Drospirenone and Ethinyl Estradiol (Oral)

Drospirenone and Ethinyl Estradiol is one product with two hormones (Drospirenone and Ethinyl Estradiol), which stop ovulation and alter the uterus lining and cervical mucus to prevent pregnancy.

Overview

Drospirenone and Ethinyl Estradiol is a hormonal birth control tablet that has two kinds of hormones, drospirenone and ethinyl estradiol, and prevents pregnancy when used properly. It works by preventing a woman's egg (ovum) from developing fully each month. The ovum can't accept a sperm anymore and this prevents fertilization.

This medication also helps treat acne in women aged 14 and above, as well as premenstrual dysphoric disorder. Premenstrual dysphoric disorder is a very serious version of premenstrual syndrome. People with premenstrual dysphoric syndrome may have severe physical and emotional symptoms 10-14 days before the menstrual flow begins.

This medication doesn't help prevent HIV/AIDs or other STDs. It won't work as an emergency birth control solution, like after unprotected sexual intercourse.

Drospirenone and Ethinyl Estradiol comes in tablet form and is only available with a doctor's prescription under the following brand names: Yasmin, Yaz 28, Vestura, Gianvi, Nikki, Loryna, Syeda, Ocella, and Zarah.

Conditions Treated

Type Of Medicine

  • Hormonal contraceptive

Side Effects

Many medicines do bring about side effects. The side effects may be very serious or less serious, permanent or temporary.

The side effects outlined below have been experienced by at least one percent of people using Drospirenone and Ethinyl Estradiol. Many of them can be treated, and some may vanish on their own eventually.

Contact your healthcare specialist if you feel these effects and they're troublesome and severe. Your pharmacist can advise you on how to manage them.

  • Back pain
  • Dizziness
  • Nausea
  • Headache
  • Darkening facial skin
  • Changes in weight
  • Breast tenderness, pain, or swelling
  • Abdominal bloating or cramping
  • Acne (normally less common after 90 days of treatment and can improve if you already have acne)
  • Changed interest in sex
  • Diarrhea
  • Dizziness
  • Problem with wearing contact lenses
  • Nervousness
  • Vomiting
  • Trouble sleeping

While most of the following effects occur less often, they might result in serious issues if you don't get medical attention.

See your physician promptly if you suffer any of these effects:

  • Increased blood pressure
  • Flu-like symptoms
  • Mood swings
  • Swelling of feet or ankles
  • Worsening migraines or headaches
  • Tenderness, swelling, or pain in the upper abdominal area
  • Vaginal yeast infection along with vaginal irritation or itching, or curd-like, white, or thick discharge
  • Signs of liver problem (such as itchy skin, pale stools, dark urine, abdominal pain, yellow skin or eyes)
  • Signs of depression (such as changes in weight, poor concentration, thoughts of suicide, reduced interest in activities, changes in sleep)
  • Changes in bleeding pattern between or during periods, such as:
    • Extended bleeding during periods
    • Reduced bleeding during periods
    • Occasional halting of menstrual bleeding
    • Breakthrough spotting or bleeding between periods
    • Complete halting of menstrual bleeding for several consecutive months

For women who have had abnormalities in their breast:

Stop taking this medicine and immediately seek medical care if you develop any of these effects:

  • Seizures
  • Tenderness, itching, redness, peeling, or burning of skin
  • Sudden vision loss (completely or partly)
  • Signs of allergic reaction (like hives, breathing difficulty, swelling of throat or face)
  • Signs of blood clot in your leg or arm (like tenderness, swelling, warmth, pain, or redness in leg or arm)
  • Signs of blood clot in your lungs (like coughing up blood, coughing, passing out, sweating, difficulty breathing, or acute chest pain that’s severe when breathing in)
  • Signs of heart attack (like chest pressure or pain, nausea and vomiting, pain stretching through arm and shoulder, sweating)
  • Signs of stroke (like sudden worsening or severe headache, dizziness, vomiting, fainting, speech or vision problems, numbness or weakness in the leg, arm, or face)

Birth control medications don’t seem to bring about cancer. But if you’ve got breast cancer now or have had it previously, don’t take birth control medications as some kinds of breast cancer are very sensitive to hormones.

