Is it possible to take Yarina for 1 month? Contraceptive pills Yarina - instructions for use, analogues, price, reviews

Yarina tablets contain 3 mg and 30 mcg .

Additional substances: titanium dioxide, corn starch, talc, lactose monohydrate, magnesium stearate, hypromellose, macrogol 6000, povidone K25, pregelatinized starch, iron oxide.

Release form

Light yellow tablets with engraving " DO» in a hexagon, 21 tablets in a blister, one or three blisters in a cardboard package.

pharmachologic effect

Contraceptive And estrogen-progestogen action.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The abstract describes the drug as a monophasic low-dose oral combined estrogen-progestogen.

Yarina acts by blocking ovulation and increasing the viscosity of cervical mucus.

In women using birth control pills Yarina, the menstrual cycle is normalized, menstrual-like painful bleeding is less frequently detected, the intensity and duration of bleeding is reduced, resulting in a reduced likelihood iron deficiency anemia . There is evidence of a reduced risk of ovarian cancer And .

Contraindications

Contraindications to the use of Yarina tablets:

• current and past and thromboembolism (including , ), cerebrovascular changes;
• current and past hypertriglyceridemia ;
• current and past pre-thrombosis conditions (including, ischemic attacks );
• current and past with neurological symptoms;
• with vascular complications;
• risk factors vascular thrombosis , for example, complicated changes in heart valves, vascular diseases brain or heart, surgery followed by long-term immobilization, smoking after 35 years;
• decompensated or acute failure kidney function;
• liver failure or serious illnesses liver (until tests normalize);
• current and past liver tumors;
• hormone dependent or suspected of them;
• bleeding from the vagina of unknown origin;
• 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: smoking , arterial hypertension, dyslipoproteinemia , extensive trauma, migraine , prolonged immobilization, heart valve defects, surgical interventions, hereditary predisposition to development thrombosis ;
• other diseases that can provoke changes in peripheral circulation or superficial phlebitis ;
• hypertriglyceridemia;
• hereditary genesis;
• liver diseases;
• postpartum period;
• diseases that arose or were complicated during pregnancy or previous use of sex hormones ( porphyria , jaundice , pregnant women, cholelithiasis, otosclerosis, Sydenham chorea ).

Side effects

As with other combined contraceptives, such side effects Yarina, how thromboembolism or thrombosis .

Side effects of Yarina:

• from the outside genital area: discharge from the vagina or mammary glands, pain and enlargement of the mammary glands;
• from the outside digestion: vomiting, abdominal pain, nausea, ;
• from the outside vision: discomfort when using contact lenses;
• disorders from nervous activity: worsening mood, mood changes, weakening or strengthening libido , migraine ;
• leather: erythema nodosum , rash, , erythema multiforme ;
• from the metabolic side: weight change, water retention in the body;
• other disorders: .

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 begin after a seven-day break with the usually developing " withdrawal bleeding " 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?

In the absence of any hormonal use contraception in the previous month, the use of the medicine begins on the 1st day menstrual cycle. It is also acceptable 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, contraceptive patch or vaginal ring , then it is advisable to start using the medicine on the day following the taking of 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 taking the final inactive tablet (for products including 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.

Transition from contraceptives ( containing only gestagen ) to Yarina can be carried out on any day (without a temporary break). Transition from implant containing only gestagen , or a gestagen-releasing intrauterine contraceptive - on the day of its removal. Transition from injection form – from the day on which the following procedure must 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 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

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 with 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

Whenever vomiting or 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 new packaging without a seven-day break and take pills as needed. In this case, it is possible bloody issues or bleeding.

Overdose

List of symptoms that occur during an overdose: vomit , bloody vaginal discharge , nausea .

Overdose therapy is symptomatic. There is no election.

Interaction

The use of drugs that stimulate the functioning of hepatic microsomal cells may cause an increase in the excretion of reproductive organs, which causes breakthrough bleeding or weakening of the reliability of contraception. To data medicines relate , barbiturates, and others.

Arterial thromboembolism can lead to death.

