Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
ANDROID-F vs ALESSE
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Fingolimod is a sphingosine 1-phosphate receptor modulator that sequesters lymphocytes in lymph nodes, reducing central nervous system immune cell infiltration.
Combination of ethinyl estradiol and levonorgestrel suppresses gonadotropin-releasing hormone (Gn RH) secretion from the hypothalamus, inhibiting pituitary release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), thereby preventing ovulation. Additionally, it thickens cervical mucus, impeding sperm penetration, and alters endometrial receptivity.
Relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease
Prevention of pregnancy,Treatment of moderate acne vulgaris (in women ≥15 years who have achieved menarche and desire contraception),Contraception in women with heavy menstrual bleeding (off-label)
Adults: 1 tablet (methyltestosterone 2.5 mg, ethinyl estradiol 0.025 mg) orally once daily, with food.
One tablet (ethinyl estradiol 20 mcg, levonorgestrel 0.1 mg) orally once daily at the same time each day for 21 days, followed by 7 days of placebo. For initiation, start on the first day of menstrual period or first Sunday after onset of menses.
2.5-3.5 hours (terminal half-life); oral administration may require multiple daily doses for stable levels.
Levonorgestrel: terminal half-life ~17-20 hours (range 11-25 hr). Ethinyl estradiol: biphasic; terminal half-life ~13-27 hours (mean ~17 hr). Clinical context: steady-state achieved within 5-7 days. The half-life supports once-daily dosing with at least 24-hour contraceptive coverage.
Metabolized primarily by CYP4F2, with minor contributions from CYP2D6, CYP2E1, CYP3A4, and CYP1A2. Undergoes biotransformation to an inactive metabolite.
Ethinyl estradiol is primarily metabolized by CYP3A4 and undergoes conjugation (glucuronidation and sulfation). Levonorgestrel is metabolized by CYP3A4 and reduction, with conjugation to glucuronide and sulfate conjugates.
Primarily renal (90% as glucuronide and sulfate conjugates, 10% unchanged); small amount biliary/fecal.
Renal: ethinyl estradiol (UE2) and levonorgestrel (LNG) metabolites primarily excreted in urine (UE2: ~40% as sulfate and glucuronide conjugates; LNG: ~25% as glucuronides). Fecal/biliary: ~40% (UE2) and ~45% (LNG) eliminated in feces via bile. Unchanged drug excretion is negligible.
97-99% bound to sex hormone-binding globulin (SHBG) and albumin.
Levonorgestrel: 97-99% bound to albumin and sex hormone-binding globulin (SHBG). Ethinyl estradiol: 98-99% bound, primarily to albumin (98.5%), with minor binding to SHBG. Free fractions: LNG ~1%, UE2 ~1.0-1.5%.
0.5-0.8 L/kg; reflects distribution into muscle, liver, and reproductive tissues.
Levonorgestrel: Vd ~1.8 L/kg (range 1.5-2.0 L/kg). Ethinyl estradiol: Vd ~2.5-3.5 L/kg (mean ~2.9 L/kg). Indicates extensive tissue distribution, including target organs (ovaries, endometrium, breast). Not clinically adjusted for obesity.
Oral: 3-6% (extensive first-pass metabolism); IM: 100%.
Oral: levonorgestrel ~95-100% (highly bioavailable). Ethinyl estradiol ~45-55% (first-pass metabolism reduces bioavailability; interindividual variability due to gut wall and hepatic conjugation). Both are prodrugs requiring hydrolysis for activity.
GFR 10-50 m L/min: reduce dose by 50%. GFR <10 m L/min: avoid use.
No specific GFR-based dose adjustments are recommended; however, use with caution in patients with renal impairment due to potential fluid retention and hypertension.
Child-Pugh A: reduce dose by 50%. Child-Pugh B: avoid use. Child-Pugh C: contraindicated.
Contraindicated in patients with severe hepatic disease (Child-Pugh class C) or active liver disease. In mild to moderate impairment (Child-Pugh A or B), use only if benefits outweigh risks; no specific dose reduction guidelines are available.
