The effect of yarina during a seven-day break. How to take Yarina birth control pills correctly? Interaction with other drugs

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INSTRUCTIONS
(information for patients)
on medical use of the drug
YARINA

Registration number: P N013882/01

Tradename
Yarina

Dosage form
Film-coated tablets

Compound
Each Yarina tablet contains:
. Active substances
Ethinyl estradiol 30 mcg
Drospirenone 3 mg
. Excipients
Lactose monohydrate, corn starch, pregelatinized corn starch, povidone K25, magnesium stearate, hypromellose (hydroxypropyl methylcellulose), macrogol 6000, talc (magnesium hydrosilicate), titanium dioxide (E 171), iron (II) oxide (E 172).

Description
The film-coated tablets are light yellow in color and have a hexagon engraved on one side with the letters “DO” inside.

Pharmacotherapeutic group
Combined contraceptive (estrogen + gestagen)

ATX code
G03AA12

Pharmacological properties
Yarina is a low-dose monophasic oral combined estrogen-progestogen contraceptive drug.

Yarina's contraceptive effect is carried out through complementary mechanisms, the most important of which include suppression of ovulation and changes in the properties of cervical secretion, as a result of which it becomes impenetrable to sperm.

When used correctly, the Pearl index (an indicator reflecting the number of pregnancies in 100 women using a contraceptive during the year) is less than 1. If pills are missed or used incorrectly, the Pearl index may increase.

In women taking combined oral contraceptives, the menstrual cycle becomes more regular, painful menstruation is less frequent, and the intensity of bleeding decreases, resulting in a reduced risk of iron deficiency anemia. In addition, there is evidence that the risk of developing endometrial 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 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, which should be taken into account when choosing a contraceptive, especially for women with hormone-dependent fluid retention, as well as women with acne and seborrhea.

Indications
Contraception (prevention of unwanted pregnancy).

Contraindications
Yarina should not be used if you have any of the conditions/diseases listed below.
. Thrombosis (venous and arterial) and thromboembolism currently or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke), cerebrovascular disorders.
. \tConditions preceding thrombosis (including transient ischemic attacks, angina) currently or in history.
. \tMigraine with focal neurological symptoms currently or in history
. \tDiabetes mellitus with vascular complications.
. \tMultiple or severe risk factors for venous or arterial thrombosis, including complicated lesions of the heart valve apparatus, atrial fibrillation, cerebral vascular disease or coronary artery disease; uncontrolled arterial hypertension, major surgery with prolonged immobilization, smoking over the age of 35 years.
. \tPancreatitis with severe hypertriglyceridemia currently or in history.
. \tLiver failure and severe liver diseases (until liver tests normalize)
. \tLiver tumors (benign or malignant) currently or in history.
. \tSevere and/or acute renal failure.
. \tIdentified hormone-dependent malignant diseases (including genital organs or mammary glands) or suspicion of them.
. Bleeding from the vagina of unknown origin.
. \tPregnancy or suspicion of it.
. \tBreastfeeding period.
. \tHypersensitivity to any of the components of the drug Yarina

If any of these conditions appear for the first time while taking Yarina, stop taking this drug immediately and consult your doctor. In the meantime, use non-hormonal birth control. See also “Special Instructions”.

Carefully
If you are using combined oral contraceptives if you have any of the diseases/conditions listed below, you may need to be closely monitored for reasons why. Before you start taking Yarina, tell your doctor if you have any of the following conditions and diseases.

Risk factors for the development of thrombosis and thromboembolism: smoking; thrombosis, myocardial infarction or cerebrovascular accident at a young age in one of the immediate family; obesity; dyslipoproteinemia (for example, high blood cholesterol); arterial hypertension; migraine; heart valve defects; prolonged immobilization, major surgery, major trauma
. \tOther diseases in which peripheral circulatory disorders may occur (diabetes mellitus; systemic lupus erythematosus; hemolytic uremic syndrome; Crohn's disease and ulcerative colitis; sickle cell anemia), phlebitis of the superficial veins
. \tHereditary angioedema
. \tHypertriglyceridemia
. \tLiver diseases
. \tDiseases that first appeared or worsened during pregnancy or against the background of previous use of sex hormones (for example, jaundice and/or itching associated with cholestasis, cholelithiasis, otosclerosis with hearing impairment, porphyria, herpes of pregnancy, Sydenham's chorea)
. \tPostpartum period

Pregnancy and lactation
Yarina should not be used during pregnancy and breastfeeding. If pregnancy is detected while taking Yarina, the drug should be discontinued immediately and consult a doctor. However, extensive epidemiological studies have not found an increased risk of developmental defects in children born to women who received sex hormones before pregnancy, or when taking sex hormones inadvertently in early pregnancy.

Taking combined oral contraceptives may reduce the amount of breast milk and change its composition, so their use is not recommended until you stop breastfeeding.

Directions for use and doses

When and how to take the pills
The calendar pack contains 21 tablets. In the package, each tablet is marked with the day of the week on which it should be taken. Take the tablets orally at the same time every day with a small amount of water. Follow the direction of the arrow until all 21 tablets have been taken. You do not take the drug for the next 7 days. Menstruation (withdrawal bleeding) should begin within these 7 days. It usually starts 2-3 days after taking the last Yarina tablet. After a 7-day break, start taking the next pack, even if the bleeding has not stopped yet. This means that you will always start a new pack on the same day of the week, and that your withdrawal bleed will occur on approximately the same day of the week each month.

Reception of Yarina's first package

. When no hormonal contraceptive was used in the previous month

Start taking Yarina on the first day of the cycle, that is, on the first day of menstrual bleeding. Take the pill that is marked with the appropriate day of the week. Then take the tablets in order. You can also start taking it on days 2-5 of the menstrual cycle, but in this case you must use an additional barrier method of contraception (condom) during the first 7 days of taking the pills from the first package.

. When switching from other combined oral contraceptives, vaginal ring or contraceptive patch

You can start taking Yarina the day after you take the last tablet of the current package of combined oral contraceptive (i.e., without interruption). If the current package contains 28 tablets, you can start taking Yarina the next day after taking the last active tablet. If you are not sure which pill it is, ask your doctor. You can also start taking it later, but in no case later than the next day after the usual break in taking (for drugs containing 21 tablets) or after taking the last inactive tablet (for drugs containing 28 tablets in a package).

Taking Yarina should begin on the day the vaginal ring or patch is removed, but no later than the day when a new ring is to be inserted or a new patch is applied.

. \tWhen switching from oral contraceptives containing only gestagen (mini-pills)

You can stop taking the mini-pill on any day and start taking Yarina the next day at the same time. During the first 7 days of taking the pills, you must also use an additional barrier method of contraception.

. When switching from an injectable contraceptive, an implant, or from a progestogen-releasing intrauterine contraceptive (Mirena)

Start taking Yarina on the day your next injection is due or on the day your implant or intrauterine device is removed. During the first 7 days of taking the pills, you must also use an additional barrier method of contraception.

. After childbirth

If you have just given birth, your doctor may recommend that you wait until the end of your first normal menstrual cycle before starting to take Yarina. Sometimes, on the recommendation of a doctor, it is possible to start taking the drug earlier.

. After spontaneous miscarriage or abortion in the first trimester of pregnancy

Taking missed pills

. If the delay in taking the next pill is less than 12 hours, the contraceptive effect of Yarina remains. Take the pill as soon as you remember. Take the next tablet at your usual time.
. \tIf the delay in taking pills is more than 12 hours, contraceptive protection may be reduced. The more pills you miss in a row, and the closer this skip is to the start or end of the dose, the higher the risk of pregnancy.
In this case, you can be guided by the following rules:
. More than one tablet from the package was forgotten
Consult your doctor.
. One tablet missed in the first week of taking the drug
Take the missed tablet as soon as you remember (even if this means taking two tablets at the same time). Take the next tablet at your usual time. Additionally, use a barrier method of contraception for the next 7 days. If sexual intercourse took place within a week before missing the pill, the possibility of pregnancy must be taken into account. Consult your doctor immediately.
. One tablet was missed in the second week of taking the drug
Take the missed tablet as soon as you remember (even if this means taking two tablets at the same time). Take the next tablet at your usual time. If you have taken your pills correctly during the 7 days preceding the first missed pill, the contraceptive effect of Yarina is maintained and you do not need to use additional contraceptive measures. Otherwise, as well as if you miss two or more tablets, you must additionally use barrier methods of contraception for 7 days.
. One tablet was missed in the third week of taking the drug
If all tablets have been taken correctly in the 7 days preceding the first missed pill, there is no need to use additional contraceptive methods. You can follow either of the following two options without the need for additional contraceptive measures.

1. Take the missed pill as soon as you remember (even if this means taking two pills at the same time). Take the next tablet at your usual time. Start the next pack immediately after finishing the current pack, so there is no break between packs. Withdrawal bleeding is unlikely until the second pack of tablets is gone, but spotting or breakthrough bleeding may occur on the days you take the drug.

2. Stop taking tablets from the current package, take a break of 7 days or less ( including the day you missed pills) and then start taking a new package.

Using this regimen, you can always start taking the next pack on the day of the week when you usually do it.

If you do not get your expected period after taking the pills, you may be pregnant. Consult your doctor before starting a new pack.

Recommendations in case of vomiting and diarrhea
If you have had vomiting or diarrhea (stomach upset) within 4 hours of taking Yarina tablets, the active ingredients may not have been completely absorbed. This situation is similar to skipping a drug dose. Therefore, follow the instructions for missed pills.

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

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

Additional information for special categories of patients
Children and teenagers
The drug Yarina is indicated only after the onset of menarche. Available data do not suggest dose adjustment in this group of patients.
Elderly patients
Not applicable. Yarina is not indicated after menopause.
Patients with liver disorders
Yarina is contraindicated in women with severe liver disease until liver function tests return to normal. See also section "Contraindications".
Patients with kidney problems
Yarina is contraindicated in women with severe renal failure or acute renal failure. See also section "Contraindications".

Side effect
When taking combined oral contraceptives, irregular (acyclic) vaginal bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use.

Other adverse events were observed in women while taking combined oral contraceptives:

As with other combined oral contraceptives, in rare cases the development of thrombosis and thromboembolism is possible (see also “Special Instructions”).

Overdose
No serious adverse events have been reported following overdose. Based on cumulative experience with combined oral contraceptives, symptoms that may occur with an overdose of active tablets: nausea, vomiting, spotting or metrorrhagia.

In case of overdose, consult a doctor.

Interaction with other drugs
Some medications may reduce the effectiveness of Yarina. These include drugs used to treat epilepsy (eg, primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine, topiramate, felbamate), tuberculosis (eg, rifampicin, rifabutin), and HIV infection (eg, ritonavir, nevirapine); antibiotics to treat certain other infectious diseases (eg penicillin, tetracyclines, griseofulvin); and St. John's wort medicines (used mainly to treat low mood).

Oral combination contraceptives may affect the metabolism of other drugs (eg, cyclosporine and lamotrigine).
There is a theoretical possibility of increased serum potassium levels in women receiving Yarina concomitantly with other drugs that may increase serum potassium levels. These drugs include angiotensin II receptor antagonists, some anti-inflammatory drugs (eg, indomethacin), potassium-sparing diuretics, and aldosterone antagonists. However, in a study evaluating the interaction of drospirenone with ACE inhibitors or indomethacin, there was no significant difference between serum potassium concentrations compared with placebo.

Always tell the doctor prescribing Yarina what medications you are already taking. Also tell any doctor or dentist who prescribes other drugs, or the pharmacist who sells drugs to you at the pharmacy, that you are taking Yarina.

special instructions
The following warnings regarding the use of other combined oral contraceptives should also be taken into account when using Yarina.

Thrombosis

Thrombosis is the formation of a blood clot (thrombus) that can block a blood vessel. When a blood clot breaks off, thromboembolism develops. Sometimes thrombosis develops in the deep veins of the legs (deep vein thrombosis), vessels of the heart (myocardial infarction), brain (stroke), and extremely rarely - in the vessels of other organs.
The risk of deep vein thrombosis in women taking combined oral contraceptives is higher than in those not using them, but not as high as during pregnancy.

The risk of developing thrombosis increases with age and also increases with the number of cigarettes smoked. When using Yarina, you should stop smoking, especially if you are over 35 years old.

The risk of deep vein thrombosis temporarily increases during surgery or prolonged immobilization (immobilization), for example, when applying a cast to the leg, prolonged bed rest. If you are planning surgery or hospitalization, tell your doctor in advance that you are taking combined oral contraceptives. Your doctor may advise you to stop using the drug (if you are planning to have surgery, at least four weeks before it) and not to restart it for two weeks after your immobilization ends.

If your blood pressure is high, your doctor may recommend that you stop taking combined oral contraceptives.

Tumors

The connection between taking combined oral contraceptives and breast cancer has not been proven, although it is detected slightly more often in women taking combined oral contraceptives than in women of the same age who are not using them. This difference may be due to the fact that women are screened more often when taking the drug and therefore breast cancer is detected at an early stage.

In rare cases, during the use of sex steroids, the development of benign, and in extremely rare cases, malignant liver tumors, which can lead to life-threatening intra-abdominal bleeding, has been observed. The connection with the use of drugs has not been proven. If you suddenly experience severe abdominal pain, consult your doctor immediately.

The most significant risk factor for developing cervical cancer is persistent papilloma viral infection. Cervical cancer was detected slightly more often in women using combined oral contraceptives for a long period of time. The connection with the use of combined oral contraceptives has not been proven. This may be due to more frequent gynecological examinations to detect cervical diseases or to characteristics of sexual behavior (less frequent use of barrier methods of contraception).

Reduced efficiency

The effectiveness of combined oral contraceptives may be reduced in the following cases: missed pills, vomiting and diarrhea, or as a result of drug interactions.

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

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

Intermenstrual bleeding
As with other combined oral contraceptives, when taking Yarina during the first few months, irregular vaginal bleeding (spotting or breakthrough bleeding) may occur between menstrual periods. Use hygiene products and continue taking your tablets as usual. Intermenstrual vaginal bleeding usually stops as your body adapts to Yarina (usually after 3 cycles of taking the pills). If they continue, become severe, or return after stopping, consult your doctor.

Lack of regular menstruation
If you have taken all the tablets correctly and have not had vomiting or diarrhea while taking the tablets or not taking other medications at the same time, then there is little chance of pregnancy. Continue taking Yarina as usual.
If you miss two periods in a row, consult your doctor immediately. Do not start taking the next pack until your doctor has ruled out pregnancy.

Impact on the ability to drive a car and operate machinery
Not found.

When to consult a doctor
Regular checkups
If you are taking Yarina, your doctor will tell you to have regular checkups, at least once a year.

