Yarina course. Yarina birth control pills - composition, mechanism of action, side effects, analogues and price. Yarina tablets, instructions for use

Nowadays, oral contraceptives occupy a leading position among means of preventing unwanted pregnancy. In young and middle age, up to 35 years, for patients with a “boyish” constitution (tall, thin build, small breasts), gynecologists recommend taking low-dose hormonal drugs with antiandrogenic effects: Diane, Silhouette, Janine, Tri-Mercy, Jess Plus, Lindinet . This list also includes contraceptives Yarina, reviews from doctors, pros, cons allow a woman to assess the possible risks of long-term use of this OC.

And they undoubtedly exist, since violent interference in the processes occurring in the female body is fraught with long-term negative consequences. For some – mild and insignificant changes, and for others – serious and irreversible. After all, hormone therapy “turns off” the ovaries, changes the thickness of the inner mucous membrane of the uterus (endometrium), the viscosity of cervical mucus, and even affects the functioning of certain parts of the brain.

Yarina - tablets with therapeutic and cosmetic effects

Since the appearance of pharmacological products on the market in 2001 in the USA, it was discovered that Yasmin, in Russia the medicine is called Yarina (tablets), not only prevents ovulation, but also perfectly solves skin problems, in particular acne, and hair ( increased greasiness, hair loss). The creators initially did not focus on such properties of the main active ingredient, drospirenone. It later turned out that the new progestin also promotes weight loss. Tempting bonuses and a wide advertising campaign have led to an increase in the popularity of Yarin; the use of the drug, it must be admitted, fully lives up to expectations in terms of improving appearance.

In addition, it, like other OCs, helps normalize the menstrual cycle, relieves pain during menstrual periods, heavy and prolonged bleeding, and relieves symptoms of PMS. This is achieved due to the state of artificial pregnancy, which, by the way, lasts not 9 months, but several years, during the entire period of taking Yarin. The use of the drug in this regard significantly increases the load on the heart, blood vessels, kidneys, and liver. A weak body may not be able to cope with such a burden. “Respond” with pancreatitis, cholecystitis, varicose veins, tumors, including malignant ones, strokes, heart attacks and other equally unpleasant sores.

Therefore, before prescribing this drug, the responsible doctor will not limit himself to a routine examination, but will refer the patient for a consultation with an ophthalmologist, mammologist, and an ultrasound scan of the mammary glands and pelvic organs. For blood tests, biochemical, lipid, hormones, coagulogram. Inquire about health, established diagnoses, bad habits and family heredity. She will explain in an accessible form why Yarina is not suitable for her or, on the contrary, why she is shown. Reviews from doctors, the pros and cons of therapy also need to be discussed in detail. The final decision still falls on the shoulders of the woman herself; different opinions and reliable information will obviously not be superfluous in this case.

Yarina: reviews from gynecologists

Yulia Sergeevna, practicing women's doctor

I believe that fears regarding oral contraceptives, third- and fourth-generation pills, are definitely exaggerated. These OKs have much more advantages than disadvantages. And they are prescribed not only for protection. For example, with the help of Yarin, dysmenorrhea, endometriosis, and polycystic ovary syndrome are successfully treated. Studies have confirmed that thanks to this drug it is possible to avoid inflammatory and oncological diseases of the genital area, mastopathy, atheroskerosis, osteoporosis, which overtakes women in old age. Significantly reduce the likelihood of ectopic pregnancy.

The instructions for use indicate the presence of contraindications and possible side effects for Yarin. But antibiotics also have them, but this is not a reason to refuse the medicine prescribed by the doctor. In order not to be afraid in vain, it is enough to undergo the necessary examinations and regularly see a specialist.

Pavel Valentinov, obstetrician-gynecologist

Unfortunately, in our country there is little demand for hormonal contraceptives; only about 10% of women use them. Meanwhile, in America and Europe the numbers are much higher – more than 50%. Jess Plus, Yarina receive mostly good reviews; they have proven themselves well in long-term use (several years). By the way, according to the recommendations of the World Health Organization, you should start taking OCs 3-4 months after the first menstruation, and continue until the onset of menopause (a year after menopause). Naturally, with breaks during pregnancy and breastfeeding. And always as prescribed and under the supervision of the attending physician.

