Norgestimate

Absorption

Oral norgestimate has a Tmax of 0.5-2h.
On day 21 of cycle 3, 17-desacetylnorgestimate reaches a Cmax of 1.82ng/mL, with a Tmax of 1.5h, and an AUC of 16.1h*ng/mL. At the same time, norgestrel reaches a Cmax of 2.79ng/mL, with a Tmax of 1.7h, and an AUC of 49.9h*ng/mL.

Toxicity

Data regarding overdoses of norgestimate are rare. However, the majority of patients overdosing on oral contraceptives do not become seriously ill. Treat overdoses with symptomatic and supportive care.

Description

Norgestimate is an orally-effective progestogen, recently launched in combination with ethinyl estradiol as an oral contraceptive.

Chemical properties

White Crystalline Solid

Originator

Ortho (USA)

The Uses of Norgestimate

Progestogen. In combination with estrogen as oral contraceptive

The Uses of Norgestimate

antifungal

The Uses of Norgestimate

Progestogen. In combination with estrogen as oral contraceptive.

Background

Norgestimate was first described in the literature in 1977. It was developed by Ortho Pharmaceutical Corporation as part of an effort to develop new hormonal contraceptives with reduced adverse effects. It is commonly formulated with ethinylestradiol as a combined oral contraceptive that can also be used to treat moderate acne vulgaris.
Norgestimate was granted FDA approval on 29 December 1989.

Indications

Norgestimate is formulated with ethinylestradiol as a combined oral contraceptive. It can also be given with low dose ethinylestradiol for contraception as well as the treatment of moderate acne vulgaris in women ≥15 years old.

What are the applications of Application

Norgestimate is a progestogen

Definition

ChEBI: Norgestimate is a steroid ester, a ketoxime and a terminal acetylenic compound. It has a role as a contraceptive drug, a progestin and a synthetic oral contraceptive.

Manufacturing Process

A solution of 4.5 g of D-17β-acetoxy-13β-ethyl-17α-ethynyl-gon-4-en-3-one in 15 ml of pyridine and 2.0 g of hydroxylamine hydrochloride hydroxylamine hydrochloride is heated on a steam bath for 45 min. It is then cooled and poured into a large amount of ice-water, after which the solid which is thus produced is filtered off and air dried. Recrystallization from methylene chloride-ethanol gives D-17β-acetoxy-13α-ethyl-17α-ethynyl-gon-4-en-one oxime, m.p. 214-218°C; [α]D25 = +41°.

brand name

CILEST

Therapeutic Function

Progestin

General Description

Norgestimate, (17α)-17-acetyloxy-13-ethyl-18,19-dinor-pregn-4-en-20yn-3-one oxime, is a 19-nortestosterone, 3-oxime prodrug that is orally active andused with an estrogen in oral contraceptive products. It hasminimal androgenic action. Norgestimate is metabolized to17-deacetylnorgestimate (norelgestromin) and norgestrel,which provide the progestational action.

Pharmacokinetics

Norgestimate is a progestin that suppresses ovulation for contraception and reduces free testosterone to treat moderate acne vulgaris. The therapeutic index is wide as overdoses are rare. Patients should be counselled regarding the risk of vascular problems, liver disease, hypertension, metabolic effects, headaches, and bleeding irregularities.

in vitro

norgestimate was found that, unlike other 19-nortestosterone derivatives, showed high selectivity for the progesterone receptor and low androgenic activity. moreover, norgestimate and its main active metabolite norelgestromin could not bind to or occupy sex hormone-binding globulin [1].

in vivo

the androgenic and the progestational activity of norgestimate were compared in two animal studies. it was found the difference in the pharmacological response in norgestimate treated rats was equivalent to the difference in the exposure of the animals to either directly administered or metabolically derived levonorgestrel [2].

Metabolism

Norgestimate is rapidly deacetylated to the active 17-desacetylnorgestimate, which is deoximated to the active norgestrel. 17-desacetylnorgestimate is metabolized to a number of undefined hydroxylated metabolites, mainly by CYP3A4 and to a lesser extend by CYP2B6 and CYP2C9. Norgestrel is O-glucuronidated by UGT1A1 or oxidized to a number of undefined hydroxylated metabolites by CYP3A4.

Metabolism

Norgestimate is considered to be a pro-proges tin (prodrug), because it rapidly undergoes a two-s tep m etabolic transformation to form two active products, norelgestromine (levonorgestrel 3-oxime) and levonorgestrel. Deacetylation occurs in the intestine and liver, whereas convers ion of the 3-oxime to the corresponding ketone occurs primarily in the liver. Unlike the other progestins mentioned, norgestimate and its metabolites are not bound to SHBG.

References

[1] thomas l. lemke; david a. williams (2008). foye's principles of medicinal chemistry. lippincott williams & wilkins. pp. 1316–. isbn 978-0-7817-6879-5.
[2] kuhnz w, beier s. comparative progestational and androgenic activity of norgestimate and levonorgestrel in the rat. contraception. 1994 mar;49(3):275-89.
[3] https://en. wikipedia.org/wiki/norgestimate