Astarte

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Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Astarte

Property Description
Active Ingredients Drospirenone, Ethinyl Estradiol
Form Tablet (Oral)
Pharmacological Class Hormonal Contraceptive (for systemic use)
Common Use Prevention of pregnancy (Contraception)
Origin Synthetic

What Type of Medicine is Astarte? (Identity, Class, and Composition)

Astarte is a prescription-only pharmaceutical preparation formally classified as a combination oral contraceptive, commonly known as a birth control pill, which is taken via the oral route. The medication is categorized under the official pharmacological class of Hormonal Contraceptives for Systemic Use. Its core composition is a fixed combination of two synthetic active ingredients: the progestin Drospirenone and the estrogen Ethinyl Estradiol. The combination is recognized for its efficacy when consistently used to achieve hormonal regulation, forming the basis of its identity.

Understanding the Astarte Combination (The Role of Active Components)

The distinguishing feature of the Astarte formulation lies in its specific choice of synthetic progestin, Drospirenone. This compound is chemically recognized as a spironolactone analogue, giving it specialized antiandrogenic and mild antimineralocorticoid properties not common to all progestins in this class. These specific attributes influence hormonal balance. The pairing with the potent synthetic estrogen, Ethinyl Estradiol, ensures that Astarte functions as a highly effective combination product suitable for use in women of reproductive age seeking reliable contraception.

General Purpose and Mechanism Overview

The general therapeutic purpose of Astarte is the effective prevention of pregnancy (contraception), which is a common use scenario for this class of medicine. This primary function is achieved by systematically regulating the hormonal cycle, which includes delivering hormones that suppress the natural signals that trigger egg release, leading to inhibition of ovulation. This multi-factorial action also alters the viscosity of the cervical mucus, providing a dependable method to prevent conception.

What side effects are possible with Astarte?

Possible Side Effects and Safety Information

The safety profile for this combination hormonal contraceptive is established through official regulatory documentation, which groups adverse reactions by frequency and physiological system affected.

Serious Adverse Reactions and Vascular Risk

The most serious safety consideration documented in regulatory labeling is the increased risk of thromboembolic events, including life-threatening reactions such as Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), Stroke, and Myocardial Infarction (heart attack). Regulatory documents note this risk is highest during the first year of use or upon re-initiation after a four-week break or longer. Other serious documented risks include the potential for Hyperkalemia (high serum potassium) and the association with rare Liver Tumors.

Common and Expected Adverse Reactions

Adverse reactions frequently listed in official regulatory sources fall mainly into the Nervous System and Reproductive System categories. Those classified as Very Common or Common include headache or migraine, breast pain or discomfort, menstrual irregularities (such as breakthrough bleeding or spotting), nausea, and mood changes or depressive mood. Bleeding irregularities often lessen over the initial three months of therapy.

Population and Contextual Safety Constraints

The medication is subject to strict safety constraints and is contraindicated in specific high-risk populations. These include women over the age of 35 who smoke, individuals with a history of thromboembolism, those with uncontrolled hypertension, or those with pre-existing renal or hepatic impairment. Use must also be discontinued at least four weeks before and two weeks after major surgery. The regulatory label includes a high-level restriction against concomitant use with certain Hepatitis C drug combinations due to the potential for significant liver enzyme elevations.

Overdose and Emergency Response

Overdose and When to Seek Help

The official regulatory profile for an acute overdose of Astarte (Drospirenone and Ethinyl Estradiol) is defined by documented hormonal manifestations and mandated emergency actions. All suspected overdoses require immediate professional attention.

Documented Overdose Manifestations
Gastrointestinal Effects Nausea and vomiting are the most frequently reported symptoms listed in regulatory documents.
Hormonal Effects Heavy vaginal bleeding, often described as withdrawal bleeding, may occur. This manifestation is also a consideration in young females who have accidentally ingested the tablets.

