Pharmacodynamics and pharmacokinetics
Pharmacodynamics
The abstract describes the drug as a monophasic low-dose oral combined estrogen-progestogen contraceptive drug .
Yarina acts by blocking ovulation and increasing the viscosity of cervical mucus.
In women using Yarina birth control pills, the menstrual cycle is normalized, menstrual-like painful bleeding is less common, the intensity and duration of bleeding is reduced, resulting in a reduced likelihood of iron deficiency anemia . There is evidence of a reduced risk of ovarian and endometrial .
Composition of hormones in Yarina: ethinyl estradiol and drospirenone .
- Drospirenone has an antimineralocorticoid effect and is able to prevent weight gain and the appearance of other symptoms associated with deterioration of fluid excretion from the body.
- Drospirenone demonstrates antiandrogenic activity and helps reduce acne and oily skin.
Pharmacokinetics
Drospirenone
When taken orally, it is quickly absorbed. The highest level in the blood is reached after about an hour and a half. Bioavailability approaches 75-85%. Eating food does not affect the bioavailability of drospirenone.
albumin in the blood and does not bind to corticosteroid-binding globulin . Only about 4% of the total content in serum is present in free form.
Completely metabolized. Transformation products are represented by acid derivatives of drospirenone , which are excreted in urine and feces in a ratio of 6/5. The half-life is approximately 40 hours.
In women with moderate liver dysfunction, pharmacokinetic parameters are comparable to those in healthy women, and the half-life of drospirenone in such patients is 1.8 times longer than in healthy individuals with normal liver function. In patients with moderate liver dysfunction, the clearance of drospirenone was reduced by half compared to healthy women.
The concentration of drospirenone in the blood at steady state in women with mild renal impairment is comparable to that in healthy women. And in women with moderate renal impairment, the content of drospirenone in the blood is 35% higher than in healthy women.
There were no fluctuations in blood potassium concentrations when using drospirenone.
Ethinyl estradiol
After consumption, ethinyl estradiol is actively absorbed. The highest level in the blood, as Wikipedia indicates, is achieved in an hour and a half. Metabolized in the liver, bioavailability is about 45%. The main transformation method is aromatic hydroxylation. Approximately 98% of the molecules of the substance are bound by albumin.
It is not excreted from the body in unchanged form. Ethinyl estradiol derivatives are excreted in urine and bile. The half-life is 24 hours.
Features and indications
There is nothing unusual about Yarina’s estrogenic component, ethinyl estradiol. It is necessary to regulate the functioning of the ovaries. Its presence in the drug causes some typical side effects of COCs, for example, a tendency to vein thrombosis.
The peculiarity of the product is its gestagen component. Drospirenone, unlike levonorgestrel and other similar substances, has additional activity:
- has an effect similar to the drug spironolactone; that is, it is a weak diuretic that retains potassium in the body, but at the same time prevents the appearance of edema and other signs of premenstrual syndrome;
- does not cause weight gain with long-term use;
- has an antiandrogenic effect: prevents or treats acne, excess oily skin and hair, hirsutism (appearance of facial hair).
These features determine the group of patients for whom Yarina is most suitable. They have the following symptoms:
- swelling, irritability, migraine and other signs of premenstrual syndrome;
- phenomena of hirsutism - acne, excess oiliness of hair and skin, the appearance of unwanted hairs on the face, seborrhea.
Indications for taking Yarina are the need for hormonal contraception. It can be prescribed even to young girls who have started their menstrual cycle, without changing the dose or regimen. After menopause, when there are no cycles, there is no need to use Yarina.
Contraindications
Contraindications to the use of Yarina tablets:
- current and past thrombosis and thromboembolism (including stroke, venous thrombosis, myocardial infarction, pulmonary embolism ), cerebrovascular changes;
- current and past pancreatitis with hypertriglyceridemia ;
- current and past pre-thrombosis conditions (including angina pectoris , ischemic attacks );
- current and past migraines with neurological symptoms;
- diabetes mellitus with vascular complications;
- risk factors for vascular thrombosis , for example, atrial fibrillation , complicated changes in heart valves, vascular diseases of the brain or heart, surgery followed by prolonged immobilization, arterial hypertension , smoking after 35 years;
- decompensated renal failure or acute renal failure;
- insufficiency of liver function or severe liver disease (until normalization of tests);
- current and past liver tumors;
- hormone-dependent malignant tumors or suspicion of them;
- bleeding from the vagina of unknown origin;
- lactation;
- pregnancy or suspicion of pregnancy;
- hypersensitivity to the components of the drug.