Consult your doctor as soon as possible:
. if you have any health changes, especially any of the conditions listed in this leaflet (see also Contraindications and Caution);
. with local compaction in the mammary gland;
. if you are going to use other medications (see also “Interactions with other medications”);
. if long-term immobility is expected (for example, the leg is in a cast), hospitalization or surgery is planned (check with your doctor at least 4 to 6 weeks in advance);
. if you experience unusual heavy vaginal bleeding;
. if you forgot to take a pill in the first week of taking the pack and had sexual intercourse seven days or less before;
. you have missed your next period twice in a row or you suspect that you are pregnant (do not start taking the next pack until you have consulted your doctor).
Stop taking the tablets and consult your doctor immediately if you notice possible signs of thrombosis, myocardial infarction or stroke: unusual cough; unusually severe pain behind the sternum, radiating to the left arm; unexpected shortness of breath; unusual, severe or prolonged headache or migraine attack; partial or complete loss of vision or double vision; slurred speech; sudden changes in hearing, smell, or taste; dizziness or fainting; weakness or loss of sensation in any part of the body; severe abdominal pain; severe leg pain or sudden swelling of either leg.

Compound

Each Yarina tablet contains:
□ Active substances Ethinyl estradiol 0.03 mg Drospirenone 3 mg
□ Excipients
Lactose monohydrate, corn starch, pregelatinized corn starch, povidone K25, magnesium stearate, hypromellose (hydroxypropyl methylcellulose), macrogol 6000, talc (magnesium hydrosilicate), titanium dioxide (E 171), iron (II) oxide (E 172).

Description

The tablets are film-coated, round, biconvex, light yellow in color, with a hexagon engraved on one side with the letters “DO” inside.

pharmachologic effect

Yarina is a low-dose monophasic oral combined estrogen-progestogen contraceptive drug.

In women taking combined oral contraceptives, the cycle becomes more regular, painful menstrual-like bleeding is less common, the intensity and duration of bleeding decreases, resulting in a reduced risk of iron deficiency anemia. There is also evidence of a reduced risk of endometrial and ovarian cancer.

Drospirenone also has antiandrogenic activity and helps reduce acne (blackheads), oily skin and hair. This effect of drospirenone is similar to the effect of natural progesterone produced by the female body. This should be taken into account when choosing a contraceptive, especially for women with hormone-dependent fluid retention, as well as women with acne and seborrhea.

Indications for use

Contraception (prevention of unwanted pregnancy).

Contraindications

Yarina should not be used if you have any of the conditions/diseases listed below.

Thrombosis (venous and arterial) and thromboembolism currently or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke), cerebrovascular disorders.

Conditions preceding thrombosis (including transient ischemic attacks, angina) currently or in history.

Hereditary or acquired predispositions to venous or arterial thrombosis, such as APC resistance, antithrombin III deficiency, protein C deficiency, protein S deficiency, hyperhomocysteinemia and antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant).

Migraine with focal neurological symptoms, current or history

Diabetes mellitus with vascular complications.

Multiple or severe risk factors for venous or arterial thrombosis, including complicated lesions of the heart valve apparatus, atrial fibrillation, cerebrovascular disease or coronary artery disease; uncontrolled arterial hypertension, major surgery with prolonged immobilization, smoking over the age of 35 years.

Pancreatitis with severe hypertriglyceridemia, currently or in history.

Liver failure and severe liver disease (until liver tests normalize)

Liver tumors (benign or malignant) currently or in history.

Severe and/or acute renal failure.

Identified hormone-dependent malignant diseases (including genital organs or mammary glands) or suspicion of them.

Bleeding from the vagina of unknown origin.

Pregnancy or suspicion of it.

Breastfeeding period.

Hypersensitivity to any of the components of the drug Yarina

Pregnancy and lactation

Yarina should not be used during pregnancy and breastfeeding. If pregnancy is detected while taking Yarina, the drug should be discontinued immediately and consult a doctor. However, extensive epidemiological studies have not found an increased risk of developmental defects in children born to women who received sex hormones before pregnancy, or when taking sex hormones inadvertently in early pregnancy.

Taking combined oral contraceptives may reduce the amount of breast milk and change its composition, so their use is not recommended until you stop breastfeeding.

Directions for use and doses

The calendar pack contains 21 tablets. In the package, each tablet is marked with the day of the week on which it should be taken. Take the tablets orally at the same time every day with a small amount of water. Follow the direction of the arrow until all 21 tablets have been taken. You do not take the drug for the next 7 days. Menstruation (withdrawal bleeding) should begin within these 7 days. It usually starts 2-3 days after taking the last pill.

Yarina. After a 7-day break, start taking the next tablets from the pack, even if the bleeding has not stopped yet. This means that you will always start a new pack of pills on the same day of the week, and that your withdrawal bleed will occur on approximately the same day of the week each month.

Taking pills from Yarina’s first package

When no hormonal contraceptive was used in the previous month

When switching from other combined oral contraceptives, vaginal ring or contraceptive patch

You can start taking Yarina the day after you take the last tablet of the current package of combined oral contraceptives (i.e., without interruption). If the current package contains 28 tablets, you can start taking Yarina the next day after taking the last active tablet. If you are not sure which pill it is, ask your doctor. You can also start taking it later, but in no case later than the next day after the usual break in taking (for drugs containing 21 tablets) or after taking the last inactive tablet (for drugs containing 28 tablets in a package).

Taking Yarina should begin on the day the vaginal ring or patch is removed, but no later than the day when a new ring is to be inserted or a new patch is applied.

When switching from oral contraceptives containing only gestagen (mini-pills)

When switching from an injectable contraceptive, an implant, or from a progestogen-releasing intrauterine contraceptive (Mirena)

After childbirth

After spontaneous or medical abortion in the first trimester

pregnancy

Taking missed pills

If the delay in taking the next pill is less than 12 hours,

Yarina's contraceptive effect remains. Take the tablet as soon as

remember this. Take the next tablet at your usual time.

If the delay in taking the pills is more than 12 hours, contraceptive protection may be reduced. The more pills you miss in a row, and the closer this skip is to the start or end of the dose, the higher the risk of pregnancy.

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

More than one tablet is forgotten from the pack. Consult your doctor.

One tablet missed in the first week of taking the drug

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

One tablet was missed in the second week of taking the drug

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

One tablet was missed in the third week of taking the drug

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

1. Take the missed pill as soon as you remember (even if this means taking two pills at the same time). Take the next tablet at your usual time. Start taking the tablets from the next pack immediately after you finish taking the tablets from the current pack, so there is no break between packs. Withdrawal bleeding is unlikely until the second pack of tablets is gone, but spotting or breakthrough bleeding may occur on the days you take the drug.

2. Stop taking the pills from the current pack, take a break of 7 days or less (including the day you missed the pills), and then start taking the pills from the new pack.

Using this regimen, you can always start taking the next pack of tablets on the day of the week that you usually do.

If you do not get your expected period after taking the pills, you may be pregnant. Consult your doctor before starting a new pack.

If you have had vomiting or diarrhea (stomach upset) within 4 hours of taking Yarina tablets, the active ingredients may not have been completely absorbed. This situation is similar to skipping a drug dose. Therefore, follow the instructions for missed pills.

Delaying the onset of menstruation

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

Changing the day your period starts

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

The drug Yarina is indicated only after the onset of menarche. Available data do not suggest dose adjustment in this group of patients.

Elderly patients

Not applicable. Yarina is not indicated after menopause.

Patients with liver disorders

Yarina is contraindicated in women with severe liver disease until liver function tests return to normal. See also section "Contraindications".

Patients with kidney problems

Yarina is contraindicated in women with severe renal failure or acute renal failure. See also section "Contraindications".

Side effect

When taking Yarina, like any other medicine, adverse reactions may occur, although their occurrence is not necessary in all patients. If any adverse reaction becomes serious or you notice an adverse reaction not listed in this leaflet, please tell your doctor or pharmacist.

Serious unwanted effects:

In case of undesirable effects, including serious reactions associated with the use of the drug, see the sections “Precautions”, “Special Instructions” and “Contraindications”. Please read these sections carefully and consult your doctor if necessary. The following adverse reactions have been reported in women using Yarina:

Common undesirable effects (more than 1/100 and less than 1/10):

□ mood swings, depression/low mood

□ decrease or loss of libido (decreased or loss of sexual desire)

□ migraine

□ nausea

□ pain in the mammary glands, irregular uterine bleeding (“breakthrough” bleeding), bleeding from the genital tract (bleeding from the vagina) of unspecified origin

Rare undesirable effects (more than 1/10000 and less than 1/1000):

□ venous or arterial thromboembolism*

□ *Approximate frequency based on the results of epidemiological studies covering the group of combined oral contraceptives. The frequency bordered on very rare.

□ “Venous or arterial thromboembolism” includes the following nosological units: occlusion of peripheral deep veins, thrombosis and

embolism/pulmonary vascular occlusion, thrombosis, embolism and infarction/myocardial infarction/cerebral infarction and stroke not defined as hemorrhagic.

Side effects that have been reported during use of Yarina, but the incidence of which could not be assessed: erythrema multiforme (a skin condition characterized by itchy red rashes or local swelling of the skin).

Additional Information:

Listed below are adverse reactions with a very rare incidence or with delayed symptoms, which are believed to be associated with taking drugs from the group of oral combined contraceptives (see also “Contraindications” and “Special instructions”).

□ The incidence of breast cancer diagnosis in women taking combined oral contraceptives is slightly increased. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in women taking combined oral contraceptives is small relative to the overall risk of breast cancer.

Other states

□ Erythema nodosum.

□ Women with hypertriglyceridemia (increased risk of pancreatitis while taking combined oral contraceptives).

□ Increased blood pressure.

□ Conditions that develop or worsen while taking combined oral contraceptives, but their relationship has not been proven: jaundice and/or itching associated with cholestasis; formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes during pregnancy; hearing loss associated with otosclerosis.

□ In women with hereditary angioedema, estrogen may cause or worsen symptoms.

□ Liver dysfunction.

□ Impaired glucose tolerance or effects on insulin resistance.

□ Crohn's disease, ulcerative colitis.

□ Chloasma.

□ Hypersensitivity (including symptoms such as rash, urticaria). Interaction

Interaction of oral contraceptives with other drugs

agents (inducers of microsomal liver enzymes, some antibiotics)

can lead to

breakthrough bleeding and/or decreased contraceptive effectiveness (see “Interaction with other drugs”).

Overdose

No serious adverse events have been reported following overdose. Based on cumulative experience with combined oral contraceptives, symptoms that may occur with an overdose of active tablets: nausea, vomiting, spotting or metrorrhagia.

In case of overdose, consult a doctor.

Interaction with other drugs

Some medications may reduce the effectiveness of Yarina. These include drugs used to treat epilepsy (eg, primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine, topiramate, felbamate), tuberculosis (eg, rifampicin, rifabutin), and HIV infection (eg, ritonavir, nevirapine); antibiotics to treat certain other infectious diseases (eg penicillin, tetracyclines, griseofulvin); and St. John's wort medicines (used mainly to treat low mood). Oral combination contraceptives may affect the metabolism of other drugs (eg, cyclosporine and lamotrigine).

There is a theoretical possibility of increased serum potassium levels in women receiving Yarina concomitantly with other drugs that may increase serum potassium levels. These drugs include angiotensin II receptor antagonists, some anti-inflammatory drugs (eg, indomethacin), potassium-sparing diuretics, and aldosterone antagonists. However, in a study evaluating the interaction of drospirenone with ACE inhibitors or indomethacin, there was no significant difference between serum potassium concentrations compared with placebo.

Features of application

The following warnings regarding the use of other combined oral contraceptives should also be taken into account when using Yarina.

□ Thrombosis

The results of epidemiological studies indicate a relationship between the use of combined oral

contraceptives and an increased incidence of venous and arterial thrombosis and thromboembolism (such as deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders) when taking combined oral contraceptives. These diseases are rare.

The risk of developing venous thromboembolism (VTE) is greatest in the first year of taking such drugs. An increased risk is present after initial use of combined oral contraceptives or resumption of use of the same or different combined oral contraceptives (after a dosing interval of 4 weeks or more). Data from a large study suggest that the 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 два-три 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.

In very rare cases, venous or arterial thromboembolism can cause serious functional impairment, be life-threatening, or be fatal.

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

Very rarely, when using combined oral contraceptives, thrombosis of other blood vessels occurs, for example, hepatic, mesenteric, renal, cerebral veins and arteries or retinal vessels.

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

□ with age;

□ in smokers (with increasing number of cigarettes or increasing age, the risk increases, especially in women over 35 years old);

in the presence of:

□ family history (for example, venous or arterial thromboembolism ever in close relatives or parents at a relatively young age). In the case of a hereditary or acquired predisposition, the woman should be examined by an appropriate specialist to decide on the possibility of taking the drug;

□ obesity (body mass index more than 30 kg/m2);

□ dislipoproteinemia;

□ arterial hypertension;

□ migraine;

□ heart valve diseases;

□ atrial fibrillation;

□ prolonged immobilization, major surgery, any leg surgery or major trauma. In these situations, it is advisable to stop using the drug Yarina (in the case of a planned operation, at least four weeks before it) and not to resume taking it for a period of time.

two weeks after the end of immobilization.

□ Tumors

The most significant risk factor for developing cervical cancer is persistent human papillomavirus infection. Cervical cancer was detected slightly more often in women using combined oral contraceptives for a long period of time. The connection with the use of combined oral contraceptives has not been proven. This may be due to more frequent gynecological examinations to detect cervical diseases or to characteristics of sexual behavior (less frequent use of barrier methods of contraception).

The above mentioned tumors can be life threatening or fatal.

□ Reduced efficiency

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

□ Women with a tendency to chloasma should avoid prolonged exposure to the sun and exposure to ultraviolet radiation while taking the drug.

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

□ During the use of combined oral contraceptives, cases of Crohn's disease and ulcerative colitis, as well as worsening of endogenous depression and epilepsy, have been described.

Insufficient control of the menstrual cycle

As with other combined oral contraceptives, when taking Yarina, irregular vaginal bleeding (spotting or breakthrough bleeding) may be observed during the first few months. Use hygiene products and continue taking your tablets as usual. Irregular menstrual-like bleeding usually stops as your body adapts to Yarina (usually after 3 cycles of taking the pills). If they continue, become severe, or return after stopping, consult your doctor. No regular menstrual bleeding If you took all the pills correctly and did not have vomiting or diarrhea

while taking pills or not taking other medications at the same time, then the likelihood of pregnancy is low. Continue taking Yarina as usual.

If there are no two menstrual bleeding in a row, consult a doctor immediately. Do not start taking the next pack until your doctor has ruled out pregnancy.

