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WO1998004266A1 - Contraceptif oral - Google Patents

Contraceptif oral Download PDF

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Publication number
WO1998004266A1
WO1998004266A1 PCT/US1997/012788 US9712788W WO9804266A1 WO 1998004266 A1 WO1998004266 A1 WO 1998004266A1 US 9712788 W US9712788 W US 9712788W WO 9804266 A1 WO9804266 A1 WO 9804266A1
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WO
WIPO (PCT)
Prior art keywords
phase
estrogen
daily dosage
administered
dosage
Prior art date
Application number
PCT/US1997/012788
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English (en)
Inventor
Michael Jay Gast
Original Assignee
American Home Products Corporation
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Publication date
Application filed by American Home Products Corporation filed Critical American Home Products Corporation
Priority to AU39616/97A priority Critical patent/AU3961697A/en
Publication of WO1998004266A1 publication Critical patent/WO1998004266A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/565—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/565—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol
    • A61K31/567—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol substituted in position 17 alpha, e.g. mestranol, norethandrolone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/58—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin

Definitions

  • oral contraceptives consist of a combination of a progestin and estrogen that are administered concurrently for 21 days followed either by a 7 day pill free interval or by the administration of a placebo for 7 days in each 28 day cycle.
  • the most important aspects of a successful oral contraceptive product are effective contraception, good cycle control (absence of spotting and breakthrough bleeding and occurrence of withdrawal bleeding), and minimal side effects.
  • Combination oral contraceptives have traditionally acted by suppression of gonadotropins.
  • the progestin component is primarily responsible for contraceptive efficacy through inhibition of ovulation, and other peripheral effects which include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation).
  • the estrogenic component intensifies the anovulatory effect of the progestin, and is also important for maintaining cycle control.
  • Levonorgestrel is the biologically active moiety of racemic norgestrel. It is strongly progestational, has no inherent estrogenic activity, is antiestrogenic, and possesses good biologic activity. The contraceptive effects of levonorgestrel are manifested throughout the hypothalamic- pituitary-gonadal-target organ axis. Ethinyl estradiol (EE) is the estrogen most frequently used in combination OCs.
  • progestin/estrogen combination is administered either as a fixed dosage combination (monophasic) or as biphasic or triphasic regimens in which the dosage of the combination is varied either once or twice throughout the menstrual cycle.
  • the progestin/estrogen combination is typically administered for 21 days followed by either a 7-day pill free period or the administration of a non-contraceptive placebo (or iron supplement) for 7 days.
  • 3-ketodesogestrel (3-KDSG), desogestrel (DSG), levonorgestrel (LNg), gestodene (GTD), norgestrel (NG), and norethindrone (NE) are typically used as the progestin while ethinyl estradiol (EE); 17 ⁇ -estradiol, and mestranol are typically the estrogenic components.
  • Other progestins less frequently used include drospirenone (DRSP) and dienogest (DGST).
  • DRSP drospirenone
  • DGST dienogest
  • Lachnit (PCT Publication WO 95/26730) discloses bridged regimens consisting of the administration of a combination of a progestin/estrogen combination (50 - 125 ⁇ g LNg and 10 - 40 ⁇ g EE) for the first 23-24 days of the menstrual cycle followed by the administration of an estrogen (2 - 40 ⁇ g EE) for 4-10 days for a total administration of at least 28 days per cycle.
  • a progestin/estrogen combination 50 - 125 ⁇ g LNg and 10 - 40 ⁇ g EE
  • an estrogen 2 - 40 ⁇ g EE
  • the use of 100 - 300 ⁇ g drospirenone and 10 - 40 ⁇ g EE as the 23-24 day progestin estrogen combination is disclosed.
  • Lachnit also discloses a triphasic plus bridging regimen (4-9 days, 4-9 days, 9-13 days, and 28 days for the three phases and estrogen phase, respectively) in which a combination of 50 ⁇ g LNg and 20 ⁇ g EE are administered in the first phase, a combination of 75 ⁇ g LNg and 25 ⁇ g EE are administered in the second phase, a combination of 100 ⁇ g LNg and 20 ⁇ g EE are administered in the third phase, and 10 ⁇ g EE is administered in the estrogen phase.