Women who take birth control medications potentially have a greater risk of developing cervical cancer. But this could be because of other reasons, including being involved with more sexual partners.

Some people may suffer side effects not mentioned above. See your healthcare professional if you develop any symptoms that concern you while you’re taking Drospirenone and Ethinyl Estradiol.

Dosage

Before you begin using this medication and each time you have a refill, read the leaflet containing patient information that’s issued by your pharmacist. The leaflet has crucial information about when to use your tablets and what you should do in case of a missed dose. If you’ve got any questions, please consult your pharmacist and doctor.

Take Drospirenone and Ethinyl Estradiol orally (by mouth) as instructed by your doctor, usually once a day, with or without meals. Choose one time of the day you won’t forget, and take your tablet at that time daily, 24 hours apart. Having this medicine at bedtime or after your dinner may help reduce nausea and stomach upset.

Follow the instructions on the package to locate the first pill, begin with the first pill in the package, and take the pills in the right order. Don’t skip any dose. You’re more likely to get pregnant if you skip doses, take your tablet at an unusual time of day, or start a fresh pack late.

Your pack has 24 tablets with hormones (active medication). It also has 4 tablets without hormones (reminder pills) at the pack’s end. Take a single pill with hormones (active pill) once a day for 24 successive days.

After taking the last pill with hormones, take the one without hormones (reminder pill) once a day for 4 successive days unless otherwise instructed by your healthcare professional. You should get your period within three days of taking the last active pill in the cycle in week 4 of using the pack. After taking the last reminder pill in the pack, begin a fresh pack the following day even if you get your period. Consult your doctor if you don’t see your period.

If this is your first time using Drospirenone and Ethinyl Estradiol and aren’t switching from another hormonal birth control method (like patch or other birth control medicines), take the first pill in the package on day one of your period or the first Sunday after the start of your monthly period.

If your menstrual period starts on a Sunday, start taking this medication on that day. In your first round of use only, please use an extra non-hormonal contraceptive (such as spermicide or condoms) for the first week to stop pregnancy until Drospirenone and Ethinyl Estradiol has ample time to work. And if you begin on day one of your menstrual period, you don’t have to use an additional birth control method in the first week.

Make sure to seek more information from your pharmacist and doctor about how to change from other hormonal birth control forms (e.g. patch, other birth control medicines) to Drospirenone and Ethinyl Estradiol.

Interactions

  • Drospirenone and Ethinyl Estradiol may interact with any of these substances:
  • Amiodarone
  • Anastrozole
  • Aliskiren
  • Apixaban
  • Aprepitant
  • Abiraterone Acetate
  • ACE (angiotensin converting enzyme) inhibitors e.g. lisinopril, enalapril, or ramipril)
  • Angiotensin-II receptor blockers (such as losartan, candesartan)
  • Antibiotics (such as penicillin, neomycin, sulfonamides, rifampin, nitrofurantoin, tetracyclines, metronidazole,
  • ampicilin, chloramphenicol, erythromycin, cotrimoxazole)
  • Antacids (when used with two hours of using Drospirenone and Ethinyl Estradiol)
  • Anticonvulsants (such as carbamazepine, oxcarbazepine, lamotrigine, ethosuximide, phenobarbital, primidone,
  • phenytoin, topiramate)
  • “Azole” antifungals (such as ketoconazole, itraconazole, voriconazole)
  • Beta-blockers (such as atenolol, metoprolol, propranolol)
  • Benzodiazepines (e.g. diazepam, lorazepam, chlordiazepoxide)
  • Barbiturates (such as phenobarbital)
  • Bosentan
  • Boceprevir
  • Caffeine
  • Clonidine
  • Cyproterone
  • Cyclosporine
  • Crizotinib
  • Conivaptan
  • Cobicistat
  • Clofibrate
  • Clarithromycin
  • Cholestyramine
  • Certain diuretics (such as triamterene, amiloride, spironolactone)
  • Corticosteroids (such as prednisone, hydrocortisone, dexamethasone)
  • Dronedarone
  • Doxorubicin
  • Dipyridamole
  • Deferasirox
  • Dabrafenib
  • Dabigatran
  • Diabetes medicines (such as metformin, insulin, glyburide, glipizide, chlorpropamide, rosiglitazone, nateglinide)
  • Exenatide
  • Exemestane
  • Enzalutamide
  • Folic acid
  • Heparin
  • Grapefruit juice
  • HIV protease inhibitors (such as saquinavir, indinavir, ritonavir, atazanavir)
  • HIV nonnucleoside-reverse transcriptase inhibitors (such as nevirapine, etravirine, efavirenz, delaviridine)
  • Hydrocodone
  • Hyaluronidase
  • Immune globulin
  • Mycophenolate
  • Meperidine
  • Mifepristone
  • Modafinil
  • Mitotane
  • Nilotinib
  • Nefazodone
  • NSAIDs (non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen)
  • Potassium supplements/potassium-containing salt substitutes
  • Potassium-sparing diuretics (such as triamterene, spironolactone, amiloride)
  • Peramanel
  • Progesterone
  • Propranolol
  • Prazosin
  • Prucalopride
  • Reserpine
  • Quinine
  • Quinidine
  • Rifampin
  • Ropinirole
  • Rivaroxaban
  • Retinoic acid medicines (such as isotretinoin, acitretin, estretinate)
  • Sunitinib
  • Somatropin
  • Siltuximab
  • Selegiline
  • St John’s Wort
  • Trazodone
  • Tacrolimus
  • Telaprevir
  • Tamoxifen
  • Tenofovir
  • Teriflunomide
  • Tizanidine
  • Topiramate
  • Tocilizumab
  • Tipranavir
  • Tranexamic acid
  • Tricylic antidepressants (such as clomipramine, amitriptyline)
  • Thyroid replacements (such as levothyroxine, dessicated thyroid)
  • Theophyllines (such as theophylline, aminophylline, oxtriphylline)
  • Ursodiol
  • Ulipristal
  • Vinblastine
  • Verapamil
  • Warfarin

