Androgenicity and Progestational strength of progestins in OCPS

	A	B	C	D	E	F	G	H	I	J	K	L	O	P
1	How to manage SE of OCPs
2
3	www.pandiahealth.com
4	for lay people	https://www.pandiahealth.com/how-to-manage-birth-control-pill-side-effects/
5	for prescribers	https://www.pandiahealth.com/resources/birth-control-pill-side-effects-guide-for-providers/							Based on web article by Frederick R. Jelovsek MD, MS
6	Progestin	Progestational Activity (relative to 1 mg of norethindrone)	Androgenic Activity (relative to 1 mg of norethindrone)
7
8	norethindrone 1 mg	1.0	1.000						etonogestrel	implant, nuvaring		less androgenic than levonorgestrel and norethisterone,
9	norethindrone acetate 1 mg	1.2	1.600						norelgestromin	patch		active metabolites of norgestimate	BUT it produces levonorgestrel as an active metabolite to some extent
10	ethynodiol diacetate 1 mg	1.4	0.600
11	levonorgestrel 1 mg	5.3	8.300
12	dl-norgestrel 1 mg	2.6	4.200
13	norgestimate 1 mg	1.3	1.900
14	norelgestromin 1 mg	1.3	1.900
15	desogestrel 1 mg	9.0	3.400
16	drospirenone 1 mg	1.5	0.000				3 mg of drosperinone = 20-25 mg of spironolactone in antimineralocorticoid effect
17									1.95
18	CHART 2: from least androgenic to most
19	Medication	progestin	mg of progestin	Androgenic activity	EE	progestational activity
20	Slynd	drosperinone	4.000	0.00	-	6
21	nextstellis	drosperinone	3.000	0.00	0	3.9	14.2 mg of estetrol		24 active, 4 placebo
22	Gianvi, Jasmiel, Loryna, Lo-Zumandimine, Nikki, Vestura, Yaz	drosperinone	3.000	0.00	20	4.5
23	Ocella, Syeda, Yasmin, Zarah, Zumandimine	drosperinone	3.000	0.00	30	4.5
24	Skyla 3 yrs	LNG	0.014	0.07	-	0.12
25	Kyleena 5 yrs	LNG	0.018	0.09	-	0.15					Nexplanon	Once inserted subdermally, the release rate is 60-70 mcg/day in week 5-6 and decreases to approximately 35- 45 mcg/day at the end of the first year, to approximately 30-40 mcg/day at the end of the second year, and then to approximately 25-30 mcg/day at the end of the third year.
26	Nexplanon year 3	etonogestrel	0.040	0.14		0.36
27	Nexplanon year 2	etonogestrel	0.045	0.153		0.41
28	Liletta IUD Year 1	levonorgestrel	0.0186	0.154	-	0.099
29	Mirena IUD year 1	LNG	0.020	0.17	-	0.11					Liletta/mirena start at 20mcg/day and down to 10mcg/day by year 5
30	Nexplanon year 1	etonogestrel	0.060	0.20	-	0.54
31	Xulane	norelgestromin	0.150	0.29	20	0.20	May have diminished efficacy in women ≥90 kg = 198 lbs
32	Opill	norgestrel	0.075	0.315	0	0.195	POP
33	Camila 28, Deblitane, Errin, Heather, Jolivette, Jencycla, Lyza, Nora-BE, Norethindrone, Norlyda, POP, Sharobel, Ortho Micronor	norethindrone	0.350	0.35	--	0.35
34	Balziva, Briellyn, Femcon Fe, Gildagia, Philith, Ovcon 35, zenchent Fe, Zeosa, wymzya Fe	norethindrone	0.400	0.40	35	0.4
35	NuvaRing	etonogestrel	0.120	0.41	15	1.08
36	Estarylla, Norgestimate / Ethinyl Estradiol, Femynor, Mili, Mono-Linyah, Mononessa, Orthocyclen, Previfem, Sprintec, Vylibra,	norgestimate	0.250	0.48	35	0.33
37	Brevicon; Modicon; Necon 0.5/35; Nelova 0.5/35; NEE 0.5/35	norethindrone	0.500	0.50	35	0.50
38	ortho novum 10/11, necon 10/11 [biphasic 0.5/35 and 1/35]	norethindrone	0.500	0.50	35	0.50
39	Kariva, Kimidess, Mircette, Pimtrea, Viorele, Volnea, Mylan generic	desogestrel	0.150	0.51	20	1.35	28 day desogestrel/ethinyl estradiol 0.15 mg/20 mcg tabs x21, then inert tabs x2, then 0 mg/10 mcg tabs x5
40	Apri, Cyred, Desogen, Emoquette, Enskyce, Isibloom, Juleber, orthocept, Reclipsen, Solia	desogestrel	0.150	0.51	30	1.35
41	Demulen, Zovia, Kelnor	ethynodiol diacetate	1.000	0.60	35	1.4
42	ethinyl estradiol-ethynodiol 1/50	ethynodiol diacetate	1.000	0.60	50	1.4
43	Alyacen 7/7/7, Cyclafem 777, Dasetta 7/7/7, Nortrel 7/7/7, Necon 7/7/7, Ortho Novum 7/7/7, Pirmella 7/7/7,	norethindrone	0.750	0.75	35	0.75		0.5, 0.75, 1