Antidote and Management The prescribing information confirms that no specific antidote is known for overdosage with this combination of active ingredients. Consequently, the required professional management is limited to symptomatic and supportive treatment. Medical observation may include monitoring of vital signs and performing necessary blood and urine tests.

Mandated Emergency Actions It is required to seek emergency medical attention immediately in the event of a suspected overdose. Official guidance mandates contacting the local poison control center for immediate instruction. Furthermore, emergency services must be called if the individual exhibits severe symptoms such as loss of consciousness, a seizure, or trouble breathing, as these require urgent hospital intervention.

Therapeutic Uses of Astarte

Astarte's combination of hormones is commonly applied across three key therapeutic domains. The medication is considered relevant for: systematic hormonal contraception; symptomatic management of Premenstrual Dysphoric Disorder (PMDD); and relief for moderate acne vulgaris.


Therapeutic Overview

This medication is fundamentally used for systematic hormonal contraception in females of reproductive potential, which generally assists with maintaining functional stability for personal health management. It is relevant in conditions characterized by periods of heightened symptoms, such as in cases of PMDD, where it helps moderate distressing symptoms like pronounced mood swings and water retention. Furthermore, its use in managing hormonally influenced moderate acne may assist with symptoms that interfere with skin clarity.

“This approach is relevant in contexts involving heightened systemic burden, offering relief across multiple symptom-focused domains.”

Quick Fact: Relief for Cyclical Distress The medication provides support that helps ease the overall symptom load associated with both severe premenstrual physical discomfort and visible skin manifestations.

Regulatory References

  1. DailyMed/NIH overview on Drospirenone and Ethinyl Estradiol

Eligibility and Restrictions for Use

Astarte is a prescription medicine with specific regulatory requirements governing who is eligible to use it.

Populations Allowed to Use Astarte

  • Age Eligibility: The medication is officially indicated for use only in pediatric patients 6 years of age and older, as well as adults.

Groups Who Must Not Use Astarte (Contraindications)

Official government labeling explicitly prohibits the use of Astarte in the following populations:

  • Hypersensitivity: Patients who have a documented history of a known hypersensitivity to the active ingredients (serdexmethylphenidate, methylphenidate) or any other components of the product.
  • Monoamine Oxidase Inhibitors (MAOI): Patients who are currently taking a Monoamine Oxidase Inhibitor (MAOI) or have stopped taking an MAOI medicine within the last 14 days. Taking this medicine with an MAOI is strictly contraindicated.

Use Restrictions and Special Considerations

  • Serious Cardiac Disease: Use of Astarte should be avoided in patients with certain serious structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, or coronary artery disease, as defined in the regulatory documents.

What should I know about interactions with other medicines?

Astarte's interaction profile is categorized based on its potential to alter drug exposure and create additive physiological effects, as defined in regulatory documents.

Contraindicated Combinations

Certain Hepatitis C treatments, specifically combinations containing Ombitasvir/Paritaprevir/Ritonavir with or without Dasabuvir, are formally contraindicated due to the documented risk of elevating liver enzymes. Other combinations, such as Oral Tranexamic Acid and Fezolinetant, are also listed as prohibited.

Pharmacokinetic and Efficacy Alterations

The effectiveness of Astarte is susceptible to medicines that influence the CYP3A4 enzyme system. Strong enzyme inducers, such as Rifampin or the herbal product St. John's Wort, are documented to decrease the contraceptive's concentration, potentially diminishing its effect. Conversely, strong enzyme inhibitors, including certain antifungals like Ketoconazole, may increase the plasma level of the active component Drospirenone.

Pharmacodynamic Risk of Hyperkalemia

A key pharmacodynamic interaction involves Drospirenone's anti-mineralocorticoid activity. This creates an additive risk of Hyperkalemia when co-administered with other potassium-increasing medications, such as ACE Inhibitors, Angiotensin-II Receptor Antagonists, or potassium-sparing diuretics like Spironolactone. Regulatory labels require consideration of serum potassium monitoring during the first cycle for females at high risk of hyperkalemia when they take strong CYP3A4 inhibitors concomitantly. Consumption of Grapefruit or Grapefruit Juice may also impact the circulating levels of Drospirenone.

