Contraceptive pills Jasmin (Yasmin), for whom are these contraceptives indicated? Contraceptive pills - white clinic Yasmin pills instructions for use

anonymous, female, 25

Chronic diseases: 6 years ago, a teratoma of the left ovary was removed. Part of the ovary was left, saying that over time it will function, but the last two years, ultrasound has shown its absence, the right ovary is healthy, slightly enlarged. Hello, I urgently need a consultation, as there is no possibility to see a doctor in the next month (I am abroad) 11.05 A vacuum was made for a period of 4 weeks. After a week I drank an antibiotic. No pain, all discharge came on time. After 14 days, there was a control ultrasound, which showed no problems. 13.06 I started my period, started drinking the contraceptive "yasmin" (analogue of "yarin"). I drank every day at the same time, before that I had never used such a method of contraception. Of the side effects (as it seems to me the reason is precisely in the pills), severe drowsiness, the first days did not tolerate contact lenses, by the evening it was a little hot. It is now 20.06. Menses so far. With, every day less, but blood appears after a contraction in the uterus. The blood was scarlet, on the fourth day it was almost thick black. Abundant discharge was literally a couple of days, now I manage with daily pads, but this is not a "daub", but fresh blood. Tell me what it might be, what should be feared, possible reasons? The state of health is normal, nothing hurts. The ultrasound did not show any pathologies, the doctor said to stop drinking "yasmin" (contraceptive) and prescribed "cyclo-proginov". Treatment regimen: 3 days, 1 tablet three times a day. 2 days, 1 twice a day, and the rest to finish off a pack of one tablet a day. Then a 7-day break, after drinking the contraceptive "yasmin" again, I read the instructions for cyclo-proginova, the dose of 1 table was indicated. In a day. It is not very clear, but the doctor said that the bleeding should go away within a week. Tell me how justified and correct is this scheme and the selection of drugs? And what about the fact that proginova has no contraceptive effect? And won't it happen again when you start taking yasmin? Can yasmin be thrown in the middle of a pack? (Today would be the 11th pill) please answer, I'm completely confused. (Not to make it worse (

Hello! Yasmin is a low-dose monophasic oral combined estrogen-gestagenic contraceptive drug. The contraceptive effect of this drug is carried out through complementary mechanisms, the most important of which are the suppression of ovulation and an increase in the viscosity of cervical mucus. Yasmin is taken once a day, 1 tablet, strictly at the same time. If you miss or violate the dose of the drug, negative consequences for the body are possible. After 21 days, you need to take a 7-day break, after which repeat the standard dosage. During the break, bleeding begins - a normal reaction of the body. Contraception restores a regular menstrual cycle. I do not recommend that you stop taking Yasmin, as in this case your bleeding will intensify even more due to the onset of withdrawal bleeding. You will simply disrupt your menstrual cycle. The fact is that now your body is in a period of adaptation to the drug you are taking. Irregular bleeding in the first weeks of use is normal and will stabilize over time. Among the negative side effects are the following: - dizziness; - nausea; - vomiting; -; shortness of breath; - a strong expectorant cough with the presence of blood (it is recommended to immediately call an ambulance); - insomnia; - allergic reactions. You do not write anything about such side effects. The interaction of oral contraceptives with other medicinal products can lead to breakthrough bleeding and / or decreased contraceptive reliability. Women taking these drugs must temporarily use barrier methods of contraception in addition to the drug, or choose another method of contraception. The following types of interactions have been reported in the literature. Impact on hepatic metabolism The use of drugs that induce liver microsomal enzymes can lead to an increase in the clearance of sex hormones, which in turn can lead to breakthrough bleeding or a decrease in the reliability of contraception. Such drugs include phenytoin, barbiturates, primidone, rifampicin, rifabutin, possibly oxcarbazepine, topiramate, felbamate, griseofulvin, and preparations containing St. John's wort. HIV protease inhibitors (eg ritonavir) and non-nucleoside reverse transcriptase inhibitors (eg) and combinations thereof also have the potential to affect hepatic metabolism. Impact on the intestinal-hepatic circulation According to some studies, some antibiotics (for example, penicillins and) can reduce the intestinal-hepatic circulation of estrogens, thereby lowering the concentration of ethinyl estradiol. While taking drugs that affect microsomal enzymes, and within 28 days after their cancellation, you should additionally use a barrier method of contraception. When taking antibiotics (such as penicillins and tetracyclines) and within 7 days after their cancellation, you should additionally use a barrier method of contraception. If during these 7 days of the barrier method of contraception the tablets in the current package run out, then you should start taking the tablets from the next package of Yasmin without the usual interruption in taking the tablets. The main metabolites of drospirenone are formed without the participation of the cytochrome P450 system. Therefore, the effect of inhibitors of the cytochrome P450 system on the metabolism of drospirenone is unlikely. Combined oral contraceptives can interfere with the metabolism of other drugs, resulting in an increase (for example) or a decrease (for example, lamotrigine) in plasma and tissue concentrations. Based on in vitro interaction studies, as well as an in vivo study on female volunteers taking simvastatin and midazolam as markers, it can be concluded that the effect of drospirenone at a dose of 3 mg on the metabolism of other medicinal substances is unlikely. There is a theoretical possibility of increasing serum potassium levels in women receiving Yasmin concomitantly with other drugs that may increase serum potassium levels. These drugs include angiotensin II receptor antagonists, certain anti-inflammatory drugs, potassium-sparing diuretics, and aldosterone antagonists. However, in studies evaluating the interaction of drospirenone with ACE inhibitors or indomethacin, there was no significant difference between the serum potassium concentration compared with placebo. If you are taking any of the drugs mentioned above, then the appearance of spotting may be associated with this. Honestly, I am surprised by the recommendation to you of the drug cyclo-proginova. This is a hormone replacement therapy drug, it is not used to stop bleeding urgently. ... Against the background of taking Cyclo-Proginov, ovulation is not suppressed, and the production of hormones in the body itself practically does not change. Cyclo-Proginova can be used by women of reproductive age to regulate the menstrual cycle (in the presence of hormonal insufficiency, but this is not your case), as well as by women in perimenopause for the treatment of irregular uterine bleeding. Continue taking Yasmin as before. As soon as possible, just in case, show yourself to your obstetrician-gynecologist. All the best!

