Mircette

Mircette is a combination oral contraceptive pill prescribed for the prevention of pregnancy. It utilizes a sophisticated phased ethinyl estradiol and desogestrel formulation designed to offer high efficacy with a lower hormonal load. This product is also FDA-approved for the treatment of moderate acne vulgaris in females at least 15 years of age who have achieved menarche, desire contraception, have no known contraindications to oral contraceptive therapy, and are unresponsive to topical anti-acne medications. Its unique estrogen dosing schedule aims to provide cycle control and minimize hormonal fluctuations.

Features

• Active ingredients: Desogestrel (a progestin) and Ethinyl Estradiol (an estrogen)
• Dosage form: Oral tablet
• Pack configuration: 28-day blister pack (21 active hormone tablets, 7 inert tablets)
• Hormonal profile: Low-dose combination monophasic contraceptive
• Unique estrogen dosing: Contains 2 days of 10 mcg ethinyl estradiol during the hormone-free interval to enhance follicular suppression

Benefits

• Provides highly effective pregnancy prevention when taken correctly.
• Offers a lower dose of estrogen compared to many standard combination pills, which may be associated with a reduced risk of certain estrogen-related side effects.
• The unique estrogen dosing during the placebo week can lead to improved suppression of the hypothalamic-pituitary-ovarian axis, potentially resulting in more stable hormone levels and reduced breakthrough bleeding.
• Can lead to lighter, less painful, and more regular menstrual periods.
• Is approved for the treatment of moderate acne, offering a non-antibiotic treatment option for appropriate candidates.
• May offer non-contraceptive benefits such as a reduced risk of ovarian cysts, ectopic pregnancy, and iron deficiency anemia.

Common use

Mircette is primarily and most commonly used for the prevention of pregnancy. Its secondary, FDA-approved use is for the treatment of moderate acne vulgaris in females who are at least 15 years of age, have started having menstrual periods, desire oral contraception for at least 6 months, and have not responded adequately to topical acne medications. It is not indicated for the treatment of premenstrual syndrome (PMS).

Dosage and direction

Take one tablet by mouth at the same time every day, for 28 consecutive days. The dosage follows a specific schedule:

1. Days 1 to 21: Take one white active tablet (containing 0.15 mg desogestrel and 0.02 mg ethinyl estradiol).
2. Days 22 to 23: Take one green tablet (containing 0.01 mg ethinyl estradiol only).
3. Days 24 to 28: Take one yellow inert tablet (containing no active hormones). After finishing the last yellow tablet, begin a new pack the next day, regardless of whether menstrual bleeding has started or stopped. A patient can start Mircette on the first day of her menstrual period (Day 1 Start) or on the first Sunday after her period begins (Sunday Start). Follow the specific instructions provided by the prescribing healthcare professional.

Precautions

• Oral contraceptives do not protect against HIV infection (AIDS) or other sexually transmitted diseases.
• Cigarette smoking increases the risk of serious cardiovascular side effects. This risk increases with age and heavy smoking (15 or more cigarettes per day) and is quite significant in women over 35 years of age. Women who use Mircette are strongly advised not to smoke.
• The use of combination oral contraceptives is associated with increased risks of several serious conditions, including vascular events (thrombosis, stroke, myocardial infarction) and malignancies (e.g., cervical cancer). The risk is higher in women with other risk factors such as hypertension, hyperlipidemias, obesity, and diabetes.
• Women with a history of depression should be carefully monitored. Discontinuation may be necessary if depression recurs to a serious degree.
• Carefully monitor patients with conditions that might be influenced by fluid retention (e.g., epilepsy, migraine, asthma, cardiac or renal dysfunction).
• Use with caution in patients with a history of cholestasis, cholelithiasis, or porphyria.

