Yarin plus pills №28

Film Coated Tablets

Active ingredient

1 pill contains drospirenone (micronized) 3,000 mg: ethinyl estradiol betadex clathrate (micronized) in terms of ethinyl estradiol 0.030 mg, Calcium levofemolat (micronized) 0.451 mg

Packing

28 pcs.

Mechanism of action

Yarin Plus is a low-dose monophasic oral combined estrogen-gestagenic contraceptive drug, including active pills and auxiliary vitamin pills containing calcium levomefolat.

The contraceptive effect of the drug Yarin Plus is mainly carried out by suppressing ovulation and increasing the viscosity of cervical mucus.

In women taking combined oral contraceptives (COCs), the cycle becomes more regular, the pain, intensity and duration of menstrual-like bleeding decrease, reducing the risk of iron deficiency anemia. There is also evidence of a reduction in the risk of endometrial and ovarian cancer.

Drospirenone contained in the preparation Yarin Plus has anti-mineralocorticoid action and helps prevent hormone-dependent fluid retention,which can manifest itself in a decrease in body weight and a decrease in the likelihood of peripheral edema. Drospirenone also has antiandrogenic activity and helps reduce acne (acne), oily skin and hair. This effect of drospirenone is similar to the action of natural Progesterone, produced in the female body. This should be considered when choosing a contraceptive, especially for women with hormone-dependent fluid retention, as well as women with acne and seborrhea. If used correctly, the Pearl Index (a measure reflecting the number of pregnancies in 100 women using a contraceptive during the year) is less than 1. If you skip pills or misuse, the Pearl index may increase.

Calcium levomefolat. The acidic form of calcium levomefolata, in its structure is identical to the natural L-5-methyltetrahydrofolate (L-5-methyl-THF), the main folate form contained in food. The average concentration in the blood plasma of people who do not use food enriched with folic acid is about 15 nmol / l. Levomefolat, unlike folic acid, is a biologically active form of folate. Because of this, it is absorbed better than folic acid. Levomefolat is indicated to meet the increased need and provide the necessary folate content in the woman’s body during pregnancy and during breastfeeding. The introduction of calcium levomefolata in the oral contraceptive reduces the risk of developing a defect in the fetal neural tube if a woman unexpectedly becomes pregnant immediately after the use of contraception is stopped (or, in very rare cases,when using oral contraception).

Contraception, intended primarily for women with symptoms of hormone-dependent fluid retention in the body.
Contraception and treatment of moderate acne (acne vulgaris).
Contraception in women with folate deficiency.

Contraindications

The drug Yarin Plus is contraindicated in the presence of any of the conditions / diseases listed below. If any of these conditions / diseases develop for the first time against the background of administration, the drug should be immediately canceled.

• Thrombosis (venous and arterial) and thromboembolism at present or in history (including deep vein thrombosis, thromboembolism of the pulmonary artery, myocardial infarction, stroke), cerebrovascular disorders.
• The states preceding thrombosis (including transient ischemic attacks, angina pectoris) are currently or in history.
• The presence of multiple or expressed risk factors for venous or arterial thrombosis.
• Migraine with focal neurological symptoms now or in history.
• Diabetes with vascular complications.
• Hepatic failure and severe liver disease (until normalization of liver samples).
• Severe and / or acute renal failure.
• Liver tumors (benign or malignant) currently or in history.
• Identified hormone-dependent malignant neoplasms (including the genitals or mammary glands) or suspicion of them.
• Bleeding from the vagina of unknown origin.
• Pregnancy or suspicion of her.
• Lactation period.
• Hypersensitivity or intolerance to any of the components of the drug Yarin Plus.
• Yarin Plus contains lactose, therefore it is contraindicated in patients with rare hereditary lactose intolerance, lactase deficiency or glucose-galactose malabsorption.

Dosage and administration

Tablets should be taken orally in order, indicated on the package, every day at the same time, without chewing, with a small amount of water. Take 1 pill per day continuously for 28 days. Taking the pills from the next pack begins immediately after the end of taking the previous one.

Adverse reactions

Gastrointestinal: nausea, vomiting.
From the reproductive system: changes in vaginal secretion.
On the part of the endocrine system: engorgement, tenderness of the mammary glands, secretion from them; change in body weight, change in libido.
From the side of the central nervous system: decrease in mood, headache, migraine.
Other: various skin reactions, poor tolerance to contact lenses, fluid retention in the body, allergic reactions.

Drug interactions

The interaction of oral contraceptives with other drugs can lead to "breakthrough" uterine bleeding and / or decrease the reliability of contraception.

Interactions leading to a decrease in the effectiveness of the drug Yarin Plus

Effects on hepatic metabolism:the use of drugs that induce liver microsomal enzymes can lead to an increase in the clearance of sex hormones. Such drugs include: phenytoin, barbiturates, primidone, Carbamazepine, rifampicin, 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 combinations thereof, also have the potential to affect liver metabolism.

Effects on enterohepatic recirculation:according to separate studies, some antibiotics (for example, penicillins and tetracycline) can reduce the enterohepatic recirculation of estrogens, thereby reducing the concentration of ethinyl estradiol.

During the reception of drugs that affect liver microsomal enzymes, and within 28 days after their withdrawal, a barrier method of contraception should be additionally used.

Effects on enterohepatic recirculation:according to individual studies, some antibiotics (for example, penicillins and tetracycline) can reduce the enterohepatic recirculation of estrogens, thereby reducing the concentration of ethinyl estradiol.

During the reception of drugs that affect liver microsomal enzymes, and within 28 days after their withdrawal, a barrier method of contraception should be additionally used.

When taking antibiotics (with the exception of rifampicin and griseofulvin) and for 7 days after their cancellation, an additional method of contraception should be used. If the period of use of the barrier contraceptive method ends later than the hormonal orange pills in the package, you should skip the remaining auxiliary light orange pills and start taking Yarin Plus from the new package without interruption in taking the pills.

Interactions that reduce the effectiveness of calcium levomefolata

Effect on folate metabolism:Some drugs reduce the concentration of folate in the blood or reduce the effectiveness of calcium levomefolata by inhibiting the enzyme dihydrofolate reductase (for example, Methotrexate. trimethoprim, Sulfasalazine and triamterene) or by reducing folate absorption (for example, cholestyramine) or by unknown mechanisms (for example, antiepilepsytic drugs). carbamazepine, phenytoin, phenobarbital, primidone and valproic acid).

Effect on COC metabolism (enzyme inhibitors)

The major metabolites of drospirenone are formed in plasma without the participation of the cytochrome P450 system. Therefore, the effect of cytochrome P450 inhibitors on the metabolism of drospirenone is unlikely.

The effect of COC or calcium levomefolata on the activity of other drugs

COCs can affect the metabolism of other drugs, which leads to an increase (for example, cyclosporine) or a decrease (for example, lamotrigine) of their concentration in blood plasma and tissues.

Based on research interactions, as well as studies involving female volunteers who take Omeprazole, Simvastatin, and midazolam as the substrates studied, it can be concluded that the effect of drospirenone at a dose of 3 mg on the metabolism of other drugs is unlikely.

Folates can alter the pharmacokinetics or pharmacodynamics of certain drugs that affect folate metabolism. for example, antiepileptic drugs (phenytoin), mstotrexate, or pyrimethamine. which may be accompanied by a decrease (mostly reversible, subject to an increase in the dose of the drug affecting the metabolism of folates) of the ichtherapeutic action. The appointment of folate during treatment with such drugs is recommended mainly to reduce the toxicity of the latter.

At a temperature not higher than 25 ° С. Keep out of reach children location.