Yarina tabs #21

Yarina instruction for use

You can buy Yarina contraceptive tablets here

Composition of Yarina

The composition of Yarina's tablets includes 3 mg of drospirenone and 30 μg of ethinylestradiol.
Additional substances: titanium dioxide, corn starch, talc, lactose monohydrate, magnesium stearate, hypromellose, macrogol 6000, povidone K25, pregelatinized starch, iron oxide.

Form of issue

Light yellow tablets engraved "DO" in a hexagon, 21 tablets in a blister, one or three blisters in a cardboard package.

pharmachologic effect

Contraceptive and estrogen-progestational effect.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The summary describes the preparation as a monophasic low-dose oral combination estrogen-progestational medication.
The action of Yarina is carried out by blocking ovulation and increasing the viscosity of the mucus of the cervix.
In women using the contraceptive pill Yarina, the menstrual cycle is normalized, menstrual-like painful bleeding is less common, the intensity and duration of bleeding decreases, resulting in a lower probability of iron deficiency anemia. There is evidence of a reduced risk of ovarian and endometrial cancer.
The composition of the hormones Yarina: ethinyl estradiol and drospirenone.
    Drospirenone has an antimineralocorticoid effect and is able to prevent weight gain and other symptoms associated with worsening of the excretion of fluid from the body.
    Drospirenone shows antiandrogenic activity and helps to reduce acne, fat content of the skin.

Pharmacokinetics

Drospirenone

When ingested quickly absorbed. The greatest content in the blood is reached after about an hour and a half. Bioavailability approaches 75-85%. Eating does not affect the level of bioavailability of drospirenone.
It binds in blood with albumin and does not bind to corticosteroid-binding globulin. In a free form, only about 4% of the total serum content is present.
Completely metabolized. The transformation products are represented by acid derivatives of drospirenone, which are excreted in urine and feces in a ratio of 6/5. The elimination half-life is close to 40 hours.
In women with hepatic impairment of moderate severity, pharmacokinetic parameters are comparable to those of healthy women, and the half-life of drospirenone in such patients is 1.8 times greater than in healthy individuals with normal liver function. Patients with hepatic dysfunction of the middle degree showed a decrease in clearance of drospirenone by half compared to healthy women.
The concentration of drospirenone in the blood at the onset of an equilibrium state in women with mild-to-moderate renal function is comparable to that in healthy women. And in women with impaired renal function of medium severity, the content of drospirenone in the blood is 35% higher than in healthy women.
There were no fluctuations in potassium concentration in the blood with drospirenone.

Ethinylestradiol

After use, ethinyl estradiol is actively absorbed. The greatest content in the blood, as Wikipedia points out, is achieved in an hour and a half. Metabolized in the liver, bioavailability is about 45%. The main method of transformation is aromatic hydroxylation. Approximately 98% of the molecules of the substance bind to albumin.
In an unmodified form, the body is not excreted. Ethinyl estradiol derivatives are evacuated with urine and bile. The half-life is 24 hours.

Indications for use

Yarina's tablets - what are they for? To prevent unwanted pregnancy.

Contraindications

Contraindications to the use of Yarina tablets:
    current and past thrombosis and thromboembolism (including stroke, venous thrombosis, myocardial infarction, pulmonary embolism), cerebrovascular changes;
    current and past pancreatitis with hypertriglyceridemia;
    current and past pre-thrombotic conditions (including angina, ischemic attacks);
    current and past migraines with neurologic symptoms;
    diabetes mellitus with vascular complications;
    risk factors for vascular thrombosis, for example, atrial fibrillation, complicated changes in heart valves, vascular diseases of the brain or heart, surgical intervention followed by prolonged immobilization, hypertension, smoking after 35 years;
    Decompensated renal failure or acute kidney failure;
    insufficiency of liver function or severe liver disease (before normalization of analyzes);
    current and past liver tumors;
    hormone-dependent malignant tumors or suspicion of them;
    bleeding from the vagina of unexplained origin;
    lactation;
    pregnancy or suspected pregnancy;
    hypersensitivity to the components of the drug.
If any of the above disorders develop for the first time while taking the medication, it must be reversed immediately.
Yarina hormone tablets should be taken with extreme caution in the presence of any of the following conditions or diseases:
    risk factors for thrombosis: obesity, smoking, hypertension, dyslipoproteinemia, extensive trauma, migraine, long-term immobilization, heart valve defects, surgical interventions, hereditary predisposition to thrombosis development;
    Other diseases capable of provoking changes in peripheral circulation or superficial phlebitis;
    hypertriglyceridemia;
    angioedema of hereditary genesis;
    liver disease;
    postpartum period;
    diseases that have arisen or complicated during pregnancy or passed sexual hormones (porphyria, jaundice, herpes of pregnant women, cholelithiasis, otosclerosis, Sydenham's chorea).