Yarina: reviews from those who took

Olga, 28 years old

Whatever they say, I personally like Yarina. I experienced the reviews of doctors, the pros and cons. On the positive side: my periods are painless, and before I swallowed pills in batches, and sometimes even gave injections. I completely forgot about the migraine. She looked better in appearance: she lost 5 kg, her skin cleared, her hair became thicker. However, I understand that you have to “pay” for convenience (first of all, for protection with a 100% guarantee). For me, these are regular, once every 3-4 months, visits to the gynecologist. On his advice, I periodically take medications to support the liver, vitamin and mineral complexes. I'm trying to do it right

In the sexual relations of partners, one of the leading places is occupied by the correct selection of contraceptives. The most popular are tablets for internal use. Taking them correctly allows you not only to protect yourself from unwanted pregnancy, but also to improve your health. Many specialists recommend the drug “Yarina Plus” to their patients. Reviews show that the tablets reliably protect against unwanted conception. However, they have many contraindications. The medicine should be used strictly as prescribed by the doctor.

Release form of the drug and its composition

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

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

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

Indications

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

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

Contraindications

The medicine is hormonal in nature. This is definitely worth taking into account. The tablets can only be prescribed to adult women. The drug has many contraindications. Reviews should be studied before using the drug "Yarina Plus". And pregnancy and lactation are conditions in which hormonal therapy is contraindicated, this should be understood.

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

special instructions

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

Benign tumors may develop while taking hormonal contraceptives. Neoplasms require increased attention from doctors. If left untreated, the cyst can develop into a malignant one. In rare cases, taking pills triggers the development of liver tumors, which can interfere with intra-abdominal circulation.

Dosage

It is worth taking the drug “Yarina Plus” correctly. Instructions for use, reviews from doctors and patients - all this is important to study before starting therapy. Particular attention should be paid to dosage. If taken irregularly, the product will not give good results. The drug is taken orally according to the order described on the package. It is advisable to do this at the same time every day. Take the drug with a small amount of liquid.

Taking the drug begins on the first day of the cycle (with the arrival of menstruation). The course lasts 28 days. After completing one package, you should start taking the next one. You cannot take breaks, otherwise the contraceptive effect will not be fully ensured. It is worth taking Yarina Plus contraceptives regularly. Reviews from patients show that pregnancy can occur even if you forget to take the pill just once.

If vomiting or diarrhea occurs within 4 hours after taking the contraceptive, absorption of the main component may be incomplete. To avoid unwanted pregnancy, you should repeat the drug or use other precautions.

Overdose

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

If an overdose occurs, the doctor must choose another method of protection against unwanted pregnancy. There are many contraceptive methods that can be used regardless of your menstrual cycle.

Side effects

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

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

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

Drug interactions

The instructions for use for the drug “Yarina Plus” should be carefully studied. Reviews from doctors show that the combined use of hormonal contraceptives with other medications can lead to breakthrough uterine bleeding. Therefore, a woman must inform her gynecologist about medications that must be taken at the same time. Any of them can reduce the effectiveness of hormonal contraceptives.

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

Yarina - a new description of the drug, you can see contraindications, side effects, prices in pharmacies for Yarina. Reviews about Yarina -

Low-dose monophasic oral combined estrogen-progestin contraceptive drug
Drug: YARINA®
Active substance of the drug: drospirenone, ethinylestradiol
ATX coding: G03AA12
KFG: Monophasic oral contraceptive with antiandrogenic properties
Registration number: P No. 013882/01
Registration date: 04/02/08
Owner reg. cert.: SCHERING AG (Germany)

Yarina release form, drug packaging and composition.

Light yellow film-coated tablets, engraved on one side with the letters “DO” in a hexagon.