Impact on the ability to drive a car and operate machinery

Not found.

When to Consult a Doctor Regular Checkups

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

Consult your doctor as soon as possible:

□ if you have any health changes, especially any of the conditions listed in this leaflet (see also “Contraindications” and “Use with caution”);

□ with local compaction in the mammary gland;

□ if you are going to use other medications (see also “Interactions with other medications”);

□ if prolonged immobility is expected (for example, a leg is in a cast), hospitalization or surgery is planned (consult your doctor at least 4 - 6 weeks in advance);

□ if unusual heavy vaginal bleeding occurs;

□ if you forgot to take a pill in the first week of taking the pack and had sexual intercourse seven days or less before;

□ you have not had your regular menstruation twice in a row or you suspect that

that you are pregnant (do not start taking the next pack until you have consulted your doctor).

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

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

Precautionary measures

If you are using combined oral contraceptives if you have any of the diseases/conditions listed below, you may need to be closely monitored for reasons why. Before you start taking Yarina, tell your doctor if you have any of the following conditions and diseases.

Other diseases in which peripheral circulatory disorders may occur (diabetes mellitus; systemic lupus erythematosus; hemolytic uremic syndrome; Crohn's disease and ulcerative colitis; sickle cell anemia), phlebitis of the superficial veins

Hereditary angioedema

Hypertriglyceride emia

Liver diseases

Diseases that first appeared or worsened during pregnancy or during previous use of sex hormones (for example, jaundice and/or itching associated with cholestasis, cholelithiasis, otosclerosis with hearing impairment, porphyria, herpes of pregnancy, Sydenham's chorea)

Postpartum period

Release form

Film-coated tablets. 21 tablets are placed in a blister made of aluminum foil and polyvinyl chloride film. 1 or 3 blisters, along with a pocket for carrying the blister and instructions for use, are placed in a cardboard box.

Storage conditions

Store at a temperature not exceeding 25 °C.

Keep out of the reach of children.

Best before date

3 years. Do not use after the expiration date!

Content

Among contraceptives for women, birth control pills Yarina are effective - the instructions for use of the drug contain precise information about the features of their use. The product belongs to the new generation of drugs. It is produced by the German company Bayer, which enjoys good reviews. This drug is valued by women for its reliability and minimum side effects.

What is Yarina

This is the name of a low-dose oral contraceptive for women, which contains a certain amount of hormones that complement each other. The drug acts by suppressing ovulation and increasing the amount of cervical fluid secreted, creating an obstacle to the penetration of sperm into the uterus. Additionally, the medicine regulates the menstrual cycle, reducing bleeding itself and its pain.

Compound

The active ingredients are 3 mg of drospirenone and 30 mcg of ethinyl estradiol. The drug Yarina - the instructions for its use say that it is monophasic, i.e. each tablet contains the same amount of main components, and is low-dose, because the dosage of hormones is small. Additional substances are:

pregelatinized starch;
titanium dioxide;
lactose monohydrate;
hypromellose;
povidone K25;
iron oxide;
magnesium stearate;
corn starch;
macrogol 6000.

Release form

The drug is available in the form of light yellow film-coated tablets for oral administration. Each is engraved with “DO” in a hexagon. The drug is sold in cardboard packaging of 1 or 3 blisters. Each contains 21 tablets. This amount is due to the fact that you need to take the medicine for so long before the break. The cost of Yarin tablets depends on their number in the package.

pharmachologic effect

Hormonal tablets Yarina - instructions for use indicate two main effects from their use. This blocks ovulation and increases the viscosity of the mucus secreted by the cervix. In women taking the drug, the menstrual cycle normalizes, painful bleeding becomes rare, and its intensity decreases. This reduces the risk of iron deficiency anemia. The concentration of drospirenone in the blood reaches a high level after 1-2 hours. There are no fluctuations in the amount of potassium in the plasma.

Indications for use

The only indication for oral use of Yarin tablets is protection against unplanned pregnancy. As a result of regular use of the drug according to the instructions, the number of pregnancies per 100 women is only 1. This indicator is called the Pearl index. If taken irregularly, the effectiveness of the tablets decreases.

Instructions for use

The tablets are intended for oral administration. Take 1 piece every day at the same hour. It is recommended to drink it with a small amount of liquid. Reception is carried out according to the procedure described on the package, continuously for 21 days. Next comes a 7-day break, during which “withdrawal bleeding” may develop. It begins 2-3 days after taking the last tablet and ends when the next course begins. The drug begins to act after 7 days, so at this time it is worth additionally resorting to barrier contraceptive methods.

How to take Yarina for the first time

The standard instructions for drinking Yarina assume that you did not use any hormonal contraceptives in the previous month. In this case, the intake occurs on the first day of the menstrual cycle, i.e. on the 1st day of bleeding. The dosage remains the same - 1 tablet. It is possible to shift the onset to days 2-5 of the cycle, but then it is recommended to use barrier methods of contraception for a week. It is necessary to take tablets with the same frequency - once a day.

Skipping a pill

There are times when you have to skip taking a pill. If the delay is less than 12 hours, you should take the medicine as soon as possible. The next pill comes at the usual time. When the delay is more than 12 hours, it is worth considering the likelihood of pregnancy. The higher the number of missed pills, the higher the rate. More details on what to do in this case are described in the table:

Time of reception violation	What to do
In the first 7 days		You need to use a barrier method of contraception for another week.
On days 8-14 of admission	Take the last missed tablet as quickly as possible, even if you need to take 2 tablets together. The next appointment should be at the usual time.	If you have taken it regularly over the past 7 days, then additional contraception is not required.
On 15-21 days of admission	Take the last missed tablet as quickly as possible, even if you need to take 2 tablets together. The next appointment should be at the usual time. The second package begins to be taken without interruption.	Another option is to stop taking the pills, take a week off, and then start the cycle again with another blister.

For vomiting and diarrhea

If vomiting or diarrhea begins within 4 hours after taking the drug, the active ingredients of the tablet may not be completely absorbed. In this case, you need to do the following:

protect yourself with a barrier method of contraception;
perform actions as if you missed a pill at a certain stage of the cycle, using the data in the table above.

How to change the first day of the menstrual cycle

If you need to postpone the first day of menstruation, then you need to exclude a week-long break and continue taking it, starting a new package. The use of the medicine is continued throughout the period during which menstrual flow is undesirable. At this time, spotting and even bleeding may still appear. Then take a 7-day break, after which they continue taking it according to standard instructions.

How long can you take Yarina

Taking the drug can last as long as the woman needs contraception to protect against unwanted pregnancy. Doctors recommend changing your birth control every five years. Consultation regarding intervals for the use of contraceptives can be obtained at your next gynecological examination. In general, it is recommended to take breaks of 1-3 months every six months to a year.

Drug interactions

Taking Yarina during treatment with drugs that stimulate hepatic microsomal enzymes may increase the excretion of sex hormones. This leads to breakthrough bleeding or reduced contraceptive effectiveness. These drugs include Rifabutin, Primidone, Phenytoin, Carbamazepine, barbiturates, Rifampicin. During their use and for a month after, barrier contraception is necessary. Tetracycline and penicillins reduce the enterohepatic circulation of estrogen, which reduces the concentration of ethinyl estradiol.

Side effects

The development of negative reactions after using a contraceptive is a very rare occurrence. Venous and arterial thrombosis and thromboembolism are sometimes observed. Other side effects of Yarina:

diarrhea;
discharge from the mammary glands or vagina;
nausea;
increased blood pressure;
headache;
abdominal pain;
increased or decreased libido;
migraine;
vomit;
changes in body weight;
allergy;
rash;
erythema multiforme;
worsening mood.

Overdose

If tablets are used in excess dosage, symptomatic therapy is indicated, since there is no selective antidote. This condition in patients is accompanied by:

bloody vaginal discharge;
nausea;
vomiting.

Contraindications

The downside of the drug is a large list of contraindications, so before using the medicine it is necessary to study the instructions for use. Diseases in which the use of this contraceptive is prohibited:

thromboembolism and thrombosis, including stroke, myocardial infarction, venous thrombosis;
cerebrovascular changes;
pancreatitis with hypertriglyceridemia;
ischemic attacks;
angina pectoris;
diabetes;
arterial hypertension;
acute liver failure;
renal failure;
malignant hormone-dependent tumors;
liver tumors;
lactation;
hereditary lactose intolerance;
bleeding from the vagina of unknown origin;
hypersensitivity to the components of the drug;
suspicion of pregnancy.

special instructions

Before starting to use the medicine, it is necessary to analyze your family history and exclude pregnancy. Each patient should be informed that Yarina does not protect against HIV infection and other sexually transmitted diseases. The drug is a risk factor for the development of thromboembolism and vascular thrombosis, especially in the first year of use. This applies to smokers, patients with obesity, migraines, and heart valve diseases.

Pregnancy and lactation

The medicine is not prescribed while waiting for a child or while feeding him. According to the instructions, studies have not found an increased risk of developing defects in newborns whose mothers used sex hormones in the early stages. During lactation, combined contraceptives can reduce the amount of breast milk and change its composition. If pregnancy is detected while taking Yarina, the drug must be discontinued immediately.

Use in old age

According to the instructions for use, Yarina’s medicine is not used after menopause. This is due to the fact that during this period ovulation no longer occurs, and therefore conception becomes impossible. Although in some cases, menopause extends for several years, which is why the reproductive system still continues to work. In this case, contraceptive methods should be discussed with your doctor.

Use in childhood

The use of Yarina in children is possible only after menarche, i.e. first menstrual bleeding. According to the instructions for use, no dosage adjustment is required for them. The dosage regimen remains the same as described for adult patients. Recommendations in case of skipping pills and regarding postponing the day of the start of menstruation also do not change.

Alcohol compatibility

Alcohol consumption is not a contraindication to the use of the medicine. Alcohol does not affect its contraceptive properties and does not reduce the effectiveness of using the drug. Alcohol and hormonal drugs have different stages of metabolism, so their effects on the body do not overlap. Even under this condition, it is not recommended to abuse alcoholic beverages. Due to a high dose of alcohol, vomiting or diarrhea may occur, which will affect the absorption of the drug.

Analogs

There are a number of drugs that are analogues of Yarina. They are characterized by a similar composition or principle of action. These include the following medications:

Dimia;
Midiana;
Dailla;
Claira;
Janine;
Vidor;
MODELL;
Simicia;
Regulon.

Yarina or Yarina Plus

There is a variation of the drug - Yarina plus. This contraceptive is a combination of several types of tablets with different compositions:

Active tablets. They are round, yellow and biconvex. Each tablet is engraved with a “Y” on one side. In addition to hormones, they contain calcium levomefolate - 451 mcg.
Auxiliary tablets. They have a light orange color, a biconvex shape and an “M” engraving. Each contains 451 mcg of calcium levomefolate.

The latter are the difference between Yarina Plus. An additional indication for its use is the elimination of folate deficiency. The medicine is also used for contraception for hormone-dependent fluid retention and for the treatment of moderate forms of acne. Yarina is easily replaced with Yarina Plus. The amount of active ingredients is the same, and the pharmacological activity is also the same. In addition, folate deficiency occurs frequently, so replenishing its deficiency will not be superfluous. Other reasons to use Yarina Plus:

All contraceptive methods do not provide one hundred percent guarantee of protection against unwanted pregnancy. For the proper development of a child, a normal level of folic acid is required, which Yarina Plus provides. Even if a woman becomes pregnant, she will not be deficient in folate.
If the patient expects to have a child in the future after stopping long-term use of contraceptives. Taking Yarina Plus helps to normalize hormonal levels, so in the future there will be no serious problems with conception.

Price

The drug is available with a doctor's prescription. You can also order and buy in an online store only on the recommendation of a specialist. The price table reflects information about how much Yarina costs in the catalogs of various pharmacies:

Place of purchase

Number of tablets, pcs.

Price, rubles Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

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Latest update of the description by the manufacturer 23.09.2015

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Description of the dosage form

The film-coated tablets are light yellow in color and have a hexagon engraved on one side with the letters “DO” inside.

pharmachologic effect

pharmachologic effect- contraceptive, estrogen-gestagenic.

Pharmacodynamics

Yarina ® is a low-dose monophasic oral combined estrogen-progestogen contraceptive drug.

The contraceptive effect of Yarina ® is mainly achieved by suppressing ovulation and increasing the viscosity of cervical mucus.

The incidence of venous thromboembolism (VTE) in women with or without risk factors for VTE using ethinyl estradiol/drospirenone-containing oral contraceptives at a dose of 0.03 mg/3 mg is the same as in women using levonorgestrel-containing combined oral contraceptives or other combined oral contraceptives . This was confirmed in a prospective controlled database study that compared women using oral contraceptives at a dose of 0.03 mg ethinyl estradiol/3 mg drospirenone with women using other combined oral contraceptives. Data analysis revealed a similar risk of VTE among the sample.

In women taking combined oral contraceptives, the menstrual cycle becomes more regular, painful menstrual-like bleeding is less common, the intensity and duration of bleeding decreases, resulting in a reduced risk of iron deficiency anemia. There is also evidence of a reduced risk of endometrial and ovarian cancer.

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

Pharmacokinetics

Drospirenone

When taken orally, drospirenone is rapidly and almost completely absorbed. After a single oral dose, Cmax of drospirenone in serum equal to 37 ng/ml is achieved after 1-2 hours. Bioavailability ranges from 76 to 85%. Food intake does not affect the bioavailability of drospirenone.

Drospirenone binds to serum albumin (0.5-0.7%) and does not bind to sex hormone binding globulin (SHBG) or corticosteroid binding globulin (CBG). Only 3-5% of the total concentration in the blood serum is found in free form. The increase in SHBG induced by ethinyl estradiol does not affect the binding of drospirenone to plasma proteins.

After oral administration, drospirenone is completely metabolized.

Most metabolites in plasma are represented by acidic forms of drospirenone, which are formed without the involvement of cytochrome P450.

The concentration of drospirenone in blood plasma decreases in 2 phases. Drospirenone is not excreted unchanged. Drospirenone metabolites are excreted by the kidneys and through the intestines in a ratio of approximately 1.2-1.4. T1/2 for excretion of metabolites in urine and feces is approximately 40 hours.

During cyclic treatment, the maximum steady-state serum concentration of drospirenone is achieved in the second half of the cycle.

A further increase in the serum concentration of drosperinone is observed after 1-6 cycles of administration, after which no increase in concentration is observed.

In women with moderate liver dysfunction (class B on the Child-Pugh scale), AUC is comparable to the corresponding indicator in healthy women with similar Cmax values in the absorption and distribution phases. T1/2 of drospirenone in patients with moderate liver dysfunction was 1.8 times higher than in healthy volunteers with intact liver function.