If you’re using any of the above medicines, speak to your pharmacist and doctor.
An interaction between any of these medicines and Drospirenone and Ethinyl Estradiol doesn’t necessarily mean you must stop using one of the medications. Talk to your healthcare professional about how drug interactions are being controlled and how they should be controlled.

Warnings

Before you start using any medicine, make sure to let your physician know of any allergies or medical issues you have, any medicines you’re taking, whether you’re breastfeeding or pregnant, as well as any other vital details about your health. The factors discussed below may affect how you take Drospirenone and Ethinyl Estradiol.

Pregnancy

Drospirenone and Ethinyl Estradiol shouldn’t be taken during pregnancy. Contact your physician straight away if you get pregnant while using Drospirenone and Ethinyl Estradiol, or think you could get pregnant.

Breastfeeding

Drospirenone and Ethinyl Estradiol contains hormones which may get into human milk. Those hormones may decrease the quality and quantity of human milk. If you’re breastfeeding, please use another birth control method until you’re no longer breastfeeding. Discuss your options with your doctor.

Children

The efficacy and safety of using Drospirenone and Ethinyl Estradiol haven’t been determined for children younger than 16.

Blood clots

All hormone-based contraceptives can raise the risk of forming blood clots. Certain studies have shown that birth control medicines containing drospirenone increase the risk of formation of blood clots when compared to other contraceptive pills. Inform your doctor if you’re susceptible to blood clots or have a history of the same.

Inform your physician if you’re planning to have surgery or will be inactive or immobilized for a long period of time (for example, through an illness or accident), as there’s a higher risk of formation of blood clots when taking combination hormone contraceptives.

If you suffer crushing chest heaviness or pain, pain in your calf, speech or vision changes, sudden severe headache, unexpected shortness of breath, numbness or weakness in the leg or arm, or are coughing up blood, seek medical attention immediately because these symptoms may be a sign of a blood clot.

Blood pressure

Drospirenone and Ethinyl Estradiol may increase your blood pressure, raising your risk for other heart conditions. If you suffer from high blood pressure, talk to your healthcare specialist about how Drospirenone and Ethinyl Estradiol may affect your condition, how your condition can affect the dose and efficacy of Drospirenone and Ethinyl Estradiol, and whether you require any special monitoring.

You may have to visit your healthcare specialist more often so your blood pressure is monitored while using Drospirenone and Ethinyl Estradiol. Occasionally, high blood pressure (hypertension) that results from using hormonal contraceptives may force you to stop using Drospirenone and Ethinyl Estradiol.