Not recommended for use in children due to risk of premature epiphyseal closure and virilization.
Approved for postmenarchal adolescents; same dosing as adults: one tablet orally once daily for 21 days followed by 7 days of placebo. No weight-based adjustments are recommended.
Use with caution; consider lower starting dose due to increased risk of fluid retention, hypertension, and prostatic hypertrophy in males.
Not indicated for use in postmenopausal women; no specific geriatric dosing adjustments are necessary if used off-label, but consider increased risk of thrombotic events in older women.
Risk of bradyarrhythmia and atrioventricular block, requiring first-dose monitoring for 6 hours. Fatal infections, including opportunistic infections, have occurred. Macular edema has been reported.
Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive use. The risk increases with age, particularly in women over 35 years, and with heavy smoking (≥15 cigarettes per day). Women over 35 who smoke should not use this medication.
May cause bradycardia and AV block; monitor heart rate after first dose. Increased risk of infections, including herpes viruses and cryptococcal meningitis. Macular edema, especially in patients with diabetes or uveitis. Posterior reversible encephalopathy syndrome (PRES). Respiratory effects, including decreased FEV1 and DLCO. Hepatic injury; monitor liver enzymes.
Increased risk of thromboembolic disorders (venous and arterial),Cigarette smoking increases risk of cardiovascular events, especially in women over 35,Hepatic neoplasia (benign and malignant),Elevated blood pressure,Gallbladder disease,Carbohydrate and lipid metabolism effects,Headache/migraine,Depression,Uterine bleeding irregularities,Ocular lesions (e.g., retinal thrombosis),Carcinoma of the breast and reproductive organs (close monitoring in current or history of breast cancer)
Recent myocardial infarction, unstable angina, stroke, transient ischemic attack, decompensated heart failure, history of Mobitz type II 2nd or 3rd degree AV block, sick sinus syndrome unless pacemaker is present, or severe untreated sleep apnea.
Breast cancer (current or history),Carcinoma of the endometrium or other estrogen-dependent neoplasia,Thrombophlebitis or thromboembolic disorders (current or history),Cerebrovascular or coronary artery disease (current or history),Valvular heart disease with complications,Severe hypertension,Diabetes with vascular involvement,Headaches with focal neurological symptoms (e.g., migraine with aura),Major surgery with prolonged immobilization,Known or suspected pregnancy,Active liver disease or impaired liver function,Undiagnosed abnormal uterine bleeding,Hypersensitivity to any component,Cigarette smoking in women over 35 years of age
No significant food interactions reported. Avoid excessive alcohol consumption due to hepatotoxic effects.
No specific food restrictions. Grapefruit juice may slightly increase ethinyl estradiol levels but not clinically significant. High-fat meals do not affect absorption. Avoid excessive alcohol as it may impair compliance.
ANDROID-F contains methyltestosterone, a synthetic androgen. Androgens are teratogenic in humans. In first trimester: masculinization of female fetus, including clitoromegaly, labial fusion, and urogenital sinus abnormalities. Second and third trimesters: continued virilization of female fetus; no increased risk of malformations in male fetuses. Contraindicated in pregnancy.
Pregnancy category X. Use contraindicated in pregnancy. First trimester exposure associated with cardiovascular defects (e.g., VSD), neural tube defects, and cleft lip/palate. Second and third trimester exposure may cause fetal adrenal suppression, hepatic dysfunction, and virilization of female genitalia due to progestin component (levonorgestrel). Increased risk of ectopic pregnancy if conception occurs during use.
Methyltestosterone is excreted in breast milk. No specific M/P ratio available. May cause virilization in female infants and precocious development in male infants. Breastfeeding is contraindicated during therapy.
Excreted in breast milk. Levonorgestrel M/P ratio approximately 0.3–0.4. Small amounts of ethinyl estradiol present. May reduce milk production and quality due to estrogen component. Use only if benefit outweighs risk; consider alternative contraception. American Academy of Pediatrics considers it compatible with nursing.