1 tab.
ethinylestradiol
30 mcg
drospirenone
3 mg

Excipients: lactose monohydrate, corn starch, pregelatinized corn starch, magnesium stearate, povidone K25.

Shell composition: hypromellose (hydroxypropyl methylcellulose), macrogol 6000, talc (magnesium hydrosilicate), titanium dioxide (E171), iron (II) oxide (E172).

21 pcs. - blisters (1) - cardboard packs.
21 pcs. - blisters (3) - cardboard packs.

The description of the drug is based on the officially approved instructions for use.

Pharmacological action of Yarin

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.

Pharmacokinetics of the drug.

Drospirenone

Suction

After oral administration, drospirenone is rapidly and almost completely absorbed from the gastrointestinal tract. After a single dose of the drug, the Cmax of drospirenone in plasma is reached after 1-2 hours and is 37 ng/ml. Bioavailability ranges from 76 to 85%. Food intake does not affect bioavailability.

Distribution

After oral administration, a two-phase decrease in the concentration of the drug in the serum is observed, with T1/2 in the -phase of 1.6±0.7 hours and T1/2 in the -phase of 27.0±7.5 hours, respectively. Drospirenone binds to serum albumin and does not bind to SHBG or corticosteroid binding globulin (CBG). The estradiol-induced increase in SHBG does not affect the binding of drospirenone to plasma proteins. The average apparent Vd is 3.7±1.2 l/kg.

With continuous use, Cssmax is achieved between 4 and 7 days and is approximately 60 ng/ml. A further increase in concentration is observed after approximately 1-6 cycles of taking the drug; no further increase in concentration is observed.

Metabolism

Drospirenone is biotransformed in the body to form metabolites, most of which are acidic forms of drospirenone, derivatives with an open lactone ring and 4,5-dihydro-drospirenone-3-sulfate, which are formed without the participation of isoenzymes of the cytochrome P450 system. According to in vitro studies, drospirenone is metabolized in small quantities with the participation of the CYP3A4 isoenzyme.

Removal

The clearance of drospirenone from blood serum is 1.5±0.2 ml/min/kg. Unchanged, it is excreted only in trace amounts; in the form of metabolites, it is excreted in feces and urine in a ratio of approximately 1.2-1.4. T1/2 for metabolites is approximately 40 hours.

Ethinyl estradiol

Suction

After taking the drug orally, ethinyl estradiol is quickly and completely absorbed from the gastrointestinal tract. Moreover, after a single dose of 30 mcg, Cmax in plasma is reached after 1-2 hours and is about 100 pg/ml. Ethinyl estradiol undergoes a significant first-pass effect through the liver with high interindividual variability. Absolute bioavailability varies and ranges from approximately 36% to 59%. Taking the drug with food reduces the bioavailability of ethinyl estradiol in approximately 25% of those examined, while in the rest no such changes were detected.

Distribution

The apparent Vd is about 5 l/kg. Plasma protein binding is about 98%.

Ethinyl estradiol induces the synthesis of SHBG and DSG in the liver. When taking 30 mcg of ethinyl estradiol daily, the concentration of SHBG in plasma increases from 70 to 350 nmol/l.

Css is established during the second half of the first cycle of taking the drug, while the concentration of ethinyl estradiol in the serum is 1.4-2.1 of the concentration after a single dose of the drug.

Metabolism

Ethinyl estradiol undergoes presystemic conjugation in the mucous membrane of the small intestine and in the liver. Subsequently, ethinyl estradiol is biotransformed by aromatic hydroxylation with the formation of various hydroxylated and methylated metabolites, which are found in the body both in free form and in the form of conjugates with glucuronic and sulfuric acids. Plasma clearance of ethinyl estradiol ranges from 2.3 to 7.0 ml/min/kg.

Removal

Ethinyl estradiol is almost completely biotransformed in the body and is not excreted unchanged. Metabolites are excreted in urine and bile in a ratio of approximately 4:6 with T1/2 of approximately 24 hours. T1/2 of ethinyl estradiol in the elimination phase ranges from 6.8 to 26.1 hours.

