Birth control pills Yarina Plus have firmly established themselves in the hormonal contraception market.
Yarina Plus is a low-dose (up to 30 mcg), monophasic (the combination of hormones is the same in all active tablets) combined (contains two hormones) contraceptive.
Yarina plus is an analogue of Yarina, with the only exception that the tablets also contain calcium levomefolate.
Read a detailed comparison of Yarina and Yarina Plus.
Compound
- One active tablet of Yarina Plus contains 3 mg of drospirenone , 30 mcg of ethinyl estradiol , 451 mcg of calcium levomefolate . Additional substances: microcrystalline cellulose, lactose monohydrate, hyprolose, croscarmellose sodium, magnesium stearate, orange varnish.
- One vitamin supplement tablet of Yarina Plus contains 451 mcg of calcium levomefolate . Additional substances: microcrystalline cellulose, lactose monohydrate, hyprolose, croscarmellose sodium, magnesium stearate, light orange varnish.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
Monophasic low-dose combined oral estrogen-progestin contraceptive drug, which includes active and auxiliary tablets with calcium levomefolate .
The contraceptive effect of Yarina Plus is carried out by suppressing ovulation and increasing the viscosity of cervical mucus. In patients taking such oral contraceptives, the cycle is normalized, pain, intensity and duration of bleeding are reduced, and as a result, the risk of iron deficiency anemia . There is also evidence of a decreased likelihood of endometrial and ovarian tumors.
Drospirenone exhibits an antimineralocorticoid effect and prevents fluid retention, which can reduce body weight and reduce the risk of peripheral edema. It has antiandrogenic activity and helps relieve acne , reduce oily hair and skin. These facts must be taken into account when choosing a contraceptive for women with hormonal fluid retention, as well as acne .
Calcium levomefolate is an active form of folate that is absorbed better than folic acid . Necessary to meet the increased need for folate during pregnancy and lactation. The presence of calcium levomefolate in the oral contraceptive reduces the likelihood of neural tube defects in the fetus if pregnancy occurs after discontinuation of contraception.
Pharmacokinetics
Drospirenone
After administration it is quickly absorbed. The highest level in the blood is reached after an hour and a half. Bioavailability is 76-85%. Binds to albumin and does not react with hormone binding globulin . Only 3-5% of the substance circulating in the blood is in free form. With systematic use of the drug, the concentration of drospirenone in the blood increases by 2-3 times. Most metabolites are represented by acid derivatives of drospirenone. Excreted through the kidneys and intestines.
Ethinyl estradiol
Rapidly absorbed after oral administration. The maximum level in the blood is reached after an hour and a half. Food reduces bioavailability by 25%. Ethinyl estradiol reacts actively with blood albumin. It is transformed in the liver by aromatic hydroxylation with the production of numerous metabolites. Excreted as metabolic in urine and feces. The half-life reaches 24 hours.
Calcium levomefolate
Rapidly absorbed after entering the digestive tract. In the form of L-5-methyl-THF, it is delivered to organs and peripheral tissues. Folates are involved in the biosynthesis of thymidine, purines, DNA, RNA, methionine and glycine . It is excreted mainly by the kidneys in its original form and in the form of metabolites.
Contraindications
Taking the medication is contraindicated if any of the following diseases are present or appear while taking the medication:
- the presence of several or one pronounced risk factor for vascular thrombosis ;
- pre-thrombosis conditions in the past or present;
- thrombosis or thromboembolism in the past or present, cerebrovascular disorders;
- diabetes mellitus with concomitant vascular disorders;
- migraine with focal neurological symptoms in the past or present;
- liver failure or liver disease;
- liver tumors in the past or present;
- decompensated or acute renal failure;
- malignant hormone-dependent tumors or suspicion of their presence;
- lactation;
- pregnancy or possible but not confirmed pregnancy;
- hereditary lactose intolerance lactase or impaired absorption of glucose and galactose ;
- bleeding from the vagina of unknown origin;
- hypersensitivity to the components of the drug.