Side effects

As with other combined contraceptives, it is very rare that Yarina's side effects, such as thromboembolism or thrombosis, are possible.
Yarina's side effects:
    from the genital area: discharge from the vagina or mammary glands, pain and enlargement of the mammary glands;
    from the digestive side: vomiting, abdominal pain, nausea, diarrhea;
    from the viewpoint: discomfort when using contact lenses;
    disorders of the nervous activity: deterioration of mood, mood changes, weakening or strengthening of libido, headache, migraine;
    skin: erythema nodosum, rash, urticaria, erythema multiforme;
    from the side of metabolism: weight change, water retention in the body;
    other disorders: allergic reactions.

Instructions for use Yarina (Method and dosage)

Tablets should be taken orally in order, according to the instructions on the package, at the same time, every day, washed down with water.

Yarina tablets, instructions for use

The drug is taken 1 tablet a day for 3 weeks. Receiving tablets from the next pack should start after a seven-day break with the usually developing "withdrawal bleeding". It starts about 3 days after the last pill is consumed and can continue until you take the pills from the new blister.

Reception start

How to take the first time Yarina?
If there is no use of any hormonal contraceptives in the previous month, the medication begins on the 1st day of the menstrual cycle. It is also acceptable to start the use of the menstrual cycle on day 2-5, but in this case it is necessary to use the barrier method of contraception in the first week of admission.
If the patient passes from other oral combined contraceptives, contraceptive patches or vaginal rings, then it is advisable to start using the medication on the day following the last pill of the "old" drug, but not later than the next day after the standard 7-day break (for agents containing 21 tablets ) or after using the final inactive tablet (for drugs that include 28 tablets). When using a vaginal ring or contraceptive patch, the drug should be started on the day the patch or ring is removed, but no later than the day the new ring or patch is established.
The transition from contraceptive (mini-pills containing only gestagen) to Yarina can be done on any day (without a temporary break). Transition from an implant containing only gestagen, or gestagen-releasing intrauterine contraceptive - on the day of its extraction. Transition from the injection form - from the day at which the following procedure should be performed. In all of the above cases, you need to use the barrier method of contraception in the first week of admission.
After giving birth or performing an abortion in the second trimester, the medication should be started no earlier than 4 weeks after the birth (provided that the mother does not breast-feed) or the abortion. If the application is started later, you need to use the barrier method of contraception in the 1st week of admission. But if the patient has already had sexual intercourse, before the application of Yarina it is necessary to exclude pregnancy or wait for the first menstruation.
After the abortion in the 1st trimester of pregnancy, it is allowed to start taking the medication - on the day of abortion. If this condition is met, the patient does not need additional methods of contraception.

Missed tablets

If the medicine was taken less than 12 hours late, the contraceptive protection does not go down. A woman needs to take the pill as soon as possible, the next tablet is used at the usual time.
If the medicine was taken after a delay of more than 12 hours, the contraceptive protection is reduced. The more pills are missed, the more likely the development of pregnancy. If you pass 1 tablet, the probability of getting pregnant is minimal. If you are late for more than 12 hours, follow the recommendations below.

The pass was made in the first 7 days of taking the drug

It is necessary as soon as possible to use the last missed pill, even if you want to take 2 tablets together. The subsequent tablet is consumed at the usual time. It is recommended to use the barrier method of contraception for another week. If there was sexual intercourse for 7 days before the tablet was missed, the probability of pregnancy should be taken into account.