The contraceptive Jasmin is a modern, very effective contraceptive. In addition to contraceptive properties, these pills also have medicinal features that help a woman to solve health problems. This drug is completely safe for the female body and can be used even for a very long time, which is why all the reviews about Jasmine birth control pills are only positive.

All about Jasmine

This contraceptive contains several unique components that serve to prevent unwanted pregnancy and, of course, to restore the menstrual cycle. The composition of the contraceptive pill Jasmin (Yasmin) includes components such as dienogest and ethinyl estradiol. By affecting all areas of the body's hormonal system, they prevent the development and maturation of the egg, thereby preventing ovulation. The components of the contraceptive Jasmine increase the viscosity of the cervical secretions, and therefore the entry of sperm becomes completely impossible.

Contraceptive pills, in addition to contraceptive properties, can effectively restore the process of menstruation, freeing from a variety of unpleasant painful sensations. This is suitable for those women who suffer from similar problems and at the time of irregular or heavy periods, experience any painful sensations (dysminorrhea) that can cause a disease such as anemia.

Jasmine contraceptives also contain dienogest, which can be attributed to progesterone analogues. Its effect on the body has a beneficial effect on the condition of the skin, preventing, for example, the appearance of acne.

Indication for the use of the contraceptive Jasmine

Before using this medication, you should consult your gynecologist. The hormonal system of the female body is not difficult to disrupt, and it can take a lot of time to restore it. That is why the attending physician is obliged to fully examine you before drawing a conclusion on the use of this contraceptive.

Take birth control Jasmine regularly in order to get rid of intermediate bleeding and the appearance of menstrual irregularities.

When purchasing this contraceptive, you should read the attached instructions with special care! One package of jasmine birth control pills will last exactly 21 days, taking into account the 7-day break. Basically, already on the 2nd day after a break in taking this drug, menstrual bleeding begins.

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The contraceptive Yasmin is a modern drug designed to prevent pregnancy and normalize the menstrual cycle in women aged 18 to 40 years. It is recommended to take the medication cyclically, since already from the first intake, significant changes in the cervix begin to occur.

Composition and form of release

Yasmin birth control pills contain 2 active substances: ethinyl estradiol and drospirenone, which act on the egg and slow down the ovulation process. Tablets weighing 3 mg are white coated. One blister is enough for 3 weeks.

Pharmacological properties

A hormonal targeted agent instantly affects the microflora of the cervix. Due to the reaction of uterine mucus and the main components of the drug, the work of the glands that produce cervical secretions slows down. The cervix, deprived of the required amount of nutrients and mucus, becomes difficult to access for sperm movement. The action of the drug is 87% effective, contraception has a positive effect on the hormonal background of a woman. Drospirenone included in the composition is useful for patients suffering from hormonal imbalance, up to a neuropsychic form.

Indications for use

Yasmin is a contraceptive prescribed in several cases:

1. prevention of unwanted pregnancy;
2. failure in the menstrual cycle;
3. acne;
4. swelling.

Hormonal contraception is also effective for excessive engorgement of the mammary glands.

Method of administration and dosage

Yasmin contraceptive instructions for use: the medication is taken once a day, 1 tablet at exactly the same time. If you skip or violate the dose of the drug, negative consequences for the body are possible. After 21 days, you need to take a 7-day break, after which repeat the standard dosage. During the break, bleeding begins - a normal reaction of the body. Contraception restores a regular menstrual cycle.

Contraindications

Taking pills may be contraindicated if the patient has the following diseases:

1. allergy to the components of the drug;
2. breast cancer;
3. diabetes;
4. renal and hepatic impairment;
5. pregnancy;
6. ischemia of the heart;
7. high blood pressure.

Adverse reactions

The first days after taking the contraceptive, bleeding opens - pseudo-menstruation. When taking Yasmin, the cycle lasts normally, without complications and abdominal pain. Often, this medication is taken to control the menstrual cycle, in particular, to reduce pain. You should not stop taking the drug after the onset of bleeding in order to avoid serious complications in the uterus. Among the negative side effects, the following are observed:

• dizziness;
• nausea;
• vomiting;
• stomach ache;
• shortness of breath;
• strong expectorant cough with the presence of blood (it is recommended to immediately call an ambulance);
• insomnia;
• allergic reactions.

Yasmin's contraceptive pills are a monophasic type of contraceptive, so before using it, you should consult a gynecologist. Irregular bleeding in the first weeks of use is normal and will stabilize over time.

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Last updated description by manufacturer 23.09.2015

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Active substance:

ATX

Pharmacological group

Nosological classification (ICD-10)

3D images

Composition

Description of the dosage form

Film-coated tablets, light yellow, engraved on one side with a hexagon with the letters "DO" inside.

pharmachologic effect

pharmachologic effect - contraceptive, estrogen-progestational.

Pharmacodynamics

Yarina ® is a low-dose monophasic oral combined estrogen-gestagenic contraceptive drug.

