Cerazette (Organon)

• cerazette (Organon) is a progestogen-only pill (POP) that is being marketed by the company as "the first oestrogen free pill to consistently inhibit ovulation"
• cerazette contains desogestrel 75 µg
  • desogestrel is metabolized to the active metabolite etonogestrel - this is the active metabolite of the progestogen-only contraceptive implant, Implanon
    • etonogestrel
      • half-life about 30 hours
      • steady-state plasma concentrations are achieved 4-5 days after commencing a once-daily oral administration
  • cerazette is commenced on day 1 of the menstrual cycle; taken continuously thereafter at the same time of day without remission
  • summary of product characteristics recommend that if the daily dose is delayed more than 3 hours then additional method of contraception is required for the next 7 days
• a Drug and Therapeutics Bulletin review concludes (1) that :
  • cerazette inhibits ovulation more frequently than a standard POP
  • there is insufficent evidence on whether cerazette is more effective than other POPs
  • the likelihood of a woman discontinuing cerazette because of irregular periods is similar to that with a standard POP
  • "on current evidence, there is no compelling reason to use Cerazette instead of a standard POP"
• a MeReC bulletin review states (2):
  • "..Although Cerazette may be more effective at preventing ovulation than other POPs, from current data it is not known whether this translates into improved contraceptive efficacy. Cerazette is an option for women who are suitable for a POP, possibly for those who may have difficulty complying with the stricter dosage regimen of other POPs..."
• Cerazette is the first POP with a missed pill window of 12 hours instead of 3 hours allowed by conventional POPs (3)

The summary of product characteristics must be consulted before prescribing this drug.

Reference:

1. Drug and Therapeutics Bulletin (2003), 41 (9), 68-9.
2. MeReC Bulletin 2006; 17(2):1-9.
3. Organon Laboratories Limited (June 29th 2004).Cerazette, oestrogen free contraceptive pill, gains approval for 12-hour missed pill window.