The admission was made on the 8-14 day of taking the drug

It is necessary as soon as possible to use the last missed pill even if you want to take 2 tablets together. The next tablet is taken at the usual time. If the patient has correctly taken the pill for the last 7 days, then there is no need for additional contraceptive measures. Otherwise, or if you miss 2 or more tablets, you must additionally apply barrier methods of contraception for a week.

The admission was made on the 15-21 day of taking the drug

The risk of developing pregnancy is increased because of the upcoming temporary break in taking the drug. The patient must perform one of the following two options. In this case, if during the last week the mode of taking tablets was observed, then there is no need to apply additional methods of contraception.
    You should as soon as possible to take the last missed pill, even if it means that you need to take 2 tablets at the same time. The subsequent tablets from the current package are consumed as usual until they run out. The next package should be used without interruption. Until the tablets from the second package are exhausted, bleeding cancellation is unlikely, but breakthrough bleeding and spotting during the use of tablets are not ruled out.
    It is necessary to stop the use of tablets from the current blister and start a seven-day break, and then start taking the medicine from the new blister. If the patient violated the regimen of taking tablets and during the seven-day break she did not develop a withdrawal bleeding, it is necessary to exclude pregnancy.

When vomiting and diarrhea

If there is vomiting or diarrhea within four hours of consuming the tablets, it may not be fully absorbed. In such a case, additional contraceptive measures should be taken, and it is necessary to focus on the above recommendations when skipping tablets.

How to change the first day of the menstrual cycle?

To postpone the 1st day of menstruation, you need to continue taking Yarina from the new package without a seven-day break and take the pills as needed. This may lead to bleeding or bleeding.

Overdose

The list of symptoms that occur during an overdose: vomiting, spotting from the vagina, nausea.
Overdose therapy is symptomatic. There is no selective antidote.

Interaction

The use of drugs that stimulate liver microsomal enzymes can cause an increase in the excretion of sex hormones, which causes breakthrough bleeding or a weakening of contraceptive reliability. These drugs include Phenytoin, Primidone, barbiturates, Rifampicin, Carbamazepine, Rifabutin and others.
Penicillins and tetracycline are able to lower the intestinal hepatic circulation of estrogens, thereby lowering the concentration of ethinylestradiol. In the period of using drugs that affect microsomal enzymes, and about a month after the completion of their intake should use barrier contraception.
Combined contraceptives can alter the metabolism of other drugs, which leads to an increase or decrease in their concentration in the blood and tissues.

Storage conditions

Store at room temperature. Keep away from children.
Shelf life - Three years.

special instructions

Before starting or resuming the use of the drug, you need to familiarize yourself with personal and family history, conduct a gynecological and general medical examination, exclude the presence of pregnancy. The structure and scope of research, as well as the regularity of the examinations, are determined on a case-by-case basis, individually. Standard control examinations should be conducted at least once a year.
The patient should be informed that the drug does not protect against infection with HIV and other sexually transmitted diseases.
The relationship between reception of combined contraceptives and an increase in the incidence of vascular thrombosis and thromboembolism, including pulmonary thrombosis, venous thrombosis, myocardial infarction, and cerebral vascular disorders have been established.
The risk of venous thromboembolism is highest in the first year of taking such drugs. Increased risk occurs after the initial use of oral contraceptives or the resumption of their use.
Arterial thromboembolism, whose risk is also increased when taking drugs such as Yarina, can lead to vessel occlusion, stroke or heart attack. Signs of a stroke: weakness or disappearance of the sensitivity of the face or limbs, problems with speech and its understanding, confusion, sudden loss of vision, dizziness, gait disturbance, unreasonable headache, loss of balance, loss of consciousness. Other signs of vascular occlusion: puffiness, sudden pain, blue limbs, severe pain in the abdomen.
Signs of a heart attack: severity, discomfort, pain, pressure, a feeling of contraction in the hand or in the chest; discomfort, giving in the cheekbone, back, hand, larynx, stomach; nausea, cold sweat, vomiting or dizziness, anxiety, weakness, shortness of breath, tachycardia.
Arterial thromboembolism can lead to death.
The risk of thrombosis and thromboembolism increases:
    smokers;
    with age;
    with obesity;
    in the presence of thromboembolism ever at close relatives or parents;
    with prolonged immobilization, surgical intervention, operations on the lower extremities (in these situations it is desirable to stop the use of combined contraceptives and not to resume it within 15 days after immobilization is completed);
    with arterial hypertension;
    with dyslipoproteinemia;
    with diseases of the valvular heart;
    with migraine;
    with atrial fibrillation.
An increase in the frequency and severity of migraine attacks during the use of combined contraceptives may be grounds for stopping their intake.
Rarely, combined with the use of combined contraceptives, benign liver tumors were observed, and extremely rarely malignant tumors.

