Norgestimate

Norgestimate (INN, USAN, BAN) is an acetylated progestin used as an oral contraceptive. It acts as a prodrug to norelgestromin (17-deacetylnorgestimate or levonorgestrel 3-oxime), the primary active metabolite, and levonorgestrel (deacetylation of norgestimate occurs in the intestines and the liver). Unlike levonorgestrel, norgestimate shows high selectivity for the progesterone receptor and low androgenic action due to a large drug-induced elevation in the level of sex hormone-binding globulin (SHBG) (which preferentially binds androgens and thus inhibits their action). In accordance, clinical trials have observed minimal androgenic side effects. Norgestimate and its metabolites themselves, unlike many other progestins, do not bind to SHBG. Norgestimate is used in combination with ethinyl estradiol as an oral contraceptive.