Ormeloxifene
Systematic (IUPAC) name
1-[2-[4-[(3S,4R)-7-methoxy-2,2- dimethyl-3-phenyl-chroman-4-yl] phenoxy] ethyl] pyrrolidine
Identifiers
CAS number	78994-24-8
ATC code	?
PubChem	154413
Chemical data
Formula	C30H35NO3
Mol. mass	457.604 g/mol
Pharmacokinetic data
Bioavailability	?
Metabolism	?
Half life	7 days
Excretion	?
Therapeutic considerations
Pregnancy cat.	? Image File history File links This is a lossless scalable vector image. ... IUPAC nomenclature is a system of naming chemical compounds and of describing the science of chemistry in general. ... CAS registry numbers are unique numerical identifiers for chemical compounds, polymers, biological sequences, mixtures and alloys. ... The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. ... PubChem is a database of chemical molecules. ... This article or section does not cite any references or sources. ... General Name, Symbol, Number carbon, C, 6 Chemical series nonmetals Group, Period, Block 14, 2, p Appearance black (graphite) colorless (diamond) Standard atomic weight 12. ... General Name, Symbol, Number hydrogen, H, 1 Chemical series nonmetals Group, Period, Block 1, 1, s Appearance colorless Atomic mass 1. ... General Name, Symbol, Number nitrogen, N, 7 Chemical series nonmetals Group, Period, Block 15, 2, p Appearance colorless gas Standard atomic weight 14. ... General Name, Symbol, Number oxygen, O, 8 Chemical series nonmetals, chalcogens Group, Period, Block 16, 2, p Appearance colorless (gas) very pale blue (liquid) Standard atomic weight 15. ... The molecular mass (abbreviated Mr) of a substance, formerly also called molecular weight and abbreviated as MW, is the mass of one molecule of that substance, relative to the unified atomic mass unit u (equal to 1/12 the mass of one atom of carbon-12). ... In pharmacology, bioavailability is used to describe the fraction of an administered dose of unchanged drug that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. ... Drug metabolism is the metabolism of drugs, their biochemical modification or degradation, usually through specialized enzymatic systems. ... It has been suggested that Effective half-life be merged into this article or section. ... Excretion is the process of eliminating waste products of metabolism and other materials that are of no use. ... The pregnancy category of a pharmaceutical agent is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. ...
Legal status
Routes	Oral

Ormeloxifene (also known as Centchroman) is one of the selective estrogen receptor modulators, or SERMs, a class of medication which acts on the estrogen receptor. It is best known as a non-hormonal, non-steroidal oral contraceptive which is taken once per week. In India, ormeloxifene has been available as birth control since the early 1990s, and it is currently marketed there under the trade name Saheli. Ormeloxifene has also been licensed under the trade names Centron and Sevista. The regulation of therapeutic goods, that is drugs and therapeutic devices, varies by jurisdiction. ... In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body 1. ... Selective estrogen receptor modulators (SERMs) is a class of medication that acts on the estrogen receptor. ... Birth control is a regimen of one or more actions, devices, or medications followed in order to deliberately prevent or reduce the likelihood of a woman becoming pregnant or giving birth. ...

Method of action

Ormeloxifene is a SERM, or selective estrogen receptor modulator. In some parts of the body, its action is estrogenic (e.g, bones), in other parts of the body, its action is anti-estrogenic (e.g., uterus, breasts).^{[citation needed]} It causes an asynchrony in the menstrual cycle between ovulation and the development of the uterine lining, although its exact mode of action is not well defined. In clinical trials, it caused ovulation to occur later than it normally would in some women (Singh 2001), but did not affect ovulation in the majority of women, while causing the lining of the uterus to build more slowly. It speeds the transport of any fertilized egg through the fallopian tubes more quickly than is normal (Singh 2001). Presumably, this combination of effects creates an environment such that if fertilization occurs, implantation will not be possible.^[1] Selective estrogen receptor modulators (SERMs) is a class of medication that acts on the estrogen receptor. ... The estrogen receptor is a receptor for estradiol (the main endogenous estrogen); it is located intracellularly, in parallel with other steroid hormone receptors. ... The uterus or womb is the major female reproductive organ of most mammals, including humans. ... Menstrual cycle The menstrual cycle is a recurring cycle of physiological changes that occurs in the females of human beings and other great apes. ... Ovulation is the process in the menstrual cycle by which a mature ovarian follicle ruptures and discharges an ovum (also known as an oocyte, female gamete, or casually, an egg) that participates in reproduction. ... The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges (singular salpinx) are two very fine tubes leading from the ovaries of female mammals into the uterus. ...

