Yarina: instructions for use and what it is for, price, reviews, analogues. Yarina - instructions for use, analogs, testimonials and release forms (tablets, Plus with folic acid) of a contraceptive drug for contraception and acne treatment. Side effects from

In the sexual relations of partners, one of the leading places is occupied by the correct selection of contraceptives. The most popular are tablets for internal use. Their correct intake allows not only to protect against unwanted pregnancy, but also to improve health. Many experts recommend their patients the drug "Yarina Plus". Reviews show that the pills reliably protect against unwanted conception. However, they have many contraindications. Use the medicine strictly according to the doctor's prescription.

Form of release of the drug and its composition

Tablets belong to the group of multi-phase oral contraceptives with antiandrogenic action. The main active ingredient is ethinylestradiol. Additionally, components such as calcium levomefolate, drospirenone, microcrystalline cellulose, lactose monohydrate, magnesium stearate, and croscarmellose sodium are used. The tablets are film-coated, which includes components such as hypromellose, iron dye red oxide, macrogol, titanium dioxide.

Low-dose oral contraceptive is very popular among specialists. Tablets reliably protect against unwanted pregnancy. This happens due to the suppression of ovulation. In addition, the use of tablets leads to an increase in the elasticity of cervical mucus, which prevents the passage of sperm.

The drug "Yarina Plus" is also very popular among patients. Reviews of doctors show that the tablets have an antiandrogenic effect. Thanks to this property, women also manage to effectively treat acne, excessive sweating.

Indications

First of all, the pills act as a contraceptive. They are prescribed to women who wish to protect themselves from unwanted pregnancies. If conception has already occurred, the drug will not be able to give a result. The remedy will also not be effective if it is taken incorrectly. The tablets are taken regularly according to the schedule. It is worth studying the full information about the drug "Yarina Plus". Instructions for use, reviews of doctors and patients - all this will help determine the choice of contraceptive.

It is worth remembering that the drug has antiandrogenic properties. Therefore, tablets can also be prescribed for the treatment of certain ailments associated with hormonal imbalance. If a woman has acne, suffers from painful menstruation or excessive sweating, Yarina Plus will come to the rescue. Reviews show that the first results of treatment are noticeable after a week of regular therapy.

Contraindications

The medicine is hormonal in nature. This is definitely worth considering. Tablets can only be prescribed to adult women. The drug has many contraindications. Should be studied before using the medication "Yarina Plus" reviews. And pregnancy, lactation - conditions in which hormone therapy is contraindicated, this should be understood.

Tablets cannot be prescribed for diseases such as thrombosis, migraine with a neurological nature, liver failure, type 1 and type 2 diabetes, malignant neoplasms, lactose intolerance. You can not start taking Yarina tablets on your own. Reviews of doctors, pros, cons - all this needs to be studied before starting therapy.

special instructions

If a woman suffers from chronic diseases, the specialist must consider the balance of benefits and risks. The medicine is hormonal. Therefore, any disease can be aggravated under its influence. Studies have shown that there is a relationship between the use of contraceptives and the development of thrombophlebitis. Therefore, patients who have a suspicion of any cardiovascular disease should stop using pills. The risk of developing thrombosis increases in women who smoke, as well as in patients over the age of 35 years.

Against the background of taking hormonal contraceptives, benign tumors can develop. Neoplasms require increased attention from doctors. In the absence of proper treatment, the cyst can develop into a malignant one. In rare cases, taking pills is an impetus for the development of liver neoplasms, which can interfere with intra-abdominal circulation.

Dosage

It is necessary to take the drug "Yarina Plus" correctly. Instructions for use, reviews of doctors and patients - all this is important to study before starting therapy. Particular attention should be paid to the dosage. With irregular intake, the remedy will not be able to give a good result. The drug is taken orally according to the order described on the package. It is advisable to do this daily at the same time. Use the drug with a small amount of liquid.

Reception of funds begins on the first day of the cycle (with the advent of menstruation). The course is designed for 28 days. After completing one package, it is worth starting the next one. You can’t take breaks, otherwise the contraceptive effect will not be fully ensured. It is necessary to regularly take contraceptives "Yarina Plus". Patient reviews show that pregnancy can occur, even if you forget to take a pill just once.

If vomiting or diarrhea occurs within 4 hours after taking the contraceptive, the absorption of the main component may be incomplete. In order to avoid unwanted pregnancy, the drug should be repeated or other contraceptive measures should be used.

Overdose

An overdose of Yarina Plus may cause unpleasant symptoms. Reviews of doctors show that women primarily experience bleeding from the vagina, nausea and vomiting. In rare cases, diarrhea develops. Treatment of this condition takes place in a hospital. There is no specific antidote. Symptomatic therapy is carried out in a medical institution.

If an overdose occurs, the doctor should choose another way to protect against unwanted pregnancy. There are many methods of contraception that can be used regardless of the menstrual cycle.

Side effects

Even with the correct use of hormonal contraceptives, unpredictable body reactions can develop. They are most often observed at the beginning of therapy. From the side of the central nervous system, the patient may experience dizziness, migraine, sleep disturbances. These problems are most often fixed at the beginning of the menstrual cycle and quickly disappear after the end of bleeding.

Side effects from the cardiovascular system may also develop. In the most difficult cases, a woman may develop thrombophlebitis. For patients who already have heart or blood pressure problems, hormonal therapy is contraindicated.

In rare cases, allergic reactions to the drug "Yarina Plus" may develop. Instructions, reviews of doctors, possible side effects - all this you need to know for taking hormonal-based medicines. If a rash or hives appears on the skin, you should stop using the tablets. You can always choose another method of contraception.

drug interaction

The instructions for use for the drug "Yarina Plus" should be carefully studied. Reviews of doctors show that the combined use of hormonal contraceptives with other medicines can lead to breakthrough uterine bleeding. Therefore, a woman must inform the gynecologist about the medicines that have to be taken in parallel. Any of them can reduce the effectiveness of a hormonal contraceptive.