If any of the above disorders develop for the first time while taking the medication, it should be discontinued immediately.
Yarina hormonal tablets should be taken with extreme caution if you have any of the following conditions or diseases:
- risk factors for thrombosis: obesity , smoking , arterial hypertension, dyslipoproteinemia , extensive trauma, migraine , prolonged immobilization, heart valve defects, surgical interventions, hereditary predisposition to the development of thrombosis ;
- other diseases that can provoke changes in peripheral circulation or superficial phlebitis ;
- hypertriglyceridemia;
- angioedema of hereditary origin;
- liver diseases;
- postpartum period;
- diseases that arose or were complicated during pregnancy or previous use of sex hormones ( porphyria , jaundice , herpes of pregnant women, cholelithiasis, otosclerosis, Sydenham's chorea ).
Side effects
As with other combined contraceptives, side effects of Yarina such as thromboembolism or thrombosis .
Side effects of Yarina:
- from the genital area: discharge from the vagina or mammary glands, pain and enlargement of the mammary glands;
- from the digestive system: vomiting, abdominal pain, nausea, diarrhea ;
- from the visual side: discomfort when using contact lenses;
- disorders of nervous activity: deterioration of mood, mood changes, weakening or increased libido , headache , migraine ;
- skin: erythema nodosum , rash, urticaria, erythema multiforme ;
- from the metabolic side: weight change, water retention in the body;
- other disorders: allergic reactions.
Instructions for use of Yarina (Method and dosage)
The tablets should be taken orally in order, according to the directions on the package, at the same time every day, with water.
Yarina tablets, instructions for use
The drug is taken 1 tablet per day for 3 weeks. Taking tablets from the next pack should be started after a seven-day break, with “ withdrawal bleeding ” usually developing. It begins approximately 3 days after taking the last tablet and can continue until the use of tablets from a new blister.
Start of reception
How to take Yarina for the first time?
If you have not used any hormonal contraceptives in the previous month, the use of the medicine begins on the 1st day of the menstrual cycle. It is also permissible to start using it on days 2-5 of the menstrual cycle, but in this case you need to use a barrier method of contraception in the 1st week of use.
If the patient switches from other oral combined contraceptives, a contraceptive patch or vaginal ring , then it is advisable to start using the medicine on the day following the last tablet of the “old” drug, but no later than the next day after the standard 7-day break (for products containing 21 tablets ) or after consuming the final inactive tablet (for products containing 28 tablets). When using a vaginal ring or contraceptive patch, use of the medication should begin on the day the patch or ring is removed, but no later than the day the new ring or patch is installed.
The transition from contraceptives ( mini-pills containing only gestagen ) to Yarina can be done on any day (without a temporary break). Switching from an implant containing only gestagen , or a gestagen-releasing intrauterine contraceptive - on the day of its removal. Switching from the injection form - from the day on which the following procedure should be performed. In all of the above cases, you need to use a barrier method of contraception in the 1st week of use.
After childbirth or an abortion in the second trimester, you should start taking the medicine no earlier than 4 weeks after the birth (provided that the mother is not breastfeeding) or the abortion. If use is started later, you need to use a barrier method of contraception in the 1st week of use. But if the patient has already had sexual intercourse, before starting to use Yarina, it is necessary to exclude pregnancy or wait until the 1st menstruation.
After an abortion in the 1st trimester of pregnancy, it is allowed to start taking the medication on the day of the abortion. If this condition is met, the patient does not need additional methods of contraception.
Missed pills
If the medicine was taken less than 12 hours late , contraceptive protection is not reduced. A woman needs to take the pill as quickly as possible, the next pill is taken at the usual time.