44	Amethyst, (lybrel, discontinued)	LNG	0.090	0.75	20	0.477		28 active pills
45	Alesse, Aubra, Aviane, Delyla, Larissia, Lessina, Levlite, Lutera, Orsythia, Sronyx, Vienva	LNG	0.100	0.83	20	0.53	21 active tabs	european Microgynon 20
46	Amethia Lo, CamreseLo, Lojaimiess, Loseasonique	LNG	0.100	0.83	20	0.53	84 active tabs	7 days of 10mcg EE
47	Aranelle, Leena, Tri-norinyl	norethindrone	0.830	0.83	35	0.83		0.5, 1, 0.5
48	Twirla	LNG	0.120	0.996	30	0.64			Contraindicated in women with BMI ≥30 kg/m2 due to decreased efficacy and increased risk of VTE. Diminished efficacy was observed in women with BMI ≥25 kg/m2.
49	Estrostep Fe, Tilia, Tril-egest	norethindrone	1.000	1.00	20/30/35	1.00
50	Alyacen 1/35, Cyclafem, Dasetta, Necon 1/35; Nelova 1/35; NEE 1/35; Genora 1/35; Norcept-E 1/35; Nortrel 1/35, Genora 1/35; Norcept-E 1/35;Norethin 1/35E; Norinyl 1/35; Ortho-Novum 1/35	norethindrone	1.000	1.00	35	1.00
51	Necon 1/50, norinyl 1/50, orthonovum 1/50, ovcon 50	norethindrone	1.000	1.00	50	1.00
52	Altavera, Chateal, Levlen, Levora, Marlissa, Nordette, Portia, Iclevia,	LNG	0.150	1.25	30	0.795		european Microgynon 30
53	Jolessa, Seasonale, Introvale, Quasense, Setlakin, Simpesse, Sylevia, Seasonique, Amethia, Ashlyna, Daysee, Camrese, Jaimiess	LNG	0.150	1.25	30	0.795	84 active pills	seasonique has 7 days of 10 mcg EE at end			great list of seasonale generics and manufacturers: https://www.drugs.com/availability/generic-seasonale.html
54	Cryselle, Lo Ovral, Low Ogestrel, elinest	norgestrel	0.300	1.26	30	0.78
55	Lo Loestrin	norethindrone acetate	1.000	1.60	10	1.2
56	Blisovi, Blisovi 24, Charlotte 24 Fe (chewable), Hailey 1/20, Gildess, Junel 1/20, Larin, Loestrin 1/20, Lomedia, Melodetta 24 Fe (chewable), Mibelas 24 Fe (chewable), Microgestin 1/20, Minastrin 24 Fe (chewable), Tarina, Taytulla (24/4) softgel	norethindrone acetate	1.000	1.60	20	1.2
57	Ogestrel, generic Ovral	norgestrel	0.500	2.1	50	1.3
58	Blisovi, Gildess, Junel 1.5/30, Larin, Loestrin 1.5/30, microgestin 1.5/30	norethindrone acetate	1.500	2.40	30	1.8
59
60
61	* assumes progestin activity is the same as desogestrel
62
63	CHART 3 from least progestational activity to most
64	Medication	progestin	mg of progestin	Androgenic activity	EE	progestational activity
65	Skyla IUD	levonorgestrel	0.0140	0.116	-	0.074
66	Kyleena IUD	levonorgestrel	0.0175	0.145	-	0.093
67	Liletta IUD	levonorgestrel	0.0186	0.154	-	0.099
68	Mirena IUD	levonorgestrel	0.020	0.17	-	0.106
69	Opill	norgestrel	0.075	0.315	-	0.195	POP
70	Xulane	norelgestromin	0.150	0.29	20	0.20
71	POP	norethindrone	0.350	0.35	-	0.35
72	Estarylla, Orthocyclen, sprintec, Mono-Linyah, Previfem, Estarylla, Norgestimate / Ethinyl Estradiol, Femynor, Mononessa, Sprintec, Mili	norgestimate	0.250	0.48	35	0.325			Tri-Lo Marzia, Tri-Lo-Mili, Tri-Lo Estarylla, Trinessa LO, Tri-Lo Sprintec				25 mcg EE	norgestimate/ethinyl estradiol 0.18 mg/25 mcg tab x7, then 0.215 mg/25 mcg tab x7, then 0.25 mg/25 mcg tab x7, then inert tab x7
73	Camila 28, Deblitane, Errin, Heather, Jolivette, Jencycla, Lyza, Nora-BE, Norethindrone, Norlyda, POP, Sharobel, Ortho Micronor	norethindrone	0.350	0.35	--	0.35
74	Nexplanon year 3	etonogestrel	0.040	0.14	--	0.36
75	Balzivia, Briellyn, Gildagia, philith, Ovcon 35	norethindrone	0.400	0.40	35	0.40
76	Brevicon; Modicon; Necon 0.5/35; Nelova 0.5/35; NEE 0.5/35	norethindrone	0.500	0.50	35	0.50
77	ortho novum 10/11, necon 10/11 [biphasic 0.5/35 and 1/35]	norethindrone	0.500	0.50	35	0.50
78	Aviane, Levlite, Lutera, Alesse(off market) Camrese Lo/ Loseasonique	LNG	0.100	0.83	20	0.53
79	Twirla	LNG	0.120	0.996	30	0.64		Contraindicated in women with BMI ≥30 kg/m2 due to decreased efficacy and increased risk of VTE. Diminished efficacy was observed in women with BMI ≥25 kg/m2.