Cigarette smoking/heart disease

Smoking cigarettes raises the risk of heart disease as well as death. This risk is also increased by birth control pills, especially as women get older. Women older than 35 who smoke heavily should not take Drospirenone and Ethinyl Estradiol. Women shouldn’t smoke while using Drospirenone and Ethinyl Estradiol.

Depression

Drospirenone and Ethinyl Estradiol, like other forms of birth control, may bring about depression. If you’ve had depression before, discuss with your healthcare giver how Drospirenone and Ethinyl Estradiol can affect your condition, how your condition can affect the dosage and efficacy of Drospirenone and Ethinyl Estradiol, and whether you need any special monitoring. Women who’ve had depression or related problems are more likely to suffer a recurrence while using oral birth control medicines.

Diabetes

If you’ve got diabetes or someone in your family has it, discuss with your physician how Drospirenone and Ethinyl Estradiol may affect your condition, how your condition may affect the dosage and efficacy of Drospirenone and Ethinyl Estradiol, and whether you need any special monitoring. If you’ve got diabetes, your blood sugar may need to be tested more often to find out if it has worsened after starting to use birth control pills.

Epilepsy

Women who’ve had epileptic seizures before should consult their physician about the likelihood of Drospirenone and Ethinyl Estradiol increasing the frequency of epileptic seizures.

Electrolyte imbalance

Drospirenone and Ethinyl Estradiol has progesterone drospirenone, which can increase the levels of potassium in women who are vulnerable to electrolyte imbalance. Women with decreased liver or kidney function or insufficient adrenal hormones are more vulnerable to this condition. Women who are given other medications that may increase their potassium levels should have their levels monitored by their physician when they first begin using Drospirenone and Ethinyl Estradiol. Some of these medicines include ACE inhibitors, potassium supplements, some diuretics, angiotensin-II receptor antagonists, aldosterone antagonists, non-steroidal anti-inflammatory drugs, and heparin.

Eye conditions

Women who are using birth control medications may experience a buildup of fluid in their eye cornea, which may lead to vision changes. This buildup of fluid can also mean that contact lenses stop fitting as well as before, especially if you’ve got hard contact lenses. In contrast, soft contact lenses normally don’t cause issues. If you feel uncomfortable wearing contact lenses, consult your eye doctor.

Fibroid tumors

Drospirenone and Ethinyl Estradiol may make fibroid tumors (noncancerous growths inside the uterus) worse, resulting in sudden enlargement, tenderness, or pain. If you suffer these effects, call up your physician.

Gallbladder problems

Using hormonal contraceptives worsens the risk of gallbladder issues. If you have symptoms of gallbladder issues, like severe back (between shoulder blades) or stomach pain, vomiting or nausea, contact your doctor.

Kidney disease

If you’ve got kidney disease, discuss with your physician how Drospirenone and Ethinyl Estradiol may affect your condition, how your condition may affect the dosage and efficacy of Drospirenone and Ethinyl Estradiol, and whether you need any special monitoring. You may require blood tests regularly while using this medicine.

Liver disease

While uncommon, using hormonal contraceptives may cause liver problems. Visit your doctor right away if you have signs of liver issues such as yellow skin or eyes, dark urine, abdominal pain, itchy skin, or pale stools.

Headache and migraine

Women with migraines or headaches should talk to their doctor how Drospirenone and Ethinyl Estradiol may affect their condition and whether they need any special monitoring. Tell your physician if your migraine headaches have worsened or you have new kinds of severe, persistent, or recurrent headaches.

Regular checkups

Please visit your physician annually for a physical checkup and follow-up while you’re using Drospirenone and Ethinyl Estradiol.

Return to fertility

After discontinuing birth control treatment, you should put off pregnancy until you’ve had at least one regular spontaneous menstrual cycle to date your pregnancy. Please use an alternative method of birth control during this time. Notify your doctor if you don’t menstruate for at least 6 months after discontinuing birth control pills.

Risk of cancer

Using hormonal contraceptives can increase the risk of cervical and breast cancer in pre-menopause women. If you’ve been taking hormonal contraceptives for a while (at least 8 years), began using them when you were much younger, or one of your female family members has had cancer, you’re could be at a higher risk of having cancer. Ask your doctor if you need any special monitoring.