If it becomes necessary to take antibiotics, oral contraception alone will not be enough. Stop taking the pills should not be. However, it is additionally worth using a barrier method of protection against unwanted pregnancy. The drug "Yarina" will not be able to give a reliable result.

Schering AG has developed a formula for the progestogen component for modern oral contraceptives - drospirenone. The innovative tool was named Yarina - by the name of the girl chosen as the "face" of this brand. The contraceptive has huge advantages over traditional drugs.

Yarina - hormonal pills. This is a modern means to protect women from unwanted pregnancy. Yarina is a hormonal low-dose monophasic contraceptive drug. Its effect is due to the processes of inhibition of ovulation.

When taking the drug Yarina, the side effects of which are minimal, a woman can choose the most favorable timing for conceiving a child.

Mechanism of action

The composition of this drug includes two components: drospirinone (3 mg) and ethinylestradiol (30 mg), these substances are synthetic versions of the hormones - estrogen and progesterone.

Yarina, whose side effects are almost not observed, has an effect on the woman's menstrual cycle. As you know, the level of sex hormones changes during the menstrual cycle. When the egg is released from the ovary, ovulation occurs, the endometrial layer of the uterus prepares for the introduction of the sperm. When the egg is not fertilized, the hormonal level decreases. Then the whole cycle is repeated. Taking contraceptives causes the body to behave as if ovulation has already occurred.

A remarkable feature of drospirenone is the prevention of fluid retention in the body, therefore, when taking Yarina, weight gain is not observed.

Menstruation gradually becomes less painful, their duration decreases. Beneficial effect on the skin helps to reduce acne.

Mode of application

Tablets are taken within 21 days from the first day of menstruation, daily. Then you should take a break for 7 days. At this time, menstrual bleeding passes. Then repeat taking the contraceptive.

Yarina side effects

Sometimes there may be nausea, vomiting, soreness and in a woman, headaches, decreased mood. Allergic reactions may also develop. The drug Yarina, the side effects of which can be confused with the effects of other drugs, should be taken in accordance with the instructions.

Indications for use

• Hormonal contraception
• Dysfunctional uterine bleeding
• Menstrual irregularity
• endometriosis
• Acne and other skin manifestations

Contraindications

• Varicose veins, also thrombosis, circulatory disorders in the vessels of the heart and brain
• Diabetes
• Severe liver disease
• Kidney dysfunction
• Malignant diseases
• Pregnancy and lactation
• Allergic manifestations to the reception of the drug

Interaction with drugs

Protection against unwanted pregnancy is significantly reduced when Yarina is combined with antibiotics, especially when taking ampicillin, tetracycline.

Women receiving a short course of antibiotics should use another barrier method of contraception within 7 days after stopping the drugs.

A decrease in protection is also facilitated by taking drugs such as barbiturates, carbamazepine, primidone, rifampicin, griseofulvin together with Yarina. This interaction is based on a change in the work of liver enzymes.

Special Instructions

If for some reason the drug was missed, then it is necessary to drink a tablet of Yarina as soon as possible, then take the drug at the usual time within 12 hours.

If more than 36 hours have passed after taking the pills, it is necessary to start protecting yourself with other means in combination with the further intake of Yarina.

Smoking should be stopped, especially for women over 35 years of age. Remember that Yarina, whose side effects are not so great, is recommended by many doctors.

Name: Yarina (Yarina)

Name: Yarina

Indications for use:
Contraception (prevention of unwanted pregnancy).

The appointment of a combined contraceptive with antimineralocorticoid and antiandrogenic properties (Yarina) can be especially useful for women with hormone-dependent fluid retention, as well as women with acne (acne) and seborrhea.

Pharmachologic effect:
Low-dose monophasic oral contraceptive with anti-ISS and anti-androgenic action. The contraceptive effect is due to a number of factors, the most important of which are the inhibition of ovulation and changes in the viscosity of cervical mucus. The endometrium remains unprepared for egg implantation. As a result of an increase in the viscosity of cervical mucus, the penetration of spermatozoa into the uterine cavity is difficult. Drospirenone has anti-ISS activity, which can prevent weight gain and other symptoms associated with fluid retention (prevents estrogen-induced Na + retention, provides very good tolerance and has a positive effect on premenstrual syndrome). In combination with ethinyl estradiol, it improves the lipid profile and increases the concentration of HDL. It has antiandrogenic activity, which leads to a decrease in the formation of acne and a decrease in the production of sebaceous glands, does not affect the increase in the formation of sex hormone-binding globulin caused by ethinylestradiol (inactivation of endogenous androgens). Drospirenone is devoid of any androgenic, estrogenic, GCS and anti-GCS activity. This, in combination with anti-ISS and anti-androgenic activity, provides drospirenone with a biochemical and pharmacological profile similar to natural progesterone. Like all combined oral contraceptives, it has a positive non-contraceptive effect: menstrual bleeding becomes easier and shorter, which reduces the risk of anemia, pain is less pronounced or completely disappears.