  • Other progestins disclosed include GTD, DSG, 3-KDSG, DRSP, cyproterone acetate, norgestimate, and norethisterone.
  • Erlich discloses sequential contraceptive regimens consisting of the administration of an estrogen which effects a disturbance of follicle stimulation, followed by the administration of a combination of a progestin/estrogen in a dose at least adequate to inhibit ovulation.
  • the regimen is administered for a total of 28 days per cycle. It is preferred that the estrogen is administered for 5-14 days per cycle and the progestin/estrogen combination is administered for 23-14 days per cycle, so that the total administration is for 28 days per cycle.
  • Specific regimens include (a) 4 mg estradiol for 7 days followed by 21 days of the combination of 1 mg norethisterone acetate and 4 mg estradiol; (b) 2 mg estradiol valerate for 7 days followed by 21 days of the combination of 2 mg chlormadinone acetate and 4 mg estradiol valerate; and (c) 20 ⁇ g EE followed by 18 days of the combination of 150 ⁇ g LNg and 20 ⁇ g EE.
  • Regimen (c) in Erlich provides a total steroidal load of 2.7 mg of LNg and 560 ⁇ g EE per 28 day cycle.
  • Moore discloses bridged triphasic regimens consisting of the administration of a combination of 10 - 50 ⁇ g LNg and 5 - 20 ⁇ g EE from days 1-7 of the menstrual cycle; of 50 - 75 ⁇ g LNg and 5 - 20 ⁇ g EE from days 8-14 of the menstrual cycle; of 75 - 125 ⁇ g LNg and 5 - 20 ⁇ g EE from days 15-21 of the menstrual cycle; and 5 - 20 ⁇ g EE from days 22-28 of the menstrual cycle.
  • WO 95/17194 discloses contraceptive regimens which consist of the administration of a combination of a progestin (50 - 75 ⁇ g GTD, 75 - 125 ⁇ g LNg, 60 - 150 ⁇ g DSG, 60 - 150 ⁇ g 3-KDSG, 100 - 300 ⁇ g DRSP, 100 - 200 ⁇ g cyproterone acetate, 200 - 300 ⁇ g norgestimate, or >350 - 750 ⁇ g norethisterone) and an estrogen (15 - 20 ⁇ g EE or 2 - 6 mg 17 ⁇ -estradiol) for 23-24 days per cycle.
  • a progestin 50 - 75 ⁇ g GTD, 75 - 125 ⁇ g LNg, 60 - 150 ⁇ g DSG, 60 - 150 ⁇ g 3-KDSG, 100 - 300 ⁇ g DRSP, 100 - 200 ⁇ g cyproterone acetate, 200 - 300 ⁇ g n
  • Oettel (EP 628,312 Al) discloses combination contraceptive combinations containing the combination of three components: a biogenic estrogen (estradiol, estrone, or estriol), a synthetic estrogen (EE or mestranol), and a progestin (LNg, desogestrel, progesterone, norethisterone acetate, DGST, chlormadinone acetate, gestodene, or cyproterone acetate).
  • the combination is administered for 21 days followed by the administration of placebo (or pill free) or an estrogen on days 22-28 of the cycle.
  • Upton Upton (EP Patent Specification 253,607 BI) teaches the use of low dose progestin/estrogen combinations for combined hormone replacement therapy and contraception in climacteric women.
  • Climacteric women are defined in Upton as pre- menopausal women around 40 years of age whose hormone levels are waning. The climacteric woman still ovulates (albeit may have irregular ovulation), but she still experiences many of the symptoms of the hypoestrogenic menopausal woman, such as insomnia, hot flushes, and irritability.
  • Upton teaches the administration of a 23-26 day monophasic regimen of progestin/estrogen followed by a pill free or placebo interval of 2-5 days; with 24 days of progestin/estrogen administration followed by a 4-day pill free or placebo administration being preferred.
  • Upton teaches the use of a progestin selected from 25 - 100 ⁇ g LNg, 10 - 70 ⁇ g GTD, 25 - 100 ⁇ g DSG, 25 - 100 ⁇ g 3- KDSG, and 85 - 350 ⁇ g NE used in combination with an estrogen selected from 500 - 2000 ⁇ g 17 ⁇ -estradiol, 8 - 30 ⁇ g EE, and 15 - 60 ⁇ g mestranol.
  • Upton Based on relative potencies, Upton teaches that a dose of 75 ⁇ g LNg is equivalent to 35 ⁇ g of GTD, 75 ⁇ g of 3-KDSG or DSG, and 250 ⁇ g NE and that a dose of 1000 ⁇ g of 17 ⁇ -estradiol is equivalent to a dose of 15 ⁇ g EE and 30 ⁇ g mestranol. Upton also teaches that NG may be substituted for LNg, but at twice the dose.
  • Sartoretto (Clinica e Terapeutica 3: 399 (1974)) discloses a monophasic contraceptive regimen consisting of the administration of a combination 100 ⁇ g LNg and 20 ⁇ g EE for 21 days.