Indications for use:

Contraception.

Dosage and method of administration of the drug.

The drug should be taken 1 tablet/day continuously for 21 days.

The tablets should be taken in the order indicated on the package, at approximately the same time every day, with a small amount of water.

Taking each subsequent package begins after a 7-day break, during which withdrawal bleeding (menstrual-like bleeding) is observed, which usually begins on the 2-3rd day from taking the last tablet and may not end before taking the drug from a new package. Taking tablets from the next package should be started on the 8th day, even in cases where bleeding continues. Therefore, each new pack is started on the same day of the week, and withdrawal bleeding will begin on approximately the same day of the month.

If you have not taken any hormonal contraceptives in the previous month, take Yarina on the 1st day of the menstrual cycle (i.e., on the 1st day of menstrual bleeding), and take a pill marked with the corresponding day of the week. It is possible to start taking it on the 2-5th day of the menstrual cycle, but in this case it is recommended to use a barrier method of contraception during the first 7 days of taking the tablets from the first package.

When switching from combined oral contraceptives (combined oral contraceptives, vaginal ring, transdermal patch), taking Yarina should begin the day after taking the last tablet with the active components of the previous drug, but in no case later than the next day after the usual 7-day break in administration (for drugs containing 21 tablets) or after taking the last inactive tablet (for drugs containing 28 tablets per package. When switching from a vaginal ring, transdermal patch, it is preferable to start taking Yarina on the day the ring or patch is removed, but no later than the day when a new ring is to be inserted or a new patch is to be applied.

When switching from contraceptives containing only gestagens (“mini-pills”), Yarina can be used without interruption. During the first 7 days of taking the pills, you must use an additional barrier method of contraception.

When using injectable forms of contraceptives, an implant or an intrauterine contraceptive with a gestagen, Yarina should be taken on the day the next injection is due or on the day the implant is removed. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills.

When taking Yarina after childbirth, you should wait until the end of the first normal menstrual cycle and take the drug according to the recommended regimen. It is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills. If a woman was sexually active in the period between childbirth and the start of taking Yarina, then pregnancy should first be excluded.

After an abortion in the first trimester of pregnancy, a woman can start taking the drug immediately. In this case, the woman does not need additional methods of contraception.

If the time for taking the next pill is missed, the woman should take the missed pill as soon as possible, and take the next pill at the usual time.

If the delay in taking the pill is less than 12 hours, the reliability of contraception is not reduced.

If the delay in taking pills is more than 12 hours, the reliability of contraception may be reduced. It should be borne in mind that taking the tablets should never be interrupted for more than 7 days and that 7 days of continuous use of the drug are required to achieve adequate suppression of the function of the hypothalamic-pituitary-ovarian system.

If you are more than 12 hours late in taking your pills during the first week of taking the drug, the woman should take the missed pill as soon as she remembers (even if this means taking two pills at the same time). The next tablet is taken at the usual time. Additionally, you should use a barrier method of contraception for the next 7 days. If a woman has been sexually active for a week before missing a pill, the possibility of pregnancy must be taken into account. The more pills you miss and the closer this skip is to the 7-day break in taking pills, the higher the likelihood of pregnancy.

If the delay in taking the pills was more than 12 hours during the second week of taking the drug, then the woman should take the last missed pill as soon as possible, as soon as she 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, as well as if you miss two or more tablets, you must additionally use barrier methods of contraception (for example, a condom) for 7 days.

If the delay in taking the pills was more than 12 hours during the third week of taking the drug, the risk of decreased reliability is inevitable due to the upcoming break in taking the pills. The woman must strictly adhere to one of the following two options (in this case, if during the 7 days preceding the first missed pill, all pills were taken correctly, there is no need to use additional contraceptive methods).

A woman should take the last missed pill as soon as she remembers (even if this means taking two pills at the same time). The next tablet is taken at the usual time until the tablets in the current pack are gone. The next pack should be started immediately. Withdrawal bleeding is unlikely until the second pack is finished, but spotting and breakthrough bleeding may occur while taking the tablets.