The contraceptive effect of Yarina ® is mainly realized by suppressing ovulation and increasing the viscosity of cervical mucus.

The incidence of venous thromboembolism (VTE) in women with or without risk factors for VTE, using ethinylestradiol / drospirenone-containing oral contraceptives at a dose of 0.03 mg / 3 mg, is the same as in women using levonorgestrel-containing combined oral contraceptives or other combined oral contraceptives ... This was confirmed in a prospective, controlled database study that compared women using oral contraceptives 0.03 mg ethinylestradiol / 3 mg drospirenone with women using other combined oral contraceptives. Analysis of the data revealed the same risk of VTE among the sample.

In women taking combined oral contraceptives, the menstrual cycle becomes more regular, painful menstrual bleeding is less common, the intensity and duration of bleeding decreases, as a result of which the risk of iron deficiency anemia decreases. There is also evidence of a reduced risk of endometrial and ovarian cancer.

Drospirenone, contained in Yarin®, has an anti-mineralocorticoid effect and is able to prevent weight gain and the appearance of other symptoms (eg edema) associated with estrogen-dependent fluid retention. Drospirenone also has antiandrogenic activity and helps to reduce acne (blackheads), oily skin and hair. This effect of drospirenone is similar to that of the natural progesterone produced by the female body. This should be taken into account when choosing a contraceptive, especially for women with hormone-dependent fluid retention, as well as for women with acne (acne) and seborrhea. If used correctly, the Pearl index (an indicator reflecting the number of pregnancies in 100 women using contraceptives during the year) is less than 1. If pills are missed or misused, the Pearl index may increase.

Pharmacokinetics

Drospirenone

When taken orally, drospirenone is rapidly and almost completely absorbed. After a single oral administration, the C max of drospirenone in serum, equal to 37 ng / ml, is achieved after 1-2 hours. Bioavailability ranges from 76 to 85%. Food intake does not affect the bioavailability of drospirenone.

Drospirenone binds to serum albumin (0.5-0.7%) and does not bind to sex hormone binding globulin (SHBG) or corticosteroid binding globulin (CABG). Only 3-5% of the total concentration in the blood serum is in free form. An increase in SHBG induced by ethinylestradiol does not affect the binding of drospirenone to plasma proteins.

After oral administration, drospirenone is completely metabolized.

Most of the metabolites in plasma are acid forms of drospirenone, which are formed without the involvement of cytochrome P450.

The concentration of drospirenone in the blood plasma decreases in 2 phases. Drospirenone is not excreted unchanged. Drospirenone metabolites are excreted by the kidneys and through the intestines in a ratio of approximately 1.2-1.4. T 1/2 for the excretion of metabolites in the urine and feces is approximately 40 hours.

During cycle treatment, the maximum equilibrium serum concentration of drospirenone is reached in the second half of the cycle.

A further increase in the serum concentration of droperinone is noted after 1-6 cycles of administration, after which an increase in concentration is not observed.

In women with moderate hepatic impairment (class B on the Child-Pugh scale), AUC is comparable to the corresponding indicator in healthy women with similar C max values \u200b\u200bin the absorption and distribution phases. T 1/2 of drospirenone in patients with moderate hepatic dysfunction was 1.8 times higher than in healthy volunteers with intact liver function.

In patients with moderate hepatic dysfunction, there was a 50% decrease in drospirenone clearance compared with women with intact liver function, while there were no differences in the concentration of potassium in the blood plasma in the studied groups. When diabetes mellitus is detected and the concomitant use of spironolactone (both conditions are regarded as factors predisposing to the development of hyperkalemia), an increase in the concentration of potassium in the blood plasma has not been established.

It should be concluded that drospirenone is well tolerated in women with mild to moderate hepatic dysfunction (class B on the Child-Pugh scale).

The concentration of drospirenone in blood plasma upon reaching an equilibrium state was comparable in women with mild renal impairment (Cl creatinine - 50-80 ml / min) and in women with intact renal function (Cl creatinine -\u003e 80 ml / min). Nevertheless, in women with moderate renal impairment (Cl creatinine - 30-50 ml / min), the average concentration of drospirenone in blood plasma was 37% higher than in patients with preserved renal function. Drospirenone was well tolerated by all groups of patients. There was no change in the concentration of potassium in the blood plasma when using drospirenone.

Ethinylestradiol

After oral administration, ethinyl estradiol is rapidly and completely absorbed. C max in blood plasma, equal to about 54-100 pg / ml, is achieved in 1-2 hours. During absorption and the first passage through the liver, ethinyl estradiol is metabolized, as a result of which its oral bioavailability is, on average, about 45%.

Ethinylestradiol is almost completely (approximately 98%), albeit nonspecifically, bound to albumin. Ethinylestradiol induces the synthesis of SHBG.

Ethinylestradiol undergoes presystemic conjugation, both in the mucous membrane of the small intestine and in the liver. The main metabolic pathway is aromatic hydroxylation.

The decrease in the concentration of ethinyl estradiol in the blood plasma is biphasic. It is not excreted unchanged from the body. Ethinyl estradiol metabolites are excreted in the urine and bile in a ratio of 4: 6 with a T 1/2 of about 24 hours.

C ss is reached during the second half of the cycle.

Indications for Yarina ®

Contraception (prevention of unwanted pregnancy).

