Yarina contraindications side effects. Yarina: clear instructions

Yarina is a low-dose monophasic combined oral contraceptive.

This drug has proven itself well in the oral contraceptive market.

Manufacturer Yarina – Bayer Schering Pharma AG (Germany).

Like everything OK, Yarina acts as follows:

• Suppresses ovulation (prevents the development and release of the egg)
• Makes cervical mucus thick (i.e. the cervix becomes impenetrable to sperm)
• Changes the structure of the endometrium (the lining of the uterus), and therefore the fertilized egg cannot attach to the walls of the uterus

Compound

• Ethinyl estradiol (30 mcg) – an analogue of endogenous estradiol
• (3 mcg) – has an antiandrogenic effect
• Excipients: lactose monohydrate, corn starch, pregelatinized corn starch, povidone K25, magnesium stearate, hypromellose (hydroxypropyl methylcellulose), macrogol 6000, talc (magnesium hydrosilicate), titanium dioxide (E 171), iron (II) oxide (E 172).

The dosage and composition of hormones is the same for all tablets, because Yarina is a monophasic drug.

Price, where to buy

How much do Yarin tablets cost? The price in Russia may vary. It depends on the place of purchase (pharmacy chain, region of residence).

The price of Yarina birth control pills in pharmacies starts from 1020 rubles (for a package of 21 tablets) and can reach up to 1360 rubles. The cost of a package for three months (63 tablets) is much cheaper - on average 2950 rubles.

You can buy Yarina in pharmacies. Hormonal pills are available by prescription.

Indications for use

Who is Yarina suitable for, and in what cases is she prescribed?

Yarina tablets are needed for protection against pregnancy (for healthy women), as well as for the treatment of certain gynecological problems and acne.

Therapeutic effects from Yarina

• Restoration of the menstrual cycle
• Reducing pain and PMS symptoms
• Reducing blood loss during menstruation (or getting rid of intermenstrual bleeding)
• Reducing the risk of developing uterine and ovarian cancer
• Preventing Endometriosis
• Prevention of anemia caused by iron deficiency
• Treatment of moderate forms of acne (from acne on the face)
• Preventing edema (removing excess fluid from the body while preserving potassium)
• Prevention and treatment of excess greasiness in hair and skin, sulfur, the appearance of unwanted body hair (hirsutism)
• Prevention and treatment of dysmenorrhea

Sometimes, to facilitate pregnancy, doctors prescribe Duphaston after Yarina. This is necessary in order to restore the endometrium, which may become thinner while taking OCs. You need to drink Duphaston strictly after ovulation for 10 days (if the cycle is 28 days, then you drink it from the 16th to the 25th day of the cycle).

Yarina is also often prescribed by doctors for polycystic ovarian disease (cyst). The drug has proven itself well as a therapeutic measure for polycystic ovary syndrome, as well as in cases with single large tumors.

Yarina for endometriosis

Endometriosis is a female disease of the reproductive period (develops against the background of an increase in the amount of estrogen and a decrease in the amount of progesterone). At an early stage, it can be treated with hormonal drugs. Usually either Janine or Yarina is prescribed. The second drug is preferable in some respects.

Why Yarina?

• This is a newer and more active drug due to the content of a larger proportion of the main components
• Yarina's absorption period is only 1.5 hours
• The list of contraindications for the use of Yarina is much smaller than for other drugs (for example, Zhanine)
• Even after stopping taking Yarina, a positive effect of the drug is observed (hormonal balance is restored, tissue proliferation stops, neoplasms resolve)

Yarina with adenomyosis

Yarina is prescribed as part of the complex treatment of adenomyosis (internal endometriosis).

Adenomyosis is a chronic gynecological disease. At the initial stage, the pathological process is asymptomatic; over time, complications are possible, including infertility.

Main signs of the disease:

• long and heavy menstruation
• pelvic pain of varying intensity and nature

Visit your gynecologist regularly to detect pathology in a timely manner.

Yarina for uterine fibroids

Uterine fibroids are a benign tumor that develops from the muscle cells of the uterus. For a long time, the tumor may not show any signs and not cause discomfort to the woman. .

When diagnosed with uterine fibroids, Yarina is prescribed to normalize the cycle, reduce the amount of menstrual blood loss (which stops the growth of fibroids), eliminate painful sensations during menstruation, to block ovulation, to prevent malignant tumors of the uterus and ovaries, as well as to prevent anemia.

Due to the monophasic nature of Yarina, containing both estrogens and progesterones, the nutrition of the fibroids first stops, after which it stops its development and freezes.

Yarina with an ovarian cyst

The cause of cysts is hormonal imbalance. A cyst is a sac filled with fluid. As it grows, it can cause the development of polycystic ovary syndrome, and then infertility. When walking, exercising, or during sexual intercourse, cysts provoke pain in the lower abdomen.

How does Yarina work? At the level of the hypothalamic-pituitary system, the production of follicle-stimulating hormone is blocked (lack of ovulation). The permeability of cervical secretions for sperm decreases, and egg implantation also does not occur. As a result, during the period of taking OK, the female reproductive system has the opportunity to completely rest and recover.

Yarina for mastopathy

The mammary gland is very sensitive to sex hormones. Violation of their balance leads to the development of mastopathy and its unpleasant manifestations.