Risk of occurrence thrombosis And thromboembolism increases:

• in smokers;
• with age;
• for obesity;
• in the presence of thromboembolism ever to immediate family or parents;
• with prolonged immobilization, surgery, operations on lower limbs(in these situations, it is advisable to stop the use of combined contraceptives and not resume it for 15 days after completion of immobilization);
• at arterial hypertension ;
• at dyslipoproteinemia ;
• for diseases of the heart valves;
• at migraine ;
• at atrial fibrillation .

Increased frequency and severity of attacks migraine during the period of 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 the likelihood of developing pancreatitis when taking medications like Yarina.

In women with hereditary Quincke's edema 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.

Which is better: Midiana or Yarina?

and Yarina are complete analogues by 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?

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?

and Yarina are analogues and only slightly differ in the structure of the active substances. 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?

Unlike Yarina, it 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?

And Yarina is analogous 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 are that the latter drug contains additional calcium levomefolate , reducing the deficit folate in the body of a woman and fetus in the event of an unplanned pregnancy. The prices of the drugs are comparable.

Janine or Yarina - which is better?

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.

For children

Alcohol compatibility

Alcohol is not a contraindication for taking Yarina and does not reduce its contraceptive properties.

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 pregnancy. early stages. At the same time, the use of combined contraceptives can reduce the volume breast milk and change its composition, so the use of such drugs is not recommended until completion breastfeeding.

The contraceptive Yarina provides reliable protection from unwanted pregnancy and has a wide range of additional positive effects on the woman’s body. Active components the combined composition of the drug is created favorable conditions for tolerability of the period of menstruation and alignment of the cycle. Distinctive feature This oral contraceptive has a 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 passing preliminary consultation with your 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. This effect is most often observed in last days before stopping the course and may last until the second or third day of the new admission period.

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. If use during lactation is absolutely necessary, 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.

Analogues

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, 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

Keep out of reach of children when low humidity and the absence of direct sunlight on the packaging of Yarina at a temperature of 20 to 25 degrees.

Shelf life – 3 years.

Drug price

Price medicine averages 1181 rubles.

Monophasic oral contraceptive with antiandrogenic properties

Active ingredients

Ethinylestradiol
- drospirenone

Release form, composition and packaging

Film-coated tablets light yellow in color, engraved on one side in the form of the letters "DO" in a hexagon.

Excipients: lactose monohydrate - 48.17 mg, corn starch - 14.4 mg, pregelatinized corn starch - 9.6 mg, K25 - 4 mg, magnesium stearate - 800 mcg.

Shell composition: hypromellose (hydroxypropyl methylcellulose) - 1.0112 mg, macrogol 6000 - 202.4 mcg, talc (magnesium hydrosilicate) - 202.4 mcg, titanium dioxide (E171) - 556.5 mcg, iron (II) oxide (E172) - 27.5 mcg.

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

pharmachologic effect

Low-dose monophasic oral combined estrogen-progestogen contraceptive drug.

The contraceptive effect of the drug Yarina is carried out through complementary mechanisms, the most important of which include suppression of ovulation and increased viscosity of cervical mucus.

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

In women taking combined oral contraceptives, the menstrual cycle becomes more regular, painful menstrual-like bleeding is less common, 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 Yarina, 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, produced female body. This should be taken into account when choosing a contraceptive, especially for women with hormone-dependent fluid retention, as well as women with acne and seborrhea.

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

Pharmacokinetics

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 is achieved after 1-2 hours and is 37 ng/ml. Bioavailability ranges from 76% to 85%. Food intake does not affect bioavailability.

Distribution

The concentration of drospirenone in blood plasma decreases in two phases.

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

During cyclic treatment, C ss max of drospirenone in plasma is achieved in the second half of the cycle.

A further increase in the plasma concentration of drospirenone is observed after approximately 1-6 cycles of taking the drug; no subsequent increase in concentration is observed.

Metabolism

After oral administration, drospirenone is completely metabolized. Most metabolites in plasma are represented by acidic forms of drospirenone, which are formed without the participation of isoenzymes of the cytochrome P450 system.