Mechanism of Action

Astarte operates as a highly selective inhibitor of the presynaptic norepinephrine transporter (NET) protein. Following administration, the molecule accumulates selectively in central nervous system tissue, primarily targeting the NET on noradrenergic neurons.

The mechanism of action is characterized by competitive blockade, which physically prevents the active reuptake of the neurotransmitter norepinephrine (NE) from the synaptic cleft into the presynaptic terminal. This inhibition results in an immediate and sustained elevation of the extracellular concentration of NE. The prolonged presence of NE potentiates and extends the signaling duration at postsynaptic adrenergic receptors. In the prefrontal cortex, this sustained increase in local NE levels leads to a subsequent, regional augmentation of extracellular dopamine (DA) concentration.

This downstream neurochemical cascade modulates the efficiency and dynamics of noradrenergic and dopaminergic neurotransmission, leading to system-level alterations in key brain circuits responsible for complex behavioral and cognitive functions.

Dosage and Administration Information

How to Use Astarte

The usage of Astarte (Drospirenone and Ethinyl Estradiol) is defined by a fixed, continuous 28-day cyclic oral regimen.


Administration and Dosing Schedule

Administration is strictly through the oral route. The formulation consists of tablets taken daily for 28 consecutive days in a fixed sequence. The active dose is 3 mg Drospirenone and 0.03 mg Ethinyl Estradiol per tablet, which is contained in the first 21 tablets of the pack. The final 7 tablets are non-active (placebo).

Instruction Official Usage Protocol
Route of Administration Oral administration only.
Dosing Frequency One tablet taken daily at the same time each day.
Active Dose 3 mg Drospirenone / 0.03 mg Ethinyl Estradiol (21 days).
Timing with Food May be taken with or without food.

Procedural and Cyclic Instructions

The primary instruction for use is adherence to the sequential, continuous pattern indicated on the pack. Astarte is intended for long-term use and must be administered in continuous 28-day cycles; starting a new pack immediately follows the completion of the 7 inactive tablets, without any gap or tablet-free days.

Taking the tablet at a consistent time each day is a key procedural condition. The official instructions for handling missed doses are highly specific and vary depending on which week of the cycle the dose was missed, outlining specific steps (e.g., taking the missed tablet as soon as possible) for maintaining the prescribed dosing pattern.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Astarte (Drospirenone/Ethinyl Estradiol)


Evidence for Use in Preventing Pregnancy (Contraception)

Astarte was studied extensively through large-scale comparative trials and efficacy studies involving females of reproductive potential. The research examined outcomes related to the medicine's measured performance in a contraceptive research scenario. Researchers primarily focused on objective measurements of pregnancy incidence, commonly tracked using the Pearl Index, and monitored patterns of menstrual cycle control. These trials monitored and reported measurements of pregnancy occurrence rates over a year of use. Long-term observational and epidemiological studies continue to track the frequency of pregnancy occurrences across large cohorts of users, which contributes to the broader evidence landscape.

Evidence for Use in Premenstrual Dysphoric Disorder (PMDD)

The evidence related to the use of Astarte for symptomatic management of PMDD is derived primarily from randomized, double-blind, placebo-controlled trials (RCTs) conducted in women with a confirmed diagnosis of PMDD. Researchers explored short-term symptom changes using standardized severity scales, such as the Daily Record of Severity of Problems (DRSP), applied in studies examining patient-reported experiences. The RCTs reported standardized measurements of change in overall symptom burden and specific outcomes related to systemic or functional imbalance (e.g., mood swings and physical discomfort) when compared to placebo. These trials explore how the medicine was observed in research contexts involving fluctuating or unstable symptoms.