Oral contraceptives when taken regularly:

• reduce proliferative processes in the breast (uncontrolled cell growth with the formation of cysts, fibroadenomas, etc. does not occur) This is achieved primarily through the establishment of menstrual function and the regulation of connections in the hypothalamus - pituitary gland - ovaries - mammary glands.
• help reduce the level of estrogen in the blood (protect the breasts from their excessive influence).
• have a therapeutic effect on the organs of the woman’s reproductive system.
• reduce the risk of breast cancer by 2 times. The effect of taking it lasts for 10 years, so it is preferable to use hormonal contraceptives after 30–35 years of age.
• reduce the rate of progression of mastopathy.

Yarina for endometrial hyperplasia

Hyperplasia must be treated comprehensively. Therapy should consist of several successive stages. Yarina is used at the first stage of treatment (reception can last up to six months).

The first stage of treatment is to stop the bleeding. If the drug does not work, then curettage of the uterine cavity is performed and a number of hemostatic drugs are administered to stop the bleeding.

If necessary, blood substitutes and drugs that normalize the water-salt balance in the body are also administered. In some cases, intravenous injections of vitamins B, C, rutin and folic acid are given.

Contraindications

You should know that Yarina is prohibited for:

• Intolerance to the drug components
• Pancreatitis
• Threat of thrombosis
• Thrombosis, thromboembolism
• Angina and ischemic attacks
• Myocardial infarction
• Diabetes mellitus
• Vascular pathologies
• Hormonal tumors
• Diseases of the liver, kidneys (+ their poor functioning)
• Migraine + neurological disorders
• Pregnancy or lactation
• Vaginal bleeding of unknown origin
• Diabetes
• Circulatory disorder
• Edema of the mucous membranes (Quincke's edema)
• Menopause (after 40, 45 with caution)
• Smoking (especially after 35)

Side effects

Side effects from Yarina may be as follows:

• Sometimes, when taking Yarina, intermenstrual bleeding of unknown origin may occur.
• Spotting in the middle of the cycle
• Decreased libido
• Headache, dizziness, migraine
• Weight fluctuations (weight loss or weight gain)
• Nausea, vomiting, diarrhea (diarrhea), stomach pain
• Apathy, depression, mood swings
• Breast enlargement
• Breast tenderness
• Allergy to the components of the drug (rash, redness, hives, eczema and other allergic reactions)
• Stagnation of fluid in the body

• Changes in blood pressure, thromboebolism
• Bronchial asthma
• Liver dysfunction (jaundice, cholestasis)
• Difficulty absorbing glucose

• Hyperkalemia, hypertriglyceridemia

Yarina and the thrush. Some women on forums write that they developed thrush while stopping or starting taking the drug. What to do if this happens?

• take Mikoflucan once
• drink Yarina to the end
• after a week's pass, switch to another OK
• you can use candles for girls (Hexicon D, Polizhenax Virgo), as well as sprays (Epigen Intim, Panavir-inlight)
• pay attention to digestion; if there is a problem, taking probiotics (hilak forte, bactistatin) is recommended

It should be remembered that the consequences of taking Yarina are individual for everyone: some lose weight, some gain weight, some have no changes in weight. Some people experience hair loss, while for others it becomes thicker.

Therefore, the side effects are individual for everyone. And for some they may not exist at all.

Therefore, asking “Do Yarina make you lose weight”, “Is it possible to lose weight after Yarina” or “Do Yarina make you fat”, “Is it possible to gain weight from Yarina” is pointless to ask. Because there is no correct answer.

To avoid side effects and weight fluctuations, you need to choose the right drug. And for this you should make an appointment with a good gynecologist, undergo an examination and take tests.

Instructions for use

How to take Yarina correctly? From what day should I take it?

The rules for taking Yarina are the same as for most COCs with 21 active tablets. You drink Yarina every day at the same time, with a small amount of water, for 21 days. Afterwards, take a break for 7 days (at this time withdrawal bleeding occurs - menstruation). On the 8th day you start drinking a new package.

ATTENTION! A break from taking Yarina is possible only if you have completed 21 active tablets. It is impossible to interrupt taking OK in the middle of a pack, this can cause severe disruptions in the functioning of the body. You should also consult your doctor about discontinuing the drug.

How to drink Yarina for the first time?

If you have never taken COCs before

You should start taking Yarina on the first day of your period (cycle). This is necessary so that at the end of menstruation you do not have to use additional means of contraception, because... Yarina begins to act on the seventh day. If you started taking it on the 2-3rd day of your cycle, then after your period, for a few days it is better to use a condom to be on the safe side.

ATTENTION! If you start drinking OK for the first time, you first need to consult a doctor, undergo an examination and take tests, this is necessary in order to choose the right contraceptive. The right remedy for you is a guarantee of a good start on birth control pills, without complications.

If you are switching from another oral medication

You finish the package, take a break for 7 days (if there are 21 tablets in the blister) and on the 8th day you start taking Yarina.

After childbirth, abortion (second trimester) and miscarriage

Usually, taking OK can be started after 21 days, if there are no complications. But everything is very individual, so you need to consult a specialist.

If the abortion was done in the early stages (first trimester), then you can start taking Yarina immediately.

Yarina's compatibility

Yarina and alcohol. The instructions do not say whether you can drink alcohol while taking Yarina. The compatibility of these substances is acceptable within reasonable limits. You can indulge in 1-2 glasses of wine from time to time. However, it is worth remembering that drugs such as oral contraceptives place additional stress on the liver. Alcohol does the same thing. Plus, vomiting or diarrhea may develop due to alcohol consumption, and this negatively affects the absorption of the drug. Alcohol also affects the central nervous system, causes drowsiness, and impairs memory. You may simply forget to take your pill.