Removal

It is excreted in the form of metabolites by the kidneys and through the intestines in a ratio of approximately 1.2-1.4. T1/2 of metabolites is approximately 40 hours.

Pharmacokinetics in special groups of patients

In women with moderate hepatic impairment (Child-Pugh class B), AUC is comparable to that in healthy women with similar C max values ​​in the absorption and distribution phases. T1/2 of drospirenone in patients with moderate liver dysfunction was 1.8 times higher than in healthy volunteers with intact liver function. In patients with moderate liver dysfunction, a 50% decrease in the clearance of drospirenone was observed compared with women with preserved liver function, while there were no differences in the concentration of potassium in the blood plasma in the studied groups. When diabetes mellitus is detected and concomitant use (both conditions are regarded as factors predisposing to the development of hyperkalemia), an increase in the concentration of potassium in the blood plasma has not been established. It should be concluded that drospirenone is well tolerated in women with mild to moderate liver dysfunction (Child-Pugh class B).

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

Ethinyl estradiol

Suction

After taking the drug orally, ethinyl estradiol is quickly and completely absorbed from the gastrointestinal tract.

Cmax in plasma is reached after 1-2 hours and is 54-100 pg/ml. Ethinyl estradiol undergoes a first-pass effect through the liver, resulting in its oral bioavailability averaging 45%.

Distribution

Ethinyl estradiol is almost completely (approximately 98%), although nonspecifically, bound to albumin.

Ethinyl estradiol induces the synthesis of SHBG.

The decrease in the concentration of ethinyl estradiol in the blood plasma is biphasic.

C ss is established during the second half of the first cycle of taking the drug.

Metabolism

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

Removal

Ethinyl estradiol is excreted in the form of metabolites by the kidneys and through the intestines in a ratio of approximately 4:6. T1/2 of metabolites is about 24 hours.

Indications

• contraception.

Contraindications

• thrombosis (venous and arterial) currently or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disorders);
• conditions preceding thrombosis (including transient cerebrovascular accidents, angina pectoris) currently or in history;
• migraine with focal neurological symptoms currently or in history;
• diabetes 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 hypertriglyceridemia currently or in history;
• liver failure and severe liver diseases (until normalization of liver tests);
• liver tumors (benign or malignant) currently or in history;
• severe and/or acute renal failure;
• identified hormone-dependent malignant diseases (including genital organs or mammary glands) or suspicion of them;
• bleeding from the vagina of unknown origin;
• pregnancy or suspicion of it;
• lactation (breastfeeding);
• hypersensitivity to the components of the drug.

If any of the above diseases or conditions develop for the first time while taking the drug, it should be discontinued immediately.

WITH caution

The potential risks and expected benefits of using combined oral contraceptives should be carefully weighed in each case. 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 in at a young age from any of the immediate relatives/);
• other diseases in which peripheral circulatory disorders may occur (diabetes mellitus, SLE, hemolytic uremic syndrome, Crohn's disease, UC, 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, herpes pregnant, Sydenham's chorea);
• postpartum period.

Dosage

The tablets should be taken orally in the order indicated on the package, every day at approximately the same time, with a small amount of water. Take 1 tablet/day continuously for 21 days. Taking tablets from the next package begins after a 7-day break, during which menstrual-like bleeding usually develops (withdrawal bleeding). As a rule, it begins 2-3 days after taking the last pill and may not end until you start taking pills from a new package.

Start taking the drug Yarina

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

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

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

After an abortion in the first trimester of pregnancy. You can start taking the drug immediately - on the day of the abortion. If this condition is met, the woman does not need additional contraception.

After childbirth or abortion in the second trimester of pregnancy. You should start taking the drug no earlier than 21-28 days after childbirth (in the absence of breastfeeding) or abortion in the second trimester of pregnancy. If use is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills. However, if a woman has already been sexually active, pregnancy should be ruled out before starting to take Yarina or she must wait until her first menstruation.

Taking missed pills

less than 12 hours, contraceptive protection is not reduced. The woman should take the tablet as soon as possible, and the next tablet should be taken at the usual time.