Yarina (Yarina) method of administration and dose:
Inside, 1 tablet, in the order indicated on the pack, every day at about the same time with a small amount of water, continuously for 21 days. The reception of each next package begins after a 7-day break, during which menstrual-like bleeding is observed. It usually starts 2-3 days after taking the last day of the pill and may not end before the start of a new pack. In the absence of taking any hormonal contraceptives in the previous month, the product is taken on the first day of the menstrual cycle (the first day of menstrual bleeding). It is allowed to start taking on the 2nd-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 tablets from the first package. When switching from taking other combined oral contraceptives, it is preferable to start taking the product the next day after taking the last day of the active tablet from the previous package, but no later than the next day after the usual 7-day break in taking (for products containing 21 tablets) or after taking the last day of an inactive tablet (for products containing 28 tablets per pack). When switching from contraceptives containing only gestagens (mini-pills, injection forms, implant): you can switch from mini-pill any day (without a break), from an implant - every day it is removed, from an injection form - from the day when you must the next injection was made. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the tablets. After an abortion in the first trimester of pregnancy, you can start taking it immediately. Under this condition, there is no need for additional contraceptive protection. After childbirth or abortion in the second trimester of pregnancy, it is recommended to start taking the product on days 21-28. 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 tablets. If there is sexual intercourse, pregnancy must be excluded before the start of taking the product, or it is necessary to wait for the first menstruation. Taking missed pills: if the delay in taking the pill was less than 12 hours, contraceptive protection is not reduced. It is necessary to take a pill as soon as possible, the next one is taken at the usual time. If the delay in taking the tablets was more than 12 hours (the interval from the moment of taking the last pill is more than 36 hours), contraceptive protection may be reduced. If you miss 1-2 weeks of taking the product, you must take the next missed tablet as soon as possible (even if this means taking 2 tablets at the same time). The next tablet is taken at the usual time. In addition, a barrier method of contraception must be used for the next 7 days. If sexual intercourse took place within 1 week before missing the pill, the possibility of pregnancy should be considered. The more pills missed, and the closer the missed pill is to a 7-day break in taking the product, the higher the risk of pregnancy. If a product is missed by 3 weeks, the next missed tablet should be taken as soon as possible (even if this means taking 2 tablets at the same time). The next tablet is taken at the usual time. In addition, a barrier method of contraception must be used for the next 7 days. In addition, taking tablets from a new package should be started as soon as the current pack is finished, i.e. nonstop. Most likely there will be no "withdrawal" bleeding until the end of the second pack, but "spotting" spotting or "withdrawal" uterine bleeding may occur on the days of taking the product from the second pack. In the event of a missed tablet intake and the absence of "withdrawal" bleeding in the first free from taking the product interval, pregnancy must be excluded. In case of missing a product intake, the following two basic rules can be followed: the product intake should never be interrupted for more than 7 days; 7 days of continuous tablet intake are required to achieve adequate suppression of the hypothalamic-pituitary-ovarian system. In case of vomiting within 3-4 hours after taking the tablet, absorption may not be complete. In this case, it is necessary to follow the rules for taking the product in case of skipping tablets. If the patient does not want to change the normal mode of taking the product, she is obliged to take, if necessary, an additional tablet (or several tablets) from another package. To delay the day of the onset of menstruation, it is necessary to continue taking the tablets from the new package immediately after taking all the tablets from the previous one, without interrupting the intake. Tablets from the new package can be taken as much as possible until the pack is over. Against the background of taking the product from the second package, "spotting" bloody discharge from the vagina or uterine "breakthrough" bleeding may be noted. It is necessary to resume taking the product from a new pack after the usual 7-day break. To transfer the day of the onset of menstruation to another day of the week, it is necessary to shorten the next break in taking the pills by as many days as it is necessary to postpone the onset of menstruation. The shorter the interval, the higher the risk of "withdrawal" bleeding and further "spotting" discharge and "breakthrough" bleeding during the second pack (as in the case of a delay in the onset of menstruation).

Yarina (Yarina) contraindications:
Yarina is not required to be used in the presence of any of the conditions listed below. If any of these conditions develop for the first time while taking the drug, the product should be immediately discontinued.

The presence of thrombosis (venous and arterial) at present or in history (for example, deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders).
Presence or history of pre-thrombotic conditions (eg, transient ischemic attacks, angina pectoris).
Diabetes mellitus with vascular complications.
The presence of severe or multiple risk factors for venous or arterial thrombosis may also be considered a contraindication.
Current or history of severe liver disease (until liver tests return to normal).
Severe renal failure or acute renal failure.
Current or history of liver tumors (benign or malignant).
Identified hormone-dependent malignant diseases of the genital organs or mammary glands or suspicion of them.
Vaginal bleeding of unknown origin.
Pregnancy or suspicion of it.
breastfeeding period.
Hypersensitivity to any of the components of Yarina.

Yarina (Yarina) side effects:
The following undesirable effects have been described in women taking Yarina, and their relationship with the product has not been confirmed or refuted: soreness of the mammary glands, discharge from the mammary glands; headache; migraine; change in libido; decreased mood; poor tolerance to contact lenses; nausea; vomit; changes in vaginal secretion; various skin disorders; fluid retention; change in body weight; hypersensitivity reaction.

Occasionally, chloasma may develop, especially in women with a history of chloasma during pregnancy.

Pregnancy:
The drug should not be taken during pregnancy and lactation!

Overdose:
No serious side effects have been reported with overdose. Symptoms that may occur in this case are nausea, vomiting, and slight vaginal bleeding. There is no specific antidote; symptomatic treatment should be carried out.

Use with other medicinal products:
Drug interactions resulting in increased clearance of sex hormones may lead to breakthrough bleeding or decreased contraceptive reliability. This has been found for hydantoin, barbiturates, primidone, carbamazepine, and rifampicin; there are also suggestions for oxcarbazepine, topiramate, felbamate, and griseofulvin. The mechanism of this interaction is based on a change in the work of liver enzymes. Maximum enzymatic induction usually does not occur for 2-3 weeks, but may then persist for at least 4 weeks after discontinuation of drug therapy.