ANDROID-F is contraindicated in pregnancy; no dosing recommendations for use in pregnancy. No established dose adjustments exist as the drug should not be administered.
Contraindicated. No dose adjustments apply as drug must be discontinued immediately if pregnancy suspected or confirmed. Pharmacokinetic changes in pregnancy (increased clearance, volume of distribution) not relevant due to contraindication.
Android-F is a brand of methyltestosterone, an androgen used primarily for male hypogonadism. Monitor liver function due to potential hepatotoxicity. Avoid in males with breast or prostate cancer. Use with caution in older patients due to increased risk of prostatic hypertrophy. May suppress clotting factors II, V, VII, and X.
ALESSE is a combined oral contraceptive (COC) containing ethinyl estradiol (20 mcg) and levonorgestrel (100 mcg). It is indicated for contraception and treatment of acne vulgaris in women aged ≥14. Monitor for thromboembolic events, especially in smokers >35 years. Assess for contraindications including migraines with aura, hypertension, and history of DVT/PE. Advise use of backup contraception if a pill is missed. Start on first day of menses or first Sunday after onset. Check BP at baseline and annually. Counsel on increased risk of VTE, especially in first year.
Take exactly as prescribed; do not increase dose or frequency.,Report any signs of liver problems (yellowing eyes/skin, dark urine, persistent nausea) immediately.,Women should report hoarseness, acne, or menstrual changes.,Men should report frequent or persistent erections, or breast swelling/tenderness.,May cause decreased sperm count in men; discuss family planning.,Avoid concurrent use with other medications without consulting doctor.
Take one pill daily at the same time each day, even if you do not have sex.,Missed pill instructions: if late by <12 hours, take it as soon as remembered and continue schedule. If >12 hours, take missed pill (even if means taking two in one day) and use backup contraception for 7 days.,Possible side effects: nausea, breast tenderness, headache, breakthrough bleeding, especially in first 3 months.,Seek emergency care for signs of blood clot: leg pain/swelling, sudden chest pain, shortness of breath, severe headache, vision changes.,Do not smoke while on ALESSE, especially if over age 35, as it increases risk of serious cardiovascular events.,Inform your healthcare provider of all medications and supplements you take, as some (e.g., rifampin, anticonvulsants, St. John's wort) may reduce effectiveness.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about ANDROID-F vs ALESSE, answered by our medical review team.
ANDROID-F is a Androgen/Estrogen Combination that works by Fingolimod is a sphingosine 1-phosphate receptor modulator that sequesters lymphocytes in lymph nodes, reducing central nervous system immune cell infiltration.. ALESSE is a Estrogen/Progestin Combination Contraceptive that works by Combination of ethinyl estradiol and levonorgestrel suppresses gonadotropin-releasing hormone (Gn RH) secretion from the hypothalamus, inhibiting pituitary release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), thereby preventing ovulation. Additionally, it thickens cervical mucus, impeding sperm penetration, and alters endometrial receptivity.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between ANDROID-F and ALESSE depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of ANDROID-F is: Adults: 1 tablet (methyltestosterone 2.5 mg, ethinyl estradiol 0.025 mg) orally once daily, with food.. The standard adult dose of ALESSE is: One tablet (ethinyl estradiol 20 mcg, levonorgestrel 0.1 mg) orally once daily at the same time each day for 21 days, followed by 7 days of placebo. For initiation, start on the first day of menstrual period or first Sunday after onset of menses.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between ANDROID-F and ALESSE in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. ANDROID-F is classified as Category C. ANDROID-F contains methyltestosterone, a synthetic androgen. Androgens are teratogenic in humans. In first trimester: masculinization of female fetus, including clitoromegaly, labi. ALESSE is classified as Category C. Pregnancy category X. Use contraindicated in pregnancy. First trimester exposure associated with cardiovascular defects (e.g., VSD), neural tube defects, and cleft lip/palate. Seco. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.