  • Lachnit-Fixson (U.S. Patent 3,969,502) discloses biphasic progestin/estrogen combination regimens in which a combination of 50-125 ⁇ g LNg and 25-35 ⁇ g EE are ad inistered for 10-12 days in the first phase and 100-350 ⁇ g LNg and 30-50 ⁇ g EE are administered for 10-12 days in the second phase.
  • Placebo is administered for 5-7 days following the administration of the contraceptive steroid regimen.
  • Lachnit-Fixson U.S. Patent 3,957,982 discloses triphasic 21 -day progestin/estrogen regimens in which a combination of 40-90 ⁇ g LNg and 20-50 ⁇ g EE is administered for 4-6 days in the first phase, 50-125 ⁇ g LNg and 30-50 ⁇ g EE is administered for 4-6 days in the second phase, and 100-250 ⁇ g LNg and 25-50 ⁇ g EE is administered for 9-11 days in the third phase. It is preferred that the first, second, and third phases are 6, 5, and 10 days, respectively. Bennick (U.S.
  • Patent 5,418,2278 discloses triphasic regimens which consist of the administration of a combination progestin/estrogen in a 6-8 day phase, a second 6-8 day phase, and a third 6-8 day phase, with it being preferred that the three contraceptive steroid phases be 7 days each.
  • the first contraceptive steroid phase consists of a progestin at a daily dosage equivalent to 75 - 150 ⁇ g DSG and an estrogen at a daily dosage equivalent to 20 - 25 ⁇ g EE;
  • the second contraceptive steroid phase consists of a progestin at a daily dosage equivalent to 75 - 125 ⁇ g DSG and an estrogen at a daily dosage equivalent to 20 ⁇ g EE;
  • the third contraceptive steroid phase consists of a progestin at a daily dosage equivalent to 75 - 100 ⁇ g DSG and an estrogen at a daily dosage equivalent to 20 ⁇ g EE.
  • Placebo is administered for 7 days following the 21 -day contraceptive steroid period.
  • Bennick discloses that the progestin may be 3-KDSG, DSG, LNg, or GTD.
  • the Bergink discloses a 24 day triphasic combination regimen in which the first 7-9 day phase consists of the administration of a progestin at a daily dosage equivalent to 100 ⁇ g DSG and an estrogen at a daily dosage equivalent to 25 ⁇ g EE, the second 7-9 day phase consists of the administration of a progestin at a daily dosage equivalent to 125 ⁇ g DSG and an estrogen at a daily dosage equivalent to 20 ⁇ g EE, and the third 7-9 day phase consists of the administration of a progestin at a daily dosage equivalent to 50 ⁇ g DSG and an estrogen at a daily dosage equivalent to 20 ⁇ g EE. It is preferred that the three phases be 8 days each. Following the 24 day contraceptive steroid administration, a placebo may be administered for 4 days, the 4 day interval may be pill free, or a progestin at a dosage equivalent to 25-35 ⁇ g DSG may be administered.
  • Boissonneault U.S. Patent 4,962,098 discloses triphasic progestin/estrogen combinations in which the amount of the estrogenic component is increased stepwise over the three phases. Contraceptive steroid combinations are taken for 4-7 days during the first phase (5 days being preferred); for 5-8 days during the second phase (7 days preferred); and for 7-12 days during the third phase (9 days being preferred). Following the administration of 21 -days of the contraceptive steroid combination, placebo is taken for 7 days. For all three phases, 0.5-1.5 mg of norethindrone acetate is used in the progestin, with 1 mg being preferred. 10-30 ⁇ g EE is used in the first phase, 20-40 ⁇ g in the second, and 30-50 ⁇ g in the third phase.
  • Pasquale U.S. Patent 4,921,843 discloses combination progestin/estrogen contraceptive regimens which contain 0.5 to 1 mg of progestin and an estrogen having a dose equivalent to 10-40 ⁇ g of EE.
  • NE, LNg, D-17 ⁇ -acetoxy-13 ⁇ -ethyl-17 ⁇ -ethinyl- gon-4-en-3-one oxime, and 19-nor-17-hydroxy progesterone ester are disclosed as progestins, with NE being preferred.
  • Pasquale U.S. Patent 4,628,051 discloses triphasic progestin/estrogen combination regimens in which contraceptive steroid is administered for 21 days. Contraceptive steroid combinations are taken for 5-8 days during the first phase (7 days being preferred); for 7-11 days during the second phase (7 days preferred); and for 3-7 days during the third phase (7 days being preferred). In all three phases, an estrogen at a daily dosage equivalent to 20-50 ⁇ g EE is administered in combination with a progestin having a daily dosage equivalent to 65-750 ⁇ g NE in the first phase, 0.25-1.0 mg NE in the second phase, and 0.35-2.0 mg NE in the third phase.
  • a specific triphasic regimen discloses the administration of 35 ⁇ g EE in each of the three 7-day phases in combination with 0.5 mg, 0.75 mg, and 1.0 mg in the first, second, and third phases, respectively.