In patients with moderate liver dysfunction, a 50% decrease in the clearance of drospirenone was observed compared with women with preserved liver function, while there were no differences in the concentration of potassium in the blood plasma in the studied groups. When diabetes mellitus is detected and concomitant use of spironolactone (both conditions are regarded as factors predisposing to the development of hyperkalemia), an increase in the concentration of potassium in the blood plasma has not been established.

It should be concluded that drospirenone is well tolerated in women with mild to moderate liver dysfunction (Child-Pugh class B).

The concentration of drospirenone in the blood plasma when reaching a steady state was comparable in women with mild renal impairment (Cl creatinine - 50-80 ml/min) and in women with preserved renal function (Cl creatinine - > 80 ml/min). However, in women with moderate renal impairment (Cl creatinine - 30-50 ml/min), the average concentration of drospirenone in the blood plasma was 37% higher than in patients with preserved renal function. Drospirenone was well tolerated by all groups of patients. There were no changes in the concentration of potassium in the blood plasma when using drospirenone.

Ethinyl estradiol

After oral administration, ethinyl estradiol is rapidly and completely absorbed. C max in blood plasma, equal to approximately 54-100 pg/ml, is achieved in 1-2 hours. During absorption and first passage through the liver, ethinyl estradiol is metabolized, resulting in its bioavailability when taken orally, on average, about 45%.

Ethinyl estradiol is almost completely (approximately 98%), although nonspecifically, bound by albumin. Ethinyl estradiol induces the synthesis of SHBG.

Ethinyl estradiol undergoes presystemic conjugation, both in the mucous membrane of the small intestine and in the liver. The main route of metabolism is aromatic hydroxylation.

The decrease in the concentration of ethinyl estradiol in the blood plasma is biphasic. It is not excreted from the body unchanged. Ethinyl estradiol metabolites are excreted in urine and bile in a ratio of 4:6 with T1/2 of about 24 hours.

C ss is achieved during the second half of the cycle.

Indications of the drug Yarina ®

Contraception (prevention of unwanted pregnancy).

Contraindications

Yarina ® should not be used if you have any of the conditions/diseases listed below:

thrombosis (venous and arterial) and thromboembolism currently or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke), cerebrovascular disorders;

conditions preceding thrombosis (including transient ischemic attacks, angina) currently or in history;

migraine with focal neurological symptoms currently or in history;

diabetes mellitus with vascular complications;

multiple or severe risk factors for venous or arterial thrombosis, incl. complicated lesions of the valvular apparatus of the heart, atrial fibrillation, diseases of the cerebral vessels or coronary arteries; uncontrolled arterial hypertension, major surgery with prolonged immobilization, smoking over the age of 35 years;

pancreatitis with severe hypertriglyceridemia currently or in history;

liver failure and severe liver diseases (until normalization of liver tests);

liver tumors (benign or malignant) currently or in history;

severe and/or acute renal failure;

identified hormone-dependent malignant diseases (including genital organs or mammary glands) or suspicion of them;

bleeding from the vagina of unknown origin;

pregnancy or suspicion of it;

breastfeeding period;

hypersensitivity to any of the components of the drug Yarina ®.

If any of these conditions develop for the first time while taking Yarina, the drug should be discontinued immediately.

CAREFULLY

The potential risks and expected benefits 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 the development of thrombosis and thromboembolism: smoking, obesity, dyslipoproteinemia, arterial hypertension, migraine, heart valve defects, prolonged immobilization, major surgical interventions, extensive trauma, hereditary predisposition to thrombosis (thrombosis, myocardial infarction or cerebrovascular accident at a young age in anyone - or one of the closest relatives);

other diseases in which peripheral circulatory disorders may occur (diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, Crohn's disease and ulcerative colitis, sickle cell anemia), phlebitis of the superficial veins;

hereditary angioedema;

hypertriglyceridemia;

liver diseases;

diseases that first appeared or worsened during pregnancy or against the background of previous use of sex hormones (for example, jaundice and/or itching associated with cholestasis, cholelithiasis, otosclerosis with hearing impairment, porphyria, pregnancy herpes, Sydenham's chorea);

postpartum period.

Use during pregnancy and breastfeeding

The drug is not prescribed during pregnancy and breastfeeding. If pregnancy is detected while taking Yarina ®, it should be discontinued immediately. However, extensive epidemiological studies have not revealed an increased risk of developmental defects in children born to women who received sex hormones before pregnancy or teratogenic effects in cases of inadvertent use of sex hormones in early pregnancy. At the same time, data on the results of taking the drug Yarina ® during pregnancy are limited, which does not allow us to draw any conclusions about the negative impact of the drug on pregnancy, the health of the newborn and the fetus. Currently, no significant epidemiological data are available.

Taking combined oral contraceptives may reduce the amount of breast milk and change its composition, so their use is not recommended until you stop breastfeeding. Small amounts of sex steroids and/or their metabolites may be excreted in milk.

Side effects

The most commonly reported adverse reactions to Yarina ® include nausea and breast pain. They occurred in more than 6% of women using this drug.

Serious adverse reactions include arterial and venous thromboembolism.

The table below shows the frequency of adverse reactions. which were reported during clinical trials of the drug Yarina ® (N=4897). Within each group, allocated depending on the frequency of occurrence of an adverse reaction, adverse reactions are presented in order of decreasing severity. By frequency they are divided into frequent (≥1/100 and<1/10), нечастые (≥1/1000 и <1/100) и редкие (≥1/10000 и <1/1000). Для дополнительных нежелательных реакций, выявленных только в процессе постмаркетинговых исследований, и для которых оценку частоты возникновения провести не представлялось возможным, указано «частота неизвестна» (см. табл. 1).

Table 1

System-organ classes (MedDRA version)	Often	Infrequently	Frequency unknown
Mental disorders	Mood swings, depression, depressed mood, decreased or loss of libido
Nervous system	Migraine
Vascular disorders		Venous or arterial thromboembolism*
Gastrointestinal tract	Nausea
Skin and subcutaneous tissues			Erythema multiforme
Reproductive system and mammary glands	Pain in the mammary glands, irregular uterine bleeding, bleeding from the genital tract of unspecified origin

Adverse events during clinical trials were codified using the MedDRA dictionary (Medical Dictionary for Regulatory Activities, version 12.1). Different MedDRA terms reflecting the same symptom were grouped together and presented as a single adverse reaction to avoid diluting or diluting the true effect.

* - Approximate frequency based on the results of epidemiological studies covering the group of combined oral contraceptives. The frequency bordered on very rare.

Venous or arterial thromboembolism includes the following entities: peripheral deep vein occlusion, thrombosis and embolism/pulmonary vascular occlusion, thrombosis, embolism and infarction/myocardial infarction/cerebral infarction and stroke not defined as hemorrhagic.

For venous and arterial thromboembolism, migraine, see also “Contraindications” and “Special instructions”.

Additional Information

Listed below are adverse reactions with a very rare incidence or with delayed symptoms, which are believed to be associated with taking drugs from the group of combined oral contraceptives (see also “Contraindications” and “Special instructions”).

Tumors:

The incidence of breast cancer diagnosis in women taking combined oral contraceptives is slightly increased. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in women taking combined oral contraceptives is small relative to the overall risk of breast cancer.

Liver tumors (benign and malignant).

Other states:

Erythema nodosum;

Women with hypertriglyceridemia (increased risk of pancreatitis while taking combined oral contraceptives);

Increased blood pressure;

Conditions that develop or worsen while taking combined oral contraceptives, but their relationship with the drug has not been proven (jaundice and/or itching associated with cholestasis; formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic-uremic syndrome; Sydenham's chorea ; herpes of pregnant women; hearing loss associated with otosclerosis);

In women with hereditary angioedema, estrogen may cause or worsen symptoms;

Liver dysfunction;

Impaired glucose tolerance or effects on insulin resistance;

Crohn's disease, ulcerative colitis;

Chloasma;

Hypersensitivity (including symptoms such as rash, urticaria).

Interaction. The interaction of combined oral contraceptives with other drugs (inducers of microsomal liver enzymes, some antibiotics) can lead to breakthrough bleeding and/or a decrease in contraceptive effectiveness (see “Interaction”).

Interaction

Interaction of oral contraceptives with other drugs may lead to breakthrough bleeding and/or decreased contraceptive reliability. Women taking these drugs should temporarily use barrier methods of contraception in addition to Yarina ®, or choose another method of contraception.

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

Effect on hepatic metabolism. The use of drugs that induce liver microsomal enzymes can lead to an increase in the clearance of sex hormones, which in turn can lead to breakthrough bleeding or reduced contraceptive reliability. 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 their combinations can also potentially affect hepatic metabolism.

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

During your appointment drugs affecting microsomal enzymes, and within 28 days after their cancellation, a barrier method of contraception should be additionally used.

During your appointment antibiotics(such as penicillins and tetracyclines) and for 7 days after their discontinuation, a barrier method of contraception should be additionally used. If during these 7 days of the barrier method of contraception the tablets in the current package run out, then you should start taking 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 effect of inhibitors of the cytochrome P450 system on the metabolism of drospirenone is unlikely.

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

Based on interaction studies in vitro, as well as research in vivo Using female volunteers taking omeprazole, simvastatin and midazolam as markers, it can be concluded that the effect of drospirenone 3 mg on the metabolism of other medicinal substances is unlikely.

There is a theoretical possibility of increased serum potassium levels in women receiving Yarina ® concomitantly with other drugs that may 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 in serum potassium concentrations compared with placebo.

Directions for use and doses

Inside, in the order indicated on the package, every day at approximately the same time, with a small amount of water.

Take one tablet per day continuously for 21 days. Taking tablets from the next package begins after a 7-day break, during which menstrual-like bleeding usually develops (withdrawal bleeding). As a rule, it begins on the 2-3rd day after taking the last pill and may not end until you start taking pills from a new package.

How to start taking Yarina ®

If you have not taken any hormonal contraceptives in the previous month

Taking Yarina ® begins on the first day of the menstrual cycle (i.e., on the first day of menstrual bleeding). It is possible to start taking it 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 drugs containing 21 tablets) or after taking the last inactive tablet (for drugs containing containing 28 tablets per package). Taking Yarina ® should begin on the day the vaginal ring or patch is removed, but no later than the day when a new ring is to be inserted or a new patch is applied.

When switching from contraceptives containing only gestagens (mini-pills, injectable forms, implant), or from a gestagen-releasing intrauterine contraceptive (Mirena)

You can switch from the “mini-pill” to Yarina ® on any day (without a break), from an implant or intrauterine contraceptive with gestagen - on the day of its removal, from the injection form - from the day when the next injection is due. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills.

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 second trimester of pregnancy. If use is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills. However, if a woman has already been sexually active, pregnancy should be excluded before starting to take Yarina ® or she must wait until her first menstruation.

Taking missed pills

If the delay in taking the drug is less than 12 hours, contraceptive protection is not reduced. The woman should take the pill as soon as possible, and the next one should be taken at the usual time.

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

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

The drug should never be interrupted for more than 7 days;

To achieve adequate suppression of hypothalamic-pituitary-ovarian regulation, 7 days of continuous tablet use are required.

Accordingly, the following advice can be given if the delay in taking tablets exceeds 12 hours (the interval since the last tablet was taken is more than 36 hours).

First week of taking the drug

The last missed pill should be taken as soon as possible, as soon as the woman remembers (even if this means taking two pills at the same time). The next tablet is taken at the usual time. Additionally, a barrier method of contraception (such as a condom) should be used for the next 7 days. If sexual intercourse took place within a week before missing the pill, the possibility of pregnancy must be taken into account.

Second week of taking the drug

The last missed pill should be taken as soon as possible, as soon as the woman remembers (even if this means taking two pills at the same time). The next tablet is taken at the usual time. Provided that the woman has taken the pills correctly for the 7 days preceding the first missed pill, there is no need to use additional contraceptive measures. Otherwise, or 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 options below. However, if during the 7 days preceding the first missed pill, all pills were taken correctly, there is no need to use additional contraceptive methods.

1. It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers it (even if this means taking two pills at the same time). The next tablets are taken at the usual time until the tablets in the current pack are gone. You should start taking the tablets from the next package 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 tablets from the current package, thus starting a 7-day break (including the day you skipped tablets), and then start taking tablets from a new package.

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

If vomiting or diarrhea occurs within 4 hours of taking the tablets, absorption may not be complete and additional measures should be taken to protect against unwanted pregnancy. In such cases, you should follow the above recommendations when skipping pills.

Changing the day of the onset of menstrual bleeding

In order to delay the onset of menstrual-like bleeding, it is necessary to continue taking tablets from the new package of Yarina ® without a 7-day break. Tablets from the new package can be taken for as long as necessary, incl. until the tablets in the package run out. While taking the drug from the second package, spotting from the vagina or breakthrough uterine bleeding are possible. You should resume taking Yarina ® from the next package after the usual 7-day break.

In order to move the day of the onset of menstrual bleeding 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 subsequently experience spotting and breakthrough bleeding while taking the second pack (just as if she would like to delay the onset of menstrual-like bleeding).

Additional information for special categories of patients

Children and teenagers. The drug Yarina is indicated only after the onset of menarche. Available data do not suggest dose adjustment in this group of patients.

Elderly patients. Not applicable. The drug Yarina ® is not indicated after menopause.

Patients with liver disorders. The drug Yarina ® is contraindicated in women with severe liver disease until liver function tests return to normal (see also “Contraindications” and “Pharmacokinetics”).

Patients with kidney disorders. The drug Yarina ® is contraindicated in women with severe renal failure or acute renal failure (see also “Contraindications” and “Pharmacokinetics”).

Overdose

Symptoms(identified based on cumulative experience with oral contraceptives): nausea, vomiting, spotting or metrorrhagia.

Treatment: symptomatic. There is no specific antidote.

No serious adverse events have been reported following overdose.

special instructions

If any of the conditions, diseases and risk factors listed below currently exist, the potential risks and expected benefits of combined oral contraceptives should be carefully weighed on an individual basis and discussed with the woman before she decides to start taking drug. In case of worsening, intensification or first manifestation of any of these conditions, diseases or increase in risk factors, the woman should consult with her doctor, who may decide whether to discontinue the drug.

Diseases of the cardiovascular system

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

The overall risk of VTE in patients taking low-dose combined oral contraceptives (ethinyl estradiol content less than 50 mcg) is 2-3 times higher than in non-pregnant patients who do not take combined oral contraceptives, however, this risk remains lower compared to with the risk of VTE during pregnancy and childbirth. VTE can be life-threatening or fatal (in 1-2% of cases).