Take the drug with extreme caution if you have at least one of the following conditions:
- risk factors for thrombosis : obesity , smoking, dyslipoproteinemia, migraine, arterial hypertension , heart valve defects, hereditary thrombosis
- diseases that may cause peripheral circulatory disorders: diabetes mellitus, sickle cell anemia, hemolytic-uremic syndrome, systemic lupus erythematosus, Crohn's disease, phlebitis ;
- hypertriglyceridemia;
- angioedema of a hereditary nature;
- diseases that arose or intensified during pregnancy or against the background of the use of sex hormones ( cholelithiasis , jaundice due to cholestasis , otosclerosis, herpes of pregnant women, porphyria, Sydenham chorea );
- liver diseases not listed as contraindications;
- postpartum period.
Pregnancy and lactation
According to the instructions, Yarina Plus tablets are prohibited from use during pregnancy and breastfeeding. If conception occurs while using the drug, its immediate discontinuation is necessary. There have been no specific studies revealing the negative impact of the medication on the process of gestation and its health. Contraception cannot be used during lactation. Its use may lead to a decrease in the amount of milk in the mother and a change in its composition. During lactation, sex hormones can enter the child’s body and affect his health.
Side effects
- Nervous disorders: migraine , headache .
- Mental disorders: changes in libido , depressed mood.
- Circulatory disorders: changes in blood pressure , thromboembolism .
- Respiratory disorders: bronchial asthma .
- Digestive disorders: abdominal pain, nausea, diarrhea , vomiting.
- Skin disorders: erythema multiforme, eczema, acne , rash, itching , erythema nodosum, urticaria .
- Visual disturbances: discomfort when wearing contact lenses.
- Hearing disorders: hypoacusia .
- Reproductive disorders: pain or enlargement of the mammary glands, vaginal candidiasis leucorrhoea , non-cyclic bleeding, changes in the menstrual cycle, vaginitis .
- Other disorders: weight changes, fluid retention, allergic reactions .
Severe side effects of Yarina Plus, which have been reported from people using combined oral contraceptives:
- thromboembolic venous and arterial disorders;
- cerebrovascular disorders;
- increased blood pressure;
- hypertriglyceridemia;
- hyperkalemia;
- impaired glucose tolerance ;
- changes in liver function indicators;
- liver tumors;
- angioedema in persons with a hereditary type of this disease;
- chloasma;
- the appearance or worsening of conditions arising from the use of oral combined contraceptives - jaundice, cholelithiasis, porphyria, herpes of pregnancy , hearing loss, Sydenham's chorea, systemic lupus erythematosus, hemolytic-uremic syndrome, Crohn's disease , cervical cancer .
pharmachologic effect
Yarina is a combined oral contraceptive with ethinyl estradiol and the progestogen drospirenone. Contraception occurs primarily by preventing the release of an egg (ovulation) during the menstrual cycle.
Yarina thickens the vaginal fluid to prevent sperm from entering the egg (fertilization) and changes the lining of the uterus to prevent the implantation of a fertilized egg. If the fertilized egg does not attach to the uterus, it passes out of the body.
The drug does not have estrogenic, glucocorticoid or antiglucocorticoid effects. This gives drospirenone a pharmacological profile very similar to the natural hormone progesterone.
Clinical studies indicate that the mild antimineralocorticoid properties of Yarina result in a weak antimineralocorticoid effect.
Yarina Plus tablets, instructions for use (Method and dosage)
The tablets are taken orally in the order indicated on the package, at the same time every day, with water and without chewing.
Reception begins on the first day of the cycle (the first day of menstrual bleeding). Take one tablet per day continuously for 4 weeks. The use of tablets from the next pack begins immediately after the completion of the previous one.
If symptoms of vomiting or diarrhea occur within 5 hours after taking the medication, absorption of the active substance becomes ineffective. In the described case, it is necessary to use additional contraceptive measures.
Yarina Plus is not used during menopause.
The medicine is contraindicated for women with severe renal and liver dysfunction.