  • a second specific triphasic regimen discloses the administration of 35 ⁇ g EE in each of the three 7-day phases in combination with 50 ⁇ g, 75 ⁇ g, and 100 ⁇ g in the first, second, and third phases, respectively.
  • a third specific triphasic regimen discloses the administration of 35 ⁇ g EE in each of the three 7-day phases in combination with 25 ⁇ g, 35 ⁇ g, and 50 ⁇ g in the first, second, and third phases, respectively.
  • Lachnit-Fixson U.S. Patent 4,621,079 discloses triphasic 21 -day progestin/estrogen combination regimens in which a combination of 40-70 ⁇ g GTD and 20-35 ⁇ g EE is administered for 4-6 days in the first phase; 50-100 ⁇ g GTD and 30-50 ⁇ g EE is administered for 4-6 days in the second phase; and 80-120 ⁇ g GTD and 20-50 ⁇ g EE is administered for 9-11 days in the third phase. Placebo is administered for 7 days following the 21 -day contraceptive steroid regimen.
  • Pasquale U.S. Patent 4,530,839 discloses triphasic 21-day progestin/estrogen combination regimens in which a dose of 20-50 ⁇ g EE is administered in all three phases in combination with a contraceptively effective daily dose of progestin in the first phase, 1.5-2 times that dose of progestin in the second phase, and 2-2.5 times the first phase dose of progestin in the third phase.
  • Each of the three phases is 7 days long.
  • a specific regimen discloses 20-50 ⁇ g EE in combination with 500 ⁇ g LNg, 750 ⁇ g LNg, and 1 mg LNg during each of the three 7-day phases, respectively.
  • Edgren U.S. Patent 4,390,531 discloses triphasic 21-day progestin/estrogen combination regimens in which a dose of 20-40 ⁇ g EE (or another estrogen in an equivalent dosage) is administered in all three phases in combination with 0.3-0.8 mg NE (or another progestin in an equivalent dosage) for 5-8 days in the first phase, twice the dose of NE for 7-11 days in the second phase, and the dose of NE being the same as in the first phase for 3-7 days in the third phase. It is preferred that each of the three phases is 7 days. Placebo is administered for 6-8 days following administration of the contraceptive steroid combination.
  • a specific regimen discloses a first phase of 7 days of 0.5 mg NE in combination with 35 ⁇ g EE, a second 7 day phase of 1.0 mg NE in combination with 35 ⁇ g EE, and a third 7 day phase of 0.5 mg NE in combination with 35 ⁇ g EE.
  • this invention provides a method of contraception which comprises administering to a female of child bearing age a first phase of a combination of a progestin at a daily dosage of 40-500 ⁇ g trimegestone, 250 ⁇ g - 4 mg dienogest, or 250 ⁇ g - 4 mg drospirenone, and an estrogen at a daily dosage equivalent in estrogenic activity to 10-20 ⁇ g ethinyl estradiol for 9-13 days beginning on day 1 of the menstrual cycle. The same daily dosage of the progestin and estrogen is administered for each of the 9-13 days.
  • a second phase of a combination of a progestin at a daily dosage of 40- 250 ⁇ g trimegestone, 400 ⁇ g - 4 mg dienogest, or 400 ⁇ g - 4 mg drospirenone, and an estrogen at a daily dosage equivalent in estrogenic activity to 10-20 ⁇ g ethinyl estradiol is administered for 11-15 days beginning on the day immediately following the last day of administration of the first phase, such that the total administration for both phases is 23-25 days.
  • the same daily dosage of the progestin and estrogen is administered for each of the 11-15 days.
  • the daily dosage of the progestin in the second phase is greater that the daily dosage for the first phase, and the daily dosage of the estrogen in the second phase is typically greater than or equal to the daily dosage of estrogen in the first phase.
  • an estrogen phase is administered in which an estrogen at a daily dosage equivalent to 5-15 ⁇ g ethinyl estradiol is administered for 3-5 days.
  • the total administration during each cycle is 28 days. It is preferred that total administration of the progestin/estrogen combination be 24 days.
  • Preferred regimens include those in which the first phase is 10 days and the second phase is 14 days; and those in which the first and second phases are 12 days each. It is more preferred that the first phase is 10 days and the second phase is 14 days.
  • Preferred dosages of trimegestone are 50-125 ⁇ g and 75-250 ⁇ g when administered as the progestin in the first and second phases, respectively.
  • Preferred dosages of dienogest are 400 ⁇ g- 1 mg and 800 ⁇ g - 2 mg when administered as the progestin in the first and second phases, respectively.