Usage

Ormeloxifene may be used as a contraceptive or as a treatment for dysfunctional uterine bleeding.

As birth control

Ormeloxifene may be used as a weekly oral contraceptive. This is touted as a major advantage by its developer and its manufacturer. Hormonal birth control pills should be taken at approximately the same time each day. In the case of progestogen only pills other than Cerazette that do not consistently inhibit ovulation, a delay of as little as three hours can increase the risk of pregnancy because of the limited duration of their effect on the cervical mucus. Ormeloxifene's weekly schedule is an advantage for women who prefer an oral contraceptive, but find it difficult or impractical to adhere to a daily schedule. Progestogen Only Pills or Progestin Only Pills (POP) are contraceptive pills that only contain synthetic progestogens (progestins) and do not contain oestrogen. ...

For the first twelve weeks of use, it is advised to take the ormeloxifene pill twice per week. From the thirteenth week on, it is taken once per week. The consensus is that backup protection in the first month is a cautious but sensible choice.^{[citation needed]}

Effectiveness

One Phase III multicenter trial of ormeloxifene 30 mg weekly by 898 women for an average of 15 months found a Pearl Index of 2.84.^[2] In health care, including medicine, a clinical trial (synonyms: clinical studies, research protocols, medical research) is the application of the scientific method to human health. ... Multicenter research trial. ... The Pearl Index, also called the Pearl rate, is a technique used in clinical trials for measuring the effectiveness of a birth control method. ...

A second Phase III multicenter trial of ormeloxifene 30 mg twice-a-week for 3 months followed by 30 mg weekly by 376 women for an average of 10.5 months found an Pearl Index of 1.83 and a 12-month life-table pregnancy rate of 1.63% ±0.74%.^[3] Decrement tables, also called life table methods, are used to calculate the probability of certain events. ...

Manufacture and marketing

Ormeloxifene has been tested and licensed as a form of birth control, as well as a treatment for dysfunctional uterine bleeding. It was first manufactured by Torrent Pharmaceuticals, and marketed as birth control under the trade name Centron. Centron was discontinued. A new license for ormeloxifene was issued to Hindustan Latex Ltd., which now manufactures ormeloxifene as birth control under the trade name Saheli. Torrent Pharmaceuticals has resumed manufacture of ormeloxifene under the trade name Sevista, as a treatment for dysfunctional uterine bleeding. Torrent Pharmaceuticals Ltd. ... Hindustan Latex Limited (HLL) is a large manufacturing company in Thiruvananthapuram, Kerala, India. ...

See also

• Hormonal contraception
• Selective estrogen receptor modulator
• Reproductive health

Hormonal contraception refers to birth control methods that act on the hormonal system. ... Selective estrogen receptor modulators (SERMs) is a class of medication that acts on the estrogen receptor. ... Within the framework of WHOs definition of health[1] as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health addresses the reproductive processes, functions and system at all stages of life. ...

References

1. ^ Singh M (2001). "Centchroman, a selective estrogen receptor modulator, as a contraceptive and for the management of hormone-related clinical disorders.". Med Res Rev 21 (4): 302-47. PMID 11410933. 
2. ^ Puri V, et al. (1988). "Results of multicentric trial of Centchroman", in Dhwan B. N., et al. (eds.): Pharmacology for Health in Asia : Proceedings of Asian Congress of Pharmacology, 15-19 January 1985, New Dehli, India. Ahmedabad: Allied Publishers. 
3. ^ Nityanand S, et al. (1990). "Clinical evaluation of Centchroman: a new oral contraceptive", in Puri, Chander P.; Van Look, Paul F. A. (eds.): Hormone Antagonists for Fertility Regulation. Bombay: Indian Society for the Study of Reproduction and Fertility. 

External links

• United States National Library of Medicine Ormeloxifene entry in the Medical Subject Headings (MeSH) database
• United States National Library of Medicine Centchroman entry in the Medical Subject Headings (MeSH) database
• Reproductive Health Online, a Johns Hopkins University affiliate providing information on Centchroman
• Saheli manufacturer's website - Product details
• Saheli manufacturer's website - Clinical studies
• Central Drug Research Institute, Lucknow, India: a government-funded laboratory, conducting R&D on Centchroman as birth control.
• Ministry of Health and Family Welfare - Indian government site; information about availability of Saheli.
• Aphrodite Women's Health - user experiences of Centchroman
• Centchroman Health Group - user experiences of Centchroman