ATTENTION! Oral contraceptives are contraindicated in cases of liver dysfunction.

Film-coated tablets in blister packs, two types:

• Active tablets are orange, round, biconvex, on one side with “Y+” embossed in a regular hexagon (21 pieces in a blister). Active ingredient: 1 tablet contains ethinyl estradiol (micronized, in the form of betadex clathrate) - 30 mcg, drospirenone (micronized) - 3 mg, calcium levomefolate (micronized) - 451 mcg. Excipients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hyprolose, magnesium stearate.
• Auxiliary (vitamin) tablets are light orange, round, biconvex, on one side with “M+” embossed in a regular hexagon (7 pieces in a blister). Active ingredient: 1 tablet contains calcium levomefolate (micronized) - 451 mg. Excipients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hyprolose, magnesium stearate.

Pharmacological action

Yarina Plus is a low-dose monophasic oral combined estrogen-progestogen contraceptive drug, including active tablets and auxiliary vitamin tablets containing calcium levomefolate. The contraceptive effect of Yarina Plus is mainly achieved by suppressing ovulation and increasing the viscosity of cervical mucus.

In women taking combined oral contraceptives (COCs), the cycle becomes more regular, the pain, intensity and duration of menstrual bleeding decreases, resulting in a reduced risk iron deficiency anemia. There is also evidence of a reduced risk of endometrial and ovarian cancer.

Drospirenone, contained in Yarina Plus, has an antimineralocorticoid effect and helps prevent hormone-dependent fluid retention, which can manifest itself in weight loss and a reduction in the likelihood of peripheral edema. Drospirenone also has antiandrogenic activity and helps reduce acne (blackheads), oily skin and hair. This effect of drospirenone is similar to the effect of natural progesterone produced in the female body. This should be taken into account when choosing a contraceptive, especially for women with hormone-dependent fluid retention, as well as women with acne and seborrhea. When used correctly, the Pearl index (an indicator reflecting the number of pregnancies in 100 women using a contraceptive during the year) is less than 1. If pills are missed or used incorrectly, the Pearl index may increase.

The acid form of calcium levomefolate is structurally identical to naturally occurring L-5-methyltetrahydrofolate (L-5-methyl-THF), the main folate form found in food. The average concentration in the blood plasma of people who do not consume foods fortified with folic acid is about 15 nmol/l. Levomefolate, unlike folic acid, is a biologically active form of folate. Thanks to this, it is absorbed better than folic acid. Levomefolate is indicated to meet the increased need and ensure the necessary folate content in a woman’s body during pregnancy and lactation. The addition of calcium levomefolate to an oral contraceptive reduces the risk of developing a neural tube defect if a woman becomes unexpectedly pregnant immediately after stopping contraception (or, in very rare cases, when using oral contraception).

Indications for use

• contraception (primarily for women with symptoms of hormone-dependent fluid retention in the body);
• contraception and treatment of moderate acne (acne vulgaris);
• contraception in women with folate deficiency.

Directions for use and doses

Take the tablets at approximately the same time every day, with water if necessary. Follow the direction of the arrows until you have taken all 28 tablets. As a rule, menstruation begins 2-3 days after taking the last active tablet of Yarina Plus (i.e. during the period when you take the last 7 tablets from the last row of the package). Do not take a break between packs, i.e. Start taking pills from a new pack the day after you finish your current pack, even if you have not yet finished your menstrual-like bleeding (withdrawal bleeding). This means that you will always start a new pack on the same day of the week, and that the withdrawal bleed will occur around the same dates each month.

Start taking the drug

• When no hormonal contraceptive was used in the previous month
  Start taking Yarin Plus on the first day of the cycle, that is, on the first day of menstrual bleeding. Take the pill that is marked with the appropriate day of the week. Then take the pills in order. Yarina Plus begins to act immediately, so there is no need to use additional barrier methods of contraception. Consult your doctor if you are not sure when exactly to start taking the drug.
• When switching from other combined oral contraceptives
  You can start taking Yarin Plus the next day after you take the last pill from the current package of hormonal contraceptives (this means that there will be no break in taking the pills). If your previous contraceptive also contains tablets without active substances, you can start taking Yarin Plus the day after taking the last active tablet (if you have doubts, ask your doctor about this). You can start taking it later, but no later than the day that follows the planned 7-day break in taking the contraceptives you are currently using (or no later than the next day after taking the last inactive pill from the package of the contraceptives you are using).
• When switching from a vaginal ring or contraceptive patch
  If you have previously used a vaginal ring or transdermal patch, it is preferable to start taking it on the day the ring/patch was removed, but no later than the day on which the ring/patch was scheduled to be replaced. If you follow these rules, additional contraception is not necessary.
• When switching from oral contraceptives containing only gestagen (mini-pills)
  You can stop taking the mini-pill on any day and start taking Yarin Plus the next day at the same time. During the first 7 days of taking the pills, you must also use an additional barrier method of contraception (for example, a condom).
• When switching from an injectable contraceptive, an implant, or from a progestogen-releasing intrauterine contraceptive (Mirena)
  Start taking Yarin Plus on the day when the next injection is due or on the day the implant or intrauterine contraceptive is removed. During the first 7 days of taking the pills, you must also use an additional barrier method of contraception.
• After childbirth
  If you have just given birth, your doctor may recommend that you wait until the end of your first normal menstrual cycle before starting to take Yarina Plus. Sometimes, on the recommendation of a doctor, it is possible to start taking the drug earlier.
• After spontaneous miscarriage or abortion in the first trimester of pregnancy
  Consult your doctor. It is usually recommended to start taking it immediately.