Contraceptive protection is reduced when taking antibiotics such as ampicillins and tetracyclines. The mechanism of this action has not been elucidated.

Women receiving any of the above classes of medicinal products in a short course in addition to Yarina should temporarily use a barrier method of contraception during concomitant use of products and for 7 days after their withdrawal. While taking rifampicin and for 28 days after its withdrawal, in addition to Yarina, a barrier method of contraception (for example, a condom) should be used. If a co-administration of a product is started at the end of taking a pack of Yarina, the next pack of Yarina must be started without the usual interruption in intake.

In women who have been receiving products that affect liver enzymes for a long time, it is necessary to consider the use of other methods of contraception.

Other interactions

There is a theoretical possibility of an increase in serum potassium levels in women receiving Yarina at the same time as other products that can increase serum potassium levels. These products include ACE (angiotensin-converting enzyme) inhibitors, angiotensin-II receptor antagonists, some anti-inflammatory products (eg, indomethacin), potassium-sparing diuretics, and aldosterone antagonists. However, in a study evaluating the interaction of an ACE inhibitor with a combination of drospirenone / estradiol in women with moderate arterial hypertension, there was no significant difference between the serum potassium concentration in women treated with enalapril compared with placebo.

Impact on laboratory tests

The use of sex steroids can affect the biochemical parameters of liver, thyroid, adrenal and kidney function, as well as the levels of plasma transport proteins, such as corticosteroid-binding globulin and lipid / lipoprotein fractions, indicators of carbohydrate metabolism, coagulation and fibrinolysis. Changes usually occur within laboratory norms. Due to its antimineralocorticoid activity, drospirenone increases the activity of renin and plasma aldosterone.

Release form:
Coated tablets for oral administration.
Cycle pack containing 21 tablets.

Storage conditions:
The shelf life is 3 years.
Do not use after the expiration date!
Keep out of the reach of children!
Released by prescription.

Yarina (Yarina) composition:
Each coated tablet contains.
Active ingredients: 3 mg drospirenone, 0.03 mg ethinyl estradiol.
Excipients: lactose monohydrate, corn starch, modified starch (pregelatinized starch), polyvidone 25000, magnesium stearate, hydroxypropyl methylcellulose, macrogol 6000, talc, titanium dioxide, yellow iron oxide.

Additionally:
If any of the conditions/risk factors listed below are currently present, then the potential risk and expected benefit of treatment with Yarina should be carefully weighed in each individual case and discussed with the woman before she decides to start taking the product. In case of worsening, worsening or first manifestation of any of these conditions or risk factors, the woman is obliged to consult her doctor, who can decide whether to discontinue the product.

Diseases of the cardiovascular system
A number of epidemiological studies have revealed a slight increase in the incidence of venous and arterial thrombosis and thromboembolism when taking combined oral contraceptives.

Venous thromboembolism (VTE), manifesting as deep vein thrombosis and / or pulmonary thromboembolism, can develop during the use of all combined oral contraceptives. The approximate incidence of VTE in women taking oral contraceptives with a low dose of estrogens (less than 50 micrograms of ethinyl estradiol) is up to 4 per 10,000 women per year compared with 0.5-3 per 10,000 women per year in women not using OCs. However, the frequency of VTE developing while taking combined oral contraceptives is less than the frequency associated with pregnancy (6 per 10,000 pregnant women per year).
In women taking combined oral contraceptives, extremely rare cases of thrombosis of other blood vessels, such as hepatic, mesenteric, renal arteries and veins, the central retinal vein and its branches, have been described. The relationship with the use of combined oral contraceptives has not been proven.

A woman should stop taking the product and consult a doctor if symptoms of venous or arterial thrombosis develop, which may include: unilateral leg pain and/or swelling; sudden severe chest pain, with or without radiating to the left arm; sudden shortness of breath; a sudden attack of coughing; any unusual, severe, prolonged headache; increased frequency and severity of migraine, sudden partial or complete loss of vision; diplopia; slurred speech or aphasia; dizziness; loss of consciousness with / or without a seizure; weakness or very significant loss of sensation that suddenly appeared on one side or in one part of the body; motor disturbances; "sharp" abdomen.

The risk of 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 further increases, especially in women over 35 years old);
in the presence of:

family history (i.e. venous or arterial thromboembolism ever or in close relatives or parents at a relatively young age);
obesity (body mass index over 30 kg/m2);
dyslipoproteinemia;
arterial hypertension;
heart valve disease;
atrial fibrillation;
prolonged immobilization, major surgery, any operation on the legs, or major trauma.
In these situations, it is advisable to stop the use of combined oral contraceptives (in the case of a planned operation, at least four weeks before it) and not resume taking it for two weeks after the end of immobilization.
An increased risk of thromboembolism in the postpartum period should be taken into account. Circulatory disturbances 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 migraine during the use of combined oral contraceptives (which may precede cerebrovascular disorders) may be grounds for immediate discontinuation of these products.

Biochemical parameters that may be indicative of a hereditary or acquired predisposition to venous or arterial thrombosis include activated protein C (APC) resistance, hyperhomocysteinemia, antithrombin III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (cardiolipin antibodies, lupus anticoagulant).

When considering the risk/benefit ratio, the physician should take into account that adequate treatment of these diseases may reduce the associated risk of thrombosis, and that the risk of thrombosis associated with pregnancy is higher than with combined oral contraceptives.

Tumors
An increased risk of developing cervical cancer with long-term use of combined oral contraceptives has been reported in some epidemiological studies. Its relationship with the use of combined oral contraceptives has not been proven. Controversy remains as to the extent to which these findings relate to sexual behavior and other factors such as human papillomavirus (HPV).

