Yarina Plus tabs #28

Yarina Plus instruction for use

You can buy Yarina Plus on this page

Composition

    The active Yarina Plus contains 3 mg of drospirenone, 30 μg of ethinylestradiol, 451 μg of calcium levometholate. Additional substances: microcrystalline cellulose, lactose monohydrate, giprolose, sodium croscarmellose, magnesium stearate, orange varnish.
    The composition of one vitamin supplementary pill of Yarina Plus contains 451 μg of calcium levometholate. Additional substances: microcrystalline cellulose, lactose monohydrate, giprolose, sodium croscarmellose, magnesium stearate, light orange varnish.

Form of issue

    Active combination tablets are orange, round, biconvex, with an engraved "Y +" in a hexagon on one side.
    Auxiliary vitamin tablets have light orange color, round form, biconvex, with engraving "M +" in a hexagon on one side.
21 active and 7 auxiliary tablets in a blister, 1/3 of a blister with labels for a calendar of reception in a paper package.

pharmachologic effect

Replenishes the lack of folate, has a contraceptive and estrogen-progestational effect.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Monophasic low-dose combined oral estrogen-progestational contraceptive, which includes active and supplementary tablets with calcium levometholate.
The contraceptive effect of Yarina Plus is carried out by suppressing ovulation and increasing the viscosity of the cervical mucus. In patients taking similar oral contraceptives, the cycle is normalized, the soreness, intensity and duration of bleeding decrease, and as a result, the risk of iron deficiency anemia decreases. There are also data on a decrease in the likelihood of the appearance of endometrial and ovarian neoplasms.
Drospirenone demonstrates an antimineralocorticoid effect and prevents fluid retention, which can reduce body weight and reduce the risk of peripheral edema. It has antiandrogenic activity and helps to reduce acne, reduce fat and hair. These facts should be considered when choosing a contraceptive for women with a delay in fluid hormonal nature, as well as with acne.
Levomefolat calcium is an active form of folate, digestible better than folic acid. It is necessary to meet the increased need for folate during pregnancy and during lactation. The presence of calcium levomefolate in a contraceptive oral means reduces the likelihood of a fetal neural tube in the event that a pregnancy occurs after the abolition of contraception.

Pharmacokinetics

Drospirenone
After intake, it is absorbed quickly. The highest level in the blood is achieved after an hour and a half. Bioavailability is 76-85%. It binds to albumin and does not react with the hormone-binding globulin. Only 3-5% of the substance circulating in the blood is in free form. With the systematic use of the drug, the concentration of drospirenone in the blood increases 2-3 times. Most metabolites are acid derivatives of drospirenone. They are excreted through the kidneys and intestines.
Ethinylestradiol
Quickly absorbed after ingestion. The maximum level in the blood is reached after an hour and a half. Food reduces bioavailability by 25%. Ethinyl estradiol reacts actively with blood albumin. It is transformed in the liver by aromatic hydroxylation with the production of numerous metabolites. It is excreted as metabolic products with urine and feces. The elimination half-life reaches 24 hours.
Calcium levometholate
Quickly absorbed after getting into the digestive tract. In the form of L-5-methyl-THF it is delivered to organs and peripheral tissues. Folates are involved in the biosynthesis of thymidine, purines, DNA, RNA, methionine and glycine. It is excreted mainly by the kidneys in the original form and in the form of metabolites.

Indications for use

    Contraception for women with signs of fluid retention hormonal nature.
    Contraception in patients with a deficiency of folate.
    Contraception and acne therapy.