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

Very rarely, when using combined oral contraceptives, thrombosis of other blood vessels (for example, hepatic, mesenteric, renal, cerebral veins and arteries or retinal vessels) occurs. There is no consensus regarding the relationship between the occurrence of these events and the use of combined oral contraceptives. Symptoms of deep vein thrombosis (DVT) include the following: unilateral swelling of the lower extremity or along a vein in the leg, pain or discomfort in the leg only when upright or when walking, localized warmth in the affected leg, redness or discoloration of the skin on the leg.

Symptoms of pulmonary embolism (PE) include: difficulty or rapid breathing; sudden cough, incl. with hemoptysis; sharp pain in the chest, which may intensify with deep inspiration; sense of anxiety; severe dizziness; fast or irregular heartbeat. Some of these symptoms (eg shortness of breath, cough) are non-specific and may be misinterpreted as signs of other more or less serious events (eg respiratory tract infection).

Arterial thromboembolism can lead to stroke, vascular occlusion, or myocardial infarction. Symptoms of a stroke include: sudden weakness or loss of feeling in the face, arm or leg, especially on one side of the body, sudden confusion, problems with speech and comprehension; sudden unilateral or bilateral vision loss; sudden disturbance in gait, dizziness, loss of balance or coordination; sudden, severe or prolonged headache for no apparent reason; loss of consciousness or fainting with or without an epileptic seizure. Other signs of vascular occlusion: sudden pain, swelling and slight blue discoloration of the extremities, acute abdomen.

Symptoms of myocardial infarction include: pain, discomfort, pressure, heaviness, a feeling of squeezing or fullness in the chest, arm, or chest; discomfort radiating to the back, cheekbone, larynx, arm, stomach; cold sweat, nausea, vomiting or dizziness, severe weakness, anxiety or shortness of breath; fast or irregular heartbeat. Arterial thromboembolism can be fatal. The risk of developing thrombosis (venous and/or arterial) and thromboembolism increases:

With age;

For smokers (the risk increases with increasing number of cigarettes or increasing age, especially in women over 35 years of age).

In the presence of:

Obesity (body mass index more than 30 kg/m2);

Family history (for example, venous or arterial thromboembolism ever in close relatives or parents at a relatively young age). In the case of a hereditary or acquired predisposition, the woman should be examined by an appropriate specialist to decide on the possibility of taking combined oral contraceptives;

Prolonged immobilization, major surgery, any leg surgery or major trauma. In these situations, it is advisable to stop using combined oral contraceptives (in the case of planned surgery, at least 4 weeks before it) and not resume use for 2 weeks after the end of immobilization;

Dyslipoproteinemia;

Arterial hypertension;

Migraine;

Heart valve diseases;

Atrial fibrillation.

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

Poor peripheral circulation may also occur in diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis) and sickle cell anemia. An increase in the frequency and severity of migraine during use of combined oral contraceptives (which may precede cerebrovascular events) may be grounds for immediate discontinuation of these drugs.

Biochemical indicators indicating a hereditary or acquired predisposition to venous or arterial thrombosis include the following: resistance to activated protein C, hyperhomocysteinemia, antithrombin-III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant). When assessing the risk-benefit ratio, it should be taken into account that adequate treatment of the relevant condition may reduce the associated risk of thrombosis. It should also be taken into account that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives (ethinyl estradiol content - 0.05 mg).

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 connection with the use of combined oral contraceptives has not been proven. The possibility of interrelating these data with disease screening is discussed. Controversy remains regarding the extent to which these findings are related to screening for cervical pathology or to sexual behavior (lower use of barrier methods of contraception).

A meta-analysis of 54 epidemiological studies found 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 of stopping these drugs. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in women currently or recently taking combined oral contraceptives is small relative to the overall risk of breast cancer. Its connection with the use of combined oral contraceptives has not been proven. The observed increased risk may also be a consequence of careful monitoring and earlier diagnosis of breast cancer in women using combined oral contraceptives. Women who have ever used combined oral contraceptives are diagnosed with earlier stages of breast cancer than women who have never used them.

In rare cases, during the use of combined oral contraceptives, the development of benign, and in extremely rare cases, malignant liver tumors, which sometimes led to life-threatening intra-abdominal bleeding, was observed. In case of severe abdominal pain, liver enlargement or signs of intra-abdominal bleeding, this should be taken into account when making a differential diagnosis. Malignant tumors can be life-threatening or fatal.

Other states

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

Women with hypertriglyceridemia (or a family history of this condition) may have an increased risk of developing pancreatitis while taking combined oral contraceptives.

Although slight increases in blood pressure have been described in many women taking combined oral contraceptives, clinically significant increases have rarely been observed. However, if a persistent, clinically significant increase in blood pressure develops while taking the drug, these drugs should be discontinued and treatment of arterial hypertension should be initiated. The drug can be continued if normal blood pressure values are achieved with the help of antihypertensive therapy. The following conditions have been reported to develop or worsen both during pregnancy and while taking combined oral contraceptives (but have not been shown to be associated with combined oral contraceptives): jaundice and/or pruritus associated with cholestasis; formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes during pregnancy; hearing loss associated with otosclerosis. Cases of Crohn's disease and ulcerative colitis have also been described during the use of combined oral contraceptives. In women with hereditary forms of angioedema, exogenous estrogens may cause or worsen symptoms of angioedema.

Acute or chronic liver dysfunction may require discontinuation of the drug until liver function tests return to normal. Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous use of sex hormones, requires discontinuation of the drug. 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 low-dose combined oral contraceptives (ethinyl estradiol content less than 0.05 mg). However, women with diabetes should be closely monitored while taking this drug.

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

Preclinical safety data

Preclinical data from routine repeated-dose toxicity, genotoxicity, carcinogenicity and reproductive toxicity studies do not indicate a particular risk to humans. However, it should be remembered that sex steroids can promote the growth of certain hormone-dependent tissues and tumors.

Laboratory tests

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

Reduced efficiency

The effectiveness of Yarina ® may be reduced in the following cases: when taking tablets, vomiting and diarrhea (see “Taking missed tablets”) or as a result of drug interactions.

Insufficient control of the menstrual cycle

While taking Yarina ® , irregular (acyclic) spotting/bleeding from the vagina (spotting or breakthrough bleeding) may occur, especially during the first months of use. Therefore, evaluation of any irregular menstrual-like bleeding should be carried out after an adaptation period of approximately 3 cycles. If irregular menstrual-like bleeding recurs or develops after previous regular cycles, a thorough examination should be performed to rule out malignancy or pregnancy.

Some women may not develop withdrawal bleeding during a pill-free break. If Yarina ® was taken as recommended, it is unlikely that the woman is pregnant. However, if the drug is not used regularly and there are no two consecutive menstrual-like bleedings, the drug cannot be continued until pregnancy has been ruled out.

Medical examinations

Before starting or resuming the use of the drug Yarina ®, it is necessary to familiarize yourself with the woman’s life history and family history, conduct a thorough general medical and gynecological examination, and exclude pregnancy. The scope of research and the frequency of follow-up examinations should be based on existing standards of medical practice, with the necessary consideration of the individual characteristics of each patient. As a rule, blood pressure, heart rate are measured, body mass index is determined, the condition of the mammary glands, abdominal cavity and pelvic organs is checked, including a cytological examination of the cervical epithelium (Papanicolaou test). Typically, follow-up examinations should be carried out at least once every 6 months.

Yarina is a monophasic oral contraceptive. This means that all tablets in the package contain the same dose of hormones. One tablet of Yarina contains 30 mcg (0.03 mg) of ethinyl estradiol and 3 mg of Drospirenone.

One package contains one blister (plate) of Yarina for use for one month.

ATTENTION: The drug has contraindications. Do not start using this drug without first consulting your doctor.

Analogs

Preparations Midiana and Yarina Plus contain the same dose of hormones as Yarina.

Advantages of Yarina

Oral contraceptives (OC) Yarina have an antiandrogenic effect. This means that they block the action of male sex hormones (androgens) in a woman’s body. It is known that androgens are a common cause of oily facial skin and acne. Therefore, Yarina can have a cosmetic effect - eliminate or at least weaken acne (blackheads).

In addition, Yarina helps relieve pain during menstruation, as well as reduce the manifestations of premenstrual syndrome (PMS). Yarin tablets do not retain water in the body, so taking them does not increase a woman’s weight.

Yarina can be used as a treatment for endometriosis, adenomyosis, uterine fibroids, polycystic ovary syndrome and some other gynecological diseases.

Rules for receiving Yarina

If you are taking Yarina for the first time: the first tablet should be taken on the first day of menstruation (this day is considered the first day of the menstrual cycle). Your period may stop when you start taking the pills due to the effects of hormones. It's not scary.
You can start taking the pills on the 3-5th day of your period, but in this case you need to use additional contraception (for example, a condom) for another week after starting to take the pills.
It is advisable to take the tablets at approximately the same hour every day.
It is recommended to take the tablets in the order indicated on the blister. But, if you mixed something up and started taking the tablets out of order, then nothing bad will happen, since all Yarin tablets contain the same dose of hormones.
After finishing the blister (when you have finished 21 tablets), you should take a 7-day break, during which you do not need to take tablets. During the 7-day break, you may begin to menstruate.
Taking the first tablet from the next blister should be started on the 8th day after a 7-day break, regardless of menstruation (even if it has not yet begun or has not yet ended).

Do I need to use protection during the 7-day break?

During the week-long break between packs, there is no need to use additional contraceptives, since the contraceptive effect remains at a high level.

But this is only true for those cases when the woman took the pills from the previous package without skipping and according to the rules. If you missed one or more tablets in the third week of taking Yarina, or if the effect of the tablets could be reduced for another reason (vomiting, diarrhea, taking medications, etc.), then it is recommended not to take a 7-day break at all.

How to switch to Yarina from other birth control pills?

If you have been taking other birth control pills and now want to switch to Yarina, follow these rules:

If the blister of previous birth control pills contained 28 tablets, then taking the first Yarin tablet should be started the day after the end of 28 tablets of the previous OC.
If the package of previous OCs contained 21 tablets, then taking the first Yarin tablet can be started the day after the blister of previous birth control pills ends, or on the 8th day after a seven-day break.

How to switch to OK Yarina from a vaginal ring or hormonal patch?

The first tablet of Yarin should be taken on the day when you remove the vaginal ring or remove the hormonal patch, or on the day when you need to attach a new patch, or put the vaginal ring back on.

How to switch to Yarin from an intrauterine device (IUD)?

When switching to Yarina birth control pills from an intrauterine device, take the first pill on the day the device is removed. For 7 days after starting to take Yarin, use additional contraception (for example, condoms).

How to start taking Yarin after an abortion?

If the pregnancy was terminated at less than 12 weeks, the first Yarin tablet can be taken on the day of the abortion.

If you are more than 12 weeks pregnant, then you can start taking Yarina 21-28 days after the abortion. To avoid unwanted pregnancy, in this case, use a condom for another week after you start taking birth control pills. If you had unprotected sexual intercourse before starting to take OK, then you should not take Yarina until you are sure that you are not pregnant.

How to start taking Yarina after childbirth?

You can start taking Yarina 21 or 28 days after birth. If you start taking the pills later, you need to take additional protection for another 7 days. If you had unprotected sex before starting to take birth control pills, you can start taking the pills only after you have ruled out a possible pregnancy.

Can I take Yarina if I am breastfeeding?

What should I do if I missed Yarina’s pill?

If the delay in taking the Yarin tablet is less than 12 hours (that is, less than 36 hours have passed since taking the last tablet), then the contraceptive effect of the tablets is not reduced. Take the missed pill as soon as you remember. In this case, there is no need to take additional protection.

If the delay in taking the dose was more than 12 hours, then look at which tablet was missed:

From 1 to 7 tablets: you need to take the missed tablet as soon as you remember, even if this means taking 2 tablets at the same time. Use additional contraception (such as a condom) for the next 7 days.
From 8 to 14 tablets: you need to take the missed tablet as soon as you remember, even if this means taking 2 tablets at the same time. If you took the pills according to the rules for the previous 7 days (before skipping), you don’t have to use additional contraception. In any other case, it is recommended to take additional protection for another week after release.
From 15 to 21 tablets: take the missed Yarina tablet as soon as you remember, even if this means taking 2 tablets at the same time. After this, continue taking the tablets as usual, and after finishing the blister, immediately start the next blister (without taking a 7-day break). If you took all your pills on time for the previous 7 days before missing the pill, then there is no need for additional contraception. Otherwise, use protection for another 7 days after missing it.

What should I do if I missed several Yarina tablets?

If you missed 2 Yarina tablets in a row, pay attention to which tablets you missed. If these are tablets of the first or second week of taking (from 1 to 14), then take 2 tablets as soon as you remember about the omission and 2 more tablets the next day. Then take one tablet per day as usual until the pack runs out. Use additional contraception for another 7 days after resuming taking the pills.

If you missed two tablets in a row in the 3rd week of taking it (from 15 to 21), then there are two options: 1. continue taking Yarina, one tablet per day until the package runs out and then, without taking a 7-day break, start new packaging. At the same time, use additional contraception for another 7 days after the missed period. 2. throw away the current (unfinished) package and start taking a new package with the first tablet (one tablet per day, as usual). In this case, you need to use additional contraception for another 7 days after the missed date.

If you miss 3 Yarina tablets in a row, throw away the current pack of tablets and start a new pack with the first tablet. Use additional contraception for another 7 days. You will have an increased risk of pregnancy, so if your period does not come during the next break, contact your gynecologist.

If you are not sure what to do in your situation, use additional contraception until you talk to your doctor. In any case, if you miss two or more tablets, be sure to use additional protection (using condoms) for at least 7 days.

1-2 days after missing the pills, you may experience spotting or breakthrough bleeding, similar to your period. This is not dangerous and is associated with Yarina’s passes. Continue taking the pills according to the instructions and the discharge will stop.

Bloody discharge when taking Yarina

Some women experience spotting brown discharge while taking Yarina. Such discharge is normal if you started taking Yarina several months ago, if the discharge appears in the middle of the package or continues for several days after the end of menstrual-like bleeding.

However, in some situations, spotting may indicate a decrease in the effect of Yarina and even some diseases. You can read more about this in the article: About spotting while taking OK.

What reduces the contraceptive effect of Yarina?

The contraceptive effect of Yarina can be reduced by vomiting, diarrhea, taking large doses of alcohol, or taking certain medications. Read more about this here:

How to delay menstruation with the help of Yarin?

If you need to delay your period, then after finishing one package of Yarin, start a new blister the next day without taking a 7-day break. In this case, menstruation will be delayed by 2-4 weeks, but slight spotting may appear approximately in the middle of the next package.

Please note: you can postpone your period only if you took Yarin at least one month before unwanted menstruation.

Do I need to take long breaks from taking Yarina?