Stop taking Yarina Plus

You can stop taking Yarina Plus at any time. If you are not planning a pregnancy, ask your doctor about other methods of contraception. If you want to become pregnant, stop taking Yarina Plus and wait until your menstrual bleeding occurs naturally before trying to become pregnant. This will help you calculate your baby's expected due date.

Taking missed pills

If the delay in taking the next pill is less than 12 hours, the contraceptive effect of Yarina Plus is maintained. Take the pill as soon as you remember. Take the next tablet at your usual time. If the delay in taking the pills is more than 12 hours, contraceptive protection may be reduced. The more pills you miss in a row, and the closer this skip is to the start or end of the dose, the higher the risk of pregnancy. In this case, you can be guided by the following rules:

More than one tablet from the package was forgotten
Consult your doctor.

One tablet missed in the first week of taking the drug
Take the missed tablet as soon as you remember (even if this means taking two tablets at the same time). Take the next tablet at your usual time. Additionally, use a barrier method of contraception for the next 7 days. If sexual intercourse took place within a week before missing the pill, the possibility of pregnancy must be taken into account. Consult your doctor immediately (see also Regimen for taking missed pills).

One tablet was missed in the second week of taking the drug
Take the missed tablet as soon as you remember (even if this means taking two tablets at the same time). Take the next tablet at your usual time. If you have taken your pills correctly during the 7 days preceding the first missed pill, the contraceptive effect of Yarina Plus is maintained and you do not need to use additional contraceptive measures. Otherwise, as well as if you miss two or more tablets, you must additionally use barrier methods of contraception for 7 days.

One tablet was missed in the third week of taking the drug
If all tablets have been taken correctly in the 7 days preceding the first missed pill, there is no need to use additional contraceptive methods. You can follow either of the following two options without the need for additional contraceptive measures.

1. Take the missed tablet as soon as you remember (even if this means taking two tablets at the same time). Take the next tablet at your usual time. Start the next pack immediately after finishing the current pack, so there is no break between packs. Withdrawal bleeding is unlikely until the second pack of tablets is gone, but spotting or breakthrough bleeding may occur on the days you take the drug.
2. Stop taking the pills in your current pack, take a break of 7 days or less (including the day you missed the pills), and then start a new pack. Using this regimen, you can always start taking the next pack on the day of the week when you usually do it. If after a break in taking the pills there is no expected menstrual bleeding, you may be pregnant. Consult your doctor before starting a new pack.

In severe gastrointestinal disorders, absorption may be incomplete, so additional contraceptive measures should be taken. If vomiting or diarrhea occurs within 4 hours after taking an active tablet, the recommendations regarding missed tablets apply, which are listed in the section “Taking missed tablets.” If you do not want to change your usual dosing schedule, you will need to take additional tablet(s) from a different package.

Delay in the onset of menstrual bleeding

You can delay the onset of menstrual bleeding if you start taking the next package of Yarina Plus immediately after finishing the current package. You can continue taking the tablets from this pack for as long as you wish or until the pack runs out. If you want menstrual-like bleeding to begin, stop taking the pills. While taking Yarina from the second package, spotting or bleeding may occur on the days of taking the pills. Start the next pack after the usual 7-day break.

Changing the day of the onset of menstrual bleeding

If you take the tablets as recommended, you will have menstrual bleeding on about the same day every 4 weeks. If you want to change it, shorten (but do not lengthen) the period of time you are free from taking pills. For example, if your cycle usually starts on Friday, but in the future you want it to start on Tuesday (3 days earlier), the next pack should start 3 days earlier than usual. If your pill-free break is very short (for example, 3 days or less), menstrual-like bleeding may not occur during the break. In this case, bleeding or spotting may occur while taking the tablets from the next package.

Side effect

When taking the drug Yarina Plus, like any other medicines, adverse reactions may occur, although their occurrence is not necessary in all patients. See sections "With caution" and "Special instructions". Please read these sections carefully and if you experience any adverse reactions, including serious ones, consult your doctor.

The following is the frequency of adverse reactions reported during clinical trials drug Yarina. These adverse reactions can also be attributed to the drug Yarina Plus.

Frequent adverse reactions (more than 1/100 and less than 1/10):

• depressed mood
• headache
• migraine
• nausea
• pain in the mammary glands
• vaginal candidiasis
• cycle disorder
• acyclic bleeding

Uncommon adverse reactions (more than 1/1000 and less than 1/100):

• change in body weight
• fluid retention
• libido change
• increased blood pressure (BP)
• decrease in blood pressure
• vomit
• eczema
• vaginitis

Rare adverse reactions (more than 1/10000 and less than 1/1000):

• hypoacusis
• thromboembolism
• bronchial asthma
• discharge from the mammary glands

Adverse reactions that were reported during use of Yarina Plus, but the frequency of which could not be assessed: hypersensitivity reaction, mood swings, contact lens intolerance, abdominal pain, diarrhea, rash, urticaria, erythema nodosum, erythema multiforme, breast enlargement iron

In women with hereditary forms of angioedema, exogenous estrogens may cause or worsen symptoms of angioedema. If any of the side effects become serious or if you notice any side effects not listed in the instructions, please tell your doctor.

