Last update July 16, 2017

Nomegestrol Acetate

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Third generation synthetic progestogen which is structurally related to progesterone.
It has been used as a part of only-one-component contraceptives which have one year lasting effect for subdermal implants. Also orally used alone or associated to estrogen (see info on Estradiol + Nomegestrol).

In a study comparing effects on breastfeeding women (120 with a Nomegestrol implant and 120 with an intrauterine device (IUD), there were no significant differences on duration of breastfeeding nor somatic follow-up criteria nor health issues in infants (Abdel -Aleem 1996).

There is controversy about whether an early implant in the first few days after delivery affects milk production. Some authors consider it safer to wait for 4 to 6 weeks (ABM 2015).

Because there is less published experience than with other drugs in the same group, alternatives known as safer and of shorter half life may be preferable.

Progestogens in general are considered the contraceptive of choice during breastfeeding since they neither affect excretion and composition of the milk nor cause side effects nor affect the growth of the infants and the duration of lactation.
Progestogen implants are considered a good choice in women who are breastfeeding (Meckstroth 2001).

During lactation, progestogen-only contraceptives are preferred over those combined with estrogen. Otherwise, those with lower doses of estrogen should be used.
Within the first 6 weeks postpartum, non-hormonal contraceptive methods should be the first option. There is a controversy on whether milk production is decreased when progestogens are used prior breastfeeding is well established.


See below the information of these related products:

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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

Nomegestrol Acetate in other languages or writings:

Group

Nomegestrol Acetate belongs to this group or family:

Tradenames

Main tradenames from several countries containing Nomegestrol Acetate in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 63 %
Molecular weight 371 daltons
Protein Binding 97 - 98 %
VD 1.7 l/Kg
Tmax 2 hours
46 (28 - 83) hours

References

  1. Roy M, Hazra A, Merkatz R, Plagianos M, Alami M, Gaur LN, Aruldas K, Sussman H, Variano B, Sitruk-Ware R; Progesterone Vaginal Ring Study Group at Participating Centers.. Progesterone vaginal ring as a new contraceptive option for lactating mothers: Evidence from a multicenter non-randomized comparative clinical trial in India. Contraception. 2020 Sep;102(3):159-167. Abstract Full text (link to original source)
  2. EMA. Estradiol + Nomegestrol acetato. Ficha técnica. 2016 Full text (in our servers)
  3. CDC - Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, Simmons KB, Pagano HP, Jamieson DJ, Whiteman MK. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. CDC - MMWR Recommendations & Reports. 2016 Abstract Full text (link to original source) Full text (in our servers)
  4. EMA. Estradiol + Nomegestrol acetate. Drug Summary. 2016 Full text (in our servers)
  5. 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)
  6. Lopez LM, Grey TW, Stuebe AM, Chen M, Truitt ST, Gallo MF. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2015 Abstract
  7. 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)
  8. Altshuler AL, Gaffield ME, Kiarie JN. The WHO's medical eligibility criteria for contraceptive use: 20 years of global guidance. Curr Opin Obstet Gynecol. 2015 Abstract Full text (link to original source) Full text (in our servers)
  9. OMS. Criterios médicos de elegibilidad para el uso de anticonceptivos Quinta edición. Who Library. 2015 Full text (link to original source) Full text (in our servers)
  10. Dutta DK, Dutta I. Desogestrel mini pill: is this safe in lactating mother? J Indian Med Assoc. 2013 Abstract
  11. 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)
  12. 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)
  13. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  14. 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
  15. CLM - Comité de Lactancia Materna de la AEP. Preguntas frecuentes sobre lactancia materna. Folleto. 2012 Full text (link to original source) Full text (in our servers)
  16. Espey E, Ogburn T, Leeman L, Singh R, Ostrom K, Schrader R. Effect of progestin compared with combined oral contraceptive pills on lactation: a randomized controlled trial. Obstet Gynecol. 2012 Abstract
  17. Shaamash AH, Sayed GH, Hussien MM, Shaaban MM. A comparative study of the levonorgestrel-releasing intrauterine system Mirena versus the Copper T380A intrauterine device during lactation: breast-feeding performance, infant growth and infant development. Contraception. 2005 Abstract
  18. Meckstroth KR, Darney PD. Implant contraception. Semin Reprod Med. 2001 Abstract
  19. Bjarnadóttir RI, Gottfredsdóttir H, Sigurdardóttir K, Geirsson RT, Dieben TO. Comparative study of the effects of a progestogen-only pill containing desogestrel and an intrauterine contraceptive device in lactating women. BJOG. 2001 Abstract
  20. Croxatto HB. Progestin implants. Steroids. 2000 Abstract
  21. Díaz S, Zepeda A, Maturana X, Reyes MV, Miranda P, Casado ME, Peralta O, Croxatto HB. Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, Norplant implants, and Copper T 380-A intrauterine devices. Contraception. 1997 Abstract
  22. Abdel-Aleem H, Abol-Oyoun el-S M, Shaaban MM, el-Saeed M, Shoukry M, Makhlouf A, Salem HT. The use of nomegestrol acetate subdermal contraceptive implant, uniplant, during lactation. Contraception. 1996 Abstract
  23. Croxatto HB, Díaz S. The place of progesterone in human contraception. J Steroid Biochem. 1987;27(4-6):991-4. Review. Abstract
  24. Betrabet SS, Shikary ZK, Toddywalla VS, Toddywalla SP, Patel D, Saxena BN. ICMR Task Force Study on hormonal contraception. Transfer of norethisterone (NET) and levonorgestrel (LNG) from a single tablet into the infant's circulation through the mother's milk. Contraception. 1987 Abstract
  25. Nilsson S, Nygren KG, Johansson ED. d-Norgestrel concentrations in maternal plasma, milk, and child plasma during administration of oral contraceptives to nursing women. Am J Obstet Gynecol. 1977 Abstract

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