Contraindications

Yarina ® should not be used in the presence of any of the conditions / diseases listed below:

thrombosis (venous and arterial) and thromboembolism at present or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke), cerebrovascular disorders;

conditions preceding thrombosis (including transient ischemic attacks, angina pectoris) at the present time or in anamnesis;

migraine with focal neurological symptoms at present or in history;

diabetes mellitus with vascular complications;

multiple or severe risk factors for venous or arterial thrombosis, incl. complicated lesions of the valve apparatus of the heart, atrial fibrillation, diseases of the vessels of the brain or coronary arteries; uncontrolled arterial hypertension, serious surgery with prolonged immobilization, smoking over the age of 35;

pancreatitis with severe hypertriglyceridemia at present or in history;

liver failure and severe liver disease (before normalization of liver function tests);

liver tumors (benign or malignant), currently or in history;

severe and / or acute renal failure;

identified hormone-dependent malignant diseases (including genitals or mammary glands) or suspicion of them;

bleeding from the vagina of unknown origin;

pregnancy or suspicion of it;

lactation period;

hypersensitivity to any component of Yarina ®.

If any of these conditions develop for the first time while taking Yarina ®, the drug should be stopped immediately.

CAREFULLY

The potential risk and expected benefit of using combined oral contraceptives in each individual case should be carefully weighed in the presence of the following diseases / conditions and risk factors:

risk factors for the development of thrombosis and thromboembolism: smoking, obesity, dyslipoproteinemia, arterial hypertension, migraine, heart valve defects, prolonged immobilization, serious surgical interventions, extensive trauma, hereditary predisposition to thrombosis (thrombosis, myocardial infarction or cerebrovascular accident at a young age -or from the next of kin);

other diseases in which peripheral circulation disorders may occur (diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, Crohn's disease and ulcerative colitis, sickle cell anemia), phlebitis of superficial veins;

hereditary angioedema;

hypertriglyceridemia;

liver disease;

diseases that first appeared or worsened during pregnancy or against the background of previous use of sex hormones (for example, jaundice and / or itching associated with cholestasis, cholelithiasis, otosclerosis with impaired hearing, porphyria, herpes of pregnant women, Sydenham's chorea);

postpartum period.

Application during pregnancy and lactation

The drug is not prescribed during pregnancy and lactation. If pregnancy is detected while taking Yarina ®, it should be canceled immediately. However, extensive epidemiological studies have not revealed an increased risk of developmental defects in children born to women who received sex hormones before pregnancy or teratogenic effects in cases of taking sex hormones inadvertently in early pregnancy. At the same time, data on the results of taking Yarina® during pregnancy are limited, which does not allow any conclusions to be drawn about the negative effect of the drug on pregnancy, the health of the newborn and the fetus. There are currently no significant epidemiological data available.

Taking combined oral contraceptives can reduce the amount of breast milk and change its composition, so their use is not recommended until breastfeeding is stopped. Small amounts of sex steroids and / or their metabolites can be excreted in milk.

Side effects

The most commonly reported adverse reactions to Yarina® are nausea and breast pain. They occurred in more than 6% of women using this drug.

Arterial and venous thromboembolism are serious adverse reactions.

The table below shows the frequency of adverse reactions. which were reported during clinical trials of the drug Yarina ® (N \u003d 4897). Within each group, allocated depending on the frequency of occurrence of an adverse reaction, adverse reactions are presented in order of decreasing severity. By frequency, they are divided into frequent (≥1 / 100 and<1/10), нечастые (≥1/1000 и <1/100) и редкие (≥1/10000 и <1/1000). Для дополнительных нежелательных реакций, выявленных только в процессе постмаркетинговых исследований, и для которых оценку частоты возникновения провести не представлялось возможным, указано «частота неизвестна» (см. табл. 1).

Table 1

System Organ Classes (MedDRA version)	Often	Infrequently	Frequency unknown
Mental disorders	Mood swings, depression, depressed mood, decreased or loss of libido
Nervous system	Migraine
Vascular disorders		Venous or arterial thromboembolism *
Gastrointestinal tract	Nausea
Skin and subcutaneous tissue			Erythema multiforme
Reproductive system and mammary glands	Pain in the mammary glands, irregular uterine bleeding, bleeding from the genital tract of unspecified origin

Adverse events from clinical trials have been codified using the MedDRA (Medical Dictionary of Regulatory Activities, version 12.1). Various MedDRA terms reflecting the same symptom have been grouped together and presented as a single adverse reaction to avoid weakening or blurring the true effect.

* - Approximate frequency based on the results of epidemiological studies covering the group of combined oral contraceptives. The frequency bordering on very rare.

Venous or arterial thromboembolism includes the following nosological units: peripheral deep vein occlusion, thrombosis and embolism / pulmonary vascular occlusion, thrombosis, embolism and infarction / myocardial infarction / cerebral infarction and stroke not defined as hemorrhagic.

For venous and arterial thromboembolism, migraine, see also "Contraindications" and "Special instructions".

Additional Information

Listed below are adverse reactions with a very rare frequency of occurrence or with delayed symptoms, which are believed to be associated with taking drugs from the group of combined oral contraceptives (see also "Contraindications" and "Special instructions").

Tumors:

The frequency of diagnosing breast cancer in women taking combined oral contraceptives is slightly increased. Due to the fact that breast cancer is rare in women under 40 years of age, the increase in the number of breast cancer diagnoses in women taking combined oral contraceptives is insignificant in relation to the overall risk of this disease.

Liver tumors (benign and malignant).

Other conditions:

Erythema nodosum;

Women with hypertriglyceridemia (increased risk of pancreatitis while taking combined oral contraceptives);

Increased blood pressure;

Conditions that develop or worsen while taking combined oral contraceptives, but their relationship with taking the drug has not been proven (jaundice and / or pruritus associated with cholestasis; formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic uremic syndrome; Sydenham's chorea ; herpes of pregnancy; hearing loss associated with otosclerosis);

In women with hereditary angioedema, estrogen intake can cause or worsen its symptoms;

Liver dysfunction;

Impaired glucose tolerance or impact on insulin resistance;

Crohn's disease, ulcerative colitis;

Chloasma;

Hypersensitivity (including symptoms such as rash, hives).