A woman can also stop taking pills from the current pack. She should then take a break for 7 days, including the day she missed the pill, and then start taking a new pack. If a woman misses a pill and then does not have withdrawal bleeding during the pill-break, pregnancy must be ruled out.

If a woman has had vomiting or diarrhea within 3 to 4 hours after taking Yarina, absorption of the active substances may be incomplete. In this case, you need to follow the recommendations when skipping pills. If a woman does not want to change her normal dosing regimen, she should take an additional tablet (or several tablets) from a different package if necessary.

In order to delay the onset of menstruation, a woman should continue taking tablets from a new package of Yarina immediately after all the tablets from the previous one have been taken, without interruption. The tablets from this new package can be taken for as long as the woman wishes (until the package runs out). While taking the drug from the second package, a woman may experience spotting or breakthrough uterine bleeding. You should resume taking Yarina from the next new package after the usual 7-day break.

In order to postpone the start of menstruation to another day of the week, a woman should shorten the next break in taking the drug by as many days as she wants. The shorter the interval, the higher the likelihood that she will not have withdrawal bleeding and will continue to have spotting and breakthrough bleeding while taking the second pack (just as if she wanted to delay the onset of menstruation).

Side effects of Yarin:

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

While taking combined oral contraceptives in women, other undesirable effects were observed, which were classified as follows: often (1/100), infrequently (1/1000, but<1/100), редко (<1/1000).

From the digestive system: often - nausea, abdominal pain; infrequently - vomiting, diarrhea.

From the reproductive system: often - engorgement, soreness of the mammary glands; infrequently - hypertrophy of the mammary glands; rarely - vaginal discharge, discharge from the mammary glands.

From the side of the central nervous system: often - headache, decreased mood, mood swings; uncommon - decreased libido, migraine; rarely - increased libido.

On the part of the organ of vision: rarely - intolerance to contact lenses (unpleasant sensations when wearing them).

Dermatological reactions: infrequently - rash, urticaria; rarely - erythema nodosum, erythema multiforme.

Other: often - weight gain; infrequently - fluid retention in the body; rarely - weight loss, allergic reactions.

As with other combined oral contraceptives, in rare cases the development of thrombosis and thromboembolism is possible.

Contraindications to the drug:

Yarina should not be used if you have any of the conditions/diseases listed below. If any of these conditions develop for the first time while taking it, the drug should be discontinued immediately.

The presence of thrombosis (venous and arterial) currently or in history (for example, deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders);

The presence or history of conditions preceding thrombosis (for example, transient cerebrovascular accidents, angina pectoris);

Current or history of migraine with focal neurological symptoms;

Diabetes mellitus with vascular complications;

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

Pancreatitis with severe hyperglyceridemia currently or in history;

Liver failure and severe liver disease (until normalization of liver tests);

The presence or history of benign or malignant liver tumors;

Severe or acute renal failure;

Identified or suspected hormone-dependent malignant diseases of the genital organs or mammary glands;

Vaginal bleeding of unknown origin;

Pregnancy or suspicion of it;

Lactation (breastfeeding);

Hypersensitivity to the components of the drug.

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, valvular heart disease, prolonged immobilization, major surgery, 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, ulcerative colitis, sickle cell anemia, phlebitis of 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, cholestasis, gallbladder disease, otosclerosis with hearing impairment, porphyria, pregnancy herpes, Sydenham's chorea);

Postpartum period.

Use during pregnancy and lactation.

Yarina is not prescribed during pregnancy and breastfeeding.

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

Taking combined oral contraceptives can reduce the amount of breast milk and change its composition, therefore, their use is contraindicated during lactation. Small amounts of sex steroids and/or their metabolites can be excreted in milk, but there is no evidence of their negative effects on the health of the newborn.

Special instructions for the use of Yarin.

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

The woman should be informed that Yarina is not being protected from HIV infection (AIDS) and other sexually transmitted diseases.