If you have been taking Yarina for more than 6-12 months, you may be wondering if you should take a break for a few months. You can read about how useful such breaks are by following the link: Is it necessary to take long breaks from taking birth control pills?

What to do if you don’t have your period during a 7-day break from taking Yarin?

Carefully remember whether you took all the pills correctly last month.

If you followed the basic rules for taking Yarin tablets, did not skip or were more than 12 hours late in taking them, then do not worry. After completing the 7-day break, you can start taking a new blister. If you don’t have your period during the next 7-day break, then contact your gynecologist to rule out a possible pregnancy. For other possible reasons for a delay, read the article 10 reasons for a delay in menstruation.

If in the past month you had errors in taking pills (missing, being late), then stop taking Yarina pills until you are sure that you are not pregnant.

What should I do if I become pregnant while taking Yarina?

Pregnancy when taking Yarin tablets correctly is extremely rare. It is more likely that pregnancy occurred as a result of mistakes that you made in the previous month.

So, what to do if the test unexpectedly shows 2 stripes? First of all, stop taking the pills and contact your gynecologist.

Taking Yarina in the early stages of pregnancy cannot harm the health of your unborn child, so you can leave the pregnancy without fear. In this case, start taking folic acid as soon as possible.

Yarina's appointment before surgery

If you are undergoing a planned operation, then taking Yarin tablets should be stopped a month (4 weeks) before surgery. This will reduce the risk of blood clots in the vessels. If the operation is required urgently, be sure to tell the surgeon that you are taking birth control pills. In this case, the doctor will take additional measures to prevent blood clots (with the help of medications).

You will be able to start taking Yarin 2 weeks after you are able to walk independently after surgery.

How often should you visit a gynecologist while taking Yarin?

Even if nothing bothers you, you need to visit a gynecologist for preventative care at least once a year.

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РЇСЂРёРЅР°: РёРЅСЃС‚СЂСѓРєС†РёСЏ Rє RїСЂРёРјРµРЅРµРЅРёСЋ

РЇСЂРёРЅР° СЌС‚Рѕ РјРѕРЅРѕС„Р°Р·РЅС‹Р№ РѕСЂР°Р»СЊРЅС‹Р№ РєРѕРЅС‚СЂР°С†РµРїС‚РёРІ. Р'СЃРµ С‚Р°Р±Р»РµС‚РєРё РІ СѓРїР°РєРѕРІРєРµ СЃРѕРґРµСЂР¶Р°С‚ РѕРґРЅСѓ Рё С‚Сѓ Р¶Рµ РґРѕР·Сѓ РіР ѕСЂРјРѕРЅРѕРІ: СЌС‚РёРЅРёР»СЌСЃС‚СЂР°РґРёРѕР» 30 RјРєРі Рё РґСЂРѕСЃРїРµСЂРёРЅРѕРЅРѕРЅ 3 РјРі. РћРґРЅР° СѓРїР°РєРѕРІРєР° СЂР°СЃСЃС‡РёС‚Р°РЅР° РЅР° 1 РјРµРЅСЃС‚СЂСѓР°Р»СЊРЅС‹Р№ С†РёРєР». РњРёРґРёР°РЅР° Рё РЇСЂРеРЅР° РїР»СЋСЃ – СЌС‚Рѕ RїРѕР»РЅС‹Рµ Р°РЅР°Р»РѕРіРё RїСЂРµРїР°СЂР°С‚Р° РЇСЂРё PSP°. РџСЂРµРёРјСѓС‰РµСЃС‚РІР° РїСЂРµРїР°СЂР°С‚Р° РЇСЂРёРЅР°:

RђРЅС‚РёР°РСРґСЂРѕРіРµРЅРЅС‹Р№ СЌС„С„РµРєС‚
РЈР»СѓС‡С€Р°РµС‚ СЃРѕСЃС‚РѕСЏРЅРёРµ РєРѕР¶Рё
РЎРЅРёР¶Р°РµС‚ Р±РѕР»Рё РІРѕ РІСЂРµРјСЏ РјРµРЅСЃС‚СЂСѓР°С†РёРё
РќРµ Р·Р°РґРµСЂР¶РёРІР°СЋС‚ Р¶РёРґРєРѕСЃС‚СЊ І РЕСЂРіР°РЅРёР·РјРµ
РќРµ РѕР±Р»Р°РґР°СЋС‚ Р°РЅР°Р±РѕР»РёС‡РµСЃРєРёРј SЌС„С„РµРєС‚РѕРј
РџСЂРёРјРµРЅСЏРµС‚СЃСЏ РєР°Рє Р»РµС‡РµР±РЅРѕРµ SЃСЂРµРґСЃС‚РІРѕ РїСЂРё R°РґРµРЅРѕРјРёРѕР·Р µ, RјРёРѕРјРµ RјР°С‚РєРё, R°РґРµРЅРѕРјРёРѕР·Рµ, RїРѕР»РёРєРёСЃС‚РѕР·Рµ

RљР°Рє РїСЂРёРЅРјРјР°С‚СЊ РЇСЂРёРЅСѓ?

Р СЃР»Рё РїСЂРµРґСЃС‚РѕРёС‚ РїСЂРёРµРј РЇСЂРёРЅС‹ РІРїРµСЂРІС‹Рµ, С‚Рѕ RїРµСЂРІСѓСЋ S‚Р°Р±Р »РµС‚РєСѓ РЅР°С‡РеРЅР°СЋС‚ РїСЂРёРЅРёРјР°С‚СЊ СЃ РїРµСЂРІРѕРіРѕ РґРЅСЏ РЅР°С‡ Р°Р»Р° РјРµРЅСЃС‚СЂСѓР°С†РёРё. РњРѕР¶РЅРѕ РЅР°С‡Р°С‚СЊ РїСЂРёРµРј С‚Р°Р±Р»РµС‚РѕРє РґРѕ 5-РіРѕ РґРЅСЏ RјРµРЅСЃС‚СЂСѓР°Р»С ЊРЅРѕРіРѕ С†РеРєР»Р°, РЅРѕ С‚РѕРіРґР° РЅРµРѕР± S…РѕРґРёРјРѕ РІ С‚РµС‡РµРЅРµ RїРѕСЃР»РµРґСѓСЋС‰РµР№ РЅРµРґРµР»Рё РґРѕРїРѕР»РЅРёС‚РµР»СЊР ЅРѕ РїСЂРµРґРѕС…СЂР°РЅСЏС‚СЊСЃСЏ Р±Р°СЂСЊРµСЂРЅРѕР№ РєРѕРЅС‚СЂР°С†РµРїС†РеРµР№. РўР°Р±Р»РµС‚РєРё РѕР±СЏР·Р°С‚РµР»СЊРЅРѕ RїСЂРёРЅРёРјР°С‚СЊ RµР¶РµРґРЅРµРІРЅРѕ РІ РѕРґРЅРѕ Ryo S ‚Рѕ Р¶Рµ РІСЂРµРјСЏ СЃСѓС‚РѕРє. RR»РёС‚РµР»СЊРЅРѕСЃС‚СЊ РїСЂРёРµРјР° 21 РґРµРЅСЊ, Р·Р°С‚РµРј РґРµР»Р°РµС‚СЃСЏ 7-РґРЅРµРІРЅС ‹Р№ РїРµСЂРµСЂС‹РІ Рё РЅР° 8-Рµ СЃСѓС‚РєРё РЅР° S‡РёРЅР°СЋС‚ РїСЂРёРµРј РЅРѕРІРѕР№ РєРѕРЅРІР°Р»СЋС‚С‹. R' SЌS‚РѕС‚ 7-РґРЅРµРІРЅС‹Р№ РїРµСЂРёРѕРґ RїСЂРѕР№РґРµС‚ RјРµРЅСЃС‚СЂСѓР°С†РёСЏ. РџСЂРёРµРј РЅРѕРІРѕР№ РєРѕРЅРІР°Р»СЋС‚С‹ РЅРµРѕР±С…РѕРґРёРјРѕ RїСЂРёРЅРёРјР°С‚СЊ СЃС‚СЂРѕР іРѕ СЃ 8 РґРЅСЏ РїРѕСЃР»Рµ 7-РґРЅРµРІРЅРѕРіРѕ RїРµСЂРµСЂС‹РІР°, РґР°Р¶Рµ РµСЃР»Рё РјРµРЅСЃС‚С ЂСѓР° S†РёСЏ РµС‰С' РЅРµ Р·Р°РєРѕРЅС‡РеР»Р°СЃСЊ.

Р СЃС‚СЊ Р»Рё РЅРµРѕР±С…РѕРґРёРјРѕСЃС‚СЊ РІ РєРѕРЅС‚СЂР°С†РµРїС†РёРё РІРѕ РІСЂРµРјСЏ 7-РґРЅР µРІРЅРѕРіРѕ РїРµСЂРµСЂС‹РІР°?

РџСЂРѕС‚РёРІРѕР·Р°С‡Р°С‚РѕС‡РЅС‹Р№ СЌС„С„РµРєС‚ РїСЂРµРїР°СЂР°С‚Р° СЂР°СЃРїСЂРѕСЃС‚С ЂР°РЅСЏРµС‚СЃСЏ Рё РЅР° 7-РґРЅРµРІРЅС‹Р№ РїРµСЂРµСЂС‹РІ, РїРѕСЌС‚РѕРјСѓ РґРѕРїРѕР»РЅРёС‚РµР»СЊРЅР°СЏ RєРѕРЅС‚СЂР°С†РµРїС†РёСЏ R І СЌС‚РѕС‚ РїРµСЂРеРѕРґ РЅРµ РЅСѓР¶РЅР°. RћРґРЅР°РєРѕ РґР°РЅРЅРѕРµ SѓS‚РІРµСЂР¶РґРµРЅРёРµ SЃРїСЂР°РІРµРґР»РёРІРѕ S‚РѕР»СЊРєРѕ РІ С‚ РѕРј СЃР»СѓС‡Р°Рµ, РµСЃР»Рё РїСЂРµРґС‹РґСѓС‰Р°СЏ SѓРїР°РєРѕРІРєР° РїСЂРёРЅРёРјР°Р »Р°СЃСЊ Р±РµР· РїРѕРіСЂРµС€РЅРѕСЃС‚РµР№. Р СЃР»Рё Р±С‹Р»Р° РїСЂРѕРїСѓС‰РµРЅР° 1 РеР»Рё Р±РѕР»РµРµ S‚Р°Р±Р»РµС‚РѕРє, Р±С‹Р»Р° СЂРІРѕС‚Р° РёР »Рё РґРёР°СЂРµСЏ, С‚Рѕ РїРµСЂРµСЂС‹РІ РґРµР»Р°С‚СЊ РЅРµ РЅСѓР¶РЅРѕ, РЅСѓР¶РЅРѕ РїСЂРѕСЃС‚Р * РЅР°С‡Р°С‚СЊ РїСЂРёРµРј РЅРѕРІРѕР№ РєРѕРЅРІР°Р»СЋС‚С‹ .

РџРµСЂРµС…РѕРґ СЃ РґСЂСѓРіРіРє… РїСЂРѕС‚РеРІРѕР·Р°С‡Р°С‚РѕС‡РЅС‹С… С‚Р°Р±Р»РµС‚РѕРє

РџСЂРё РїРµСЂРµС…РѕРґРµ SЃ РґСЂСѓРіРѕРіРѕ РІРІРґР° РїСЂРѕС‚РёРІРѕР·Р°С‡Р°С‚РѕС‡РЅС‹С… С‚Р° Р±Р»РµС‚РѕРє РЅР° RљРћРљ РЇСЂРеРЅР° РЅРµРѕР±С…РѕРґРјРјРѕ RїСЂРёРґРµСЂР¶РёРІР °С‚СЊСЃСЏ СЃР»РµРґСѓСЋС‰РёС… РїСЂР°РІРёР»:

Р СЃР»Рё РІС‹ РїСЂРеРЅРёРјР°Р»Рё РїСЂРѕС‚РёРІРѕР·Р°С‡Р°С‚РѕС‡РЅС‹Рµ S‚Р°Р±Р»РµС‚РєРё, РіРґРµ Р ±С‹Р»Рѕ 28 С ‚Р°Р±Р»РµС‚РѕРє, С‚Рѕ РІ СЌС‚РѕРј SЃР»СѓС‡Р°Рµ РЇСЂРеРЅСѓ РЅР°РґРѕ РЅР°С‡РёРЅР°С‚СЊ РїСЂРёР SРёРјР°С‚СЊ, РЅРµ РґРµР»Р°СЏ РїРµСЂРµСЂС‹РІ, С‚Рѕ РµСЃС‚СЊ СЃСЂР°Р·Сѓ РїРѕСЃР»Рµ 28 С‚Р°Р±Р»РµС‚РєРё.
Р СЃР»Рё Сѓ РїСЂРµРґС‹РґСѓС‰РµРіРѕ РїСЂРµРїР°СЂР°С‚Р° Р±С‹Р»Р° 21 С‚Р°Р±Р»РµС‚РєР° РІ РєРѕРЅРІР °Р»СЋС‚Рµ, С‚ Рѕ РЅСѓР¶РЅРѕ РЅР°С‡Р°С‚СЊ РїСЂРёРµРј РЇСЂРёРЅС‹ РїРѕСЃР»Рµ 7-РґРЅРµРІРЅРѕРіРѕ РїРµСЂРµСЂС ‹РІР°.

РџРµСЂРµС…РѕРґ Рє РчСЂРеРЅР° РїРѕСЃР»Рµ РїСЂРёРјРµРЅРµРЅРЅРІР°РіРіРёРЅР°Р»СЊРЅРѕРіРѕ РєРѕР»СЊС †Р° РёР»Рё РїР»Р°СЃС‚С‹СЂСЏ

РќР°С‡Р°Р»Рѕ РїСЂРеРµРјР° РЇСЂРёРЅР° СЃРѕРІРїР°РґР°РµС‚ СЃ РґРЅРµРј СѓРґР°Р»РµРЅРёСЏ РєРѕР»СЊС† Р° РёР»Рё СЃРЅСЏС‚РёСЏ РїР»Р°СЃС‚С‹СЂСЏ.

РџРµСЂРµС…РѕРґ Рє РЇСЂРёРЅР° СЃ Р’РњРЎ

РџРµСЂРІР°СЏ С‚Р°Р±Р»РµС‚РєР° РЇСЂРёРЅР° СЃРѕРІРїР°РґР°РµС‚ СЃ СѓРґР°Р»РµРЅРёРµРј Р’РњРЎ. РџСЂРё СЌС‚РѕРј РІ РїРµСЂРІС‹Рµ 7 РґРЅРµР№ РЅРµРѕР±С…РѕРґРёРјР° РґРѕРїРѕР»РЅРёС‚РµР»СЊРЅР°СЏ R єРѕРЅС‚СЂР°С†РµРїС†РёСЏ.