If the medicine was taken more than 12 hours late , contraceptive protection is reduced. The more pills you miss, the greater the likelihood of pregnancy. If you skip 1 tablet, the chance of getting pregnant is minimal. If you are late for more than 12 hours, follow the recommendations below.
The pass was made in the first 7 days of taking the drug
You should take the last missed tablet as soon as possible, even if you need to take 2 tablets together. The next tablet is taken at the usual time. It is recommended to use a barrier method of contraception for another week. If you had sexual intercourse within 7 days before missing a pill, you must consider the possibility of pregnancy.
The pass was made on days 8-14 of taking the drug
You should take the last missed tablet as soon as possible, even if you need to take 2 tablets together. The next tablet is taken at the usual time. If the patient has taken the pills correctly over the past 7 days, then there is no need to use additional contraceptive measures. Otherwise, or if you miss 2 or more tablets, you must additionally use barrier methods of contraception for another week.
The pass was made on days 15-21 of taking the drug
The risk of pregnancy increases due to the upcoming temporary break in taking the drug. The patient must do one of the following two options. Moreover, if the pill regimen has been followed over the last week, there is no need to use additional methods of contraception.
- You should take the last missed pill as soon as possible, even if this means taking 2 pills at the same time. Subsequent tablets from the current package are consumed as usual until they run out. The next package should be used without interruption. Until the tablets from the second package run out, withdrawal bleeding is unlikely, but breakthrough bleeding and spotting while using the tablets cannot be ruled out.
- You need to stop taking the tablets from the current blister and start a seven-day break, and then start taking the medicine from the new blister. If the patient has not taken the pills and has not developed withdrawal bleeding during the seven-day break, pregnancy must be excluded.
For vomiting and diarrhea
If vomiting or diarrhea within four hours after taking the tablets, they may not be completely absorbed. In such a case, additional contraceptive measures should be taken, and the above recommendations should also be followed when skipping pills.
How to change the first day of the menstrual cycle?
To postpone the 1st day of menstruation, you need to continue taking Yarina from a new package without a seven-day break and take the tablets as needed. In this case, spotting or bleeding is possible.
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.
Interaction
The use of drugs that stimulate the work of hepatic microsomal enzymes may cause an increase in the excretion of sex hormones , which causes breakthrough bleeding or weakening the reliability of contraception. These drugs include Phenytoin, Primidone, barbiturates, Rifampicin, Carbamazepine, Rifabutin and others.
Penicillins and tetracycline can reduce the enterohepatic circulation of estrogen , thereby reducing the concentration of ethinyl estradiol . During the period of use of drugs that affect microsomal enzymes , and for about a month after completion of their use, barrier contraception should be used.
Combined contraceptives may change the metabolism of other drugs, causing their concentrations in the blood and tissues to increase or decrease.
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.
special instructions
Before starting or resuming use of the drug, you need to familiarize yourself with your personal and family history, conduct a gynecological and general medical examination, and exclude the presence of pregnancy. The structure and scope of research, as well as the regularity of examinations, are determined in each individual case individually. Standard follow-up examinations must be carried out at least once a year.
The patient should be informed that the drug does not protect against HIV infection and other sexually transmitted diseases.
A relationship has been established between taking combined contraceptives and an increase in the incidence of vascular thrombosis and thromboembolism, including pulmonary artery thrombosis , venous thrombosis, myocardial infarction , and cerebrovascular disorders.
The risk of venous thromboembolism is highest in the 1st year of taking such drugs. An increased risk occurs after initial use of oral contraceptives or resumption of their use.
Arterial thromboembolism , the risk of which also increases when taking drugs like Yarina, can lead to vascular occlusion, stroke or heart attack . Signs of a stroke: weakness or loss of sensation in the face or limbs, problems with speech and its understanding, confusion, sudden loss of vision, dizziness, gait disturbance, causeless headache, loss of balance, loss of consciousness. Other signs of vascular occlusion: swelling, sudden pain, blue discoloration of the limbs, sharp pain in the abdomen.