A meta-analysis of 54 epidemiological studies demonstrated that there is a slightly increased relative risk (RR=1.24) of developing breast cancer diagnosed in women who were using combined oral contraceptives at the time of the study. Its relationship with the use of combined oral contraceptives has not been proven. The observed increase in risk may be due to earlier diagnosis of breast cancer in women using combined oral contraceptives. Breast cancers in women who ever used combined oral contraceptives were clinically less pronounced than in women who never used them.

In rare cases, against the background of the use of combined oral contraceptives, the development of liver tumors was observed. In the event of severe pain in the abdomen, liver enlargement, or signs of intra-abdominal bleeding, this should be taken into account when making a differential diagnosis.

Other states
Potassium excretion may be reduced in patients with renal insufficiency. In a clinical study, drospirenone had no effect on serum potassium concentration in patients with mild or moderate deterioration in renal function. The theoretical risk of hyperkalemia can only be considered for patients whose pre-treatment serum potassium was in the upper limit of normal and who are additionally using potassium-sparing foods.

In women with hypertriglyceridemia, or a family history of it, an increased risk of pancreatitis cannot be excluded while taking combined oral contraceptives.

Although a slight increase in blood pressure has been described in many women taking combined oral contraceptives, clinically significant increases were not often noted. The relationship between taking combined oral contraceptives and clinically significant arterial hypertension has not been established. The antimineralocorticoid effect of drospirenone may counteract the ethinylestradiol-induced increase in blood pressure, which is observed in normotensive women taking other types of combined oral contraceptives. However, if persistent, clinically significant hypertension develops while taking combined oral contraceptives, it is prudent for the physician to discontinue these products and treat hypertension. Taking combined oral contraceptives can be continued if normal blood pressure values ​​are achieved with 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 itching associated with cholestasis; the formation of stones in the gallbladder; porphyria; systemic lupus erythematosus; hemolytic uremic syndrome; chorea; herpes of pregnant women; hearing loss associated with otosclerosis. Cases of Crohn's disease and ulcerative colitis have also been described with the use of combined oral contraceptives, but the relationship with the intake of products has not been proven.

Acute or chronic liver dysfunction may require discontinuation of the use of combined oral contraceptives until liver function tests return to normal. Recurrent cholestatic jaundice that develops for the first time during pregnancy or previous use of sex hormones requires discontinuation of combined oral contraceptives.

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

Women with a tendency to chloasma while taking combined oral contraceptives should avoid prolonged exposure to the sun and exposure to ultraviolet radiation.

While taking combined oral contraceptives, irregular bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use. Therefore, the assessment of any irregular bleeding is only significant after an adaptation period of approximately three cycles.

If irregular bleeding recurs or develops after previous regular cycles, then non-hormonal causes should be considered and adequate diagnostic measures taken to exclude malignant neoplasms or pregnancy. These may include diagnostic curettage.

In some women, withdrawal bleeding may not develop during the pill break. If combined oral contraceptives were taken as directed, it is unlikely that the woman is pregnant. However, if previously combined oral contraceptives were taken irregularly or if there are no consecutive withdrawal bleedings, pregnancy must be excluded before continuing to take combined oral contraceptives.

Medical examinations

Before starting the use of Yarina, a woman is recommended to undergo a thorough general medical and gynecological examination (including examination of the mammary glands and a cytological examination of cervical mucus), to exclude pregnancy. In addition, it is necessary to exclude violations of the blood coagulation system. A woman should be warned that products like Yarina do not protect against HIV infection (AIDS) and other sexually transmitted diseases!

In the case of long-term use of the product, it is necessary to carry out control examinations after 6 months.

Often there are many questions about how to apply them correctly.

What to do if you miss two tablets?

How long can the drug be used?

What to do if there is no period after a 7-day break?

Delay of menstruation after the end of the reception

The possibility of getting pregnant after taking Yarina

Taking pills for polycystic

Yarina is one of the remedies prescribed for this disease, along with other drugs. Treatment of polycystic ovaries is long, it is necessary to take the medicine for at least several months. During treatment, tests should be carried out to determine if the drug helps. The advantage of Yarina in the treatment of polycystic disease is that, due to low doses of hormones, it has almost no effect on weight, does not cause edema.

Yarina and endometriosis

Yarina and hair loss

How does Yarina help with acne?

In some cases, at the beginning of the intake, and during the first 3-6 months, it is possible to increase the rash associated with the body's adaptation to the drug. Most often, after the end of this period, the skin condition improves. If this does not happen, you should consult a doctor to replace Yarina with another drug.

Can breast enlargement while taking Yarina?

Are they recovering from Yarina?

Nausea when taking pills

Change in libido

Yarina and antibiotics

Which is better - Yarina or Jess?

Yarina or Logest - what to prefer?

The package also contains 21 active tablets, after which you should take a seven-day break.

What is better to take - Yarina or Novinet?

What to choose - Yarina or Diana-35?

Which is better - Janine or Yarina?

Yarina or Midian?

Yarina or Marvelon - what to choose?

When choosing a contraceptive, you should always take into account the individual characteristics of each woman, since there is not a single drug that would suit absolutely everyone.

Transition from Yarina to Zhanin

How to switch from Yarina to Lindinet 20?

Transfer from NuvaRing to Yarina

Film-coated tablets in a blister calendar pack of 21 pcs.; in a cardboard box 1 pack.

1 tablet contains drospirenone 3 mg, ethinylestradiol 0.03 mg, excipients: lactose monohydrate; corn starch; modified starch (pregelatinized starch); polyvidone 25000; magnesium stearate; hydroxypropyl methylcellulose; macrogol 6000; talc; titanium dioxide; yellow iron oxide.