Interaction. The interaction of combined oral contraceptives with other drugs (inducers of liver microsomal enzymes, some antibiotics) can lead to breakthrough bleeding and / or a decrease in contraceptive effectiveness (see "Interaction").

Interaction

The interaction of oral contraceptives with other drugs can lead to breakthrough bleeding and / or a decrease in contraceptive reliability. Women taking these drugs should temporarily use barrier methods of contraception in addition to Yarina®, or choose another method of contraception.

The following interactions have been reported in the literature.

Effect on hepatic metabolism. The use of drugs that induce liver microsomal enzymes can lead to an increase in the clearance of sex hormones, which in turn can lead to breakthrough bleeding or a decrease in the reliability of contraception. These drugs include: phenytoin, barbiturates, primidone, carbamazepine, rifampicin, rifabutin, possibly oxcarbazepine, topiramate, felbamate, griseofulvin, and preparations containing St. John's wort.

HIV protease inhibitors (such as ritonavir) and non-nucleoside reverse transcriptase inhibitors (eg nevirapine) and combinations thereof can also potentially affect hepatic metabolism.

Effect on intestinal-hepatic circulation... According to some studies, some antibiotics (for example, penicillins and tetracycline) can reduce the intestinal-hepatic circulation of estrogens, thereby lowering the concentration of ethinyl estradiol.

During the reception drugs that affect microsomal enzymes, and within 28 days after their cancellation, you should additionally use a barrier method of contraception.

During the reception antibiotics (such as penicillins and tetracyclines) and within 7 days after their cancellation, you should additionally use a barrier method of contraception. If during these 7 days of the barrier method of contraception the tablets in the current package run out, then you should start taking the tablets from the next package of Yarina ® without the usual interruption in taking the tablets.

The main metabolites of drospirenone are formed in plasma without the participation of the cytochrome P450 system. Therefore, the effect of inhibitors of the cytochrome P450 system on the metabolism of drospirenone is unlikely.

Combined oral contraceptives can interfere with the metabolism of other drugs, resulting in an increase (eg, cyclosporine) or a decrease (eg, lamotrigine) in plasma and tissue concentrations.

Based on interaction studies in vitroas well as research in vivo on female volunteers taking omeprazole, simvastatin and midazolam as markers, it can be concluded that the effect of drospirenone at a dose of 3 mg on the metabolism of other medicinal substances is unlikely.

There is a theoretical possibility of increasing serum potassium levels in women receiving Yarina® concurrently with other drugs that may increase serum potassium levels. These drugs include angiotensin II receptor antagonists, certain anti-inflammatory drugs, potassium-sparing diuretics, and aldosterone antagonists. However, in studies evaluating the interaction of drospirenone with ACE inhibitors or indomethacin, there was no significant difference between the serum potassium concentration compared with placebo.

Method of administration and dosage

Inside, in the order indicated on the package, every day at about the same time, with a little water.

Take one tablet a day continuously for 21 days. Taking the tablets from the next pack begins after a 7-day break, during which menstrual bleeding usually develops (withdrawal bleeding). As a rule, it starts on the 2-3rd day after taking the last pill and may not end before taking the pills from a new package.

How to start taking Yarina ®

In the absence of taking any hormonal contraceptives in the previous month

Taking Yarina ® begins on the first day of the menstrual cycle (i.e. on the first day of menstrual bleeding). It is allowed to start taking on the 2-5th day of the menstrual cycle, but in this case it is recommended to additionally use a barrier method of contraception during the first 7 days of taking the pills from the first package.

When switching from other combined oral contraceptives, vaginal ring, or contraceptive patch

It is preferable to start taking Yarina® the next day after taking the last active tablet from the previous package, but in no case later than the next day after the usual 7-day break (for preparations containing 21 tablets) or after taking the last inactive tablet (for preparations, containing 28 tablets per pack). Taking Yarina ® should be started on the day of removal of the vaginal ring or patch, but no later than the day when a new ring should be inserted or a new patch applied.

When switching from contraceptives containing only gestagens (“mini-pills”, injectable forms, implant), or from a progestogen-releasing intrauterine contraceptive (Mirena)

You can switch from "mini-pili" to Yarina ® any day (without interruption), from an implant or intrauterine contraceptive with gestagen - on the day of its removal, from an injection form - from the day when the next injection is to be made. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills.

After an abortion in the first trimester of pregnancy

You can start taking the drug immediately, on the day of the abortion. If this condition is met, the woman does not need additional contraception.

After childbirth or abortion in the second trimester of pregnancy

You should start taking the drug no earlier than 21-28 days after childbirth (in the absence of breastfeeding) or abortion in the II trimester of pregnancy. If the reception is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills. However, if a woman has already had a sex life, pregnancy should be excluded or the first menstrual period should be waited for before taking Yarina ®.

Taking missed pills

If the delay in taking the drug is less than 12 hours, contraceptive protection is not reduced. The woman should take the pill as soon as possible, the next one is taken at the usual time.

If the delay in taking the pills is more than 12 hours, the contraceptive protection is reduced. The more pills are missed and the closer the pass is to the 7-day pill break, the greater the likelihood of pregnancy.

In this case, you can be guided by the following two basic rules:

The drug should never be interrupted for more than 7 days;

To achieve adequate suppression of hypothalamic-pituitary-ovarian regulation, 7 days of continuous pill intake are required.