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. If risk factors become more severe, intensify, or when risk factors first appear, it may be necessary to discontinue the drug.

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

The risk of developing deep vein thrombosis in women taking combined oral contraceptives is higher than in women not taking them, but not as high as during pregnancy.

It should be taken into account that the risk of developing venous or arterial thrombosis and/or thromboembolism increases with age; in smokers (with increasing number of cigarettes or increasing age, the risk further increases, especially in women over 35 years of age); if there is a family history (for example, venous or arterial thromboembolism ever occurred in close relatives or parents at a relatively young age; in the case of a hereditary predisposition, the woman should be examined by an appropriate specialist to decide on the possibility of taking combined oral contraceptives); obesity (body mass index more than 30 kg/m2); dyslipoproteinemia; arterial hypertension; migraine; heart valve diseases; atrial fibrillation; prolonged immobilization; major surgery; any surgery on the legs or major trauma. In these situations, it is advisable to stop using Yarina (in the case of a planned operation, at least 4 weeks before it) and not resume use for 2 weeks after the end of immobilization.

In rare cases, during the use of combined oral contraceptives, the development of liver tumors has been observed, which in some cases led to life-threatening intra-abdominal bleeding. If severe abdominal pain, liver enlargement, or signs of intra-abdominal bleeding occur, this should be taken into account when making a differential diagnosis.

The most significant risk factor for developing cervical cancer is persistent papilloma viral 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. 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).

The relationship between the development of breast cancer and the use of combined oral contraceptives has not been proven, although the disease is detected slightly more often in women taking combined oral contraceptives than in women of the same age who do not use contraceptives. 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.

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.

While taking combined oral contraceptives, irregular bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use. Therefore, any irregular bleeding should be assessed only after an adaptation period of approximately three cycles. If irregular bleeding recurs or develops after previous regular cycles, careful evaluation should be performed to rule out malignancy or pregnancy.

Some women may not develop withdrawal bleeding during a pill-free break. If combined oral contraceptives are taken as directed, the woman is unlikely to be pregnant. However, if combined oral contraceptives have not been taken regularly before or if there are no consecutive withdrawal bleeds, pregnancy should be ruled out before continuing to take the drug.

The patient should be informed that if symptoms of venous or arterial thrombosis develop, she should immediately consult a doctor. These symptoms include a sudden attack of coughing, sudden severe chest pain with or without radiation to the left arm, any unusual, severe, prolonged headache, increased frequency and severity of migraines, partial or complete loss of vision, diplopia, slurred speech or aphasia, sudden changes in hearing, smell, taste, dizziness or fainting, weakness or very significant loss of sensitivity that suddenly appeared on one side or in one part of the body, unilateral leg pain and/or swelling, movement disorders, symptom complex “acute” abdomen.

Impact on the ability to drive vehicles and operate machinery

Not found.

Drug overdose:

No serious adverse events have been reported following overdose.

Symptoms: nausea, vomiting, spotting or metrorrhagia.

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

Interaction of Yarin with other drugs.

Interaction of oral contraceptives with other drugs may lead to breakthrough bleeding and/or decreased contraceptive reliability. The following types of interactions have been reported in the literature.

The use of drugs that induce microsomal liver enzymes can lead to an increase in the clearance of sex hormones. Such drugs include phenytoin, barbiturates, primidone, carbamazepine, rifampicin; There are also suggestions for oxcarbazepine, topiramate, felbamate, griseofulvin and preparations containing St. John's wort.

HIV protease inhibitors (eg, ritonavir) and non-nucleoside reverse transcriptase inhibitors (eg, nevirapine) and combinations thereof also have the potential to affect hepatic metabolism.

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.

While taking any of the above medications, a woman should additionally use a barrier method of contraception (for example, a condom).

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

While taking antibiotics (with the exception of rifampicin and griseofulvin) and for 7 days after their discontinuation, you should additionally use a barrier method of contraception. If the period of using the barrier method of contraception ends later than the tablets in the package, you need to move on to the next package of Yarina without the usual break in taking the tablets.