Pharmacological action

Low-dose monophasic oral combined estrogen-progestogen contraceptive drug. The contraceptive effect of Yarina is carried out through complementary mechanisms, the most important of which include the suppression of ovulation and the increase in the viscosity of cervical mucus.

In women taking combined oral contraceptives, the menstrual cycle becomes more regular, painful periods are less common, bleeding intensity decreases, resulting in a reduced risk of iron deficiency anemia. In addition, there is evidence that the risk of endometrial cancer and ovarian cancer is reduced.

Drospirenone, contained in Yarin, has an antimineralocorticoid effect and is able to prevent weight gain and the appearance of other symptoms (for example, edema) associated with hormone-induced fluid retention. Drospirenone also has antiandrogenic activity and helps to reduce the symptoms of acne (blackheads), oily skin and hair. This action of drospirenone is similar to the action of natural progesterone produced by the female body. This should be considered when choosing a contraceptive, especially for women with hormone-dependent fluid retention, as well as women with acne (acne) and seborrhea.

When used correctly, the Pearl Index (an indicator that reflects 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.

Indications for use

• contraception (prevention of unwanted pregnancy)
• acne (acne) and seborrhea in women

Dosage and administration

Tablets should be taken orally in the order indicated on the package, every day at about the same time, with a small amount of water. Take 1 tablet continuously for 21 days. Taking the tablets from the next package begins after a 7-day break, during which menstrual-like bleeding (withdrawal bleeding) usually develops. As a rule, it starts 2-3 days after taking the last pill and may not end before taking the pills from the new package.

Start taking Yarina

• In the absence of taking any hormonal contraceptives in the previous month taking Yarina begins on the 1st day of the menstrual cycle (i.e. on the 1st 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 tablets 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 containing 28 tablets per pack). Yarina's reception should be started on the day the vaginal ring or patch is removed, but no later than the day when a new ring should be inserted or a new patch should be pasted.
• When switching from contraceptives containing only gestagens ("mini-pill", injectable forms, implant), or from a progestogen-releasing intrauterine contraceptive (Mirena). You can switch from "mini-pill" to Yarina on any day (without a break), from an implant or intrauterine contraceptive with a progestogen - on the day it is removed, from an injection form - from the day 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 tablets.
• 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 tablets. However, if a woman has already had a sexual life, pregnancy should be excluded before taking Yarina, or it is necessary to wait for the first menstruation.

Taking missed pills

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

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

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

1. The drug should never be interrupted for more than 7 days.
2. 7 days of continuous tablet intake are required to achieve adequate suppression of hypothalamic-pituitary-ovarian regulation.

Accordingly, the following advice can be given if the delay in taking the tablets is more than 12 hours (the interval from the moment of taking the last tablet is more than 36 hours).

First week of taking the drug

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

Second week of taking the drug

It is necessary to take the last missed tablet as soon as possible, as soon as the woman remembers about it (even if this requires taking two tablets at the same time). The next tablet is taken at the usual time. Provided that the woman has taken her pills correctly in the 7 days preceding the first missed pill, there is no 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 example, a condom) for 7 days.

Third week of taking the drug

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

1. It is necessary to take the last missed tablet as soon as possible, as soon as the woman remembers about it (even if this requires taking two tablets at the same time). The next pills are taken at the usual time until the pills from the current package run out. The next pack should be started immediately without interruption. Withdrawal bleeding is unlikely until the second pack is finished, but spotting and breakthrough bleeding may occur while taking the tablets.
2. You can stop taking the pills from the current pack, thus starting a 7-day break (including the day you missed the pills), and then start taking the pills from the new pack.

If a woman misses a pill and then does not have withdrawal bleeding during the pill break, pregnancy should be ruled out.

In case of vomiting or diarrhea up to 4 hours after taking the tablets, absorption may not be complete and additional precautions should be taken to prevent unwanted pregnancy. In such cases, you should be guided by the above recommendations when skipping tablets.

Changing the start date of the menstrual cycle

In order to postpone the onset of menstruation, it is necessary to continue taking the tablets from the new Yarina package without a 7-day break. Tablets from a new package can be taken for as long as necessary, including until the package runs out. On the background of taking the drug from the second package, spotting from the vagina or breakthrough uterine bleeding is possible. Resume taking Yarina from the next package should be after the usual 7-day break. In order to move the day of the start of menstruation to another day of the week, a woman should shorten the next break in taking pills by as many days as she wants. The shorter the interval, the higher the risk that she will not have withdrawal bleeding and will experience spotting and breakthrough bleeding during the second pack (just as she would like to delay the onset of her period).

Additional information for special categories of patients

• For children and adolescents, Yarina is indicated only after the onset of menarche. Available data do not suggest dose adjustment in this group of patients.
• After the onset of menopause, Yarina is not indicated.
• Yarina is contraindicated in women with severe liver disease until liver function tests return to normal.
• Yarina is contraindicated in women with severe renal insufficiency or acute renal failure.

Side effect

While taking combined oral contraceptives in women, the following undesirable effects were observed:

As with other combined oral contraceptives, in rare cases, thrombosis and thromboembolism may develop.

Contraindications for use

• thrombosis (venous and arterial) at present or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders);
• conditions preceding thrombosis (including transient disorders of cerebral circulation, angina pectoris) at the present time or in history;
• 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 (including complicated valvular heart disease, atrial fibrillation, cerebrovascular or coronary artery disease; uncontrolled arterial hypertension, major surgery with prolonged immobilization, smoking over the age of 35 years) ;
• pancreatitis with severe hypertriglyceridemia at present or in history;
• liver failure and severe liver disease (before normalization of liver tests);
• liver tumors (benign or malignant) at present or in history;
• severe and / or acute renal failure;
• identified hormone-dependent malignant diseases (including genital organs or mammary glands) or suspicion of them;
• vaginal bleeding of unknown origin;
• pregnancy or suspicion of it;
• lactation (breastfeeding);
• hypersensitivity to the components of the drug.