80	Cyclafem 777, Pirmella 7/7/7, Dasetta 7/7/7, Alyacen 7/7/7, Nortrel 7/7/7, Necon 7/7/7	norethindrone	0.750	0.75	35	0.75		0.5, 0.75, 1
81	Lo Ovral, Low Ogestrel	norgestrel	0.300	1.26	30	0.78
82	Altavera, Chateal, Jolessa, Kurvelo, Levlen, Levora, Lillow, Marlissa, Nordette, Portia,,,	LNG	0.150	1.25	30	0.795
83	Seasonale, Iclevia, INtrovale, Quasense, Setlakin, Sylevia	LNG	0.150	1.25	30	0.795
84	Seasonique, Amethia, Ashlyna, Camrese, Daysee, Jaimiess, Simpesse	LNG	0.150	1.25	30	0.795		seasonique has 10 mcg of EE placebo			simpesse = seasonique = Daysee, Ashlyna, Jaimiess, Camrese.
85	Aranelle, Leena, Tri-norinyl	norethindrone	0.830	0.83	35	0.83		0.5, 1, 0.5
86	Cyclafem, Dasetta, Necon 1/35; Nelova 1/35; NEE 1/35; Genora 1/35; Norcept-E 1/35; Nortrel, Genora 1/35; Norcept-E 1/35;Norethin 1/35E; Norinyl 1/35; Ortho-Novum 1/35	norethindrone	1.000	1.00	35	1.00
87	Necon 1/50, norinyl 1/50, orthonovum 1/50, ovcon 50	norethindrone	1.000	1.00	50	1.00
88	NuvaRing	etonogestrel*	0.120	0.41	15	1.08
89	Lo Loestrin	norethindrone acetate	1.000	1.60	10	1.2
90	Blisovi, Gildess, Junel 1/20, Junel Fe 24, Larin, Loestrin 1/20, Microgestin 1/20	norethindrone acetate	1.000	1.60	20	1.2			Junel Fe 24 and similar is 20mcg EE + 4 days of 75 mg ferrous fumarate
91	Ogestrel, generic Ovral	norgestrel	0.500	2.1	50	1.3
92	Kariva, Mircette, Viorele	desogestrel	0.150	0.51	20	1.35
93	Apri, Desogen, Emoquette, Enskyce, orthocept, Reclipsen	desogestrel	0.150	0.51	30	1.35
94	Demulen, Zovia, kelnor	ethynodiol diacetate	1.000	0.60	35	1.4
95	Blisovi, Gildess, Junel 1.5/30, Larin, Loestrin 1.5/30, microgestin 1.5/30	norethindrone acetate	1.500	2.40	30	1.8
96
97	Gianvi, Jasmiel, Loryna, Lo-Zumandimine, Nikki, Vestura, Yaz	drosperinone	3.000	0.00	20	4.5			In patients with conditions requiring chronic therapy with medications that may increase potassium, monitor serum potassium during the first treatment cycle and periodically thereafter if patient begins medication or develops a condition that increases risk for hyperkalemia.
98	Ocella, Syeda, Yasmin, Zarah, Zumandimine	drosperinone	3.000	0.00	30	4.5
99	nextstellis	drosperinone	3.000	0.00	0	4.5	14.2 mg of estetrol		24 active, 4 placebo
100	Slynd	drosperinone	4.000	0.00	-	6	24 active 4 placebo