  • Preferred dosages of drospirenone are 500 ⁇ g - 3 mg and 1 -4 mg when administered as the progestin in the first and second phases, respectively.
  • Preferred estrogens include, but are not limited to ethinyl estradiol; 17 ⁇ - estradiol; conjugated estrogens, USP; estrone or a salt thereof; and mestranol; with ethinyl estradiol being more preferred.
  • ethinyl estradiol is used as the estrogen during the last 3-5 days of the cycle, it is preferred that the daily dosage of ethinyl estradiol is 5-15 ⁇ g, with 15 ⁇ g being more preferred.
  • 17 ⁇ -estradiol is used as the estrogen during the last 3-5 days of the cycle, it is preferred that the daily dosage of 17 ⁇ -estradiol is 1-3 ⁇ g.
  • estrone examples include, but are not limited to the sodium and piperate salt.
  • conjugated estrogens USP are used as the estrogen, it is preferred that the daily dosage is 0.3-5 mg, with a daily dose of 1.25 mg conjugated estrogens, USP being equivalent to a daily dose of 15 ⁇ g ethinyl estradiol.
  • trimegestone is abbreviated as TMG.
  • the following daily dosages of a combination of dienogest and ethinyl estradiol are preferred for contraception when administered according to a biphasic regimen for 24 consecutive days beginning on the first day of menses, with the first phase being 10 days and the second phase being 14 days, followed by the administration of ethinyl estradiol for 3-5 days.
  • the total administration during each cycle is 28 days. It is preferred that the dose of ethinyl estradiol during the 3-5 day period be the same as the dose of ethinyl estradiol that was administered during the 24 day period, or lower.
  • Regimen B is more preferred.
  • dienogest is abbreviated as DGST. PREFERRED DAILY DOSAGES
  • the following daily dosages of a combination of drospirenone and ethinyl estradiol are preferred for contraception when administered according to a biphasic regimen for 24 consecutive days beginning on the first day of menses, with the first phase being 10 days and the second phase being 14 days, followed by the administration of ethinyl estradiol for 3-5 days.
  • the total administration during each cycle is 28 days. It is preferred that the dose of ethinyl estradiol during the 3-5 day period be the same as the dose of ethinyl estradiol that was administered during the 24 day period, or lower.
  • Regimen C is more preferred.
  • dienogest is abbreviated as DRSP.
  • the combination progestin/estrogen contraceptive be administered in unit dosage form i.e., tablet or pill, with each unit providing the entire daily dosage. It is preferred that the progestin and estrogen are admixed together in the same dosage unit. Such dosage units can be prepared by conventional methodology that is well known to one skilled in the art. In each dosage unit, the contraceptively active progestin and estrogen are combined with excipients, vehicles, pharmaceutically acceptable carriers, and colorants. For example, the following illustrates an acceptable composition of a contraceptive progestin/estrogen combination of this invention.
  • the estrogen be administered in unit dosage form i.e., tablet or pill, with each unit providing the entire daily dosage.
  • unit dosage form i.e., tablet or pill
  • each unit providing the entire daily dosage.
  • dosage units can be prepared by conventional methodology that is well known to one skilled in the art.
  • the estrogen is combined with excipients, vehicles, pharmaceutically acceptable carriers, and colorants.
  • excipients, vehicles, pharmaceutically acceptable carriers, and colorants for example, the following illustrates an acceptable estrogen composition of this invention.
  • This invention also provides a contraceptive kit adapted for daily oral administration which comprises, 9-13 first phase dosage units each containing fixed dosage of a combination of a progestin at a daily dosage of 40-500 ⁇ g trimegestone, 250 ⁇ g - 4 mg dienogest, or 250 ⁇ g - 4 mg drospirenone, and an estrogen at a daily dosage equivalent in estrogenic activity to 10-20 ⁇ g ethinyl estradiol; 11-15 second phase dosage units each containing fixed dosage of a combination of a progestin at a daily dosage of 40-500 ⁇ g trimegestone, 250 ⁇ g - 4 mg dienogest, or 250 ⁇ g - 4 mg drospirenone, and an estrogen at a daily dosage equivalent in estrogenic activity to 10- 20 ⁇ g ethinyl estradiol; and 3-5 estrogen phase dosage units each containing a fixed dosage of an estrogen at a daily dosage equivalent to 5-15 ⁇ g

