Dienogest

Dienogest (DNG) is a progestogen used in hormonal contraceptives and for the treatment of endometriosis.

Tags
Approvals
US FDA-Approved
dienogest
MOL SDF CML

Identifiers

Abbreviation

DNG

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References

Names

  • M-18575
  • MJR-35
  • SH-660
  • STS-557
  • ZK-37659
  • 17α-cyanomethyl-17β-hydroxy-estra-4,9(10)-dien-3-one
  • 17-hydroxy-3-oxo-19-nor-17α-pregna-4,9-diene-21-nitrile
  • (17-hydroxy-3-oxoestra-4,9-dien-17α-yl)acetonitrile
  • Cyanomethyldienolone

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References

  1. Wikipedia: Dienogest (View all citations for this reference)

CASRN

65928-58-7

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References

PubChem CID

68861

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References

  1. PubChem: Dienogest (View all citations for this reference)

ECHA InfoCard

  • 100.167.087
  • EC /List #: 639-448-2

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References

  1. ECHA: Dienogest (View all citations for this reference)

IUPHAR/BPS

7654

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References

  1. IUPHAR/BPS: Dienogest (View all citations for this reference)

DrugBank Accession Number

DB09123

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References

  1. DrugBank: Dienogest
    Wishart DS, Feunang YD, Guo AC, Lo EJ, Marcu A, Grant JR, Sajed T, Johnson D, Li C, Sayeeda Z, Assempour N, Iynkkaran I, Liu Y, Maciejewski A, Gale N, Wilson A, Chin L, Cummings R, Le D, Pon A, Knox C, Wilson M. DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res. 2017 Nov 8. doi: 10.1093/nar/gkx1037     (View all citations for this reference)

UNII

46M3EV8HHE

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References

  1. UNII: Dienogest (View all citations for this reference)

KEGG Entry Number

D03799

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References

  1. KEGG: Dienogest (View all citations for this reference)

Wikipedia Entry Name

Dienogest

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References

  1. Wikipedia: Dienogest (View all citations for this reference)

ChEBI ID

CHEBI:70708

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References

  1. ChEBI: Dienogest (View all citations for this reference)

ChEMBL ID

CHEMBL1201864

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References

  1. ChEMBL: Dienogest (View all citations for this reference)

ChemSpider ID

62093

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References

  1. ChemSpider: Dienogest (View all citations for this reference)

ATC Code(s)

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References

  1. ECHA: Dienogest (View all citations for this reference)

Physical & Chemical Properties

Molecular Formula

C20H25NO2

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References

Molecular Weight

311.43 g/mol

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References

Appearance

White, almost white, or slightly yellow crystalline powder

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References

  1. BP 2017: Dienogest monograph.
    2. (View all citations for this reference)

Melting Point

144-145

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References

  1. PubChem: Dienogest (View all citations for this reference)

Solubility

Practically insoluble in water, sparingly soluble in methylene chloride, slightly soluble in methanol

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References

  1. BP 2017: Dienogest monograph.
    2. (View all citations for this reference)

Specific Optical Rotation

-352 to -344, 0.125 g dried substance in methanol, diluted to 25.0 mL

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References

  1. BP 2017: Dienogest monograph.
    2. (View all citations for this reference)

Toxicology

GHS Hazard Code(s)

Class Category Code Description
Carcinogenicity 2 H351 Suspected of causing cancer if inhaled
Reproductive Toxicity 1A H360 May damage fertility or the unborn child
Reproductive Toxicity, Effects On or Via Lactation H362 May cause harm to breast-fed children

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References

  1. ECHA: Dienogest (View all citations for this reference)

Side Effects

In COCs with ethinyl estradiol: irregular vaginal bleeding, headache, breast pain, nausea/vomiting, depression, decreased libido

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References

  1. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    2. (View all citations for this reference)

Carcinogenicity

No evidence in vivo and in vitro.

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References

  1. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    2. (View all citations for this reference)

Mutagenicity

No evidence in vivo and in vitro.

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References

  1. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    2. (View all citations for this reference)

LD50

  • mouse oral: 4 g/kg
  • rabbit oral: 1600 mg/kg
  • LDLo mouse intraperitoneal: 1 g/kg
  • LDLo mouse subcutaneous: 5 g/kg
  • LDLo rabbit intraperitoneal: 1.5 g/kg
  • LDLo rabbit oral: 1 g/kg

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References

  1. ChemIDPlus: A Toxnet Database. Dienogest. (View all citations for this reference)

Biochemistry & Pharmacology

Progesterone Receptor Activity

Agonist. Some antagonist behavior.