Oral combination contraceptives may affect the metabolism of other drugs, resulting in increased (eg cyclosporine) or decreased (eg lamotrigine) plasma and tissue concentrations.

There is a theoretical possibility of an increase in serum potassium levels in women receiving Yarina concomitantly with other drugs that can increase potassium levels (for example, angiotensin II receptor antagonists, some NSAIDs /indomethacin/). 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.

Terms of sale in pharmacies.

The drug is available with a prescription.

Terms of storage conditions for the drug Yarina.

The drug should be stored at a temperature not exceeding 25°C. Shelf life: 3 years.

The contraceptive Yarina provides reliable protection against unwanted pregnancy and has a wide range of additional positive effects on the woman’s body. The active components of the combined composition of the drug create favorable conditions for the tolerability of the menstrual period and the alignment of the cycle. A distinctive feature of this oral contraceptive is the relatively small number of side effects. However, despite good tolerability, there is a certain list of contraindications for use and features of therapeutic use. This necessitates a preliminary consultation with the attending physician.

Dosage form

The dosage form of the Yarina contraceptive is light yellow, round, biconvex, film-coated tablets. One side is engraved with a hexagon with the letters "DO" inside it.

The drug is packaged in cardboard packages containing 1 or 3 blisters of 21 tablets.

Description and composition

Yarina is a combination product, the active elements of which are the following substances:

• drospirenone – 3 mg/tab.;
• ethinyl estradiol – 30 mcg/tab.

Auxiliary components:

• lactose monohydrate;
• titanium dioxide;
• macrogol 6000;
• iron oxide II;
• talc;
• povidone;
• corn starch (gelatinized);
• magnesium stearate;
• hypromellose.

Pharmacological group

Yarina's drug is a monophasic low-dose contraceptive medication with a combined composition. The drug has antiandrogenic and antimineralocorticoid properties. The main therapeutic effect of the drug is to suppress the secretory ability of pituitary hormones, prevent ovulation and slow down the maturation of follicles. Yarina helps to increase the viscosity of the cervical canal fluid, which results in preventing sperm from entering the uterine cavity. Drospirenone has a pronounced antimineralocorticoid effect, which prevents weight gain and other consequences of water retention in the body. The substance prevents estrogenic sodium retention and creates conditions for positive tolerance in premenstrual syndrome.

Drospirenone has a powerful antiandrogenic effect, which has a positive effect on reducing the activity of the sebaceous glands and the formation of acne. In combination with ethinyl estradiol, the substance significantly improves the lipid profile and helps increase the level of high-density lipoproteins.

Drospirenone does not have glucocorticoid, androgenic, antiglucocorticoid or estrogenic activity, which, in combination with antiandrogenic and antimineralocorticoid properties, brings the substance closer to a natural hormone.

Yarina does not prevent the increase in the concentration of sex hormone binding globulin. This effect helps to suppress the activity of endogenous androgens.

With the use of this drug, there is a high probability of preventing the development of ovarian and endometrial cancer.

Yarina helps to even out the menstrual cycle, as well as reduce the manifestation of painful menstruation and profuse discharge, which prevents the manifestation of iron deficiency anemia.

Drospirenone is almost completely absorbed from the gastrointestinal tract. The maximum concentration of the substance in the blood serum is observed 1–2 hours after the first dose.

Bioavailability varies from 75 to 85%. Food intake does not affect this indicator.

Drospirenone tends to be completely metabolized in the liver. Metabolic products are excreted in urine and feces. The half-life averages 40 hours.

Indications for use

Yarina is used exclusively as prescribed by a specialist.

for adults

Indications for medicinal use of the drug are:

• prevention of unwanted pregnancy;
• hormone-dependent fluid retention;
• seborrhea;
• disrupted menstrual cycle;
• menstrual pain accompanied by heavy discharge.

for children

The use of the drug in childhood and adolescence is possible only after the onset of menarche (first menstrual bleeding).

Pregnant and lactating women are strictly contraindicated from taking Yarina.

