Last update: March 16, 2018

C22H28O2

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Progestin drug that is an active metabolite of desogestrel.
It is used for contraception as subcutaneous implants with a duration of 3 years.

It is excreted into breast milk in small quantities, and, no problems were observed in infants whose mothers used this medication.

Although it is considered safer to start using it after 4-6 postnatal weeks, there have been studies that found that implants applied early in the first days or hours after birth does not affect either production or milk composition and growth of infants (Carmo 2017, Lopez 2015, Braga 2015, Phillips 2015, WHO 2015, Mwalwanda 2013, CDC 2013, Gurtcheff 2011).
Only 1 in 100 women using etonogestrel implants may have a significant decrease in milk production (Stuebe 2016).

During lactation progestin-only drugs are preferred or in combination with estrogen for birth control, but whatever is used, the ones with the lower dose of estrogen should be used.
Within the first 6 weeks postpartum, non-hormonal methods are of choise.

Hormone containing contraceptives do not affect the composition of milk, minerals (Mg, Fe, Cu, Ca, P) fat, lactose and calories but only a few the proteins.

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

C22H28O2 is Etonogestrel in Molecular formula.

Is written in other languages:

Group

C22H28O2 belongs to this group or family:

Tradenames

Main tradenames from several countries containing C22H28O2 in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight 325 daltons
Protein Binding 96 - 99 %
VD 3,1 l/Kg
Tmax 200 hours
T1/2 25 hours
M/P ratio 0,5 -
Theoretical Dose 0,00003 mg/Kg/d
Relative Dose 2,2 %

References

  1. Carmo LSMP, Braga GC, Ferriani RA, Quintana SM, Vieira CS. Timing of Etonogestrel-Releasing Implants and Growth of Breastfed Infants: A Randomized Controlled Trial. Obstet Gynecol. 2017 Abstract
  2. Stuebe AM, Bryant AG, Lewis R, Muddana A. Association of Etonogestrel-Releasing Contraceptive Implant with Reduced Weight Gain in an Exclusively Breastfed Infant: Report and Literature Review. Breastfeed Med. 2016 Abstract
  3. Berens P, Labbok M; Academy of Breastfeeding Medicine. ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. Breastfeed Med. 2015 Abstract Full text (link to original source) Full text (in our servers)
  4. Braga GC, Ferriolli E, Quintana SM, Ferriani RA, Pfrimer K, Vieira CS. Immediate postpartum initiation of etonogestrel-releasing implant: A randomized controlled trial on breastfeeding impact. Contraception. 2015 Abstract
  5. Phillips SJ, Tepper NK, Kapp N, Nanda K, Temmerman M, Curtis KM. Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception. 2015 Abstract Full text (link to original source) Full text (in our servers)
  6. Berens P, Labbok M; Academy of Breastfeeding Medicine. Protocolo clínico de la ABM n.º 13: Anticoncepción durante la lactancia, revisado en 2015. Breastfeed Med. 2015 Full text (link to original source) Full text (in our servers)
  7. Merk. Implanon. Product Monograph. 2015 Full text (in our servers)
  8. WHO. Department of Reproductive Health and Research World Health Organization. Medical Eligibility Criteria for Contraceptive Use. WHO/RHR/15.07. 2015 Abstract Full text (link to original source) Full text (in our servers)
  9. AEMPS-Merk. Implanon. Ficha técnica. 2014 Full text (in our servers)
  10. Bahamondes L, Bahamondes MV, Modesto W, Tilley IB, Magalhães A, Pinto e Silva JL, Amaral E, Mishell DR Jr. Effect of hormonal contraceptives during breastfeeding on infant's milk ingestion and growth. Fertil Steril. 2013 Abstract Full text (link to original source) Full text (in our servers)
  11. Mwalwanda CS, Black KI. Immediate post-partum initiation of intrauterine contraception and implants: a review of the safety and guidelines for use. Aust N Z J Obstet Gynaecol. 2013 Abstract
  12. CDC. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Abstract Full text (link to original source) Full text (in our servers)
  13. Gurtcheff SE, Turok DK, Stoddard G, Murphy PA, Gibson M, Jones KP. Lactogenesis after early postpartum use of the contraceptive implant: a randomized controlled trial. Obstet Gynecol. 2011 Abstract
  14. Centers for Disease Control and Prevention (CDC). U S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm Rep. 2010 Abstract Full text (link to original source) Full text (in our servers)
  15. Duvan Cİ, Gözdemir E, Kaygusuz I, Kamalak Z, Turhan NÖ. Etonogestrel contraceptive implant (Implanon): analysis of patient compliance and adverse effects in the breastfeeding period. J Turk Ger Gynecol Assoc. 2010 Abstract
  16. Brito MB, Ferriani RA, Quintana SM, Yazlle ME, Silva de Sá MF, Vieira CS. Safety of the etonogestrel-releasing implant during the immediate postpartum period: a pilot study. Contraception. 2009 Abstract
  17. [No authors listed] Intrauterine devices: an effective alternative to oral hormonal contraception. Prescrire Int. 2009 Abstract
  18. Hohmann H. Examining the efficacy, safety, and patient acceptability of the etonogestrel implantable contraceptive. Patient Prefer Adherence. 2009 Abstract Full text (link to original source)
  19. Graesslin O, Korver T. The contraceptive efficacy of Implanon: a review of clinical trials and marketing experience. Eur J Contracept Reprod Health Care. 2008 Abstract
  20. Taneepanichskul S, Reinprayoon D, Thaithumyanon P, Praisuwanna P, Tosukhowong P, Dieben T. Effects of the etonogestrel-releasing implant Implanon and a nonmedicated intrauterine device on the growth of breast-fed infants. Contraception. 2006 Abstract
  21. Díaz S. Contraceptive implants and lactation. Contraception. 2002 Abstract
  22. Reinprayoon D, Taneepanichskul S, Bunyavejchevin S, Thaithumyanon P, Punnahitananda S, Tosukhowong P, Machielsen C, van Beek A. Effects of the etonogestrel-releasing contraceptive implant (Implanon on parameters of breastfeeding compared to those of an intrauterine device. Contraception. 2000 Abstract
  23. Kelsey JJ. Hormonal contraception and lactation. J Hum Lact. 1996 Abstract
  24. [No authors listed] Progestogen-only contraceptives during lactation: II. Infant development. World Health Organization, Task Force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development, and Research Training in Human Reproduction. Contraception. 1994 Abstract

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