Marvelon (Desogestrel / Ethinyl Estradiol)

Description

Marvelon is a prescription birth control pill that contains desogestrel and ethinyl estradiol. It mainly prevents pregnancy by stopping the ovaries from releasing an egg. It also thickens mucus at the cervix, making it harder for sperm to reach an egg, and changes the uterine lining. Marvelon 21 contains 21 active white pills, followed by 7 pill-free days. Marvelon 28 contains the same 21 active pills plus 7 green inactive pills to help maintain a daily routine.

Directions

Take one tablet at about the same time every day. Start on the first day of your period or on the first Sunday after it begins. If your period starts on Sunday, start that day. For Marvelon 21, take 21 white tablets, then take no tablets for 7 days before starting a new pack on day 8. For Marvelon 28, take 21 white tablets followed by 7 green tablets, then begin the next pack the next day.

If you miss one tablet, take it when you remember and take the next tablet at the usual time, even if this means taking two in one day. If you miss two tablets in a row in weeks 1 or 2, take two when you remember and two the next day, then continue daily and use condoms for 7 days.

If you miss two tablets in week 3, or three or more tablets at any time, follow the package instructions or ask a healthcare provider, as the steps depend on when you started the pack. Vomiting within 3 to 4 hours after taking a tablet counts as a missed tablet. Contact your healthcare provider if you miss two periods in a row.

Ingredients

The active ingredients in Marvelon are desogestrel and ethinyl estradiol per white tablet. Non-medicinal ingredients in the white tablets include hydroxypropyl methylcellulose, lactose monohydrate, polyethylene glycol, povidone, colloidal anhydrous silica, starch, stearic acid, talc, titanium dioxide, and vitamin E. The green placebo tablets in Marvelon 28 may contain FDandC Blue, ferric oxide, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, polyethylene glycol, starch, talc, and titanium dioxide, without any hormones.

Cautions

• Before using this medication, you may want to consult a healthcare provider about the following:
  • Any existing health conditions
  • Any allergies
  • A list of all medications currently being taken
• Avoid cigarettes, or do not take Marvelon at all once you pass 35. Smoking sharply increases the risk of serious blood clots on the pill, and the danger increases with your age and with how much you smoke.
• Learn the warning signs of a clot before you start, and get emergency care if any appear: pain or swelling in one calf, sudden breathlessness, chest pain, a crushing headache, weakness down one side, or vision that drops out.
• Tell your surgeon you take Marvelon well before any operation. Expect to stop it roughly four weeks beforehand and stay off it until two weeks after you are moving normally again.
• Have your blood pressure checked at routine visits, and stop the pill if it becomes severely increased.
• Consult a healthcare provider about any history of migraine before taking this pill.
• Mention diabetes, prediabetes, or high triglycerides so your healthcare provider can monitor you, since severely increased triglycerides can trigger pancreatitis.
• Stop the pill and report jaundice immediately. Yellowing of the skin or eyes points to a liver problem.
• Check your breasts for new lumps and maintain whatever screening your provider recommends.
• Expect some spotting or breakthrough bleeding over the first few months and keep taking the pill on schedule anyway. Tell your healthcare provider if it persists.
• Rifampin, several antiseizure drugs, some HIV medicines, and St. John’s wort can all increase hormone clearance and potentially leave you unprotected.
• Wait at least four weeks after childbirth before starting Marvelon if you are not breastfeeding, and talk to your healthcare provider first if you are nursing, as the pill can reduce milk supply.
• Use condoms alongside the pill whenever you need protection from sexually transmitted infections.
• Tell your healthcare provider about hereditary or acquired angioedema, since estrogen can cause or worsen attacks.

Contraindications

Avoid taking or using this medication if any of the following apply:

• Hypersensitivity to desogestrel, ethinyl estradiol, or any other ingredient of the tablet
• A deep vein thrombosis or pulmonary embolism now or at any time in the past
• An arterial clot such as a heart attack or stroke, now or previously, or a warning event like a mini-stroke or angina
• A cerebrovascular disorder, current or past
• Valvular heart disease with complications
• Severe liver disease, current or past, until liver test values return to normal
• A liver tumor, benign or malignant
• A known or suspected cancer influenced by sex hormones, including cancers of the breast or genital organs
• Vaginal bleeding that has not been explained by a diagnosis
• Steroid-dependent jaundice, cholestatic jaundice, or jaundice during a previous pregnancy
• Eye damage caused by disease of the blood vessels in the eye, such as partial or complete vision loss or a defect in the visual field
• Known or suspected pregnancy
• Migraine with focal aura, currently or in the past
• Pancreatitis, especially if it occurs alongside severely raised triglycerides
• Severe or multiple risk factors for arterial or venous clotting, including high blood pressure, a clotting disorder, severe dyslipoproteinemia, smoking past age 35, diabetes with blood vessel damage, major surgery, and prolonged immobility
• Treatment with the hepatitis C regimens ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, or with glecaprevir and pibrentasvir

Side Effects

Common side effects of Marvelon include:

• Nausea, sometimes with vomiting, mostly during the first cycle
• Breakthrough bleeding or spotting between periods
• Breast tenderness or enlargement
• Headache
• A change in weight, up or down
• Abdominal cramps or bloating
• Shifts in mood or sex drive
• Lighter, shorter, or missed periods
• Dizziness
• Darker patches of skin on the face

Stop Marvelon and get emergency care if you develop pain or swelling in one calf, sudden shortness of breath, chest pain, coughing up blood, a severe headache, weakness or numbness down one side, trouble speaking, or sudden loss of vision. Consult a healthcare provider if you experience yellowing of the skin or eyes, dark urine, severe pain high on the right side of your abdomen, or a new lump in your breast. Swelling of the face, lips, or throat with any difficulty breathing may be signs of an allergic reaction and need immediate care. If two periods fail to arrive, rule out pregnancy before continuing.

References

Marvelon 21 and Marvelon 28 Product Monograph. Kirkland, QC: Organon Canada Inc.; 2024.

Marvelon Consumer Information. Kirkland, QC: Organon Canada Inc.; 2024.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....