Overdose
To date, there have been no reports of overdose with Yarina. However, excessive use of pills may cause nausea, vomiting, and in some cases withdrawal bleeding.
There are no antidotes, and further treatment should be symptomatic, based on knowledge of the pharmacological action of the components. In case of overdose, patients should be monitored for signs of metabolic acidosis. Liver function tests, especially transaminase levels, should be performed 2-3 weeks after consumption.
Interaction
The use of drugs that stimulate microsomal liver enzymes can lead to increased excretion of sex hormones. Similar medications include: barbiturates, Phenytoin, Primidone, Carbamazepine, Rifampicin and others.
Some antibiotics ( penicillins and tetracycline ) can reduce the concentration of ethinyl estradiol . During the period of use of drugs acting on microsomal liver enzymes, and another 4 weeks after their discontinuation, you must additionally use a barrier method of contraception.
During the use of antibiotics ( Rifampicin and Griseofulvin do not cause such a need) and for another week after their discontinuation, it is recommended to additionally use a barrier method of contraception.
A number of drugs lower blood folate of calcium levomefolate by blocking the enzyme dihydrofolate reductase ( Trimethoprim, Methotrexate, Triamterene and Sulfasalazine ), reducing folate ( Cholestyramine ) or through unknown mechanisms ( Phenobarbital, Carbamazepine, Primidone, Phenytoin, Valproic acid ).
Folates are capable of changing the pharmacokinetic parameters of antiepileptic drugs , Methotrexate, Pyrimethamine , which is accompanied by a decrease in the therapeutic effect of the latter.
When to start drinking Yarina
An important aspect of how to drink Yarina Plus is the correct start date for use. If the patient has not used contraceptives containing hormones in the past month, the first tablet of the medication should be taken on day 1 of the menstrual cycle. When the drug modification Yarina Plus begins to work, there is no need to supplement protection with barrier methods of contraception. The effect occurs immediately. It is permissible to start taking the medicine on the 2-5th day of the start of menstruation. In this case, you will need to use barrier contraceptives for a period of 7 days.
special instructions
There is a proven connection between the use of contraceptives of the described type and an increased risk of vascular thrombosis , but these diseases develop rarely. The risk of venous thrombosis is greatest in the first 12 months of taking the drug. The overall likelihood of venous thrombosis in patients using combined low-dose oral contraceptives is approximately 2.5 times higher than in patients not using such drugs. Venous or arterial thrombosis can be life-threatening and cause death in approximately 1% of cases.
Venous thrombosis can manifest as main pulmonary embolism, deep vein thrombosis, and other disorders. Arterial thromboembolism can cause vascular occlusion, stroke or myocardial infarction .
The risk of developing such thrombosis increases:
- in smokers;
- with age;
- with lesions of the heart valves;
- in obese ;
- in the presence of a hereditary or acquired tendency to thrombosis ;
- for dyslipoproteinemia ;
- with prolonged immobilization, surgery, interventions on the lower extremities;
- for migraines ;
- for arterial hypertension ;
- with atrial fibrillation .
An increase in the frequency and severity of migraine may be grounds for immediate discontinuation of this drug.
In very rare cases, when using contraceptives of the described type, the appearance of benign, and even less often, malignant liver tumors .
If severe abdominal pain occurs, liver enlargement, or symptoms of intra-abdominal bleeding, the possibility of a neoplasm should be taken into account during differential diagnosis.
In patients with deteriorating kidney function and elevated levels of potassium in the blood, the possibility of developing hyperkalemia as a result of the use of drugs that lead to a slowdown in the excretion of potassium from the body.
In patients with hypertriglyceridemia, pancreatitis may increase when taking combined contraceptives .
If during the period of use of Yarina Plus a persistent increase in blood pressure is detected, the medicine should be discontinued and therapy for arterial hypertension . It is allowed to continue taking the drug if, thanks to antihypertensive therapy, the blood pressure level has returned to normal.