Contraindications

Mircette is contraindicated in women with any of the following conditions:

• Thrombophlebitis or thromboembolic disorders
• A past history of deep vein thrombosis or pulmonary embolism
• Cerebrovascular or coronary artery disease
• Known or suspected carcinoma of the breast or estrogen-dependent neoplasia
• Carcinoma of the endometrium or other known or suspected genital malignancy
• Undiagnosed abnormal genital bleeding
• Cholestatic jaundice of pregnancy or jaundice with prior pill use
• Hepatic adenomas or carcinomas, or active liver disease
• Known or suspected pregnancy
• A history of migraine with aura
• Major surgery with prolonged immobilization
• Diabetes with vascular involvement
• Uncontrolled hypertension
• Hypersensitivity to any component of Mircette
• Heavy smoking (≥15 cigarettes/day) and over age 35

Possible side effects

Serious adverse reactions include vascular events (arterial and venous thrombosis), hepatic lesions (adenomas, carcinomas), hypertension, and gallbladder disease. Common, less serious side effects that may subside after the first few cycles include:

• Nausea and vomiting
• Breakthrough bleeding and spotting
• Breast tenderness and enlargement
• Headache (including migraines)
• Change in weight (increase or decrease)
• Change in libido
• Mood changes, including depression
• Bloating or fluid retention
• Chloasma or melasma (skin darkening)
• Intolerance to contact lenses

Drug interaction

The effectiveness of Mircette can be reduced by drugs that induce hepatic microsomal enzymes, leading to increased clearance of sex hormones. This can result in breakthrough bleeding and/or contraceptive failure. Women on these medications should use a non-hormonal backup method of contraception.

• Enzyme-inducing drugs: Barbiturates, bosentan, carbamazepine, felbamate, griseofulvin, oxcarbazepine, phenytoin, rifampin, St. John’s Wort, topiramate, and certain HIV medications (e.g., ritonavir, nelfinavir).
• Conversely, combination oral contraceptives may affect the metabolism of other drugs (e.g., cyclosporine, theophylline, tizanidine, lamotrigine), increasing their plasma concentrations and potential for toxicity. Consult a healthcare provider and pharmacist about all concomitant medications.

Missed dose

Instructions vary depending on how many tablets are missed and in which week of the cycle.

• 1 active tablet missed (24-48 hours late): Take the missed tablet as soon as possible. Take the next tablet at the regular time. No backup contraception is needed.
• 2 active tablets missed in a row in Weeks 1 or 2: Take 2 tablets as soon as possible and 2 tablets the next day. Then resume 1 tablet daily. Use backup contraception (e.g., condoms) for 7 days.
• 2 active tablets missed in a row in Week 3, OR 3 or more active tablets missed in a row at any time:
  • Day 1 Starter: Discard the rest of the pack and start a new pack that same day.
  • Sunday Starter: Keep taking 1 pill daily until Sunday, then discard the pack and start a new pack that day.
  • In both cases, use backup contraception for 7 days. Consider the possibility of pregnancy if missed doses occurred in the first week and unprotected sex occurred in the previous 5 days.
• Any missed green (estrogen-only) or yellow (inert) tablets: These can be discarded. Continue taking the remaining tablets one per day. No backup contraception is needed.

Overdose

Serious ill effects have not been reported following acute overdose of oral contraceptives. Overdosage may cause nausea and vomiting. Withdrawal bleeding may occur in females. There is no specific antidote. Treatment should be symptomatic and supportive.

Storage

Store at room temperature, 20°C to 25°C (68°F to 77°F). Excursions are permitted between 15°C and 30°C (59°F and 86°F). Keep out of reach of children and pets. Protect from light and moisture. Do not store in the bathroom.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The full official prescribing information should be consulted before initiating therapy.

Reviews

• Clinical Efficacy: “In large-scale clinical trials, Mircette demonstrated a Pearl Index of approximately 0.17 for pregnancy prevention, indicating high efficacy with perfect use. Its unique estrophasic regimen showed superior follicular suppression compared to traditional 21/7 regimens, translating to excellent cycle control with a low incidence of breakthrough bleeding.” – Journal of Women’s Health
• Patient Tolerability: “Many patients transitioning from higher-dose COCs to Mircette report a significant reduction in estrogenic side effects such as nausea, breast tenderness, and bloating. The low-dose profile is particularly well-suited for patients sensitive to hormones or those seeking long-term contraception with minimal metabolic impact.” – Clinical Pharmacology Review
• Acne Treatment: “As an FDA-approved treatment for moderate acne, Mircette offers a dual benefit for appropriate patients. Studies showed a statistically significant reduction in total, inflammatory, and non-inflammatory acne lesion counts over six cycles of treatment, providing a valuable option for women who also desire contraception.” – Dermatologic Therapy