Contraindications for use

Yarina Plus is contraindicated in the presence of any of the conditions/diseases listed below. If any of these conditions/diseases develop for the first time while taking the drug, the drug should be discontinued immediately.

• Thrombosis (venous and arterial) and thromboembolism currently or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke), cerebrovascular disorders.
• Conditions preceding thrombosis (including transient ischemic attacks, angina) currently or in history.
• The presence of multiple or severe risk factors for venous or arterial thrombosis.
• Migraine with focal neurological symptoms currently or in history.
• Diabetes mellitus with vascular complications.
• Liver failure and severe liver diseases (until normalization of liver tests).
• Severe and/or acute renal failure.
• Liver tumors (benign or malignant) currently or in history.
• Detected hormone-dependent malignant neoplasms (including genitals or mammary glands) or suspicion of them.
• Bleeding from the vagina of unknown origin.
• Pregnancy or suspicion of it.
• Breastfeeding period.
• Hypersensitivity or intolerance to any of the components of the drug Yarina Plus.
• Yarina Plus contains lactose and is therefore contraindicated in patients with rare hereditary lactose intolerance, lactase deficiency or glucose-galactose malabsorption.

With caution

The potential risk and expected benefit of using the drug Yarina Plus should be assessed in each individual case in the presence of the following diseases/conditions and risk factors:

• Risk factors for the development of thrombosis and thromboembolism: smoking, obesity, dyslipoproteinemia, controlled arterial hypertension, migraine without focal neurological symptoms, uncomplicated valvular heart disease, hereditary predisposition to thrombosis (thrombosis, myocardial infarction or cerebrovascular accident at a young age in one of the immediate relatives);
• Other diseases in which peripheral circulatory disorders may occur: diabetes mellitus without vascular complications, systemic lupus erythematosus, hemolytic-uremic syndrome, Crohn's disease and ulcerative colitis, sickle cell anemia, phlebitis of superficial veins;
• Hereditary angioedema;
• Hypertriglyceridemia;
• Liver diseases that are not contraindications (see “Contraindications”);
• 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 hearing impairment, porphyria, pregnancy herpes, Sydenham's chorea);
• Postpartum period.

Use of the drug Yarina during pregnancy and breastfeeding

The drug is contraindicated during pregnancy. If pregnancy is detected while taking Yarina Plus, the drug should be discontinued immediately. Data on the results of taking Yarina Plus during pregnancy are limited and do not allow any conclusions to be drawn about negative impact drug for pregnancy, fetal and newborn health. At the same time, extensive epidemiological studies have not revealed an increased risk of developmental defects in children born to women who took COCs before pregnancy or teratogenic effects in cases of careless use of COCs. early dates pregnancy. Specific epidemiological studies have not been conducted on the drug Yarina Plus.

The drug is contraindicated during breastfeeding. Taking COCs can reduce the amount of breast milk and change its composition, so their use is not recommended until discontinuation breastfeeding. Small amounts of sex hormones and/or their metabolites may be excreted in milk, but there is no evidence of their negative effects on the health of the child.

Use for liver and kidney dysfunctions

• The use of the drug is contraindicated in the presence or history of severe forms of liver disease (until the liver test results are normalized), the current presence or history of benign or malignant liver tumors;
• The drug is contraindicated for use in women with severe renal impairment and acute renal failure.

Special instructions

If any of the conditions, diseases and risk factors listed below currently exist, the potential risks and expected benefits of using Yarina Plus should be carefully weighed in each individual case and discussed with the woman before she decides to start taking this drug. drug.

For disorders of the cardiovascular system

There is epidemiological evidence of an increased incidence of venous and arterial thrombosis and thromboembolism (such as deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke) when taking COCs. These diseases are rarely observed. The risk of developing venous thromboembolism (VTE) is greatest in the first year of taking such drugs. An increased risk is present after initial use of combined oral contraceptives or resumption of use of the same or different combined oral contraceptives (after a dosing interval of 4 weeks or more). Data from a large prospective study involving 3 groups of patients indicate that this increased risk is predominantly present during the first 3 months.

Overall risk of VTE in patients taking low-dose combined oral contraceptives (Data from a large prospective study of 3 patient groups show that in women with or without risk factors for VTE using ethinyl estradiol/drospirenone containing contraceptives at a dosage of 0.03 mg/3 mg, respectively , the incidence of VTE is the same as with the use of levonorgestrel-containing oral contraceptives. VTE can be fatal (in 1-2% of cases).

VTE, manifested as deep vein thrombosis or pulmonary embolism, can occur with the use of any combined oral contraceptives.

It is extremely rare that when using combined oral contraceptives, thrombosis of other blood vessels occurs, for example, hepatic, mesenteric, renal, cerebral veins and arteries or retinal vessels. There is no consensus regarding 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 extremity or along a vein in the leg, pain or discomfort in the leg only when upright or when walking, localized warmth in the affected leg, redness or discoloration of the skin on the leg.