Contraindications

• thrombosis;
• accompanied by vascular complications;
• pregnancy and;
• chronic form of liver failure;
• hypersensitivity to the components of the drug;
• non-menstrual vaginal bleeding;
• the presence of benign or malignant tumors;
• children's age before menarche;
• angina pectoris;
• cardiac ischemia;
• acute form of renal failure;
• various malfunctions of the liver.

Applications and dosages

The product should be taken at the same time in the order indicated on the package. Interrupting the course and skipping doses is highly undesirable due to the weakening of the contraceptive effect of the medication.

for adults

The drug Yarina is recommended to take 1 tablet per day for three weeks. A repeated course is possible only seven days after the end of the previous one. During the period between courses, so-called “withdrawal bleeding” may occur. Most often, this effect is observed in the last days before stopping the course and can last until the second or third day of the new period of use.

It is recommended to start using Yarina immediately on the first day of the start of the cycle (the first day of menstrual bleeding). It is possible to shift the start of use by 2-3 days, but in this case the first week of use should be accompanied by the use of barrier contraceptives.

The effect of the drug decreases 12 hours after taking the last dose. If the missed dose does not exceed 12 hours, you should take the dose as quickly as possible. At the same time, the usual time of constant use does not shift.

You should not interrupt taking the medication for more than 7 days. In case of a long break in use, it is necessary to use barrier-type contraceptives.

for children

The use of Yarina for children is possible only after the start of the first menstrual bleeding. The dosage is selected individually.

for pregnant women and during lactation

During pregnancy and breastfeeding, taking Yarina's medication is strictly prohibited. In case of emergency use during lactation, breastfeeding should be stopped immediately.

Side effects

• pain in the mammary glands;
• nausea;
• decreased libido;
• low mood;
• minor changes in body weight (rare);
• discharge from the mammary glands;
• fluid retention (extremely rare);
• skin allergic manifestations;
• migraine;
• vaginal secretion disorders.

Interaction with other drugs

Taking drugs that provoke an increase in the clearance of sex hormones may cause a decrease in the effectiveness of the contraceptive and the occurrence of breakthrough bleeding.

Also, the effectiveness of the drug Yarin is reduced by tetracyclines and ampicillins.

Drugs that affect liver enzyme levels may cause side effects.

Angiotensin-converting enzyme inhibitors, potassium-sparing diuretics, NSAIDs and angiotensin II antagonists, when used simultaneously with Yarina, increase the level of potassium in the blood plasma.

special instructions

When using combined oral contraceptives, the risk of arterial or venous thrombosis and thromboembolism increases.

Some studies report rare cases of cervical cancer.

While taking Yarina, blood pressure levels may increase.

During the first months of use, there is a possibility of irregular breakthrough bleeding.

Before use, be sure to exclude possible pregnancy.

It should be remembered that oral contraceptives do not protect against sexually transmitted pathologies.

Overdose

The main and most common signs of overdose with Yarin are the following conditions:

• bleeding from the vagina of various etiologies and structures;
• gagging;
• metrorrhagia;
• nausea.

Analogs

Instead of Yarina, the following drugs can be used:

1. is a partial analogue of the drug Yarina. It is produced in pills, which are prescribed to prevent unwanted pregnancy.
2. is a monophasic combined contraceptive. The drug is produced in tablets, the contraceptive effect of which is explained by the incoming desogestrel and ethinyl estradiol.
3. refers to monophasic combined contraceptives that have an antiandrogenic effect. The drug is produced in tablets that are prescribed to protect against unwanted pregnancy, treat acne, and premenstrual syndrome.
4. is a substitute for Yarina in the clinical and pharmacological group. The therapeutic effect of an oral monophasic contraceptive is explained by gestodene and ethinyl estradiol. The drug is produced in tablets.

Storage conditions

Store out of the reach of children, at low humidity and away from direct sunlight on the packaging of Yarina at a temperature of 20 to 25 degrees.

Shelf life – 3 years.

Drug price

The cost of the medicine is on average 1181 rubles.