In patients with hypertriglyceridemia, there may be an increase in the likelihood of developing pancreatitis when taking medications such as Yarina.
In women with hereditary edema of Quincke, exogenous estrogens can cause or worsen the course of the disease.
During the use of combined contraceptives, irregular bleeding or spotting may occur, especially during the first months of use. Therefore, an assessment of irregular bleeding of any character should be carried out only after the adaptation period is completed, which is approximately 3 cycles.
If the bleeding described above is repeated, then a checkup and examination should be performed to exclude malignant tumors or pregnancy.
As the consequences of cancellation in some patients with a break in admission or when stopping the taking of tablets may develop bleeding.
Yarina's intake can change the results of a number of laboratory tests, for example, liver, kidney, adrenal, thyroid, protein carrier, coagulation, carbohydrate metabolism and fibrinolysis.
The drug does not affect the ability to drive vehicles.

Yarina's Analogues

The most common analogues are:  Yaz, Midiana.
The price of Yarina's analogs is generally less affordable than the price of the described drug.

Which is better: Midiana or Yarina?

Midiana and Yarina are complete analogues in composition and quantitative ratio of components in the preparation. The testimonies testify to the absence of cardinal differences in the effect of these two means. Midian is cheaper in value. The choice should be based on economic considerations and individual portability.
Diana 35 or Yarina - which is better?
Diana 35 and Yarina analogues on the mechanism of action and the effect. However, it is worth noting that the former has a lower concentration of hormonal components and a higher price. Side effects and therapeutic effects depend on individual characteristics.

Children

This drug category is shown only after menarche.

Compatibility with alcohol

Alcohol is not a contraindication for taking Yarina and does not reduce its contraceptive properties.

In pregnancy and lactation

The medicine is not prescribed for pregnancy and lactation.
If the pregnancy was detected during the application of Yarina, then the medicine should be immediately canceled. Studies have not shown an increased risk of developmental defects in newborns whose mothers have had sex hormones before or during pregnancy. At the same time, the use of combined contraceptives can reduce the volume of breast milk and change its composition, so the use of such drugs is not recommended until the end of breastfeeding.

Reviews about Yarina

The doctors' comments about Yarina are rather reserved characterize the drug, which has its advantages and disadvantages.
The Internet forum reports that a large number of women taking Yarina hormone tablets developed a variety of side effects: from acne and other skin changes to severe vascular disorders. In other reviews, it was reported that birth control pills favorably affect the skin condition and are recommended for polycystic ovaries.
The doctors' comments on the tablets in endometriosis indicate positive results of treatment with a continuous regimen. This scheme of application contributes to the suppression of menstrual function, inhibits the retrograde flow of blood into the pelvic organs and stimulates regression in endometrioid heterotopia. Duration of admission with endometriosis is at least six months.
Reviews about Yarina after cancellation are generally satisfactory, but sometimes there may be changes in the form of weight gain or the appearance of acne. There are a number of reports from the fact that after the abolition there are no monthly ones. The situation is normal if there are no monthly ones within 4-5 days after the end of the contraceptive intake. But in case they do not appear within a week, you should consult a gynecologist for advice.

Yarina and pregnancy after it

The forum and numerous reviews indicate that pregnancy after withdrawal of the drug is not accompanied by abnormalities of its course or pathological changes in the development of the fetus.