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References

  1. WHO International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 91: Combined Estrogen-Progestogen Contraceptives and Combined Estrogen-Progestogen Menopausal Therapy. 2007, Lyon, France. (View all citations for this reference)
  2. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    3. (View all citations for this reference)
  3. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    4. (View all citations for this reference)

Androgen Receptor Activity

Antagonist (40% of CPA, the most potent anti-androgenic progestin)

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References

  1. Sitruk-Ware, R.; El-Etr, M., Progesterone and related progestins: potential new health benefits. Climacteric 2013, 16, 69-78.
    2. (View all citations for this reference)
  2. Africander, D.; Verhoog, N.; Hapgood, J. P., Molecular mechanisms of steroid receptor-mediated actions by synthetic progestins used in HRT and contraception. Steroids 2011, 76 (7), 636-52.
    3. (View all citations for this reference)
  3. Sitruk-Ware, R.; Small, M.; Kumar, N.; Tsong, Y.-Y.; Sundaram, K.; Jackanicz, T., Nestorone®: clinical applications for contraception and HRT. Steroids 2003, 68 (10-13), 907-913.
    4. (View all citations for this reference)
  4. Kuhl, H., Pharmacology of estrogens and progestogens: influence of different routes of administration. Climacteric 2005, 8 Suppl 1, 3-63.
    5. (View all citations for this reference)
  5. Bartsch, V., Gynaecological uses of dienogest alone and in combination with oestrogens. Journal of Medical Drug Reviews 2015, 5, 1-31.
    6. (View all citations for this reference)
  6. Ruan, X.; Seeger, H.; Mueck, A. O., The pharmacology of dienogest. Maturitas 2012, 71 (4), 337-44.
    7. (View all citations for this reference)
  7. Lello, S., Nomegestrol Acetate Pharmacology, Safety Profile and Therapeutic Efficacy. Drugs 2010, 70 (5), 541-559.
    8. (View all citations for this reference)
  8. Sitruk-Ware, R., New progestagens for contraceptive use. Hum. Reprod. Update 2006, 12 (2), 169-78.
    9. (View all citations for this reference)
  9. WHO International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 91: Combined Estrogen-Progestogen Contraceptives and Combined Estrogen-Progestogen Menopausal Therapy. 2007, Lyon, France. (View all citations for this reference)
  10. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    11. (View all citations for this reference)
  11. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    12. (View all citations for this reference)

Estrogen Receptor Activity

Weak or no agonist and antagonist activity

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References

  1. Africander, D.; Verhoog, N.; Hapgood, J. P., Molecular mechanisms of steroid receptor-mediated actions by synthetic progestins used in HRT and contraception. Steroids 2011, 76 (7), 636-52.
    2. (View all citations for this reference)
  2. Sitruk-Ware, R., New progestagens for contraceptive use. Hum. Reprod. Update 2006, 12 (2), 169-78.
    3. (View all citations for this reference)
  3. Bartsch, V., Gynaecological uses of dienogest alone and in combination with oestrogens. Journal of Medical Drug Reviews 2015, 5, 1-31.
    4. (View all citations for this reference)
  4. Su, Y.; Lian, Q. Q.; Ge, R. S., Contraceptives with novel benefits. Expert Opin Investig Drugs 2012, 21 (1), 83-90.
    5. (View all citations for this reference)
  5. Ruan, X.; Seeger, H.; Mueck, A. O., The pharmacology of dienogest. Maturitas 2012, 71 (4), 337-44.
    6. (View all citations for this reference)
  6. Lello, S., Nomegestrol Acetate Pharmacology, Safety Profile and Therapeutic Efficacy. Drugs 2010, 70 (5), 541-559.
    7. (View all citations for this reference)
  7. WHO International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 91: Combined Estrogen-Progestogen Contraceptives and Combined Estrogen-Progestogen Menopausal Therapy. 2007, Lyon, France. (View all citations for this reference)
  8. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    9. (View all citations for this reference)
  9. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    10. (View all citations for this reference)

Glucocorticoid Receptor Activity

Low to no activity

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References

  1. Africander, D.; Verhoog, N.; Hapgood, J. P., Molecular mechanisms of steroid receptor-mediated actions by synthetic progestins used in HRT and contraception. Steroids 2011, 76 (7), 636-52.
    2. (View all citations for this reference)
  2. Su, Y.; Lian, Q. Q.; Ge, R. S., Contraceptives with novel benefits. Expert Opin Investig Drugs 2012, 21 (1), 83-90.
    3. (View all citations for this reference)
  3. Ruan, X.; Seeger, H.; Mueck, A. O., The pharmacology of dienogest. Maturitas 2012, 71 (4), 337-44.
    4. (View all citations for this reference)
  4. Lello, S., Nomegestrol Acetate Pharmacology, Safety Profile and Therapeutic Efficacy. Drugs 2010, 70 (5), 541-559.
    5. (View all citations for this reference)
  5. WHO International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 91: Combined Estrogen-Progestogen Contraceptives and Combined Estrogen-Progestogen Menopausal Therapy. 2007, Lyon, France. (View all citations for this reference)
  6. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    7. (View all citations for this reference)
  7. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    8. (View all citations for this reference)

