Nomegestrol acetate
Nomegestrol acetate (NOMAC), sold under the brand names Lutenyl and Zoely among others, is a progestin medication which is used in birth control pills, menopausal hormone therapy, and for the treatment of gynecological disorders. It is available both alone and in combination with an estrogen. NOMAC is taken by mouth. A birth control implant for placement under the skin was also developed but ultimately was not marketed.
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| Trade names | Alone: Lutenyl With E2: Naemis, Zoely |
| Other names | NOMAC; NOMAc; Nomegesterol acetate; TX-066; TX-525; ORG-10486-0; Uniplant; 19-Normegestrol acetate; 6-Methyl-17α-acetoxy-δ6-19-norprogesterone; 17α-Acetoxy-6-methyl-19-norpregna-4,6-diene-3,20-dione |
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| Routes of administration | By mouth |
| Drug class | Progestogen; Progestin; Progestogen ester; Steroidal antiandrogen |
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| Pharmacokinetic data | |
| Bioavailability | 63% |
| Protein binding | 97.5–98.0% (to albumin) |
| Metabolism | Liver (by hydroxylation via CYP3A3, CYP3A4, CYP2A6) |
| Metabolites | Six main metabolites, all essentially inactive |
| Elimination half-life | ~50 hours (range 30–80 hours) |
| Excretion | Urine, feces |
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| ECHA InfoCard | 100.055.781 |
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| Formula | C23H30O4 |
| Molar mass | 370.489 g·mol−1 |
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Side effects of NOMAC include menstrual irregularities, headaches, nausea, breast tenderness, and others. NOMAC is a progestin, or a synthetic progestogen, and hence is an agonist of the progesterone receptor, the biological target of progestogens like progesterone. It has some antiandrogenic activity and no other important hormonal activity.
Nomegestrol, a related compound, was patented in 1975, and NOMAC was described in 1983. NOMAC was first introduced for medical use, for the treatment of gynecological disorders and in menopausal hormone therapy, in Europe in 1986. It was subsequently approved in Europe in 2011 as a component of birth control pills. NOMAC is available widely throughout the world. It is not available in the United States or Canada.