РџСЂРёРµРј РЇСЂРёРЅР° РїРѕСЃР»Рµ Р°Р±РѕСЂС‚Р°

РќР°С‡Р°Р»Рѕ РїСЂРёРµРјР° РЇСЂРёРЅР° СЃРѕРІРїР°РґР°РµС‚ СЃ РґРЅРµРј Р°Р±РѕСЂС‚Р°. Р' СЃР»СѓС‡Р°Рµ, РµСЃР»Рё СЃСЂРѕРє Р±РµСЂРµРјРµРЅРЅРѕСЃС‚Рё Р±С‹Р» Р±РѕР»РµРµ 12 РЅРµРґРµР»СЊ, C ‚Рѕ РѕЃРїРѕР»СЊР·РѕРІР°РЅРёРµ РїСЂРµРїР°СЂР°С ‚Р° РјРѕР¶РЅРѕ РЅР°С‡Р°С‚СЊ S‡РµСЂРµР· 3-4 РЅРµРґРµР»Рё РїРѕСЃР»Рµ Р°Р±РѕСЂС‚Р°.

RџСЂРёРјРµРЅРµРЅРёРµ RЇСЂРёРЅС‹ RїРѕСЃР»Рµ SЂРѕРґРѕРІ

RџСЂРёРµРј RїСЂРµРїР°СЂР°С‚Р° RїРѕСЃР»Рµ SЂРѕРґРѕРІ RјРѕР¶РЅРѕ RЅР°С‡Р°С‚СЊ S‡РµСЂРµР· 21-28 РґРЅРµР№, РµСЃР»Рё РІС‹ РЅРµ РєРѕСЂРјРёС‚Рµ РіСЂСѓРґСЊСЋ. Р СЃР»Рё РїСЂРёРµРј РЇСЂРеРЅС‹ РЅР°С‡Р°С‚ РїРѕР·Р¶Рµ 28 РґРЅРµР№, С‚Рѕ РЅРµРѕР±С…РѕРґРёРјР° РґРѕР їРѕР»РЅРёС‚РµР»СЊРЅР°СЏ Р±Р°СЂСЊРµСЂРЅР°СЏ РєРѕРЅС ‚СЂР°С†РµРїС†РёСЏ РІ С‚РµС‡РµРЅРёРµ 1 РЅРµРґРµР»Рё. RќР°С‡РёРЅР°С‚СЊ RїСЂРеРµРј RЇСЂРёРЅС‹ RјРѕР¶РЅРѕ S‚РѕР»СЊРєРѕ RІ S‚РѕРј SЃР»СѓС‡Р°Рµ, РєРѕ РіРґР° Р¶РµРЅС‰РёРЅР° СѓРІРµСЂРµРЅР° РІ РѕС‚СЃСѓС‚СЃС‚РІРёРё Р±РµСЂРµРјРµРЅРЅРѕСЃС‚Рё. R”R”SЏ RєRѕSЂRјSЏS‰РёС… R¶РµРЅС‰РёРЅ RљРћРљ RSRµ RїРѕРґС…РѕРґСЏС‚ РІ RєР°С‡РµСЃС‚РІРµ RєРѕR ЅС‚СЂР°С†РµРїС†РеРё, С‚Р°Рє РєР°Рє СОССЃС‚СЂРѕРіРµРЅС‹ ... R”R”SЏ RєRѕSЂRјSЏS‰РёС… СЃСѓС‰РµСЃС‚РІСѓСЋС‚ S‡РёСЃС‚РѕРїСЂРѕРіРµСЃС‚РёРЅРѕРІС‹Рµ Rї СЂРµРїР°СЂР°С‚С‹.

Р§С‚Рѕ РїСЂРµРґРїСЂРёРЅСЏС‚СЊ РІ СЃР»СѓС‡Р°Рµ РїСЂРѕРїСѓСЃРєР° РЇСЂРёРЅС‹?

РљРѕРЅС‚СЂР°С†РµРїС‚РёРІРЅС‹Р№ СЌС„С„РµРєС‚ РїСЂРµРїР°СЂР°С‚Р° РЅРµ SЃРЅРёР¶Р°РµС‚СЃС Џ РµСЃР»Рё РїСЂРѕРёР·РѕС€Р»Р° Р·Р°РґРµСЂР ¶РєР° РІ РїСЂРёРµРјРµ РїСЂРµРїР°СЂР°С‚Р° РЅРµ Р±РѕР»РµРµ 12 С‡Р°СЃРѕРІ. РќСѓР¶РЅРѕ РІС‹РїРёС‚СЊ РїСЂРѕРїСѓС‰РµРЅРЅСѓСЋ S‚Р°Р±Р»РµС‚РєСѓ. RћS‡РµСЂРµРґРЅСѓСЋ S‚Р°Р±Р»РµС‚РєСѓ РІС‹РїРёС‚СЊ RїРѕ RїР»Р°РЅСѓ. R' РґР°РЅРЅРѕРј SЃР»СѓС‡Р°Рµ РґРѕРїРѕР»РЅРѕР»РЅРёС‚РµР»СЊРЅР°СЏ RєРѕРЅС‚СЂР°С†РµРїС†РёСЏ РЅРµ РЅС ѓР¶РЅР°. Р СЃР»Рё РїСЂРѕРїСѓСЃРє СЃРѕСЃС‚Р°РІРёР» Р±РѕР»РµРµ 12 С‡Р°СЃРѕРІ, С‚Рѕ РґР°Р»СЊРЅРµР№С€Р°СЏ С‚Р°Р єС‚РёРєР° Р·Р°РІРІРёСЃРёС ‚ РѕС‚ С‚РѕРіРѕ РєР°РєР°СЏ РѕјРµРЅРЅРѕ S‚Р°Р±Р»РµС‚РєР° РїРѕ СЃС‡РµС‚Сѓ Р±С‹Р»Р° РїСЂРѕРїS ѓС‰РµРЅР°. Р СЃР»Рё СЌС‚Рѕ СЃ 1 РїРѕ 7 С‚Р°Р±Р»РµС‚РєРё, С‚Рѕ РЅСѓР¶РЅРѕ РІС‹РїРёС‚СЊ S‚Р°Р±Р»РµС‚РєСѓ, Рє Р°Рє С ‚РѕР»СЊРєРѕ РІСЃРїРѕРјРЅРёР»Рё Рѕ РїСЂРѕРїСѓСЃРєРµ Рё РґР°Р»РµРµ RїРѕ RѕР±С‹С‡РЅРѕР№ СЃС…РµРј Рµ. R' SЌS‚РѕРј SЃР»СѓС‡Р°Рµ РЅРµРѕР±С…РѕРґРёРјР° РґРѕРїРѕР»РЅРёС‚РµР»СЊРЅР°СЏ РєРѕРЅС‚СЂР°С†Рµ РїС†РёСЏ 7 РґРЅРµР№. Р СЃР»Рё СЌС‚Рѕ СЃ 8 РїРѕ 14 С‚Р°Р±Р»РµС‚РєРё, СЃС…РµРјР° РґРµР№СЃС‚РІРёР№ РєР°Рє РІ РїСЂРµРґС‹РґС ѓС‰РµРј СЃР»СѓС‡Р°Рµ, РЅРѕ РІ РґРѕРїРѕР»РЅРёС‚РµР»СЊРЅРѕР№ РєРѕРЅС‚СЂР°С†РµРїС†РеРё РЅРµС‚ РЅРµРѕР±С…РѕРґРёРјРѕS ЃС‚Рё, РµСЃР»Рё РґРѕ СЌС‚РѕРіРѕ РЅРµ Р±С‹Р»Рѕ РїСЂРѕРїСѓСЃРєРѕРІ РІ РїСЂРёРµРјРµ. R' RїSЂRѕS‚РёРІРЅРѕРј SЃР»СѓС‡Р°Рµ РЅСѓР¶РЅР° РґРѕРїРѕР»РЅРёС‚РµР»СЊРЅР°СЏ RєРѕРЅС‚СЂР°С†Р µРїС†РёСЏ 7 РґРЅРµР№. Р СЃР»Рё СЌС‚Рѕ СЃ 15 РїРѕ 21 С‚Р°Р±Р»РµС‚РєРё, С‚Рѕ РЅСѓР¶РЅРѕ РІС‹РїРёС‚СЊ РїСЂРѕїСѓС‰РµРЅ РЅСѓСЋ С‚Р°Р±Р»РµС‚РєСѓ, РєР °Рє С‚РѕР»СЊРєРѕ РІСЃРїРѕРјРЅРёР»Рѕ РїСЂРѕРїСѓСЃРєРµ, РґР°Р»РµРµ RїРѕ РѕР±С‹С‡РЅРѕР№ СЃС…Рµ РјРµ, РїРѕ РѕРєРѕРЅС‡Р°РЅРёРё РєРѕРЅРІР°Р»СЋС‚С‹ РЅСѓР¶РЅРѕ РЅР° S‡Р°С‚СЊ РЅРѕРІСѓСЋ Р±РµР· 7-РґРЅРµРІРЅРѕРіРѕ РїРµСЂРµСЂС‹РІР°. Р СЃР»Рё РґРѕ СЌС‚РѕРіРѕ РїСЂРѕРїСѓСЃРєР° РІ С‚РµС‡РµРЅРёРµ 7 РґРЅРµР№ РїРѕРіСЂРµС€РЅРѕСЃС‚Р е РІ РїСЂРёРµРјРµ РїСЂРµРїР°СЂР°С‚Р° РЅРµ Р±С‹Р»Рѕ, С‚Рѕ РЅРµС‚ РЅРµРѕР± S…РѕРґРёРјРѕСЃС‚РІ РґРѕРїРѕР»РЅРёС‚РµР»СЊРЅРѕР№ РєРѕРЅС‚СЂР°С†РµРїС†РеРё, РІ РїСЂРѕС‚Рё RІРЅРѕРј SЃР»СѓС‡Р°Рµ – 7 РґРЅРµР№ РїСЃРїРѕР»СЊР·РѕРІР°С‚СЊ РїСЂРµР· РµСЂРІР°С‚РёРІ.

R SЃР»Рё РїСЂРѕРїСѓС‰РµРЅРѕ RЅРµСЃРєРѕР»СЊРєРѕ S‚Р°Р±Р»РµС‚РѕРє

R SЃР»Рё РїСЂРѕРїСѓС‰РµРЅРѕ 2 S‚Р°Р±Р»РµС‚РєРё RїРѕРґСЂСЏРґ, S‚Рѕ РЅСѓР¶РЅРѕ RїРѕСЃС‚СѓРїРё S‚СЊ SЃР»РµРґСѓСЋС‰РёРј РѕР±СЂР°Р·РѕРј: Р СЃР»Рё СЌС ‚Рѕ СЃ 1 РїРѕ 14 РґРЅРё, С‚Рѕ РЅСѓР¶РЅРѕ РїСЂРёРЅСЏС‚СЊ 2 С‚Р°Р±Р»РµС‚РєРё Рё РµС‰С' 2 С‚Р°Р±Р»Р µС‚РєРё РЅР° СЃР» РµРґСѓСЋС‰РёР№ РґРµРЅСЊ. Р”Р°Р”РµРµ РїРѕ РѕР±С‹С‡РЅРѕР№ СЃС…РµРјРµ. РџСЂРё СЌС‚РѕРј РЅСѓР¶РЅРѕ РџСЃРїРѕР»СЊР·РѕРІР°С‚СЊ 7 РґРЅРµР№ Р±Р°СЂСЊРµСЂРЅСѓСЋ РєРѕРЅС‚С ЂР°С†РµРїС†РёСЋ. Р СЃР»Рё РїСЂРѕРїСѓСЃРє РІС‹РїР°Р» РЅР° 15-21 РґРЅРё, С‚Рѕ РµСЃС‚СЊ 2 РІР°СЂРеР°РЅС‚Р°: 1) РґРѕРїРёС ‚СЊ РЇСЂРёРЅСѓ РґРѕ РєРѕРЅС†Р° РїРѕ 1 С‚Р °Р±Р»РµС‚РєРµ 1 СЂР°Р· РІ РґРµРЅСЊ Рё, РЅРµ РґРµР»Р°СЏ 7-РґРЅРµРІРЅС‹Р№ РїРµСЂРµСЂС‹РІ‡, РЅР°С‡Р° S‚СЊ РЅРѕРІСѓСЋ SѓРїР°РєРѕРІРєСѓ, РёСЃРїРѕР»СЊР ·СѓСЏ РґРѕРїРѕР»РЅРёС‚РµР»СЊРЅСѓСЋ РєРѕРЅС‚СЂР°С†РµРїС†РёСЋ 7 РґРЅРµР№; 2). * РѕР±С‹С‡РЅРѕР№ СЃС… РµРјРµ, РїСЂРµРґРѕС…СЂР°РЅСЏСЏСЃСЊ РґРѕРїРѕР»РЅРёС‚РµР»СЊРЅРѕ. R SЃР»Рё РїСЂРѕРїСѓС‰РµРЅРѕ 3 С‚Р°Р±Р»РµС‚РєРё, РЅР°С‡РЅРёС‚Рµ RЅРѕРІСѓСЋ SѓRїР°РєРѕРІРєСѓ R їРѕ РѕР±С‹С‡РЅРѕР№ СЃС…РµРјРµ, РёСЃРїРѕР»СЊР·СѓСЏ 7 РґРЅРµР№ Р±Р°СЂСЊРµСЂРЅСѓСЋ RєРѕРЅС‚СЂР°С†РµРїС†РёСЋ. РџРѕСЃР»Рµ РїСЂРѕРїСѓСЃРєР° С‚Р°Р±Р»РµС‚РѕРє С‡РµСЂРµР· 1-2 РґРЅСЏ РјРѕРіСѓС‚ РїРѕСЏРІРёС‚ СЊСЃСЏ РјР°Р¶СѓС‰РёРµ РІС‹РґРµР»РµРЅРёСЏ. RS‚Рѕ РЅРѕСЂРјР°Р»СЊРЅРѕ Рё РЅРµ РѕРїР°СЃРЅРѕ.

Р§С‚Рѕ РјРѕР¶РµС‚ СЃРЅРёР·РёС‚СЊ СЌС„С„РµРєС‚РёРІРЅРѕСЃС‚СЊ РЇСЂРёРЅС‹?

R'РѕР»СЊС€РеРµ РґРѕР·С‹ Р°Р»РєРѕРіРѕР»СЏ
Р”РёР°СЂРµСЏ
Р РІРѕС‚Р°
РџСЂРёРµРј РЅРµРєРѕС‚РѕСЂС‹С… Р»РµРєР°СЂСЃС‚РІРµРЅРЅС‹С… РїСЂРµРїР°СЂР°С‚РѕРІ

RљР°Рє РѕС‚СЃСЂРѕС‡РёС‚СЊ RјРµРЅСЃС‚СЂСѓР°С†РёСЋ СЃ RїRѕRјРѕС‰СЊСЋ РљРјРёРЅС‹?