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

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

1. The drug should never be interrupted for more than 7 days.

2. 7 days of continuous tablet use are required to achieve adequate suppression of hypothalamic-pituitary-ovarian regulation.

Accordingly, can be given following tips if the delay in taking pills exceeds 12 hours (the interval from the moment of taking the last pill is more than 36 hours).

First week of taking the drug

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

Second week of taking the drug

It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers it (even if this means taking two pills at the same time). The next 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.

Third week of taking the drug

The risk of pregnancy increases due to the upcoming break in taking the pills. A woman must strictly adhere to one of the following two options. Moreover, if during the 7 days preceding the first missed pill, all pills were taken correctly, there is no need to use additional contraceptive methods.

1. It is necessary to take the last missed pill as soon as possible, as soon as the woman remembers it (even if this means taking two pills at the same time). The next tablets are taken at the usual time until the tablets in the current pack are gone. The next pack should be started immediately without interruption. Withdrawal bleeding is unlikely until the second pack is finished, but spotting and breakthrough bleeding may occur while taking the tablets.

2. You can stop taking tablets from the current package, thus starting a 7-day break (including the day you skipped tablets), and then start taking tablets from a new package.

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

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

Changing the start day of the menstrual cycle

In order to delay the onset of menstrual bleeding, it is necessary to continue taking tablets from the new package of Yarina without a 7-day break. Tablets from the new package can be taken for as long as necessary, including until the tablets from the package run out. While taking the drug from the second package, spotting from the vagina or breakthrough uterine bleeding are possible. You should resume taking Yarina from the next package after the usual 7-day break. In order to move the day of the onset of menstrual bleeding to another day of the week, a woman should shorten the next break in taking pills by as many days as she wants. The shorter the interval, the higher the risk that she will not have withdrawal bleeding, and will subsequently experience spotting and breakthrough bleeding while taking the second pack (just as if she would like to delay the onset of menstrual-like bleeding).

Additional information for special categories of patients

Children and teenagers

After menopause Yarina's drug is not indicated.

women with severe liver disease until liver function tests return to normal.

Yarina is contraindicated women with renal failure severe or with acute renal failure.

Side effects

The most common adverse reactions to Yarina include nausea and pain in the mammary glands. They occurred in more than 6% of women using this drug.

Serious adverse reactions are arterial and venous thromboembolism.

The table below shows the frequency of adverse reactions reported during clinical trials drug Yarina (n=4897). Within each group, allocated depending on the frequency of occurrence, adverse reactions are presented in order of decreasing severity. They are divided by frequency in the following way: often (≥1/100 and<1/10), нечасто (≥1/1000 и <1/100), редко (≥1/10 000 и <1/1000). Для дополнительных нежелательных реакций, выявленных только в процессе постмаркетинговых исследований, и для которых оценку частоты возникновения провести не представлялось возможным, указано "частота неизвестна".

Mental disorders: often - mood swings, depression/depressed mood, decreased or loss of libido.

From the nervous system: often - migraine.

From the cardiovascular system: rarely - venous or arterial thromboembolism*.

From the digestive system: often - nausea.

For the skin and subcutaneous tissues: frequency unknown - erythema multiforme.

From the reproductive system and mammary gland: often - pain in the mammary glands, irregular uterine bleeding, bleeding from the genital tract of unspecified origin.

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

* - Approximate frequency based on the results of epidemiological studies covering the group of combined oral contraceptives. The frequency bordered on very rare. “Venous or arterial thromboembolism” includes the following entities: peripheral deep vein occlusion, thrombosis and embolism/pulmonary vascular occlusion, thrombosis, embolism and infarction/myocardial infarction/cerebral infarction and stroke not defined as hemorrhagic.

Additional Information

Listed below are very rare or delayed-onset adverse reactions that are believed to be associated with oral combination contraceptives.

Tumors

• The incidence of breast cancer diagnosis in women taking combined oral contraceptives is slightly increased. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in women taking combined oral contraceptives is small relative to the overall risk of breast cancer;
• liver tumors (benign and malignant).