Accordingly, the following tips can be given if the delay in taking the pills is more than 12 hours (the interval since taking the last pill is more than 36 hours).

The first week of taking the drug

It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers about it (even if this requires taking two pills at the same time). The next pill is taken at the usual time. Additionally, a barrier method of contraception (such as a condom) should be used for the next 7 days. If intercourse took place within a week before the pill was missed, the likelihood of pregnancy must be taken into account.

Second week of taking the drug

It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers this (even if this requires taking two pills at the same time). The next pill is taken at the usual time. Provided that the woman took the pills correctly in the 7 days preceding the first missed pill, there is no need to use additional contraceptive measures. Otherwise, as well as when missing two or more pills, you must additionally use barrier methods of contraception (for example, a condom) for 7 days.

The third week of taking the drug

The risk of pregnancy increases due to the upcoming pill break. A woman must strictly adhere to one of the two options below. Moreover, if within 7 days preceding the first missed pill, all pills were taken correctly, there is no need to use additional contraceptive methods.

1. It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers about it (even if this requires taking two pills at the same time). The next pills are taken at the usual time until the end of the pills in the current package. Taking the tablets from the next package should be started immediately without interruption. Withdrawal bleeding is unlikely until the second pack runs out, but spotting and breakthrough bleeding may occur while taking the pills.

2. You can interrupt taking pills from the current package, thus starting a 7-day break (including the day of missing pills), and then start taking pills from a new package.

If a woman missed taking the pills, and then during a break in taking she does not have withdrawal bleeding, pregnancy must be excluded.

In case of vomiting or diarrhea in the period up to 4 hours after taking the tablets, absorption may be incomplete, and additional measures should be taken to prevent unwanted pregnancy. In such cases, you should focus on the above recommendations when skipping tablets.

Change in day of onset of menstrual bleeding

In order to postpone the onset of menstrual bleeding, it is necessary to continue taking pills from the new Yarina ® package without a 7-day break. The tablets from the new packaging can be taken as long as necessary, incl. until the tablets from the package run out. While taking the drug from the second package, spotting bleeding from the vagina or breakthrough uterine bleeding is possible. You should resume taking Yarina ® from the next package after the usual 7-day break.

In order to postpone the day of the onset of menstrual bleeding to another day of the week, a woman should shorten the next break in taking pills for as many days as she wants. The shorter the interval, the higher the risk that she will not have withdrawal bleeding, and in the future there will be spotting and breakthrough bleeding while taking the second pack (as well as in the case when she would like to delay the onset of menstrual bleeding).

Additional information for special categories of patients

Children and adolescents. Yarin's drug is indicated only after the onset of menarche. Available data do not suggest dose adjustment in this patient population.

Elderly patients. Not applicable. Yarina ® is not indicated after menopause.

Patients with liver disorders. The drug Yarina ® is contraindicated in women with severe liver diseases until the liver function indicators return to normal (see also "Contraindications" and "Pharmacokinetics").

Patients with renal impairment. Yarina ® is contraindicated in women with severe renal failure or acute renal failure (see also "Contraindications" and "Pharmacokinetics").

Overdose

Symptoms (identified on the basis of the total experience of the use of oral contraceptives): nausea, vomiting, spotting spotting or metrorrhagia.

Treatment: symptomatic. There is no specific antidote.

Serious overdose irregularities have not been reported.

special instructions

If any of the conditions, diseases and risk factors listed below are currently available, then the potential risks and expected benefits of using combined oral contraceptives in each individual case should be carefully weighed and discussed with the woman before she decides to start taking drug. In the event of an aggravation, intensification or the first manifestation of any of these conditions, diseases or an increase in risk factors, a woman should consult with her doctor, who may decide whether to discontinue the drug.

CVS diseases

The results of epidemiological studies indicate a relationship between the use of combined oral contraceptives and an increase in the incidence of venous and arterial thrombosis and thromboembolism (such as deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders) when taking combined oral contraceptives. These diseases are rare. The risk of developing VTE is highest in the first year of taking such drugs. The increased risk is present after initial use of combined oral contraceptives or resumption of use of the same or different combined oral contraceptives (after an interval between doses of 4 weeks or more). Data from a large prospective study involving 3 patient groups indicate that this increased risk is present predominantly during the first 3 months.

The overall risk of VTE in patients taking low-dose combined oral contraceptives (ethinylestradiol content is less than 50 μg) is 2-3 times higher than in non-pregnant patients who do not take combined oral contraceptives, however, this risk remains lower compared to with the risk of VTE during pregnancy and childbirth. VTE can be life threatening or fatal (1-2% of cases).

VTE, manifested as deep vein thrombosis, or pulmonary embolism, can occur with any combined oral contraceptive pill.

Very rarely, when using combined oral contraceptives, thrombosis of other blood vessels occurs (for example, hepatic, mesenteric, renal, cerebral veins and arteries or vessels of the retina). There is no consensus on the relationship between the occurrence of these events and the use of combined oral contraceptives. Symptoms of deep vein thrombosis (DVT) include the following: unilateral swelling of the lower limb or along a vein in the leg, pain or discomfort in the leg only when standing upright or when walking, a local fever in the affected leg, redness or discoloration of the skin on the leg.

The symptoms of pulmonary embolism (PE) are as follows: Difficulty or rapid breathing; sudden cough, incl. with hemoptysis; sharp pain in the chest, which may worsen with a deep breath; sense of anxiety; severe dizziness; a fast or irregular heartbeat. Some of these symptoms (eg shortness of breath, cough) are non-specific and can be misinterpreted as signs of other more or less severe events (eg, respiratory tract infection).