РќР°С‡РЅРёС‚Рµ РїСЂРеРµРј РѕС‡РµСЂРµРґРЅРѕРіРѕ Р±Р»РёСЃС‚РµСЂР° Р±РµР· 7-РґРЅРµРІРЅРѕРіРѕ R їРµСЂРµСЂС‹РІР°. РћС‚СЃСЂРѕС‡РёС‚СЊ РјРµРЅСЃС‚СЂСѓР°С†РёСЋ СЃ RїРѕРјРѕС‰СЊСЋ РїСЂРёРµРјР° РґР°РхРЅРѕРіР ѕ РїСЂРµРїР°СЂР°С‚Р° РјРѕР¶РЅРѕ S‚РѕР»СЊРєРѕ РІ СЃР»СѓС‡Р°Рµ, РµСЃР» Рё РІС‹ РїСЂРёРЅРёРјР°Р»Рё РЇСЂРёРЅСѓ РІ РїСЂРµРґС‹РґСѓС‰РµРј S†РёРєР»Рµ.

R'РµСЂРµРјРµРЅРЅРѕСЃС‚СЊ РЅР° С„РѕРЅРµ РЇСЂРёРЅС‹

РЇСЂРёРЅР° – СЌС‚Рѕ РїСЂРµРїР°СЂР°С‚ СЃ РІС‹СЃРѕРєРѕР№ СЌС„С„РµРєС‚РёРІРЅРѕСЃС‚СЊСЋ, РѕР ґРЅР°РєРѕ Р±РµСЂРµРјРµРЅРЅРѕСЃС‚СЊ РІСЃРµ Р¶Рµ РјРѕР¶РµС‚ РЅР°СЃС‚СѓРїРёС‚СЊ РїСЂРё РїРѕРіСЂРµС€РЅРѕСЃС‚СЏС… РІ РїСЂРјРјРµРЅРµРЅРёРё. Р СЃР»Рё Р±РµСЂРµРјРµРЅРЅРѕСЃС‚СЊ РЅР°СЃС‚СѓРїРёР»Р°, СЃР»РµРґСѓРµС‚ РїСЂРµРєСЂР°С‚РёС‚СЊ R їСЂРёРµРј S‚Р°Р±Р»РµС‚РѕРє. РІРѕРєР°Р·Р°РЅРѕ, С‡С‚Рѕ РїСЂРµРїР°СЂР°С‚ РЅРµ РѕРєР°Р·С‹РІР°РµС‚ РЅРµРіР°С‚РёРІРЅРѕРіРѕ РІ R»РёСЏРЅРёРµ РЅР° РїР»РѕРґ Рё S‚РµС‡ РµРЅРёРµ Р±РµСЂРµРјРµРЅРЅРѕСЃС‚Рё, RїРѕСЌС‚РѕРјСѓ RїСЂРё R¶РµР»Р°РЅРёРё RјРѕР¶РЅРѕ СЃРѕС…СЂР° РЅСЏС‚СЊ Р±РµСЂРµРјРµРЅРЅРѕСЃС‚СЊ.

R SЃР»Рё РїСЂРµРґСЃС‚РѕРёС‚ RїR»Р°РЅРѕРІРѕРµ RѕРїРµСЂР°С‚РёРІРЅРѕРµ R»РµС‡РµРЅРёРµ

R SЃР»Рё РїСЂРµРґСЃС‚РѕРёС‚ RїR»Р°РЅРѕРІРѕРµ RѕРїРµСЂР°С‚РёРІРЅРѕРµ R»РµС‡РµРЅРёРµ, СЃР»РµРґ СѓРµС‚ РїСЂРµРєСЂР°С‚РёС‚СЊ РїСЂРёРµРј РЇСЂРёРЅС‹ Р·Р° 4 РЅРµРґРµР»Рё РґРѕ РѕРїРµСЂР°С †RyoRyo. RS‚Рѕ РЅСѓР¶РЅРѕ РґР»СЏ СЃРЅРёР¶РµРЅРёСЏ СЂРёСЃРєР° РѕСЃР»РѕР¶РЅРµРЅРёР№ РІ РІРІрґРµ С‚СЂРѕРјР± РѕР·Р° СЃРѕСЃСѓРґРѕРІ. R' SЃР»СѓС‡Р°Рµ SЃСЂРѕС‡РЅРѕР№ РѕРїРµСЂР°С†РеРё РЅРµРѕР±С…РѕРґРјРѕ RїСЂРµРґСѓРїСЂРµРґРёС‚ SЊ S…РёСЂСѓСЂРіР° Рѕ РїСЂРёРµРјРµ RљРћРљ.

Р§Р°СЃС‚РѕС‚Р° РїРѕСЃРµС‰РµРЅРёСЏ РіРЅРµРєРѕР»РѕРіР° РїСЂРё РїСЂРёРµРјРµ РЇСЂРёРЅС‹

РџРѕСЃРµС‰Р°С‚СЊ РіРѕРЅРµРєРѕР»РѕРіР° РЅРµРѕР±С…РѕРґРјРјРѕ 1 СЂР°Р· РІ РіРѕРґ, РґР°Р¶Рµ РµСЃР»Рё РЅРµС‚ РЅРеРєР°РєРёС… Р¶Р°Р»РѕР±.

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Yarina: instructions for use

Each yarina tablet contains: □ Active substances ethinyl estradiol 0.03 mg drospirenon 3 mg □ excipients of lactose monohydrate, corn starch, corn -bonded corn, magnium K25, magnesium stearate, gydro -mopylmethyl cellulose), macrogol 6000, talco (macrogol ( Magnesium hydrosilate), titanium dioxide (E 171), iron (II) oxide (E 172).

The tablets are film-coated, round, biconvex, light yellow in color, with a hexagon engraved on one side with the letters “DO” inside.

pharmachologic effect

Yarina is a low-dose monophasic oral combined estrogen-progestogen contraceptive drug.

Indications for use

Contraception (prevention of unwanted pregnancy).

Contraindications

Yarina should not be used if you have any of the conditions/diseases listed below.

Thrombosis (venous and arterial) and thromboembolism currently or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke), cerebrovascular disorders.

Conditions preceding thrombosis (including transient ischemic attacks, angina) currently or in history.

Migraine with focal neurological symptoms, current or history

Diabetes mellitus with vascular complications.

Pancreatitis with severe hypertriglyceridemia, currently or in history.

Liver failure and severe liver disease (until liver tests normalize)

Liver tumors (benign or malignant) currently or in history.

Severe and/or acute renal failure.

Identified hormone-dependent malignant diseases (including genital organs or mammary glands) or suspicion of them.

Bleeding from the vagina of unknown origin.

Pregnancy or suspicion of it.

Breastfeeding period.

Hypersensitivity to any of the components of the drug Yarina

Pregnancy and lactation

Taking combined oral contraceptives may reduce the amount of breast milk and change its composition, so their use is not recommended until you stop breastfeeding.

Directions for use and doses

Taking pills from Yarina’s first package

When no hormonal contraceptive was used in the previous month

When switching from other combined oral contraceptives, vaginal ring or contraceptive patch

Taking Yarina should begin on the day the vaginal ring or patch is removed, but no later than the day when a new ring is to be inserted or a new patch is applied.

When switching from oral contraceptives containing only gestagen (mini-pills)

When switching from an injectable contraceptive, an implant, or from a progestogen-releasing intrauterine contraceptive (Mirena)

After childbirth

After spontaneous or medical abortion in the first trimester

pregnancy

Taking missed pills

If the delay in taking the next pill is less than 12 hours,

Yarina's contraceptive effect remains. Take the tablet as soon as

remember this. Take the next tablet at your usual time.

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

More than one tablet is forgotten from the pack. Consult your doctor.

One tablet missed in the first week of taking the drug

One tablet was missed in the second week of taking the drug

One tablet was missed in the third week of taking the drug

2. Stop taking the pills from the current pack, take a break of 7 days or less (including the day you missed the pills), and then start taking the pills from the new pack.

Using this regimen, you can always start taking the next pack of tablets on the day of the week that you usually do.

If you do not get your expected period after taking the pills, you may be pregnant. Consult your doctor before starting a new pack.

Delaying the onset of menstruation

Changing the day your period starts

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

The drug Yarina is indicated only after the onset of menarche. Available data do not suggest dose adjustment in this group of patients.

Elderly patients

Not applicable. Yarina is not indicated after menopause.

Patients with liver disorders

Yarina is contraindicated in women with severe liver disease until liver function tests return to normal. See also section "Contraindications".

Patients with kidney problems

Yarina is contraindicated in women with severe renal failure or acute renal failure. See also section "Contraindications".

Side effect

Serious unwanted effects:

Common undesirable effects (more than 1/100 and less than 1/10):

□ mood swings, depression/low mood

□ decrease or loss of libido (decreased or loss of sexual desire)

□ migraine

□ nausea

□ pain in the mammary glands, irregular uterine bleeding (“breakthrough” bleeding), bleeding from the genital tract (bleeding from the vagina) of unspecified origin

Rare undesirable effects (more than 1/10000 and less than 1/1000):

□ venous or arterial thromboembolism*

□ *Approximate frequency based on the results of epidemiological studies covering the group of combined oral contraceptives. The frequency bordered on very rare.

□ “Venous or arterial thromboembolism” includes the following nosological units: occlusion of peripheral deep veins, thrombosis and

embolism/pulmonary vascular occlusion, thrombosis, embolism and infarction/myocardial infarction/cerebral infarction and stroke not defined as hemorrhagic.

Additional Information:

Other states

□ Erythema nodosum.

□ Women with hypertriglyceridemia (increased risk of pancreatitis while taking combined oral contraceptives).

□ Increased blood pressure.

□ In women with hereditary angioedema, estrogen may cause or worsen symptoms.

□ Liver dysfunction.

□ Impaired glucose tolerance or effects on insulin resistance.

□ Crohn's disease, ulcerative colitis.

□ Chloasma.

□ Hypersensitivity (including symptoms such as rash, urticaria). Interaction

Interaction of oral contraceptives with other drugs

agents (inducers of microsomal liver enzymes, some antibiotics)

can lead to

breakthrough bleeding and/or decreased contraceptive effectiveness (see “Interaction with other drugs”).

Overdose

In case of overdose, consult a doctor.

Interaction with other drugs

Features of application

The following warnings regarding the use of other combined oral contraceptives should also be taken into account when using Yarina.

□ Thrombosis

The results of epidemiological studies indicate a relationship between the use of combined oral

The overall risk of VTE in patients taking low-dose combined oral contraceptives (

In very rare cases, venous or arterial thromboembolism can cause serious functional impairment, be life-threatening, or be fatal.

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

Very rarely, when using combined oral contraceptives, thrombosis of other blood vessels occurs, for example, hepatic, mesenteric, renal, cerebral veins and arteries or retinal vessels.

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

□ with age;

□ in smokers (with increasing number of cigarettes or increasing age, the risk increases, especially in women over 35 years old);

in the presence of:

□ obesity (body mass index more than 30 kg/m2);

□ dislipoproteinemia;

□ arterial hypertension;

□ migraine;

□ heart valve diseases;

□ atrial fibrillation;

two weeks after the end of immobilization.

□ Tumors

The above mentioned tumors can be life threatening or fatal.

□ Reduced efficiency

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

□ Women with a tendency to chloasma should avoid prolonged exposure to the sun and exposure to ultraviolet radiation while taking the drug.

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

□ During the use of combined oral contraceptives, cases of Crohn's disease and ulcerative colitis, as well as worsening of endogenous depression and epilepsy, have been described.

Insufficient control of the menstrual cycle

while taking pills or not taking other medications at the same time, then the likelihood of pregnancy is low. Continue taking Yarina as usual.

If there are no two menstrual bleeding in a row, consult a doctor immediately. Do not start taking the next pack until your doctor has ruled out pregnancy.

Impact on the ability to drive a car and operate machinery

Not found.

When to Consult a Doctor Regular Checkups

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

Consult your doctor as soon as possible:

□ if you have any health changes, especially any of the conditions listed in this leaflet (see also “Contraindications” and “Use with caution”);

□ with local compaction in the mammary gland;

□ if you are going to use other medications (see also “Interactions with other medications”);

□ if prolonged immobility is expected (for example, a leg is in a cast), hospitalization or surgery is planned (consult your doctor at least 4 - 6 weeks in advance);

□ if unusual heavy vaginal bleeding occurs;

□ if you forgot to take a pill in the first week of taking the pack and had sexual intercourse seven days or less before;

□ you have not had your regular menstruation twice in a row or you suspect that

that you are pregnant (do not start taking the next pack until you have consulted your doctor).

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

Precautionary measures

Hereditary angioedema

Hypertriglyceride emia

Liver diseases

Postpartum period

Release form

Storage conditions

Store at a temperature not exceeding 25 °C.

Keep out of the reach of children.

Best before date

3 years. Do not use after the expiration date!

Conditions for dispensing from pharmacies

On prescription.

Yarina analogues, synonyms and group drugs

Midiana
Dimia
Janine
Novinet
Rigevidon 21 + 7
Lindinet 20
Lindinet 30

Self-medication may be harmful to your health. You should consult your doctor and also read the instructions before use.

apteka.103.by

Yarina

Composition and release form Yarina is available in the form of film-coated tablets. The active substances included in the drug are ethinyl estradiol in a dosage of 30 mg. and Drospirenone at a dosage of 3 mg. One package of the drug contains 21 tablets. How does Yarina work? Yarina's contraceptive is a combined drug, as it contains two sex hormones - estrogen and gestagen. In addition, the product is low-dose (low doses of hormones) and monophasic (all tablets contain the same amount of hormones). Yarina’s ability to protect against pregnancy is based on two mechanisms - suppression of ovulation (ovum maturation) and a change in the properties of the secretion (mucus) located in the cervix. Thick cervical mucus becomes an obstacle to sperm penetration. In addition, taking Yarina helps to regulate the menstrual cycle (if it is irregular). Pain during menstruation decreases, bleeding becomes less intense (this fact reduces the risk of developing iron deficiency anemia). Other beneficial effects of Yarina are antimineralocorticoid and antiandrogenic effects. The hormone Drospirenone has this effect - it reduces fluid retention in the body, reduces swelling, so that body weight does not increase. The antiandrogenic effect is the ability of the drug to reduce the symptoms of acne (acne) and regulate the production of sebum in the skin and hair (reduces seborrhea). Indications for use

The main indication for the use of tablets is to prevent unwanted pregnancy.

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