Contraindications

Taking medication is contraindicated in the presence or appearance in the process of taking any of the following diseases:
    presence of several or one expressed risk factors for vascular thrombosis;
    prethrombotic states in the past or present;
    thrombosis or thromboembolism in the past or present, cerebrovascular disorders;
    diabetes mellitus with concomitant vascular disorders;
    Migraine with neurologic symptoms of a focal character in the past or present;
    deficiency of liver function or liver disease;
    Liver tumors in the past or at present;
    Decompensated or acute kidney failure;
    malignant hormone-dependent tumors or suspected of their presence;
    lactation;
    pregnancy or possible but not confirmed pregnancy;
    lactose intolerance of hereditary nature, lack of lactase or impaired absorption of glucose and galactose;
    bleeding from the vagina of an unexplained genesis;
    hypersensitivity to the components of the drug.
With special care take the drug in the presence of at least one of the following conditions:
    risk factors for thrombosis: obesity, smoking, dyslipoproteinemia, migraine, arterial hypertension, valvular heart disease, predisposition to hereditary thrombosis;
    diseases against which peripheral circulatory disorders may appear: diabetes mellitus, sickle cell anemia, hemolytic-uremic syndrome, systemic lupus erythematosus, Crohn's disease, phlebitis;
    hypertriglyceridemia;
    angioedema of hereditary nature;
    diseases that have arisen or intensified during pregnancy or against the background of the use of sex hormones (cholelithiasis, jaundice on the background of cholestasis, otosclerosis, herpes of pregnant women, porphyria, Sydenham's chorea);
    liver diseases not indicated in contraindications;
    the postpartum period.

Side effects

    Disorders from the nervous activity: migraine, headache.
    Mental disorders: a change in libido, a depressed mood.
    Disorders from the circulation: changes in blood pressure, thromboembolism.
    Disorders from the side of breathing: bronchial asthma.
    Digestive disorders: abdominal pain, nausea, diarrhea, vomiting.
    Skin disorders: erythema multiforme, eczema, acne, rash, itching, erythema nodosum, urticaria.
    Visual disturbances: discomfort when wearing contact lenses.
    Hearing disorders: hypoacusia.
    Disorders from the genital area: pain or enlargement of the mammary glands, vaginal candidiasis, leucorrhoea, non-cyclic bleeding, changes in the menstrual cycle, vaginitis.
    Other disorders: weight changes, fluid retention, allergic reactions.
Severe side effects of Yarina Plus, which are reported from individuals using combined oral contraceptives:
    thromboembolic venous and arterial disorders;
    cerebrovascular disorders;
    increased blood pressure;
    hypertriglyceridemia;
    hyperkalemia;
    violation of glucose tolerance;
    changes in liver function;
    liver tumors;
    angioedema in individuals with a hereditary type of the disease;
    Chloasma;
    the appearance or deterioration of conditions that have arisen against the background of the use of oral combined contraceptives - jaundice, cholelithiasis, porphyria, herpes of pregnant women, hearing loss, Sydenham's chorea, systemic lupus erythematosus, haemolytic-uremic syndrome, Crohn's disease, cervical cancer.

Instructions for use Yarina Plus (Method and dosage)

Tablets are taken orally in the order indicated on the package, every day at the same time, washed down with water and not chewed.

Yarina Plus, user's manual

The reception begins on the first day of the cycle (the first day of menstrual bleeding). Use continuously one tablet a day for 4 weeks. The use of tablets from the next pack starts immediately after the completion of the previous one.
With symptoms of vomiting or diarrhea within 5 hours after taking the drug, the absorption of the active substance becomes ineffective. In the described case it is necessary to apply additional contraceptive measures.
Yarina Plus is not used at the onset of menopause.
The drug is contraindicated for women with severe disorders of kidney and liver function.

Overdose

Signs of an overdose: vomiting, nausea, spotting.
Treatment of overdose: selective antidote is not known, it is necessary to carry out symptomatic therapy. Calcium levometholate and its derivatives do not harm the body, regardless of the amount taken.

Interaction

The use of drugs that stimulate microsomal hepatic enzymes, can lead to an increase in the excretion of sex hormones. Such medicines include: barbiturates, phenytoin, primidone, carbamazepine, rifampicin and others.
Some antibiotics (penicillins and tetracycline) are able to reduce the concentration of ethinyl estradiol.
In the period of application of drugs acting on microsomal hepatic enzymes, and 4 more weeks after their withdrawal, the barrier method of contraception should be used additionally.
During the application of antibiotics (Rifampicin and Griseofulvin do not cause such a need), and even within a week after their withdrawal, it is recommended to use the barrier method of contraception in addition.
A number of drugs reduce the folate content in the blood or weaken the effectiveness of calcium levomefolate by blocking the enzyme dihydrofolate reductase (Trimethoprim, Methotrexate, Triamteren and Sulfasalazine), reducing folate absorption (Kolestyramin) or by unclear mechanisms (Phenobarbital, Carbamazepine, Primidone, Phenytoin, Valproic Acid).
Folates are able to change the pharmacokinetic parameters of antiepileptic drugs, methotrexate, pyrimethamine, which is accompanied by a decrease in the therapeutic effect of the latter.

