should also be used. Since the effect of another medicine on desogest may last up to 28 days after stopping the medicine, it is necessary to use the additional barrier
contraceptive method for that long Your doctor can tell you if you need to take additional contraceptive precautions and if so, for how long.
Desogest may also interfere with how certain medicines work, causing either an increase in effect (e.g. medicines containing cyclosporine) or a decrease in effect. (e.g. lamotrigine).
Ask your doctor or pharmacist for advice before taking any medicine
2.5 Pregnancy and breast-feeding
Pregnancy
Do not use Desogest if you are pregnant, or think you may be pregnant.
Breast-feeding
Based on clinical study data, Desogest does not influence the production or the quality (protein, lactose, or fat concentrations) of breast milk. However, there have been infrequent posts marketing reports of a decrease in breast milk production while using Desogest.Small amount of etonogestrel are excreted in the breast milk.
Like other progestogen-only pills, Desogest can be used during breast feeding. The health of children who were breast-fed for 7 months while their mothers were using Desogest has been studied up until they were 2½ years of age. No effects on the growth and development of the children were observed. If you are breast feeding and want to use Desogest, please contact your doctor.
2.6 Driving and using machines
Desogest has no known effect on the ability to drive or use machines
2.7 Important information about some of the ingredients of Desogest
Desogest contains lactose (milk sugar). Please contact your doctor before taking Desogest if you have been told by your doctor that you are intolerant to some sugars.
2.8 Regular check-ups
When you are using Desogest, your doctor will tell you to return for regular check-ups. In general, the frequency and nature of these check-ups will depend on your personal situation.
Contact your doctor as soon as possible if:
• you notice possible signs of a blood clot e.g. severe pain or swelling in either of your legs; unexplained pains in the chest, breathlessness, an
unusual cough, especially when you cough up blood; (possibly a sign of a thrombosis);
• you have a sudden, severe stomach ache or jaundice (you may notice yellowing of the skin, the whites of the eyes, or dark urine, possibly a sign of
liver problems);
• you feel a lump in your breast; (possibly a sign of breast cancer);
• you have a sudden or severe pain in the lower abdomen or stomach area (possibly a sign of an ectopic pregnancy - a pregnancy outside the womb);
• you are to be immobilised or are to have surgery (consult your doctor at least four weeks in advance);
• you have unusual, heavy vaginal bleeding;
• you suspect that you are pregnant

3.1 When and how to take the tablets?
Each strip of Desogest contains 28 tablets – 4 weeks supply.
• Take your tablet each day at about the same time. Swallow the tablet whole, with water.
• Arrows are printed on the front of the strip, between the tablets. The days of the week are printed on the back of the strip. Each day corresponds with one tablet.
• Every time you start a new strip of Desogest, take a tablet from the top row. Don’t start with just any tablet. For example if you start on a Wednesday, you must take the tablet from the top row marked (on the back) with WED.
• Continue to take one tablet every day until the pack is empty, always following the direction indicated by the arrows. By looking at the back of your pack you can easily check if you have already taken your tablet on a particular day.
• You may have some vaginal bleeding during the use of Desogest, (See Section 4 Side Effects) but you must continue to take your tablets as normal.
• When a strip is empty, you must start with a new strip of Desogest on the next day - without interruption and without waiting for a bleed.
3.2 Starting your first pack of Desogest
• If you are not using hormonal contraception at present (or in the past month)
Wait for your period to begin. On the first day of your period take the first Desogest tablet. Additional contraceptive precautions are not necessary. If you take your first tablet on days 2-5 of your period use an additional barrier method of contraception for the first 7 days of tablet-taking.
• When you change from a combined pill (COC), vaginal ring, or transdermal patch
If you have a tablet-, ring- or patch-free break
− You can also start at the latest the day following the tablet-, ring- or patch-free break, or placebo tablet interval, of your present contraceptive.
− If you follow these instructions, make sure you use an additional barrier method of contraception for the first 7 days of tablet-taking.
If you don’t have a tablet-, ring- or patch-free break
− Start taking Desogest on the day after you take the last tablet from the present Pill pack, or on the day of removal of your vaginal ring or patch (this means no tablet-, ring- or patch-free break).
− If your present Pill pack also contains inactive tablets you can start Desogest on the day after taking the last active tablet (if you are not sure
which this is, ask your doctor or pharmacist).
− If you follow these instructions, additional contraceptive precautions are not necessary.
• When changing from another progestogen-only pill.
Switch on any day from another mini-pill. Additional contraceptive precautions are not necessary.
• When changing from an injection or implant or a hormonal IUS
Start using Desogest when your next injection is due or on the day that your implant or your IUS is removed. Additional contraceptive precautions are not necessary.
• After you have a baby
You can start Desogest between 21 to 28 days after the birth of your baby.
If you start later, make sure that during the first cycle you use an additional barrier method of contraception for the first 7 days of tablet-taking. However, if you have already had sex, check that you are not pregnant before starting Desogest. Information for breast-feeding women can be found in section 2 'Before you take Desogest' in the paragraph 'Pregnancy and breast-feeding'.
Your doctor can also advise you.
• After a miscarriage or an abortion
Your doctor will advise you.
3.3 If you forget to take Desogest
• If you are less than 12 hours late:
− Take the missed tablet as soon as you remember and take the next one at
the usual time. Desogest will still protect you from pregnancy.
• If you are more than 12 hours late:
− If you are more than 12 hours late in taking any tablet, you may not be completely protected against pregnancy. The more consecutive tablets
you have missed, the higher the risk that you might fall pregnant.
− Take a tablet as soon as you remember and take the next one at the usual time. This may mean taking two in one day. This is not harmful. (If you have forgotten more than one tablet you don’t need to take the earlier missed ones). Continue to take your tablets as usual but you must also use an extra method, such as a condom, for the next 7 days.
− If you are more than 12 hours late taking your tablet and have had sex it is safe to use emergency contraception; please consult your pharmacist or doctor.
− If you missed one or more tablets in the very first week of tablet-intake and had intercourse in the week before missing the tablets, you may fall
pregnant. Ask your doctor for advice.
3.4 If you vomit or use medical charcoal
If you vomit, or use medical charcoal within 3 - 4 hours after taking your Desogest tablet or have severe diarrhoea, the active ingredient may not have been completely absorbed. Follow the advice for forgotten tablets in the section above.
3.5 If too many Desogest tablets are taken (overdose)
There have been no reports of serious harmful effects from taking too many Desogest tablets at one time. Symptoms that may occur are nausea, vomiting and in young girls, slight vaginal bleeding. For more information ask your doctor for advice.
3.6 If you stop taking Desogest
You can stop taking Desogest whenever you want. From the day you stop you are no longer protected against pregnancy.
If you have any further questions on the use of this product, ask your doctor or pharmacist.