Signs of a heart attack : heaviness, discomfort, pain, pressure, feeling of tightness in the arm or chest; discomfort radiating to the cheekbone, back, arm, larynx, stomach; nausea, cold sweat, vomiting or dizziness, anxiety, weakness, shortness of breath , tachycardia .
Arterial thromboembolism can be fatal.
The risk of thrombosis and thromboembolism increases:
- in smokers;
- with age;
- for obesity;
- close relatives or parents have ever had thromboembolism
- with prolonged immobilization, surgery, operations on the lower extremities (in these situations, it is advisable to stop the use of combined contraceptives and not resume it for 15 days after completion of immobilization);
- for arterial hypertension ;
- for dyslipoproteinemia ;
- for diseases of the heart valves;
- for migraines ;
- with atrial fibrillation .
An increase in the frequency and severity of migraine during the use of combined contraceptives may be grounds for stopping their use.
The appearance of benign liver tumors has rarely been observed during the use of combined contraceptives, and malignant tumors have been observed extremely rarely.
In patients with hypertriglyceridemia, it is possible that there is an increased likelihood of developing pancreatitis when taking medications like Yarina.
In women with hereditary angioedema, exogenous estrogens can cause or worsen the course of this disease.
While taking combined contraceptives, irregular bleeding or spotting may occur, especially during the first months of use. Therefore, assessment of irregular bleeding of any nature should be carried out only after an adaptation period of approximately 3 cycles has been completed.
If the bleeding described above recurs, then it is necessary to conduct an examination and examination to exclude malignant tumors or pregnancy.
As a consequence of withdrawal, some patients may develop bleeding when taking a break or stopping taking the pills.
Taking Yarina can change the results of a number of laboratory tests, for example, indicators of the liver, kidneys, adrenal glands, thyroid gland, the content of carrier proteins, the state of coagulation , carbohydrate metabolism and fibrinolysis .
The drug does not affect the ability to drive vehicles.
Changing the start date of menstruation
With the help of the drug, you can shift the onset of your next period. This property can be used in exceptional cases, for example, when traveling to the seaside or before an important sports performance.
- To prevent menstruation from starting in the current month, Yarina should not be discontinued after taking the entire package. Immediately, without a week's break, the medication from the next package begins. It can be continued for the required number of days, up to 21. Menstruation will begin 1-2 days after finishing using the medicine. In addition, spotting or short-term menstrual-like bleeding are possible while using the second package. This does not reduce the contraceptive effect.
- To reschedule your period a few days earlier, you should reduce the interval between packs by the required number of days in advance. After completing the second package, menstruation will begin, that is, menstruation will come as many days earlier as the “free” interval between packages was shorter.
Yarina's analogues
Level 4 ATC code matches:
Ovidon
Rigevidon
Non-Ovlon
Mercilon
Yarina Plus
Miniziston 20 fem
Novinet
Microgynon
Janine
Lindineth
Cyclo-Proginova
Regulon
Logest
Midiana
Belara
Femoden
Jess Plus
Jess
Zoely
The most common analogues: Dailla, Regulon, Vidora, Jess, Midiana, Claira, Janine, MODELL, Dimia, Simicia .
The price of Yarina's analogues is usually less affordable than the price of the described drug.
Which is better: Midiana or Yarina?
Midiana and Yarina are complete analogues in composition and quantitative ratio of components in the preparation. Reviews indicate that there are no fundamental differences in the effect of these two products. Midiana is cheaper in cost. The choice should be made based on economic considerations and individual tolerance.
Which is better: Novinet or Yarina?
Novinet and Yarina differ somewhat in their active ingredients, but not in their mechanism of action. The cost of Novinet is almost 2 times cheaper, and in addition to the contraceptive effect, it reduces the risk of developing iron deficiency anemia . The choice is made based on the doctor’s recommendations and economic considerations.
Which is better: Yarina or Regulon?
Regulon and Yarina are analogs and only slightly differ in the structure of the active ingredients. The mechanism of action is identical. Reviews do not record differences in the incidence of side effects. The price of Regulon is approximately 2 times lower than the price of the described medicine.
Which is better: Yarina or Klaira?