If any of the above diseases or conditions develop for the first time while taking the drug, then it should be immediately canceled.

FROM caution

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

• risk factors for thrombosis and thromboembolism (smoking, obesity, dyslipoproteinemia, arterial hypertension, migraine, valvular heart disease, prolonged immobilization, major surgery, extensive trauma, hereditary predisposition to thrombosis / thrombosis, myocardial infarction or cerebrovascular accident at a young age in whom - or from the next of kin/);
• other diseases in which peripheral circulatory disorders may occur (diabetes mellitus, SLE, hemolytic uremic syndrome, Crohn's disease, UC, sickle cell anemia, phlebitis of superficial veins);
• hereditary angioedema;
• hypertriglyceridemia;
• liver disease;
• diseases that first arose or worsened during pregnancy or against the background of a previous intake of sex hormones (for example, jaundice, cholestasis, gallbladder disease, otosclerosis with hearing loss, porphyria, herpes pregnant, Sydenham's chorea);
• postpartum period.

The use of the drug Yarina during pregnancy and lactation

The drug is not prescribed during pregnancy and during lactation.

If pregnancy is detected while taking Yarina, the drug should be immediately discontinued. However, extensive epidemiological studies have not found an increased risk of malformations in children born to women who received sex hormones before pregnancy, or teratogenic effects when sex hormones were inadvertently taken early in pregnancy.

At the same time, data on the results of taking Yarina during pregnancy are limited, which does not allow us to draw any conclusions 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 may be excreted in milk.

Use for violations of the liver and kidneys

• The use of the drug is contraindicated in the presence or history of severe forms of liver disease (until the indicators of liver tests are normal), the presence or history of benign or malignant liver tumors;
• Contraindicated in acute renal failure and severe renal failure.

special instructions

Before starting or resuming the use of the drug Yarina, it is necessary to familiarize yourself with the history of life, the family history of the woman, conduct a thorough general medical (including measurement of blood pressure, heart rate, determination of body mass index) and gynecological examination, including examination of the mammary glands and a cytological examination of a scraping from the cervix (test for Papanicolaou), exclude pregnancy. The volume of additional studies and the frequency of follow-up examinations is determined individually. In general, follow-up examinations should be carried out at least once a year.

A woman should be informed that Yarina does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

If any of the conditions, diseases and risk factors listed below are currently present, then the potential risk and expected benefit of using combined oral contraceptives should be carefully weighed in each individual case and discussed with the woman before she decides to start taking drug. With weighting, strengthening, or at the first manifestation of risk factors, drug withdrawal may be required.

Diseases of the cardiovascular system

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 disease) when taking combined oral contraceptives. These diseases are rare.

The risk of developing venous thromboembolism (VTE) is highest in the first year of taking these drugs. An increased risk is present after the initial use of oral contraceptives or the resumption of use of the same or different combined oral contraceptives (after a break between doses of 4 weeks or more). Data from a large prospective study in 3 groups of patients show that this increased risk is predominantly present during the first 3 months.

The overall risk of VTE in patients taking low-dose combined oral contraceptives (< 50 мкг этинилэстрадиола), в 2-3 раза выше, чем у небеременных пациенток, которые не принимают комбинированные пероральные контрацептивы, тем не менее, этот риск остается более низким по сравнению с риском ВТЭ при беременности и родах. ВТЭ может привести к летальному исходу (в 1-2% случаев).

Venous thromboembolism (VTE), manifested as deep vein thrombosis or pulmonary embolism, can occur with any combined oral contraceptive.

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 regarding the relationship between the occurrence of these events and the use of combined oral contraceptives. Symptoms of deep vein thrombosis (DVT) include: unilateral swelling of the lower extremity or along a vein in the leg, pain or discomfort in the leg only when standing or walking, localized fever in the affected leg, and redness or discoloration of the skin on the leg.

Symptoms of pulmonary thromboembolism (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; fast or irregular heartbeat. Some of these symptoms (eg, shortness of breath, cough) are nonspecific and may be misinterpreted as symptoms 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: sudden weakness or loss of sensation in the face, arm or leg, especially on one side of the body, sudden confusion, problems speaking and understanding; sudden unilateral or bilateral loss of vision; sudden disturbance of gait, dizziness, loss of balance or coordination of movements; sudden, severe or prolonged headache with no apparent cause; loss of consciousness or fainting with or without an epileptic seizure. Other signs of vascular occlusion: sudden pain, swelling and slight blueness of the extremities, acute abdomen.

Symptoms of a myocardial infarction include: pain, discomfort, pressure, heaviness, a feeling of tightness or fullness in the chest, arm, or chest; discomfort with irradiation 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:

• 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 years old);
• with obesity (body mass index more than 30 kg / m 2);
• if there is a 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 combined oral contraceptives;
• with prolonged immobilization, major surgery, any operation on the legs or major trauma. In these situations, it is advisable to stop the use of combined oral contraceptives (in the case of a planned operation, at least four weeks before it) and not resume taking within two weeks after the end of immobilization;
• with dyslipoproteinemia;
• with arterial hypertension;
• with migraine;
• with diseases of the heart valves;
• with atrial fibrillation.

The question of the possible role of varicose veins and superficial thrombophlebitis in the development of venous thromboembolism remains controversial. An increased risk of thromboembolism in the postpartum period should be taken into account.

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 migraine during the use of combined oral contraceptives (which may precede cerebrovascular disorders) may be grounds for immediate discontinuation of these drugs.

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

In assessing the risk-benefit ratio, it should be taken into account that adequate treatment of the respective 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 (< 50 мкг этинилэстрадиола).