Liver dysfunction may require discontinuation of Yarin Plus until the corresponding functional indicators return to normal levels. The resulting cholestatic jaundice requires discontinuation of the drug.
Taking folate may mask vitamin B12 .
Taking Yarin Plus can influence the results of a number of laboratory tests: indicators of the adrenal glands, liver, thyroid gland, kidneys, the level of transport proteins, coagulation and fibrinolysis .
The effectiveness of the medicine may be reduced if the tablets are not taken regularly, vomiting or diarrhea due to drug interactions.
While using the drug, discharge or non-cyclic bleeding from the vagina may occur, especially during the first months of taking it. Based on this, evaluation of any non-cyclic bleeding is carried out after completion of the adaptation period, which lasts 3 cycles.
If you do not take the drug regularly and there are no 2 consecutive bleedings during the withdrawal period, pregnancy must be excluded.
Before using the product, it is necessary to collect the patient’s medical history, conduct a general examination, gynecological examination, cytological diagnostics, examination of the cervix, and exclude pregnancy.
Reviews from women (before and after 30 and 40 years)
“Yarina plus didn’t suit me. I only took 9 tablets and had to cancel the appointment. I had severe weakness, dizziness, and then severe pain in the pancreas and in the heart area began. “In the end, I was prescribed a different drug.”
“I took Yarina Plus as prescribed by a doctor for the complex treatment of a corpus luteum cyst after the main treatment. There were no side effects, just none at all. And most importantly, after taking it for three months, I became pregnant without any problems. The child is healthy. We are happy".
“The first two months of taking everything was ok. but in the third month the condition began to deteriorate. There was profuse bleeding. Every day. I had to refuse the appointment.”
“Good drug. It was prescribed to me because of problems with my cycle. The only side effects were nausea and mood swings. After three months of taking it, the cycle returned to normal and the drug was discontinued. Now everything is fine, I’m healthy.”
“I took Yarina Plus for about a year. Prescribed for acne. Improvements began after two months of taking it. The downside is decreased libido.”
“A good drug Yarina plus. It helped me with acne and excess weight. Everything was back to normal. However, it doesn't suit my friend. Therefore, girls, everything is individual. If you want to take OK, go see a good specialist, get examined and get tested.”
Analogs
Level 4 ATC code matches:
Ovidon
Rigevidon
Non-Ovlon
Mercilon
Yarina
Miniziston 20 fem
Novinet
Microgynon
Janine
Lindineth
Cyclo-Proginova
Regulon
Logest
Midiana
Belara
Femoden
Jess Plus
Jess
Zoely
The closest analogue of the described product is a drug called Jazz Plus .
Reviews about Yarina Plus
Reviews about Yarina Plus on forums are generally positive. Of the associated effects, the most often noted is the appearance or elimination of acne , deterioration or improvement in the condition of hair and nails. Based on the reports of patients, we can say that unplanned pregnancy does not occur if the rules of administration are followed.
Reviews from doctors focus on the presence of calcium levomefolate , which reduces the likelihood of fetal development defects if pregnancy occurs after discontinuation of Yarina Plus.
Yarina Plus price, where to buy
The price of Yarina Plus in Russian pharmacies averages 890-940 rubles for package No. 28.
In Ukraine, a similar form of release will cost 250-320 hryvnia, depending on the region.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
ZdravCity
- Yarina plus tab.
p.p.o. 3mg+0.03mg+0.451mg n84 Bayer Weimar/Bayer Pharma RUB 2,897 order
Pharmacy Dialogue
- Yarina plus (tab. No. 28) Bayer
RUB 1,229 order
- Yarina plus (table p/o No. 28x3) Bayer
RUB 2896 order
show more
Pharmacy24
- Yarina plus N28 tablets - 3 packs Promotion of Bayer Pharma AG, Nimecchina/Bayer Weimar GmbH i Co.
KG, Nimechchyna 631 UAH.order - Yarina plus No. 28 tablets Bayer Pharma AG, Nimechchina/Bayer Weimar GmbH i Co. KG, Nimechchyna
261 UAH. order
