Ethinylestradiol

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Ethinylestradiol chemical structure
Ethinylestradiol
Systematic (IUPAC) name
17-ethynyl-13-methyl- 7,8,9,11,12,13,14,15,16,17- decahydro-6H-cyclopenta[a] phenanthrene-

3,17-diol

Identifiers
CAS number 57-63-6
ATC code G03CA01 L02AA03
PubChem 5991
DrugBank APRD00691
Chemical data
Formula C20H24O2
Mol. weight 296.403
Pharmacokinetic data
Bioavailability 97% is bound
Metabolism Liver
Half life 36±13 hours
Excretion Urine
Therapeutic considerations
Pregnancy cat.

X (USA)

Legal status

Rx-only (U.S.)

Routes Oral, transdermal

Ethinylestradiol, also ethinyl estradiol (EE), is a synthetic derivative of estradiol. Ethinyl estradiol is orally bio-active and the estrogen in most formulations of oral contraceptives (the Pill). It is one of the most commonly used medications.

While estradiol is readily absorbed when taken orally, it is also quickly inactivated by the liver. Substitution at C17 of the estrane steroid with an ethinyl group proved to provide an estrogen that is much more resistant to degradation and paved the way for the development of oral contraceptives.

EE is absorbed in the small intestine and reaches a serum peak about 2 hours later. It undergoes extensive metabolism in the liver involving the cytochrome P450 3A4 isoenzyme. EE and its metabolites are in excreted with the bile. Due to the effect of enterohepatic circulation as second peak is seen several hours later. Individually, wide variations exist in the overall absorption process, and can be further modified by drug (i.e. antibiotics) that affect the enterohepatic circulation or liver enzymes. In circulation EE is almost fully bound to plasma albumin. It is metabolized by hydroxylation of the aromatic ring and excreted in both, feces and urine, in part as glucuronide and sulfate conjugate.

EE is hormonally effective by activating the estrogen receptor and thus used as an estrogen. It finds its most common use in the estrogen-progestin combination preparations of oral contraceptives. Over time, formulations have decreased the EE dose from as high as 100 μg to as low as 20 μg.

All the contraindication and precautions apply for EE as with other estrogen medications.

Estinyl is a preparation of EE alone that is used for the management of menopausal symptoms and female hypogonadism.

EE is released into the environment as a xenoestrogen.

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Sex hormones and related medications (primarily G03, also L02, H01C) edit
Progestogens:
(receptor)

Desogestrel, Drospirenone, Dydrogesterone, Ethisterone, Etonogestrel, Ethynodiol diacetate, Gestodene, Gestonorone, Levonorgestrel, Lynestrenol, Medroxyprogesterone, Megestrol, Norelgestromin, Norethisterone, Norethynodrel, Norgestimate, Norgestrel, Norgestrienone, Tibolone
Antiprogestogen: Mifepristone

Androgens:
(receptor)

Androstanolone, Fluoxymesterone, Mesterolone, Methyltestosterone, Testosterone, (see also anabolic steroids)
Antiandrogens: Bicalutamide, Cyproterone, Flutamide, Nilutamide, Spironolactone

Estrogens:
(receptor)

Chlorotrianisene, Dienestrol, Diethylstilbestrol, Estradiol, Estriol, Estrone, Ethinylestradiol, Fosfestrol, Mestranol, Polyestradiol phosphate
Selective estrogen receptor modulator: Bazedoxifene, Clomifene, Fulvestrant, Raloxifene, Tamoxifen, Toremifene
Aromatase inhibitor: Aminogluthetimide, Anastrozole, Exemestane, Formestane, Letrozole, Vorozole

Gonadotropins:
(FSHR/LHCGR)

ovulation stim.: Clomifene, Urofollitropin
Antigonadotropins: Danazol, Gestrinone

GnRH:
(receptor)

Gonadotropin-releasing hormone agonist: Buserelin, Goserelin, Leuprorelin, Nafarelin, Triptorelin
Gonadotropin-releasing hormone antagonist: Histrelin, Abarelix