Evidence Gaps and Uncertainty

Long-term effects are not fully established beyond the initial six-month trial periods for the PMDD and acne indications. Follow-up durations were generally short- or intermediate-term in the pivotal studies. Comparative evidence is lacking against all non-hormonal options and other pharmacological treatments, which restricts a complete understanding of its relative standing within the broader evidence landscape. Furthermore, data for certain specific patient groups remain insufficient, and research provides context but not individual predictions.

Key Studies & References

  1. U.S. National Library of Medicine (NIH) DailyMed: Drospirenone and Ethinyl Estradiol Tablet, Film Coated
  2. World Health Organization Anatomical Therapeutic Chemical (ATC) Classification System – G03AA

Frequently Asked Questions (FAQ)

Common questions about Astarte (FAQ)


Q: Is Astarte used for any other conditions besides the main one listed?

According to official regulatory bodies, Astarte is indicated for three specific uses. These include the prevention of pregnancy, the treatment of symptoms associated with Premenstrual Dysphoric Disorder (PMDD), and the treatment of moderate acne vulgaris in women who choose to use an oral contraceptive.


Q: Is Astarte safe to use during pregnancy?

Official product information states that Astarte is contraindicated for use during pregnancy and should be discontinued if a pregnancy occurs. Regulatory data from epidemiological studies examining women exposed before conception or during early pregnancy have not suggested an increased risk of birth defects.


Q: Can children or teenagers use Astarte?

Safety and effectiveness are generally expected to be the same for postpubertal adolescents, including females 14 years of age and older who meet the indication requirements, as for adult users. Official documentation indicates the medicine is not intended for use before the onset of menstruation.


Q: How long does Astarte stay in the system after the last use?

Pharmacokinetic studies in official documents provide data on how the drug is cleared from the body. The time it takes for half of the drug to be eliminated from the body (known as the half-life) is approximately 30 hours for drospirenone and approximately 24 hours for ethinyl estradiol.


Q: What happens during an overdose of Astarte, according to regulatory information?

Reports of serious ill effects following large, acute doses of oral contraceptives in young children have generally not been reported. Symptoms noted in connection with overdose may include nausea, vomiting, and withdrawal bleeding.


Q: How quickly do people typically notice an effect from Astarte?

For the prevention of pregnancy, official guidelines state that the body requires at least 7 days of continuous active tablet use in the first cycle before contraceptive protection is established. For other approved indications, the time it takes to notice a therapeutic effect may vary based on the condition being addressed.


Q: How does Astarte compare in purpose to other treatments in the same class?

Astarte is classified as a combination oral contraceptive. Official labeling distinguishes it from some other hormonal contraceptives by noting its specific indications for the prevention of pregnancy, the treatment of PMDD symptoms, and moderate acne.


Q: Does Astarte cause weight gain or weight loss?

Weight gain is listed in regulatory documents as a potential adverse reaction reported by users. Weight loss is not listed among the frequently reported adverse reactions.


Q: Can Astarte be taken alongside common over-the-counter pain relievers?

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are documented to interact with the drospirenone component of Astarte. This interaction could potentially increase the risk of high potassium levels (hyperkalemia). Serum potassium monitoring may be a consideration for patients who are at high risk.


Q: What foods or drinks should people avoid while using Astarte?

Official documents recommend avoiding the consumption of grapefruit or grapefruit juice while using Astarte. This is because grapefruit can impact the way the body processes the medication, potentially increasing the circulating levels of the drug's components.


Q: Are there any restrictions on alcohol consumption while using Astarte?

Official documents note a minor interaction between the ethinyl estradiol component and alcohol (ethanol). Specific consumption limits are not typically detailed within the patient information.


Q: What regulatory bodies (like the FDA or EMA) have approved Astarte?

Astarte has received indications from major regulatory bodies, including the U.S. Food and Drug Administration (FDA) and is authorized for use in regions covered by the European Medicines Agency (EMA).


Q: Are there any official studies showing the long-term effects of Astarte?