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Abstract

L'invention concerne un procédé de contraception. Ce procédé consiste à administrer à une femme en âge de procréer, pendant 28 jours consécutifs, une combinaison de première phase d'une progestine, à raison d'une dose quotidienne de 40-500 νg de trimegestone, de 250 νg - 4 mg de dienogest, ou 250 νg - 4 mg de drospirenone, et un estrogène selon une dose quotidienne équivalente en activité estrogénique à 10-20 νg d'éthinyl estradiol pendant 9 à 13 jours, en commençant le premier jour du cycle, la même quantité de progestine et d'estrogène étant administrée au cours de la période de 9 à 13 jours; une combinaison de deuxième phase d'une progestine, à raison d'une dose quotidienne de 40-500 νg de trimegestone, de 250 νg - 4 mg de dienogest, ou 250 νg - 4 mg de drospirenone, et un estrogène selon une dose quotidienne équivalente en activité estrogénique à 10-20 νg d'éthinyl estradiol pendant 11 à 15 jours, en commençant le premier jour suivant immédiatement le dernier jour du traitement par la combinaison de première phase, la même quantité de progestine et d'estrogène étant administrée au cours de la période de 11 à 15 jours; un estrogène d'une phase d'estrogène selon une dose quotidienne équivalente en activité estrogénique à 10-20 νg d'éthynil estradiol, pendant 3 à 5 jours, en commençant le jour suivant immédiatement le dernier jour du traitement par la combinaison de deuxième phase, le même dosage d'estrogène étant administré au cours de la période de 3-5 jours. La dose quotidienne de la progestine de la deuxième phase est supérieure à la dose quotidienne de la progestine de la première phase, et la dose quotidienne de l'estrogène de la deuxième phase est supérieure ou égale à la dose quotidienne de l'estrogène de la première phase.
PCT/US1997/012788 1996-07-26 1997-07-23 Contraceptif oral WO1998004266A1 (fr)

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Cited By (6)

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WO2003049744A1 (fr) * 2001-12-05 2003-06-19 Barr Laboratories, Inc. Contraceptifs oraux pour eviter les grossesses et diminuer la symptomatologie premenstruelle
WO2003084549A1 (fr) * 2002-04-03 2003-10-16 Wyeth, A Corporation Of The State Of Delaware, Usa Therapie de substitution hormonale
WO2003097069A1 (fr) * 2002-05-17 2003-11-27 Wyeth Trimegestone et oestrogenes pour le traitement de troubles post-menauposiques
US7749987B2 (en) 1996-10-08 2010-07-06 Laboratorie Theramek Contraception method
US7855190B2 (en) 2003-07-16 2010-12-21 Teva Women's Health, Inc. Methods of hormonal treatment utilizing contraceptive regimens with continuous estrogen administration
US8415332B2 (en) 2004-10-07 2013-04-09 TEVA Woman's Health, Inc. Methods of hormonal treatment utilizing ascending-dose extended cycle regimens

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Patent Citations (1)

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Publication number Priority date Publication date Assignee Title
DE4313926A1 (de) * 1993-04-28 1994-11-03 Jenapharm Gmbh Pharmazeutisches Mehrphasenpräparat zur hormonalen Kontrazeption

Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7749987B2 (en) 1996-10-08 2010-07-06 Laboratorie Theramek Contraception method
US7615545B2 (en) 2001-12-05 2009-11-10 Duramed Pharmaceuticals, Inc. Oral contraceptives to prevent pregnancy and diminish premenstrual symptomatology
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