Other states

• erythema nodosum;
• women with hypertriglyceridemia (increased risk of pancreatitis while taking combined oral contraceptives);
• increased blood pressure;
• conditions that develop or worsen while taking combined oral contraceptives, but their relationship with taking the drug has not been proven (jaundice and/or itching associated with cholestasis; formation of gallstones; porphyria; SLE; hemolytic-uremic syndrome; Sydenham's chorea; herpes pregnant women; hearing loss associated with otosclerosis);
• In women with hereditary angioedema, estrogen may cause or worsen symptoms;
• liver dysfunction;
• impaired glucose tolerance or effect on insulin resistance;
• Crohn's disease, ulcerative colitis;
• chloasma;
• hypersensitivity (including symptoms such as rash, urticaria).

Interaction

Interaction of oral contraceptives with other drugs (inducers of microsomal liver enzymes, some antibiotics) may lead to breakthrough bleeding and/or decreased contraceptive effectiveness.

Overdose

No serious adverse events have been reported following overdose. Based on cumulative experience with combined oral contraceptives symptoms which may occur in case of overdose: nausea, vomiting, spotting vaginal discharge or metrorrhagia.

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

Drug interactions

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

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

Effect on hepatic metabolism

The use of drugs that induce liver microsomal enzymes can lead to an increase in the clearance of sex hormones, which in turn can lead to breakthrough bleeding or reduced contraceptive reliability. Such drugs include phenytoin, barbiturates, primidone, carbamazepine, rifampicin, rifabutin, possibly also oxcarbazepine, topiramate, felbamate, griseofulvin and preparations containing St. John's wort.

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

Effect on enterohepatic circulation

According to individual studies, some antibiotics (for example, penicillins and tetracyclines) may reduce the enterohepatic circulation of estrogens, thereby lowering the concentration of ethinyl estradiol. 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 (such as penicillins and tetracyclines) and for 7 days after their discontinuation, you should additionally use a barrier method of contraception. If during these 7 days of the barrier method of contraception the tablets in the current package run out, then you should start taking tablets from the next package of Yarina without the usual break in taking the tablets.

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

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

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

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

special instructions

Medical examinations

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

A woman should be warned that hormonal contraceptives do not protect against 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 using Yarina should be carefully weighed in each individual case and discussed with the woman before she decides to start taking the drug . If risk factors become more severe, intensify, or when risk factors first appear, it may be necessary to discontinue the drug.

Diseases of the cardiovascular system

The results of epidemiological studies indicate a relationship between the use of combined oral contraceptives and an increased incidence of venous and arterial thrombosis and thromboembolism, such as deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular diseases) when taking combined oral contraceptives. These diseases are rare.

The risk of developing venous thromboembolism (VTE) is greatest in the first year of taking such drugs. An increased risk is present after initial use of combined oral contraceptives or resumption of use of the same or different combined oral contraceptives (after a dosing interval of 4 weeks or more). Data from a large prospective study involving 3 groups of patients suggest that this increased risk is predominantly present during the first 3 months.

The overall risk of VTE in patients taking low-dose combined oral contraceptives (<50 мкг этинилэстрадиола), в 2-3 раза выше, чем у небеременных пациенток, которые не принимают комбинированные пероральные контрацептивы, тем не менее, этот риск остается более низким по сравнению с риском ВТЭ при беременности и родах.

VTE can be life-threatening or fatal (in 1-2% of cases).

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

Very rarely, when using combined oral contraceptives, thrombosis of other blood vessels occurs, for example, hepatic, mesenteric, renal, cerebral veins and arteries or retinal vessels. There is no consensus regarding the relationship between the occurrence of these events and the use of combined oral contraceptives.

Symptoms of deep vein thrombosis (DVT) include: unilateral swelling of the lower extremity or along a vein in the leg, pain or discomfort in the leg only when standing or walking, localized warmth in the affected leg, redness or discoloration of the skin on the leg.

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

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

Symptoms of myocardial infarction include: pain, discomfort, pressure, heaviness, a feeling of squeezing or fullness in the chest, arm, or chest; discomfort radiating to the back, cheekbone, larynx, arm, stomach; cold sweat, nausea, vomiting or dizziness, severe weakness, anxiety or shortness of breath; fast or irregular heartbeat.