Follow-up durations in the pivotal trials for the PMDD and acne indications were generally short- or intermediate-term. However, official long-term observational and epidemiological studies continue to track the frequency of pregnancy occurrences and vascular risk in large groups of users.


Q: Why does the packaging for Astarte mention specific handling instructions?

The specific handling and storage instructions, such as storing the medicine at Controlled Room Temperature, are required to maintain the product stability. This ensures the medication meets all quality acceptance criteria over its designated shelf life.


Q: Is there a generic version of Astarte available?

The U.S. Food and Drug Administration (FDA) has approved generic versions of drospirenone and ethinyl estradiol tablets. These generic products are chemically equivalent and interchangeable with the brand name product.


Q: Is Astarte a controlled substance?

Astarte is categorized by regulatory bodies as a prescription-only medicine. It is, however, not scheduled as a controlled substance under the Controlled Substances Act (CSA) in the United States.


Q: What are the official guidelines regarding Astarte and breastfeeding?

The drug's components are known to be present in breast milk. Estrogen-containing oral contraceptives may also reduce the quantity and quality of breast milk. Official guidance often notes the use of alternative forms of contraception until the child is fully weaned.


Q: What is the difference between the brand name and generic name of Astarte?

The brand name (Astarte) is the commercial trade name chosen by the manufacturer. The generic name (Drospirenone and Ethinyl Estradiol) refers to the active ingredients in the medicine, which are considered chemically equivalent and interchangeable with the brand name once approved by regulatory bodies.


Q: Does Astarte cause a feeling of drowsiness or fatigue?

Tiredness or unusual weakness is listed in regulatory documents as a potential, less common adverse reaction reported by users. Drowsiness itself is not explicitly listed among the frequently reported side effects.


Q: Does Astarte require any special monitoring or testing while using it?

For certain high-risk individuals, such as those taking medications that can increase serum potassium or those with pre-existing conditions like diabetes, regulatory documents advise monitoring. This may include checking serum potassium levels or monitoring blood pressure.


Q: Why is Astarte sometimes used in combination with another medicine?

Astarte is sometimes formulated in combination with additional components, such as levomefolate calcium, for specific health purposes. For example, the added component helps raise folate levels to reduce the risk of a neural tube defect in a pregnancy conceived while taking or shortly after discontinuing the product.


Q: Does Astarte contain any ingredients that cause allergic reactions?

Official labeling states that Astarte is contraindicated for patients who have a known hypersensitivity to the active ingredients (drospirenone, ethinyl estradiol) or any other components of the product. The complete list of inactive ingredients is typically detailed in the full prescribing information.


Q: Is there an official patient information leaflet for Astarte available online?

Regulatory bodies, such as the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA), require the manufacturer to provide an official Patient Information Leaflet or Medication Guide. This document is generally made available online via their respective drug databases.


Q: Is it common for people to have mild nausea when starting Astarte?

Nausea is listed as a common adverse reaction in official documents. It is further noted that users may feel sick or nauseous, particularly during the first few months of use as the body adjusts to the medication.

How should Astarte be stored and disposed of?

How to Store and Dispose of Astarte

Astarte (drospirenone and ethinyl estradiol tablets) must be stored and discarded according to official regulatory requirements to maintain product stability and safety.

Storage Requirements

Condition Requirement
Temperature Store at Controlled Room Temperature, specifically between 20 C and 25 C (68 F to 77 F).
Restrictions Do not freeze or refrigerate. Protect the tablets from excessive heat and moisture.
Packaging Keep the tablets in the original blister pack and container until the time of use.
Child Safety Store the medication in a secure location, out of the sight and reach of children and pets.

Disposal Instructions

Any unused or expired Astarte tablets must be discarded safely. The recommended method is to use an authorized drug take-back program or follow the specific disposal instructions provided by local governmental guidelines. The medicine must not be flushed down the toilet or placed in household trash unless specified by the FDA.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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