Mineralocorticoid Receptor Activity

No activity

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References

  1. Africander, D.; Verhoog, N.; Hapgood, J. P., Molecular mechanisms of steroid receptor-mediated actions by synthetic progestins used in HRT and contraception. Steroids 2011, 76 (7), 636-52.
    2. (View all citations for this reference)
  2. Su, Y.; Lian, Q. Q.; Ge, R. S., Contraceptives with novel benefits. Expert Opin Investig Drugs 2012, 21 (1), 83-90.
    3. (View all citations for this reference)
  3. Ruan, X.; Seeger, H.; Mueck, A. O., The pharmacology of dienogest. Maturitas 2012, 71 (4), 337-44.
    4. (View all citations for this reference)
  4. Lello, S., Nomegestrol Acetate Pharmacology, Safety Profile and Therapeutic Efficacy. Drugs 2010, 70 (5), 541-559.
    5. (View all citations for this reference)
  5. WHO International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 91: Combined Estrogen-Progestogen Contraceptives and Combined Estrogen-Progestogen Menopausal Therapy. 2007, Lyon, France. (View all citations for this reference)
  6. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    7. (View all citations for this reference)
  7. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    8. (View all citations for this reference)

Target Pathways

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References

  1. KEGG: Dienogest (View all citations for this reference)

Bioavailability

90-96.2%

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References

  1. Schindler, A. E.; Campagnoli, C.; Druckmann, R.; Huber, J.; Pasqualini, J. R.; Schweppe, K. W.; Thijssen, J. H. H., Classification and pharmacology of progestins. Maturitas 2003, 46, 7-16.
    2. (View all citations for this reference)
  2. Ruan, X.; Seeger, H.; Mueck, A. O., The pharmacology of dienogest. Maturitas 2012, 71 (4), 337-44.
    3. (View all citations for this reference)
  3. Bartsch, V., Gynaecological uses of dienogest alone and in combination with oestrogens. Journal of Medical Drug Reviews 2015, 5, 1-31.
    4. (View all citations for this reference)
  4. Stanczyk, F. Z., Pharmacokinetics and potency of progestins used for hormone replacement therapy and contraception. Rev. Endocr. Metab. Disord. 2002, 3 (3), 211-224. (View all citations for this reference)
  5. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    6. (View all citations for this reference)
  6. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    7. (View all citations for this reference)

Elimination Half-Life (t1/2)

8-10 h

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References

  1. Su, Y.; Lian, Q. Q.; Ge, R. S., Contraceptives with novel benefits. Expert Opin Investig Drugs 2012, 21 (1), 83-90.
    2. (View all citations for this reference)
  2. Ruan, X.; Seeger, H.; Mueck, A. O., The pharmacology of dienogest. Maturitas 2012, 71 (4), 337-44.
    3. (View all citations for this reference)
  3. Stanczyk, F. Z., Pharmacokinetics and potency of progestins used for hormone replacement therapy and contraception. Rev. Endocr. Metab. Disord. 2002, 3 (3), 211-224. (View all citations for this reference)
  4. WHO International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 91: Combined Estrogen-Progestogen Contraceptives and Combined Estrogen-Progestogen Menopausal Therapy. 2007, Lyon, France. (View all citations for this reference)
  5. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    6. (View all citations for this reference)
  6. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    7. (View all citations for this reference)

Serum Protein Binding

90% bound to serum albumin, 10% free. No binding to SHBG or CBG.

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References

  1. Schindler, A. E.; Campagnoli, C.; Druckmann, R.; Huber, J.; Pasqualini, J. R.; Schweppe, K. W.; Thijssen, J. H. H., Classification and pharmacology of progestins. Maturitas 2003, 46, 7-16.
    2. (View all citations for this reference)
  2. Su, Y.; Lian, Q. Q.; Ge, R. S., Contraceptives with novel benefits. Expert Opin Investig Drugs 2012, 21 (1), 83-90.
    3. (View all citations for this reference)
  3. Ruan, X.; Seeger, H.; Mueck, A. O., The pharmacology of dienogest. Maturitas 2012, 71 (4), 337-44.
    4. (View all citations for this reference)
  4. Bartsch, V., Gynaecological uses of dienogest alone and in combination with oestrogens. Journal of Medical Drug Reviews 2015, 5, 1-31.
    5. (View all citations for this reference)
  5. WHO International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 91: Combined Estrogen-Progestogen Contraceptives and Combined Estrogen-Progestogen Menopausal Therapy. 2007, Lyon, France. (View all citations for this reference)
  6. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    7. (View all citations for this reference)
  7. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    8. (View all citations for this reference)

Metabolism

CYP3A4

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References

  1. KEGG: Dienogest (View all citations for this reference)
  2. Nanda, K.; Stuart, G. S.; Robinson, J.; Gray, A. L.; Tepper, N. K.; Gaffield, M. E. Drug Interactions between Hormonal Contraceptives and Antiretrovirals. AIDS 2017, 31 (7), 917–952. (View all citations for this reference)

Excretion

Mainly via kidneys.