Arterial thromboembolism can lead to stroke, vascular occlusion, or myocardial infarction. The symptoms of a stroke are: sudden weakness or loss of sensation in the face, arm, or leg, especially on one side of the body, sudden confusion, problems with speech and understanding; sudden unilateral or bilateral loss of vision; sudden gait disturbance, dizziness, loss of balance or coordination of movements; sudden, severe, or prolonged headache for no apparent reason; loss of consciousness or fainting with or without an epileptic seizure. Other signs of vascular occlusion: sudden pain, swelling and slight blue discoloration of the limbs, acute abdomen.

Symptoms of myocardial infarction include: pain, discomfort, pressure, heaviness, feeling of tightness or distention in the chest, arm, or behind the breastbone; discomfort with radiation to the back, cheekbone, larynx, arm, stomach; cold sweats, nausea, vomiting, or dizziness, extreme weakness, anxiety, or shortness of breath; a fast or irregular heartbeat. Arterial thromboembolism can be fatal. The risk of developing thrombosis (venous and / or arterial) and thromboembolism increases:

With age;

In smokers (with an increase in the number of cigarettes or an increase in age, the risk increases, especially in women over 35).

In the presence of:

Obesity (body mass index more than 30 kg / m 2);

Family history (for example, venous or arterial thromboembolism ever in close relatives or parents at a relatively young age). In the case of a hereditary or acquired predisposition, a woman should be examined by an appropriate specialist to decide on the possibility of taking combined oral contraceptives;

Prolonged immobilization, major surgery, any leg surgery, or major trauma. In these situations, it is advisable to stop using combined oral contraceptives (in the case of a planned operation, at least 4 weeks before it) and not resume taking it within 2 weeks after the end of immobilization;

Dyslipoproteinemia;

Arterial hypertension;

Migraine;

Heart valve disease;

Atrial fibrillation.

The question of the possible role of varicose veins and superficial thrombophlebitis in the development of venous thromboembolism remains controversial. Consideration should be given to the increased risk of thromboembolism in the postpartum period.

Peripheral circulatory disorders can also occur in diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis), and sickle cell anemia. An increase in the frequency and severity of migraines during the use of combined oral contraceptives (which may precede cerebrovascular disorders) may be the reason for the immediate discontinuation of these drugs.

Biochemical indicators indicating a hereditary or acquired predisposition to venous or arterial thrombosis include the following: resistance to activated protein C, hyperhomocysteinemia, lack of antithrombin-III, protein C deficiency, lack of protein S, antiphospholipid antibodies (anticardiolipin antibodies, lupus antibodies). In assessing the risk / benefit ratio, it should be borne in mind that adequate treatment of the condition may reduce the associated risk of thrombosis. It should also be borne in mind that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives (ethinyl estradiol content - 0.05 mg).

Tumors

The most significant risk factor for cervical cancer is persistent human papillomavirus infection. There are reports of a slight increase in the risk of cervical cancer with long-term use of combined oral contraceptives. However, the relationship with the use of combined oral contraceptives has not been proven. The possibility of interconnecting these data with disease screening is discussed. Controversy persists as to the extent to which these data are associated with screening for cervical pathology or with features of sexual behavior (more rare use of barrier methods of contraception).

A meta-analysis of 54 epidemiological studies has shown that there is a slightly increased relative risk of developing breast cancer diagnosed in women currently taking combined oral contraceptives (relative risk - 1.24). The increased risk gradually disappears within 10 years after you stop taking these drugs. Due to the fact that breast cancer is rare in women under 40 years of age, the increase in the number of diagnoses of breast cancer in women who are currently taking combined oral contraceptives or have recently taken it is insignificant in relation to the overall risk of this disease. Its connection with the use of combined oral contraceptives has not been proven. The observed increase in risk may also be due to close monitoring and earlier diagnosis of breast cancer in women using combined oral contraceptives. Women who have ever used combined oral contraceptives have earlier stages of breast cancer than women who have never used them.

In rare cases, against the background of the use of combined oral contraceptives, the development of benign, and in extremely rare cases, malignant liver tumors was observed, which sometimes led to life-threatening intra-abdominal bleeding. In case of severe pain in the abdomen, enlarged liver or signs of intra-abdominal bleeding, this should be taken into account when making a differential diagnosis. Malignant tumors can be life threatening or fatal.

Other conditions

Clinical studies have shown no effect of drospirenone on the concentration of potassium in the blood plasma in patients with mild to moderate renal failure. Nevertheless, in patients with impaired renal function and an initial potassium concentration at the VGN level, the risk of developing hyperkalemia while taking drugs, leading to potassium retention in the body, cannot be excluded.

Women with hypertriglyceridemia (or a family history of this condition) may have an increased risk of developing pancreatitis while taking combined oral contraceptives.

Despite the fact that a small increase in blood pressure has been described in many women taking combined oral contraceptives, clinically significant increases were rarely observed. However, if a persistent, clinically significant increase in blood pressure develops while taking the drug, these drugs should be discontinued and treatment of arterial hypertension should be started. The drug can be continued if normal blood pressure values \u200b\u200bare achieved with the help of antihypertensive therapy. The following conditions have been reported to develop or worsen both during pregnancy and when taking combined oral contraceptives (but their relationship with taking combined oral contraceptives has not been proven): jaundice and / or pruritus associated with cholestasis; the formation of stones in the gallbladder; porphyria; systemic lupus erythematosus; hemolytic uremic syndrome; chorea; herpes during pregnancy; hearing loss associated with otosclerosis. Cases of Crohn's disease and ulcerative colitis are also described with the use of combined oral contraceptives. In women with hereditary forms of angioedema, exogenous estrogens can cause or worsen symptoms of angioedema.