Like all medicines, Desogest can cause side effects, although not everybody gets them.
Tell your doctor if you notice any unwanted effect, especially if severe or persistent.
Serious side effects associated with the use of Desogest are described in section 2 'Before you take Desogest'. Please read this section for additional information on ‘Breast cancer’ and ‘Thrombosis’ and consult your doctor at once where appropriate.
Vaginal bleeding may occur at irregular intervals while using Desogest. This may be just slight staining which may not even require a pad, or heavier bleeding, which looks rather like a scanty period. You may need to use tampons or sanitary towels. You may also not have any bleeding at all. Irregular bleeding is not a sign that Desogest is not working. In general, you need not take any action; just continue to take Desogest. If bleeding is heavy or prolonged you should consult your doctor.
How often are other possible side effects seen?
Common (affecting less than 1 in 10 women): mood changes, depressed mood, decreased sexual drive (libido), headache, nausea, acne, breast pain, irregular or no periods, weight increase.
Uncommon (affecting less than 1 in 100 women) infection of the vagina, difficulties in wearing contact lenses, vomiting, hair loss, painful periods,
ovarian cysts, tiredness.
Rare (affecting less than 1 in 1000 women) skin conditions such as: rash, hives, painful blue-red skin lumps (erythema nodosum) Apart from these side effects, breast secretion or leakage may occur.
You should see your doctor immediately if you experience symptoms of angioedema, such as (i) swollen face, tongue or pharynx; (ii) difficulty to
swallow; or (iii) hives and difficulties to breathe.

To report side effects:
Saudi Arabia:
• The National Pharmacovigilance Centre (NPC):
- Fax: +966-11-205-7662
- Call NPC at +966-11-2038222, Ext 2317-2356-2340
- SFDA Call Center: 19999
- E-mail: npc.drug@sfda.gov.sa
- Website: https://ade.sfda.gov.sa/

Other GCC states:
Ministry of Health, Oman:
Department of Pharmacovigilance & Drug Information
Directorate General of Pharmaceutical Affairs & Drug Control, Ministry of
Health
P.O.BOX: 393, Muscat, PC: 100, Sultanate of Oman
Phone: 22357688/ 22357687/ 22357686 Fax: 22358489;
Email: pharma-vigil@moh.gov.om

Ministry of Health, UAE
Pharmacovigilance & Medical Device section
P.O.Box: 1853
Tel: 80011111
Email: pv@mohap.gov.ae
Drug Department Ministry of Health & Prevention
Dubai, UAE

Ministry of Health Kuwait, Drug and Food Control:
(www.moh.gov.kw/kdfc)
Supreme council of health, pharmacy & drug control

Ministry of Public Health, State of Qatar
Pharmacy & Drug Control Department
Web:https://www.moph.gov.qa/health-services/Pages/pharmacy-ndrug-
control.aspx

Jordan Food and Drug Administration (JFDA):
P.O.Box7704, Amman 11118, Jordan
(www.jfda.jo) or E-mail: jpc@jfda.jo

MAH & Manufacturer:
Oman Pharmaceutical products Co. LLC.
reg@omanpharma.com and pv@omanpharma.com

Store below 30°C.
Protect from light and moisture
− Keep out of the reach and sight of children.
− Desogest does not require any special storage conditions.
− Do not use after the expiry date which is stated on the package. The expiry date is the last day of the month stated.
− Medicines should not be disposed of via wastewater or household waste.
Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.