Arterial thromboembolism can be life-threatening or fatal.

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

• with age;
• in smokers (with increasing number of cigarettes or increasing age, the risk increases, especially in women over 35 years of age);
• for obesity (BMI more than 30 kg/m2);
• if there are indications in the 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 or acquired predisposition, the woman should be examined by an appropriate specialist to decide on the possibility of taking combined oral contraceptives;
• with prolonged immobilization, major surgery, any operation on the lower extremities or major trauma. In these situations, it is advisable to stop using the drug (in the case of a planned operation, at least 4 weeks before it) and not to resume taking it for 2 weeks after the end of immobilization;
• with dyslipoproteinemia;
• with arterial hypertension;
• for migraines;
• for diseases of the heart valves;
• with atrial fibrillation.

The possible role of varicose veins and superficial thrombophlebitis in the development of venous thromboembolism remains controversial.

The increased risk of thromboembolism in the postpartum period should be taken into account.

Peripheral circulatory disorders may also occur in diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, chronic inflammatory bowel disease (Crohn's disease or UC), and sickle cell anemia.

An increase in the frequency and severity of migraine during use of combined oral contraceptives (which may precede cerebrovascular events) may be grounds for immediate discontinuation of these drugs.

Biochemical indicators indicating a hereditary or acquired predisposition to venous or arterial thrombosis include: resistance to activated protein C, hyperhomocysteinemia, antithrombin III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant).

When assessing the risk-benefit ratio, it should be taken into account that adequate treatment of the relevant condition may reduce the associated risk of thrombosis. It should also be taken into account that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives (<50 мкг этинилэстрадиола).

Tumors

The most significant risk factor for developing cervical cancer is persistent human papillomavirus infection. There are reports of a slight increase in the risk of developing cervical cancer with long-term use of combined oral contraceptives. However, the connection with the use of combined oral contraceptives has not been proven. The possibility of the relationship of these data with screening for cervical diseases or with sexual behavior characteristics (less frequent use of barrier methods of contraception) is discussed.

A meta-analysis of 54 epidemiological studies found that there is a slightly increased relative risk of developing breast cancer diagnosed in women currently taking combined oral contraceptives (relative risk 1.24). The increased risk gradually disappears within 10 years of stopping these drugs. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in women currently or recently taking combined oral contraceptives is small relative to the overall risk of breast cancer. The relationship between the development of breast cancer and the use of combined oral contraceptives has not been proven. The observed increased risk may also be a consequence of careful monitoring and earlier diagnosis of breast cancer in women using combined oral contraceptives. Women who have ever used combined oral contraceptives are diagnosed with earlier stages of breast cancer than women who have never used them.

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

Malignant tumors can be life-threatening or fatal.

Other states

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

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

Although slight increases in blood pressure have been described in many women taking combined oral contraceptives, clinically significant hypertension has been reported rarely. However, if a persistent, clinically significant increase in blood pressure develops while taking the drug, these drugs should be discontinued and treatment of arterial hypertension should be initiated. The drug can be continued if normal blood pressure values ​​are achieved with antihypertensive therapy.

The following conditions have been reported to develop or worsen both during pregnancy and while taking combined oral contraceptives, but their relationship with taking combined oral contraceptives has not been proven: jaundice and/or pruritus associated with cholestasis; formation of gallstones; porphyria; SLE; hemolytic-uremic syndrome; Sydenham's chorea; herpes during pregnancy; hearing loss associated with otosclerosis. Cases of Crohn's disease and UC have also been described during the use of combined oral contraceptives.

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

In case of acute or chronic liver dysfunction, it may be necessary to discontinue the drug until liver function tests return to normal. Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous use of sex hormones, requires discontinuation of the drug.

Although combined oral contraceptives may have an effect on insulin resistance and glucose tolerance, there is no need to change the therapeutic regimen in diabetic patients using low-dose combined oral contraceptives (<50 мкг этинилэстрадиола). Тем не менее, женщинам с сахарным диабетом необходим тщательный контроль во время приема препарата.