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 combined oral contraceptives. However, the relationship with the use of combined oral contraceptives has not been proven. Controversy remains about the extent to which these data are related to screening for cervical pathology or to sexual behavior (less use of barrier methods of contraception).

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 combined oral contraceptives (relative risk 1.24). The increased risk gradually disappears within 10 years after stopping these drugs. 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 currently taking combined oral contraceptives or who have recently taken it is insignificant in relation to the overall risk of this disease. The relationship between the development of breast cancer and the use of combined oral contraceptives has not been proven. The observed increase in risk may also be due to careful monitoring and earlier diagnosis of breast cancer in women using combined oral contraceptives. In women who have ever used combined oral contraceptives, earlier stages of breast cancer are detected than in 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, which in some cases led to life-threatening intra-abdominal bleeding, was observed. In the event of severe pain in the abdomen, 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 the concentration of potassium in the blood serum in patients with mild to moderate renal insufficiency. There is a theoretical risk of developing hyperkalemia in patients with impaired renal function and initial potassium levels at the ULN level or while taking medications that lead to potassium retention in the body.

In women with hypertriglyceridemia (or a family history of this condition), there may be an increased risk of developing pancreatitis while taking combined oral contraceptives.

Despite the fact that a slight increase in blood pressure has been described in many women taking combined oral contraceptives, clinically significant arterial hypertension has rarely been observed. However, if a persistent, clinically significant increase in blood pressure develops while taking combined oral contraceptives, these drugs should be discontinued and treatment of arterial hypertension should be initiated. Taking combined oral contraceptives can be continued if normal blood pressure values ​​are achieved with 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 itching associated with cholestasis; the formation of stones in the gallbladder; porphyria; SLE; hemolytic uremic syndrome; chorea of ​​Sydenham; herpes of pregnant women; hearing loss associated with otosclerosis. Cases of Crohn's disease and UC are also described against the background of the use of combined oral contraceptives.

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

In acute or chronic disorders of liver function, it may be necessary to discontinue the drug until liver function returns to normal. Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous use of sex hormones, requires discontinuation of combined oral contraceptives.

Although combined oral contraceptives may affect insulin resistance and glucose tolerance, there is no need to change the therapeutic regimen in diabetic patients using low-dose combined oral contraceptives (< 50 мкг этинилэстрадиола). Тем не менее, женщинам с сахарным диабетом необходим тщательный контроль во время приема препарата.

When using the drug, the development of chloasma is possible, especially in women with a history of pregnancy chloasma. Women with a tendency to chloasma while taking combined oral contraceptives should avoid prolonged exposure to the sun and exposure to ultraviolet radiation.

The effectiveness of combined oral contraceptives may be reduced by missed pills, vomiting and diarrhea, or as a result of drug interactions.

Effect on the menstrual cycle

While taking combined oral contraceptives, irregular (acyclic) bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use. Therefore, evaluation of any irregular bleeding should be done only after an adaptation period of approximately 3 cycles.

If irregular bleeding recurs or develops after previous regular cycles, a thorough examination should be carried out to exclude malignant neoplasms or pregnancy.

Some women may not develop withdrawal bleeding during their pill break. If combined oral contraceptives were taken as directed, then pregnancy is unlikely. However, if combined oral contraceptives have been taken irregularly before, or if there are no consecutive withdrawal bleedings, then pregnancy must be excluded before continuing to take the drug.

Impact on lab test scores

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

Influence on the ability to drive vehicles and control mechanisms

Not found.

Results of experimental studies

Preclinical data obtained in the course of standard studies in order to study toxicity with repeated administration of the drug, as well as hepatotoxicity, carcinogenic potential and toxicity to the reproductive system, do not indicate a particular risk to humans. However, it should be borne in mind that sex steroids may promote the growth of certain hormone-dependent tissues and tumors.

Overdose

Serious violations in case of overdose have not been reported. Based on cumulative experience with combined oral contraceptives symptoms that may occur in overdose: nausea, vomiting, spotting vaginal discharge or metrorrhagia.

Treatment: carry out symptomatic therapy. There is no specific antidote.

drug interaction

Interactions of oral contraceptives with other medicinal products may result in breakthrough bleeding and/or reduced contraceptive reliability. Women taking these drugs should temporarily use barrier methods in addition to Yarina, or choose another method of contraception.

The following types of interaction have been reported in the literature.

Effect on hepatic metabolism

The use of drugs that induce microsomal liver enzymes can lead to an increase in the clearance of sex hormones, which in turn can lead to breakthrough bleeding or reduce the reliability of contraception. These drugs include phenytoin, barbiturates, primidone, carbamazepine, rifampicin, rifabutin, 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 interfere with hepatic metabolism.

Effects on enterohepatic circulation

According to separate studies, some antibiotics (eg, penicillins and tetracyclines) can reduce the enterohepatic circulation of estrogens, thereby lowering the concentration of ethinyl estradiol. While taking drugs that affect microsomal enzymes, and within 28 days after their withdrawal, you should additionally use a barrier method of contraception.

While taking antibiotics (such as penicillins and tetracyclines) and within 7 days after their withdrawal, 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 break in taking the tablets.

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

Oral combined contraceptives may interfere with the metabolism of other drugs, leading to an increase (eg, cyclosporine) or a decrease (eg, lamotrigine) in plasma and tissue concentrations.

Based on in vitro interaction studies, as well as an in vivo study in 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 drug substances is unlikely.

There is a theoretical possibility of an increase in serum potassium levels in women receiving Yarina concomitantly with other drugs that can increase serum potassium levels. These drugs include angiotensin II receptor antagonists, some 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 serum potassium concentrations compared with placebo.