Klaira, unlike Yarina, has a lower concentration of hormonal components and is recommended for use by more mature women. The prices of the drugs are comparable. The choice is based on the recommendations of the attending physician and individual indications.
Diana is 35 or Yarina – which is better?
Diana 35 and Yarina are analogues in terms of mechanism of action and effect. However, it is worth noting that the first has a lower concentration of hormonal components and a higher price. Side effects and therapeutic effect depend on individual characteristics.
Yarina and Yarina Plus
The differences between Yarina and Yarina Plus are that the latter drug additionally contains calcium levomefolate , which reduces folate in the body of the woman and fetus in the event of an unplanned pregnancy. The prices of the drugs are comparable.
Janine or Yarina - which is better?
Zhanine and Yarina are analogue drugs. According to statistics, Yarina demonstrates a greater ability to provoke side effects. The prices of the drugs are almost equal.
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.
During pregnancy and lactation
The medicine is not prescribed for detected pregnancy and lactation.
If pregnancy is detected while using Yarina, the medicine must be discontinued immediately. Studies have not found an increased risk of developmental defects in newborns whose mothers took sex hormones before or during early pregnancy. At the same time, the use of combined contraceptives can reduce the volume of breast milk and change its composition, so the use of such drugs is not recommended until breastfeeding is completed.
Start of reception
The doctor who prescribed it should tell you how to take Yarina for the first time. There are also detailed instructions in the instructions for use.
You can end your appointment at any time. If pregnancy is not planned, you should start using other contraceptive methods.
Reviews about Yarina
Reviews from doctors about Yarin are quite restrained in characterizing the drug, which has its own advantages and disadvantages.
The online forum reports that a fairly large number of women who took Yarina hormonal pills developed a variety of side effects: from acne and other skin changes to severe vascular disorders. Other reviews reported that birth control pills, on the contrary, have a beneficial effect on the condition of the skin and are recommended for polycystic ovary syndrome .
Reviews from doctors about tablets for endometriosis indicate positive treatment results with continuous dosing. This regimen of use contributes to the suppression of menstrual function, inhibits retrograde blood flow to the pelvic organs and stimulates regression in endometrioid heterotopias . The duration of treatment for endometriosis is at least six months.
Reviews of Yarin after discontinuation are usually satisfactory, but sometimes changes may appear in the form of weight gain or the appearance of acne . There are a number of reports that there are no periods after withdrawal. The situation is considered normal if there are no periods within 4-5 days after stopping taking birth control pills. But if they do not appear within a week, you should consult a gynecologist for advice.
Yarina and pregnancy after her
The forum and numerous reviews indicate that pregnancy after discontinuation of the drug is not accompanied by deviations in its course or pathological changes in the development of the fetus.
Effect on the menstrual cycle
In the first months of using the drug, some women experience irregular bleeding. Adaptation occurs within 3 months of use. If after this the regular cycle has not been restored, you need to contact a gynecologist.
It is especially important to consult a doctor in time if, after several normal cycles, irregular discharge appears again. In such a situation, it is necessary to exclude pregnancy and malignant tumors of the genital organs.
Pregnancy after Yarina can occur in the next cycle after the next menstruation.
Yarina price, where to buy cheap
The price of birth control pills Yarina (No. 21) in Ukraine does not fluctuate depending on the region - both in Odessa and in the city of Kharkov it is 240-290 hryvnia.
How much does it cost in Russian pharmacies?
The price of Yarina tablets (No. 21) in Russia is 810-890 rubles. The cost of a package of 63 tablets can reach 2,300 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Yarina plus tab.
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Pharmacy24
- Yarina plus N28 tablets - 3 packs Promotion of Bayer Pharma AG, Nimecchina/Bayer Weimar GmbH i Co.
KG, Nimechchyna 631 UAH.order - Yarina No. 21 tablets Bayer Pharma AG, Nimechchina/Bayer Weimar GmbH i Co. KG, Nimechchyna
271 UAH order
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PaniPharmacy
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- Yarina plus tablets Yarina plus tablets No. 28 Germany, Bayer Pharma
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