Storage conditions

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

special instructions

The existence of a link between the use of contraceptives of the described type and the increased risk of vascular thrombosis has been proven, but these diseases rarely develop. The risk of venous thrombosis is maximal in the first 12 months of taking the drug. The overall probability of venous thrombosis in patients using combined low-dose oral contraceptives is about 2.5 times higher than in patients who do not use such agents. Venous or arterial thrombosis can endanger life, and also lead to death in approximately 1% of cases.
Venous thrombosis can manifest as thromboembolism of the main pulmonary artery, deep vein thrombosis and other disorders. Arterial thromboembolism can cause occlusion of vessels, stroke or myocardial infarction.
The risk of developing such thromboses increases:
    smokers;
    with age;
    with defeat of the valvular heart;
    in obese individuals;
    if there is a hereditary or acquired propensity to thrombosis;
    with dyslipoproteinemia;
    with prolonged immobilization, surgical intervention, interventions on the lower limbs;
    with migraine;
    with arterial hypertension;
    with atrial fibrillation.
Increasing and increasing the severity of migraine attacks can be grounds for the immediate cessation of the use of this drug.
In very rare cases with the use of contraceptives of the type described, the appearance of benign, and even less often, malignant liver tumors.
If severe pains in the abdomen, an increase in liver size, or symptoms of intra-abdominal bleeding occur, the appearance of a neoplasm should be considered during differential diagnosis.
In patients with impaired renal function and elevated potassium levels in the blood, it is impossible to exclude the possibility of hyperkalemia as a result of the use of drugs that lead to a delay in the excretion of potassium from the body.
Patients with hypertriglyceridemia may increase the risk of pancreatitis when taking combined contraceptives.
If during the period of Yarina Plus application a persistent increase in blood pressure is detected, it is necessary to cancel the medicine and begin therapy of arterial hypertension. Admission of the drug is allowed to continue, if due to hypotensive therapy the level of pressure is normal.

Dysfunction of the liver can cause the need to stop taking Yarina Plus, until the corresponding functional indicators return to normal levels. The resulting cholestatic jaundice requires withdrawal of the drug.
Admission of folate can mask deficiency of vitamin B12.
Reception Yarina Plus is able to influence the results of a number of laboratory tests: the performance of the adrenal glands, liver, thyroid, kidneys, the level of transport proteins, coagulation and fibrinolysis parameters.
The effectiveness of the drug can be reduced by irregular intake of tablets, vomiting or diarrhea, due to drug interactions.
Against the background of the drug, there may be discharge or non-cyclic bleeding from the vagina, especially during the first months of its administration. Based on this, the evaluation of any non-cyclic bleeding is carried out after the end of the adaptation period, which lasts 3 cycles.
With irregular intake of the drug and the absence of 2 consecutive bleeding during the period of withdrawal, pregnancy should be excluded.
Prior to the application of the remedy, it is necessary to collect anamnesis of the patient, to conduct a general examination, gynecological examination, cytological diagnosis of cervical examination, to exclude pregnancy.

Children

The use of the drug before menarche is prohibited.

In pregnancy and lactation

The drug is prohibited for use during lactation and during pregnancy.

Reviews about Yarina Plus

Reviews about Yarina Plus in the forums are generally positive. Of the concomitant effects, the appearance or elimination of acne, the deterioration or improvement of the condition of the hair and nails are most often noted. Based on the reports of patients, we can say that an unplanned pregnancy, while observing the rules of admission, does not arise.
The doctors' comments focus on the presence of calcium levomefolate in the preparation, which reduces the likelihood of fetal development defects in the event that a pregnancy occurred after the withdrawal of Yarina Plus.