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Medication Spotlight [Nextstellis]

Combined hormonal contraceptives have been around for a long time, and now, there is a new member which will join the class called Nextstellis. ---------- Nextstellis contains a novel estrogen called estetrol (E4), combined with the progestin drospirenone. The 28-tablet package contains 24 active pills and 4 placebo pills. Instructions are to take 1 tablet daily at the same time each day. ---------- Estetrol is plant-sourced estrogen which mimics the natural estrogen produced by the baby’s liver during pregnancy. It is hypothesized that this will have less systemic effects because of its selectivity in estrogen receptors. First of all, despite being an agonist in uterine, brain and bones, it is actually antagonist in breast tissue. This may translate to less breast tenderness symptoms. Secondly, estetrol does not undergo major metabolism in the liver, which may translate to less venous thromboembolism risk.

Drospirenone is already combined with other estrogens on the market such as ethinyl estradiol. Drospirenone is a unique progestin which has anti-androgenic properties and may be useful for acne.

All usual contraindications of birth control pills still apply to Nextstellis.

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