Choice of preparation
DGRefHelp - NHS Dumfries & Galloway
Aim to choose the lowest dosage of oestrogen and progestogen that:
- maintains efficacy
- has fewest side effects
- gives good cycle control
- takes into account differential risk of VTE
- is cost effective.
A monophasic COC containing 20 to 35 micrograms of ethinylestradiol with a low dose of either norethisterone or levonorgestrel is a suitable first line option. Examples are Rigevidon, Ovranette, Microgynon 30, Ovysmen and Brevinor. Tailored regimes may improve bleeding patterns and hence improve compliance. Please see FSRH Clinical Guideline: Combined Hormonal Contraception (January 2019, Amended October 2023) for alternative COC regimens. Transdermal or intravaginal preparations may be advantageous in situations where GI absorption is compromised, e.g. Inflammatory bowel disease, or in situations where this method will improve compliance.
CHC preparations
| Monophasic preparations Grouped by progestogen type and generation |
Oestrogen dose | Brand names |
|---|---|---|
| Norethisterone (1st) | 35 micrograms EE | Brevinor® Norimin® |
| Levonorgestrel (2nd) | 30mcg EE | Microgynon 30® Ovranette® Rigevidon® Levest® Maexeni® Ambelina® Leandra® |
| Desogestrel (3rd) | 30mcg EE | Marvelon® Gedarel 30/150® Cimizt® |
| Desogestrel (3rd) | 20mcg EE | Mercilon® Gedarel 20/150® Bimizza® |
| Gestodene (3rd) | 30mcg EE | Femodene® Katya® Akizza® Millinette 30/75® |
| Gestodene (3rd) | 20mcg EE | Femodette® Sunya® Millinette 20/75® |
| Cyproterone (equivalent to 3rd) |
35mcg EE | Co-cyprindiol® Dianette® Clairette® Teragezza® |
| Norgestimate (3rd) | 35mcg EE | Cilique® Lizinna® |
| Drospirenone (4th) | 20mcg EE |
Eloine® |
| Drospirenone (4th) | 30mcg EE |
Yasmin® |
| Triphasic pills with varied progestogens |
30 to 40mcg EE | TriRegol® Triadene® |
| Phasic with Dienogest (4th) | 1 to 3mg estradiol valerate |
Qlaira® |
| Nomegestrel acetate (4th) | 1.5mg estradiol hemihydrate |
Zoely® |
| Low dose patch with norelgestromin |
20mcg EE | Evra |
| Intravaginal ring with etonogestrel |
15mcg EE |
Nuvaring® SyreniRing® |
Prices vary between health boards and between Primary and Secondary Care. First
choice preparation will be guided by the stock arrangements/availability within each
service.