Symptoms of pulmonary embolism (PE) include: difficulty or rapid breathing; sudden cough, including with hemoptysis; sharp pain in the chest, which may intensify with deep inspiration; feeling of anxiety; severe dizziness; fast or irregular heartbeat. Some of these symptoms (eg, shortness of breath, cough) are nonspecific and may 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. Symptoms of a stroke include: sudden weakness or loss of feeling in the face, arm or leg, especially on one side of the body, sudden confusion, problems speaking and understanding; sudden unilateral or bilateral vision loss; sudden disturbance in gait, dizziness, loss of balance or coordination; 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 extremities, acute abdomen.

Symptoms of myocardial infarction include: pain, discomfort, pressure, heaviness, a feeling of squeezing or fullness in the chest, arm, or chest; discomfort radiating to the back, cheekbone, larynx, arm, stomach; cold sweat, nausea, vomiting or dizziness, severe weakness, anxiety or shortness of breath; fast or irregular heartbeat.

Arterial thromboembolism can be fatal.

The risk of developing thrombosis (venous and/or arterial) and thromboembolism increases in the presence of:

• obesity (body mass index more than 30 kg/m2);
• 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, the woman should be examined by an appropriate specialist to decide on the possibility of taking the drug Yarina Plus;
• prolonged immobilization, major surgery, any leg surgery or major trauma. In these situations, it is advisable to stop using the drug Yarina Plus (in the case of a planned operation, at least four weeks before it) and not to resume taking it for two weeks after the end of immobilization;
• dyslipoproteinemia;
• arterial hypertension;
• migraines;
• heart valve diseases;
• atrial fibrillation;
• with age;
• in smokers (with increasing number of cigarettes or increasing age, the risk increases, especially in women over 35 years of age);

The possible role of varicose veins and superficial thrombophlebitis in the development of venous thromboembolism remains controversial.

The increased risk of thromboembolism in the postpartum period should be taken into account.

Peripheral circulatory disorders may 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 use of Yarina Plus (which may precede cerebrovascular events) may be grounds for immediate discontinuation of this drug.

Biochemical indicators indicating a hereditary or acquired predisposition to venous or arterial thrombosis include the following: resistance to activated protein C, hyperhomocysteinemia, antithrombin-III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant).

When assessing the risk-benefit ratio, it should be taken into account that adequate treatment of the relevant condition may reduce the associated risk of thrombosis. It should also be taken into account that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives ( Tumors

The most significant risk factor for developing cervical cancer is persistent human papillomavirus infection. There are reports of a slight increase in the risk of developing cervical cancer with long-term use of COCs. However, the connection with taking COCs has not been proven. The possibility of the relationship of these data with screening for cervical diseases and with characteristics of sexual behavior (less frequent use of barrier methods of contraception) is discussed. A meta-analysis of 54 epidemiological studies showed that there is a slightly increased relative risk of developing breast cancer diagnosed in women currently taking COCs (relative risk 1.24).

The increased risk gradually disappears within 10 years of stopping these drugs. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in current or recent COC users is small relative to the overall risk of breast cancer. Its connection with COC use has not been proven. The observed increased risk may be a consequence of careful monitoring and earlier diagnosis of breast cancer in women using COCs. Women who have ever used COCs are diagnosed with earlier stages of breast cancer than women who have never used them.

In rare cases, during the use of COCs, the development of benign, and in extremely rare cases, malignant liver tumors was observed, which in some patients led to life-threatening intra-abdominal bleeding. If severe pain appears in the abdominal area, liver enlargement or signs of intra-abdominal bleeding, this should be taken into account when making a differential diagnosis

Other states

Clinical studies have shown no effect of drospirenone on plasma potassium concentrations in patients with mild to moderate renal failure. However, in patients with impaired renal function and an initial potassium concentration at the upper limit of normal, the risk of developing hyperkalemia cannot be excluded while taking medications that lead to potassium retention in the body.

Women with hypertriglyceridemia (or a family history of this condition) may have an increased risk of developing pancreatitis while taking COCs. Although slight increases in blood pressure have been described in many women taking COCs, clinically significant increases have rarely been observed. However, if a persistent, clinically significant increase in blood pressure develops while taking Yarina Plus, this drug should be discontinued and treatment of arterial hypertension should be started. The drug can be continued if normal blood pressure values ​​are achieved with the help of antihypertensive therapy.

The following conditions have been reported to develop or worsen both during pregnancy and while taking COCs, but their relationship with COC use has not been proven: jaundice and/or pruritus associated with cholestasis; formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes during pregnancy; hearing loss associated with otosclerosis. Cases of Crohn's disease and ulcerative colitis have also been described with the use of COCs.

In women with hereditary forms of angioedema, exogenous estrogens may cause or worsen symptoms of angioedema.

Acute or chronic liver dysfunction may require discontinuation of Yarina Plus until liver function tests return to normal. Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous use of sex hormones, requires discontinuation of the drug Yarina Plus.

Although COCs may have an effect on insulin resistance and glucose tolerance, there is no need to change the therapeutic regimen in diabetic patients using Yarina Plus. However, women with diabetes should be closely monitored while taking this drug.

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

Folates may mask vitamin B12 deficiency.

Laboratory tests

Taking Yarina Plus may affect the results of some laboratory tests, including indicators of liver, kidney, thyroid, adrenal function, the concentration of transport proteins in plasma, indicators of carbohydrate metabolism, parameters of blood coagulation and fibrinolysis. Changes usually do not go beyond normal values. Drospirenone increases plasma renin activity and aldosterone concentrations, which is associated with its antimineralocorticoid effect.