Acute or chronic abnormalities in liver function may require discontinuation of the drug until liver function values \u200b\u200breturn to normal. Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous use of sex hormones, requires discontinuation of the drug. Although combined oral contraceptives can affect insulin resistance and glucose tolerance, there is no need to change the therapeutic regimen in patients with diabetes mellitus using low-dose combined oral contraceptives (ethinyl estradiol content is less than 0.05 mg). However, women with diabetes should be monitored closely while taking this drug.

Chloasma can sometimes develop, especially in women with a history of pregnant chloasma. Women with a tendency to chloasma should avoid prolonged exposure to the sun and exposure to UV radiation while taking Yarina ®.

Non-clinical safety data

Preclinical data obtained in the course of standard studies for the detection of toxicity with repeated doses of the drug, as well as genotoxicity, carcinogenic potential and toxicity to the reproductive system, do not indicate the presence of a particular risk to humans. However, it should be remembered that sex steroids can promote the growth of some hormone-dependent tissues and tumors.

Laboratory tests

Taking combined oral contraceptives can interfere with the results of some laboratory tests, including liver, kidney, thyroid, adrenal gland function, plasma transport protein levels, carbohydrate metabolism, blood clotting and fibrinolysis. Changes usually do not go beyond the normal range. Drospirenone increases plasma renin activity and plasma aldosterone levels, which is associated with its anti-mineralocorticoid effect.

Decreased efficiency

The effectiveness of the drug Yarina ® can be reduced in the following cases: when you skip taking pills, with vomiting and diarrhea (see "Taking the missed tablets") or as a result of drug interactions.

Insufficient control of the menstrual cycle

While taking Yarina ®, you may experience irregular (acyclic) spotting / bleeding from the vagina (spotting spotting or breakthrough bleeding), especially during the first months of use. Therefore, any irregular menstrual bleeding should be assessed after an adaptation period of approximately 3 cycles. If irregular menstrual bleeding recurs or develops after previous regular cycles, a thorough examination should be carried out to rule out malignant neoplasms or pregnancy.

Some women may not develop withdrawal bleeding during a pill break. If Yarina ® was taken as recommended, it is unlikely that the woman is pregnant. However, with irregular use of the drug and the absence of two consecutive menstrual bleeding, the drug cannot be continued until pregnancy is excluded.

Medical examinations

Before starting or resuming the use of Yarina ®, it is necessary to familiarize yourself with the life history, family history of the woman, conduct a thorough general medical and gynecological examination, and exclude pregnancy. The volume of research and the frequency of follow-up examinations should be based on existing standards of medical practice, with the necessary consideration for the individual characteristics of each patient. As a rule, blood pressure, heart rate are measured, body mass index is determined, the condition of the mammary glands, abdominal cavity and pelvic organs is checked, including cytological examination of the cervical epithelium (Papanicolaou test). Usually, control examinations should be carried out at least once every 6 months.

A modern medicinal product designed to prevent pregnancy and normalize the menstrual cycle in women aged 18 to 40 years. The medication is recommended to be taken cyclically, since already from the first intake, significant changes in the cervix begin to occur.
A hormonal targeted agent instantly affects the microflora of the cervix. Due to the reaction of uterine mucus and the main components of the drug, the work of the glands that produce cervical secretions slows down. The cervix, deprived of the required amount of nutrients and mucus, becomes difficult to access for sperm movement. The action of the drug is 87% effective, contraception has a positive effect on the hormonal background of a woman. Drospirenone included in the composition is useful for patients suffering from hormonal imbalance, up to the neuropsychic form.

Indications for use:

Yasmin contraceptive is prescribed in several cases: prevention of unwanted pregnancy; failure in the menstrual cycle; acne; swelling.
Hormonal contraception is also effective for excessive engorgement of the mammary glands.

Mode of application:

Yasmin tablets are taken once a day, 1 tablet strictly at the same time. If you skip or violate the dose of the drug, negative consequences for the body are possible. After 21 days, you need to take a 7-day break, after which repeat the standard dosage. During the break, bleeding begins - a normal reaction of the body. Contraception restores a regular menstrual cycle.

Side effects:

The first days after taking the Yasmin contraceptive, bleeding opens - pseudo-menstruation. When taking Yasmin, the cycle lasts normally, without complications and abdominal pain. Often, this medication is taken to control the menstrual cycle, in particular, to reduce pain. You should not stop taking the drug after the onset of bleeding in order to avoid serious complications in the uterus. Among the negative side effects are the following: dizziness; nausea; vomiting; stomach ache; shortness of breath; strong expectorant cough with the presence of blood (it is recommended to immediately call an ambulance); insomnia; allergic reactions.

Contraindications:

Taking Yasmin tablets may be contraindicated if the patient has the following diseases: allergy to the components of the drug; breast cancer; diabetes; renal and hepatic impairment; pregnancy; ischemia of the heart; high blood pressure.

Release form:

Yasmin - tablet - 3 mg white coated. One blister is enough for 3 weeks.

Composition:

Yasmin birth control pills contain 2 active substances: ethinyl estradiol and drospirenone, which act on the egg and slow down the ovulation process.

Additionally:

Yasmin's contraceptive pills are a monophasic type of contraceptive, so before using it, you should consult a gynecologist. Irregular bleeding in the first weeks of use is normal and will stabilize over time.

Attention!

The description on this page is a simplified and supplemented version of the official instructions for use. Before purchasing or using the drug, you should consult with your doctor and familiarize yourself with the annotation approved by the manufacturer.
The information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide on the appointment of the drug, as well as determine the doses and methods of its use.