Drospirenone; Ethinyl Estradiol Tablets

What is this medication?

DROSPIRENONE; ETHINYL ESTRADIOL (dro SPY re nown; ETH in il es tra DYE ole) prevents ovulation and pregnancy. It may also be used to treat acne and premenstrual dysphoric disorder (PMDD). It belongs to a group of medications called oral contraceptives. It is a combination of the hormones estrogen and progestin.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Gianvi, Jasmiel, Lo-Zumandimine, Loryna, Nikki 28-Day, Ocella, Syeda, Vestura, Yasmin, Yaz, Zarah, Zumandimine

What should I tell my care team before I take this medication?

They need to know if you have or ever had any of these conditions:

• Abnormal vaginal bleeding
• Adrenal gland disease
• Blood vessel disease or blood clots
• Breast, cervical, endometrial, ovarian, liver, or uterine cancer
• Diabetes
• Gallbladder disease
• Heart disease or recent heart attack
• High blood pressure
• High cholesterol
• High potassium level
• Kidney disease
• Liver disease
• Migraine headaches
• Stroke
• Systemic lupus erythematosus (SLE)
• Tobacco use
• An unusual or allergic reaction to estrogens, progestins, or other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth. To reduce nausea, this medication may be taken with food. Follow the directions on the prescription label. Take this medication at the same time each day and in the order directed on the package. Do not take your medication more often than directed.

A patient package insert for the product will be given with each prescription and refill. Read this sheet carefully each time. The sheet may change frequently.

Talk to your care team regarding the use of this medication in children. Special care may be needed. This medication has been used in female children who have started having menstrual periods.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, refer to the patient information sheet you received with your medication for direction. If you miss more than one pill, this medication may not be as effective, and you may need to use a back-up contraceptive.

What may interact with this medication?

Do not take this medication with any of the following:

• Aminoglutethimide
• Amprenavir, fosamprenavir
• Atazanavir; cobicistat
• Anastrozole
• Bosentan
• Exemestane
• Letrozole
• Metyrapone
• Testolactone

This medication may also interact with the following:

• Acetaminophen
• Antiviral medications for HIV or AIDS
• Aprepitant
• Barbiturates
• Certain antibiotics like rifampin, rifabutin, rifapentine, and possibly penicillins or tetracyclines
• Certain diuretics like amiloride, spironolactone, triamterene
• Certain medications for fungal infections like griseofulvin, ketoconazole, itraconazole
• Certain medications for high blood pressure or heart conditions like ACE-inhibitors, Angiotensin-II receptor blockers, eplerenone
• Certain medications for seizures like carbamazepine, oxcarbazepine, phenobarbital, phenytoin
• Cholestyramine
• Cobicistat
• Corticosteroid like hydrocortisone and prednisolone
• Cyclosporine
• Dantrolene
• Felbamate
• Grapefruit juice
• Heparin
• Lamotrigine
• Medications for diabetes, including pioglitazone
• Modafinil
• NSAIDs
• Potassium supplements
• Pyrimethamine
• Raloxifene
• St. John's wort
• Sulfasalazine
• Tamoxifen
• Topiramate
• Thyroid hormones
• Warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. You will need a regular breast and pelvic exam and Pap smear while on this medication.

Use an additional method of contraception during the first cycle that you take these tablets.

If you have any reason to think you are pregnant, stop taking this medication right away and contact your care team.

If you are taking this medication for hormone related problems, it may take several cycles to see improvement in your condition.

Smoking increases the risk of getting a blood clot or having a stroke while you are taking this medication, especially if you are more than 35 years old. You are strongly advised not to smoke.

This medication can make your body retain fluid, making your fingers, hands, or ankles swell. Your blood pressure can go up. Contact your care team if you feel you are retaining fluid.

This medication can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye care specialist.

Tenderness, swelling, or minor bleeding of the gums may occur. Notify your dentist if this happens. Brushing and flossing your teeth regularly may help limit this. See your dentist regularly and inform your dentist of the medications you are taking.

If you are going to have elective surgery, you may need to stop taking this medication before the surgery. Consult your care team for advice.

This medication does not protect you against HIV infection (AIDS) or any other sexually transmitted infections.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
• Gallbladder problems—severe stomach pain, nausea, vomiting, fever
• Increase in blood pressure
• Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness, fatigue
• New or worsening migraines or headaches
• Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
• Unusual vaginal discharge, itching, or odor
• Worsening mood, feelings of depression

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Breast pain or tenderness
• Dark patches of skin on the face or other sun-exposed areas
• Irregular menstrual cycles or spotting
• Nausea
• Weight gain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Does Yaz have estrogen?

It does. Yaz contains a lab-made form of estrogen called ethinyl estradiol. It also contains a lab-made form of progesterone called drospirenone. Birth control pills containing estrogen and progesterone (like Yaz) are called combination birth control pills.

How do you take Yaz?

You can start Yaz at any time after your healthcare provider prescribes it. This is Day 1. For the next 24 days, you should take one light pink pill daily, so you’re taking light pink pills from Day 1 to Day 24. The light pink pills are “active,” which means they contain hormones that prevent pregnancy. Take them at the same time each day to get into the habit of taking your pill. Doing so is critical to ensuring the pill is working to prevent pregnancy.

From Day 25 to 28 you should take one white pill each day. These pills are “inactive,” meaning they don’t contain hormones preventing pregnancy. Instead, they’re placebos. They serve as reminders, so you don’t forget to take your pills.

On Day 29, you should start a new pack, beginning again by taking the first light pink pill in the new packet. This is the traditional way to take combined oral contraceptive pills.

Some people who desire to bleed less frequently may try extended cycle use of Yaz. With this option, you skip the inactive pills to have less frequent bleeding episodes. This may result in more unscheduled bleeding. You should consult with your healthcare provider if you’re interested in this option.

You’ll need to take the active (light pink) Yaz pills for seven consecutive days to prevent pregnancy. If you’re sexually active during the first seven days of starting Yaz, use a backup form of birth control, like condoms or spermicide, so you don’t get pregnant.

Can I start taking Yaz at any time?

Yes, you can start taking Yaz at any time, as long as you’re reasonably certain you’re not pregnant. If you’re not within the first five days of your period when starting, use a backup method of birth control (like a condom) for seven days.

Is Yaz a diuretic?

The progesterone component (drospirenone) found in Yaz consists of compounds similar to a diuretic called spironolactone. Diuretics move fluid out of your body. Because of the drospirenone, Yaz has mild diuretic properties. As a result, it’s less likely to cause water weight gain, as some birth control pills do.

Can Yaz be used as Plan B?

No. You shouldn’t use Yaz® as Plan B or emergency contraception.

There are different types of emergency contraception pills, including levonorgestrel (Plan B One-Step®) or ulipristal acetate (ella®). Intrauterine devices (IUDs) can also be used as emergency contraception.

A note from Cleveland Clinic

Make sure to take all birth control pills as directed by your healthcare provider. It’s important to get into the habit of taking them consistently, so you don’t forget and miss a day. Even a single missed dose can increase your chances of getting pregnant. Ask your healthcare provider about the benefits of a combination birth control pill to see if it’s right for you.

Note: Intro and FAQ sections written and reviewed by Cleveland Clinic professionals.