There is a theoretical possibility of increasing the concentration of potassium in the blood plasma in women receiving the drug Yarina Plus simultaneously with other drugs that can increase the content of potassium in the blood plasma. These drugs include angiotensin II receptor antagonists, potassium-sparing diuretics, and aldosterone antagonists. However, in studies evaluating the interaction of drospirenone with angiotensin-converting enzyme (ACE) inhibitors or indomethacin, there was no significant difference in plasma potassium concentrations compared with placebo.

Reduced efficiency

The effectiveness of Yarina Plus may be reduced in the following cases: if you miss pills, with vomiting and diarrhea, or as a result of drug interactions.

Frequency and severity of menstrual-like bleeding

While taking the drug Yarina Plus, during the first few months, irregular (acyclic) bleeding from the vagina (spotting or “breakthrough” uterine bleeding) may be observed. Use hygiene products and continue taking your pills as usual. Irregular bleeding usually stops as your body adapts to the drug (usually after 3 cycles of taking the tablets). If they continue, increase in intensity, or return after stopping, consult a doctor.

No regular menstrual bleeding

If you took all the pills correctly and did not vomit while taking the pills or taking other medications at the same time, then the likelihood of pregnancy is low. Continue taking Yarina Plus as usual. If there are no 2 menstrual bleeding in a row, consult a doctor immediately. Do not start taking the next package until your doctor rules out pregnancy.

When to consult a doctor

Regular checkups

If you are taking Yarina Plus, your doctor will tell you about the need for regular examinations, at least once every 6 months.

Consult your doctor as soon as possible

• If there are any changes in your health, especially any of the conditions listed in these instructions (see also “Contraindications” and “Use with caution”);
• With local compaction in the mammary gland;
• If you are going to use other medications (see also “Interactions with other medications”);
• If long-term immobility is expected (for example, the leg is in a cast), hospitalization or surgery is planned (consult with your doctor at least 3-4 weeks before the proposed surgery);
• If you experience unusually heavy bleeding from the vagina;
• If you forgot to take a pill in the first week of taking the pack and had sexual intercourse seven days or less before;
• You have not had regular menstrual bleeding twice in a row or you suspect that you are pregnant (do not start taking the next package until you have consulted your doctor).

Stop taking the tablets and consult your doctor immediately if you notice possible signs of thrombosis, myocardial infarction or stroke: unusual cough; unusually severe pain behind the sternum, radiating to the left arm; unexpected shortness of breath, unusual, severe and prolonged headache or migraine attack; partial or complete loss of vision or double vision; slurred speech; sudden changes in hearing, smell, or taste; dizziness or fainting; weakness or loss of sensation in any part of the body; severe abdominal pain; severe leg pain or sudden swelling of either leg.

Yarina Plus does not protect against HIV infection (AIDS) or any other sexually transmitted disease.

Impact on the ability to drive vehicles and machinery

There have been no reported cases of adverse effects of the drug Yarina Plus on the speed of psychomotor reactions; No studies have been conducted to study the effect of the drug on the speed of psychomotor reactions.

Overdose

There have been no reported cases of overdose of Yarina Plus. Symptoms that may occur in case of overdose: nausea, vomiting, spotting vaginal discharge or metrorrhagia (more often in young women). There is no specific antidote; symptomatic treatment should be carried out.

Calcium levomefolate and its metabolites are identical to folates found in food products, the daily consumption of which does not harm the body. Taking levomefolate calcium at a dose of 17 mg/day (a dose 37 times higher than that contained in 1 tablet of Yarina Plus) for 12 weeks was well tolerated.

Drug interactions

Interaction of oral contraceptives with other drugs may lead to breakthrough uterine bleeding and/or decreased contraceptive reliability.

Interactions leading to a decrease in the effectiveness of the drug Yarina Plus

Effect on hepatic metabolism: the use of drugs that induce liver microsomal enzymes can lead to an increase in the clearance of sex hormones. Such drugs include: phenytoin, barbiturates, primidone, carbamazepine, rifampicin, possibly also oxcarbazepine, topiramate, felbamate, griseofulvin and preparations containing St. John's wort. HIV protease inhibitors (eg, ritonavir) and non-nucleoside reverse transcriptase inhibitors (eg, nevirapine) and combinations thereof also have the potential to affect hepatic metabolism.

Effect on enterohepatic recirculation: According to individual studies, some antibiotics (for example, penicillins and tetracyclines) may reduce the enterohepatic recirculation of estrogens, thereby reducing the concentration of ethinyl estradiol.

While taking medications that affect liver microsomal enzymes, and for 28 days after their discontinuation, a barrier method of contraception should be additionally used.

While taking antibiotics (except for rifampicin and griseofulvin) and for 7 days after their discontinuation, a barrier method of contraception should be additionally used. If the period of use of the barrier method of contraception ends later than the hormone-containing orange tablets in the package, you should skip taking the remaining auxiliary light orange tablets and start taking Yarina Plus from a new package without interruption in taking the tablets.

Interactions that reduce the effectiveness of calcium levomefolate

Effect on folate metabolism: Some drugs reduce blood folate concentrations or reduce the effectiveness of levomefolate calcium by inhibiting the enzyme dihydrofolate reductase (eg, methotrexate, trimethoprim, sulfasalazine, and triamterene) or by reducing folate absorption (eg, cholestyramine) or through unknown mechanisms ( for example, antiepileptic drugs: carbamazepine, phenytoin, phenobarbital, primidone and valproic acid).