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References

  1. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    2. (View all citations for this reference)
  2. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    3. (View all citations for this reference)

Apparent Volume of Distribution

40 L from 2 mg/day oral dose

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References

  1. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    2. (View all citations for this reference)

Tmax

2 h

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References

  1. Schindler, A. E.; Campagnoli, C.; Druckmann, R.; Huber, J.; Pasqualini, J. R.; Schweppe, K. W.; Thijssen, J. H. H., Classification and pharmacology of progestins. Maturitas 2003, 46, 7-16.
    2. (View all citations for this reference)
  2. Su, Y.; Lian, Q. Q.; Ge, R. S., Contraceptives with novel benefits. Expert Opin Investig Drugs 2012, 21 (1), 83-90.
    3. (View all citations for this reference)
  3. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    4. (View all citations for this reference)

Clearance

Oettel et al: 75 mL/h/kg
Foster et al: 3 L/h from 2 mg/day oral dose

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References

  1. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    2. (View all citations for this reference)

Enzyme Interactions

3β-hydroxysteroid dehydrogenase-Δ5-4-isomerase: inhibitor

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References

  1. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    2. (View all citations for this reference)

Minimum Contraceptive Threshold

Oettel: 4.0 ng/mL
Foster: 1 mg/day oral dose for inhibition of ovulation in cyclical women

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References

  1. Oettel, M.; Breitbarth, H.; Elger, W.; Gräser, T.; Hübler, D.; Kaufmann, G.; Moore, C.; Patchev, V.; Römer, W.; Schröder, J.; et al. The Pharmacological Profile of Dienogest. Eur. J. Contracept. Reprod. Heal. Care 1999, 4 (sup1), 2–13.
    2. (View all citations for this reference)
  2. Foster, R. H.; Wilde, M. I. Dienogest. Drugs 1998, 56 (5), 825–833.
    3. (View all citations for this reference)

Indications

Indicated for use by women for pregnancy prevention. Also indicated for the treatment of heavy menstrual bleeding in women without organic pathology who choose to use an oral contraceptive as their method of birth control. (PubChem) Menorrhagia, endometriosis (ChEMBL)

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References

  1. PubChem: Dienogest (View all citations for this reference)
  2. ChEMBL: Dienogest (View all citations for this reference)

Metabolites

Name
Structure
Notes
Other Dienogest Metabolites

A number of other metabolites have been detected, including unspecified hydrogenation and hydroxylation products.

17α-Cyanomethyl-1,3,5(10),9(11)-estratetraene-3,17-diol
structure

Ring A aromatized.

11β-Hydroxydienogest
structure

View All (3)

Impurities

Name
Structure
CASRN
Other Names & Identifiers
(4-Bromo-17-hydroxy-3-oxoestra-4,9-dien-17α-yl)acetonitrile
structure

  • BP Dienogest Impurity M

Spiro[1,3-dioxolan-2,3′-estra-5′(10′),9′(11′)-dien]-17′-one
structure

  • BP Dienogest Impurity L

(11-Hydroperoxy-17-hydroxy-3-oxoestra-4,9-dien-17α-yl)acetonitrile
structure

  • BP Dienogest Impurity K

[17-Hydroxy-3-methoxyestra-1,3,5(10)-trien-17α-yl]acetonitrile
structure

  • BP Dienogest Impurity J

[17-Hydroxy-3-oxoestra-5(10)-en-17α-yl]acetonitrile
structure

  • BP Dienogest Impurity I

View All (13)

US FDA-Approved Products

Name
Formulation
Status
ANDA #
Natazia
DIENOGEST: N/A, 2 mg, 3 mg, N/A, N/A ESTRADIOL VALERATE: 3 mg, 2 mg, 2 mg, 1 mg, N/A Oral tablet

Prescription

022252

Estradiol Valerate; Estradiol Valerate; Dienogest
ESTRADIOL VALERATE/ESTRADIOL VALERATE/DIENOGEST: 1 mg, 2 mg, 2 mg ESTRADIOL VALERATE/ESTRADIOL VALERATE/DIENOGEST: 3 mg, 2 mg, 3 mg Oral tablet

None (Tentative Approval)

202999

Estradiol Valerate and Dienogest
DIENOGEST: N/A, 2 mg, 3 mg, N/A, N/A ESTRADIOL VALERATE: 3 mg, 2 mg, 2 mg, 1 mg, N/A Oral tablet

Prescription

202349

View All (3)