Sexually transmitted diseases (STDs)

Birth control medications don’t protect against sexually transmitted diseases, including HIV/AIDs. It’s recommended that you use latex condoms together with Drospirenone and Ethinyl Estradiol to protect yourself against STDs.

Stop taking this medication and immediately alert your doctor if you have any of these symptoms:

  • Sharp pains and/or strange swelling in your leg
  • Pain on coughing or breathing
  • Sudden breathlessness
  • Coughing up blood
  • Severe or migraine headaches
  • Sudden acute chest pain
  • Sudden vision changes
  • Sudden changes in speech or hearing
  • Sudden numbness or weakness on one side
  • Collapse
  • Fainting
  • Significant increase in blood pressure
  • Epileptic seizure
  • Itching of the entire body
  • Yellowing of whites of eyes or skin (jaundice)
  • Severe depression
  • Severe stomach pain
  • Symptoms of pregnancy

Storage

  • Keep Drospirenone and Ethinyl Estradiol at room temperature.
  • Keep Drospirenone and Ethinyl Estradiol away from moisture and light.
  • Don’t keep Drospirenone and Ethinyl Estradiol in the bathroom.
  • Keep Drospirenone and Ethinyl Estradiol away from pets and kids.
  • Don’t pour Drospirenone and Ethinyl Estradiol into a drain or flush it down the toilet unless directed to do so.
  • Properly discard Drospirenone and Ethinyl Estradiol when you longer need it or it has expired.
  • Consult your local garbage disposal company or pharmacist for more information about how to discard this medication safely.

Summary

Drospirenone and Ethinyl Estradiol can also be taken for other reasons not discussed in this medicine guide.

You should not use Drospirenone and Ethinyl Estradiol if you have allergies to it or its ingredients. Please tell your pharmacist and doctor if you’ve previously had such an allergic reaction. Stop using Drospirenone and Ethinyl Estradiol promptly and talk to your doctor if you feel you’ve suffered an allergic reaction.
Don’t use birth control medications if you’re expecting a baby or you’ve recently had one.

You shouldn’t take birth control medications if you’ve got any of these medical conditions: heart disease, uncontrollable high blood pressure, circulation problems, a blood-clotting condition, diabetic issues with your kidneys or eyes, liver cancer or liver disease, severe migraine headaches, abnormal vaginal bleeding, if you’re above 35 or you smoke, if you’ve ever had uterine or breast cancer, a heart attack, jaundice due to birth control pills, a blood clot, or a stroke.

Using birth control pills may raise your risk for blood clots, heart attack, or stroke, especially if you’re overweight, or you have some other conditions.

Smoking can significantly raise your risk for blood clots, heart attack, or stroke. Please avoid birth control medications if you’re above 35 or you smoke.

Using birth control pills may raise your risk for stroke, heart attack, or blood clots. You are at even more risk if you suffer from high blood pressure, high cholesterol, diabetes, or if you’re overweight. During your first 12 months of using birth control medications, your risk for blood clots or stroke is highest. Also, your risk is great when you resume birth control medications after not using them for at least 4 weeks.

Don’t use Drospirenone and Ethinyl Estradiol if you’re pregnant. Please stop using this medication and inform your physician if you get pregnant or miss two successive menstrual periods. If you’ve recently given birth, wait at least a month before using birth control medications.

Drospirenone and Ethinyl Estradiol won’t protect you against STIs (sexually transmitted infections). Therefore, you still may need to wear condoms as well.

Women using Drospirenone and Ethinyl Estradiol for the first time can experience menstrual abnormalities such as missed periods, spotting, or breakthrough bleeding. If you have breakthrough bleeding that persists, consult your doctor. If you don’t experience withdrawal bleeding for two successive months, make sure to have a pregnancy test prior to beginning the next month’s cycle of contraceptives.

Birth control pills contain hormones which can get into human milk and possibly harm a breastfeeding child. Drospirenone and Ethinyl Estradiol may also slow the production of breast milk. Don’t use it if you’re nursing a child. You should not use Drospirenone and Ethinyl Estradiol at least 6 months after giving birth, or until weaning. Other forms of contraception are ideal for breastfeeding women. Seek advice from your doctor.

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Last Reviewed:
March 26, 2018
Last Updated:
April 30, 2018
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