Effect on metabolism of COCs (enzyme inhibitors)

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.

Effect of COCs or calcium levomefolate on the activity of other drugs

COCs may affect the metabolism of other drugs, leading to an increase (for example, cyclosporine) or a decrease (for example, lamotrigine) in their plasma and tissue concentrations.

Based on interaction studies, as well as studies in female volunteers taking omeprazole, simvastatin and midazolam as test substrates, it can be concluded that the effect of drospirenone 3 mg on the metabolism of other drugs is unlikely.

Folates may alter the pharmacokinetics or pharmacodynamics of some drugs that affect folate metabolism, such as antiepileptic drugs (phenytoin), methotrexate or pyrimethamine, which may be accompanied by a decrease (mostly reversible, provided the dose of the drug affecting folate metabolism is increased) of their therapeutic effect. The administration of folate during treatment with such drugs is recommended mainly to reduce the toxicity of the latter.

Yarina Plus: instructions for use and reviews

Latin name: Yarina Plus

ATX code: G03AA12

Active ingredient: drospirenone + ethinyl estradiol + calcium levomefolate (drospirenonum + aethinyloestradiolum + calcii levomefolinas)

Manufacturer: Bayer Schering Pharma AG (Germany)

Updating the description and photo: 27.07.2018

The birth of a child is a miracle of nature, which is still, from a scientific point of view, difficult to explain. But the trouble is that the baby is not always welcome. Yes, and a woman can have diseases that prevent her from giving birth. This situation must be under control; good protection against unwanted pregnancy is necessary. Birth control pills "Yarina" will cope with this task perfectly. Let's take a closer look at what Yarin's hormonal tablets are, instructions, side effects, description of the drug.

Instructions for medical use

Yarina birth control pills are the only monophasic combined oral contraceptive pills. Each tablet contains ethinyl estradiol (0.03 mg) and drospirenone (3 mg). The doses of hormones are very small, which is very important. Drospirenone is a new generation progestogen; it is most similar to natural human sex hormones. It is thanks to him that the ability to cause positive effects in the female body is explained. It has antimineralocorticoid properties, Prevents weight gain associated with fluid and sodium retention in the body. Reduces the manifestations of premenstrual syndrome: swelling, headaches, labile mood.

Combined birth control pills Yarina have another important quality: they improve lipid metabolism and increase high-density lipoproteins (“good cholesterol”) in the blood. Drospirenone has antiandrogenic activity, this has a positive effect on the skin, the secretion of sebum by the sebaceous glands is reduced, and the amount of acne is reduced. Male pattern hair growth is less pronounced.

The medical use of Yarina birth control pills has a positive effect on women's health. Their action is as close as possible to natural progesterone. Pain during menstruation is less disturbing or disappears completely, and the risk of developing anemia is reduced.

How is the contraceptive effect achieved?

The instructions for medical use of the drug say that when taking Yarina birth control pills, a number of mechanisms are triggered. They lead to inhibition of ovulation and disruption of the maturation of the endometrial mucosa. Even if the egg is released, it is not mature, and the inner mucous membrane of the uterus is not ready for implantation (attachment of the egg to the wall of the uterus). In addition, the viscosity of the mucus in the cervical canal changes, and the movement and activity of sperm are inhibited. Under these conditions, their penetration into the uterine cavity is difficult. In other words, an additional mechanical barrier is created.

Indications for medical use birth control pills Yarina. The description of the drug indicates them:

Protection from unwanted pregnancy;
hormone-dependent retention of salts and fluids in the body;
severe premenstrual syndrome;
oily seborrhea in women, acne;

Has Yarina contraindications for use. Only some of them are listed here; there are more in the official instructions:

Thrombosis, varicose veins, myocardial infarction, cerebral circulatory disorders now or previously;
diabetes mellitus, at the discretion of the doctor;
conditions preceding thrombosis, heart disease at this time or earlier: angina pectoris, transient ischemic attacks;
numerous factors provoking the development of thrombosis: work associated with prolonged and intense physical and thermal overload, high body temperature, intoxication, dehydration;
severe liver diseases with pathology of its function until the tests are normalized;
chronic dysfunction of the liver, kidneys;
liver cancer now or previously;
tumors of the genital organs, mammary glands, even in cases of only suspicion of them;
uterine bleeding of unknown nature;
pregnancy, suspicion of it;
lactation;
allergy to any element of Yarin tablets.

Application dose

You should start taking the pills from the first day of your menstruation at the same time, preferably in the evening, for 21 days. Then a break is taken for 7 days, after which, regardless of the onset of menstrual bleeding, the next 21 tablets begin. If you miss a pill, you need to take it as soon as possible. You can start on day 2 or 5, but the contraceptive effect is reduced. It is recommended to add a barrier method of contraception, spermicides (condom, Pharmatex) during the first 7 days.

Side effects of Yarina: nausea, vomiting, breast tenderness, engorgement, decreased libido, weight gain, headaches, contact lenses are poorly tolerated.

Above is a description of Yarina birth control pills in free form. For more detailed information about the medical indications for use, read the official instructions included in the package. Consultation with a gynecologist is required! He and only he will be able to determine what to replace Yarina with if you fall under her contraindications.