When using the drug, the development of chloasma is possible, especially in women with a history of chloasma during pregnancy. Women with a tendency to chloasma while taking Yarina should avoid prolonged exposure to the sun and exposure to ultraviolet radiation.

The effectiveness of Yarina may be reduced by missing tablets, vomiting and diarrhea, or as a result of drug interactions.

Effect on the menstrual cycle

While taking Yarina, irregular (acyclic) bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use. Therefore, any irregular menstrual bleeding should be assessed only after an adaptation period of approximately 3 cycles.

If irregular menstrual-like bleeding recurs or develops after previous regular cycles, a thorough examination should be performed to rule out malignancy or pregnancy.

Some women may not develop withdrawal bleeding during a pill-free break. If the use of the drug Yarina was carried out in accordance with the instructions, then pregnancy is unlikely. However, if the drug is not used regularly and there are no two consecutive menstrual-like bleedings, the drug cannot be continued until pregnancy has been ruled out.

Impact on laboratory test performance

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

Impact on the ability to drive vehicles and operate machinery

Not found.

Experimental results

Preclinical data from routine studies of repeated dose toxicity, hepatotoxicity, carcinogenic potential and reproductive toxicity do not indicate a particular risk to humans. However, it should be taken into account that sex steroids may promote the growth of certain hormone-dependent tissues and tumors.

Pregnancy and lactation

The drug is not prescribed during pregnancy and breastfeeding.

If pregnancy is detected while using 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.

At the same time, data on the results of taking the drug Yarina during pregnancy are limited, which does not allow us to draw any conclusions about the negative impact of the drug on pregnancy, the health of the newborn and the fetus. Currently, no significant epidemiological data are available.

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

Use in childhood

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

The drug Yarina is not indicated.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

The drug should be stored out of the reach of children at a temperature not exceeding 25°C. Shelf life - 3 years.

Yarina is a low-dose monophasic combined oral contraceptive.

This drug has proven itself well in the oral contraceptive market.

Manufacturer Yarina – Bayer Schering Pharma AG (Germany).

Like everything OK, Yarina acts as follows:

• Suppresses ovulation (prevents the development and release of the egg)
• Makes cervical mucus thick (i.e. the cervix becomes impenetrable to sperm)
• Changes the structure of the endometrium (the lining of the uterus), and therefore the fertilized egg cannot attach to the walls of the uterus

Compound

• Ethinyl estradiol (30 mcg) – an analogue of endogenous estradiol
• (3 mcg) – has an antiandrogenic effect
• Excipients: lactose monohydrate, corn starch, pregelatinized corn starch, povidone K25, magnesium stearate, hypromellose (hydroxypropyl methylcellulose), macrogol 6000, talc (magnesium hydrosilicate), titanium dioxide (E 171), iron (II) oxide (E 172).

The dosage and composition of hormones is the same for all tablets, because Yarina is a monophasic drug.

Price, where to buy

How much do Yarin tablets cost? The price in Russia may vary. It depends on the place of purchase (pharmacy chain, region of residence).

The price of Yarina birth control pills in pharmacies starts from 1,020 rubles (for a package of 21 tablets) and can reach up to 1,360 rubles. The cost of a package for three months (63 tablets) is much cheaper - an average of 2950 rubles.

You can buy Yarina in pharmacies. Hormonal pills are available by prescription.

Indications for use

Who is Yarina suitable for, and in what cases is she prescribed?

Yarina tablets are needed for protection against pregnancy (for healthy women), as well as for the treatment of certain gynecological problems and acne.

Therapeutic effects from Yarina

• Restoration of the menstrual cycle
• Reducing pain and PMS symptoms
• Reducing blood loss during menstruation (or getting rid of intermenstrual bleeding)
• Reducing the risk of developing uterine and ovarian cancer
• Preventing Endometriosis
• Prevention of anemia caused by iron deficiency
• Treatment of moderate forms of acne (from acne on the face)
• Preventing edema (removing excess fluid from the body while preserving potassium)
• Prevention and treatment of excess greasiness in hair and skin, sulfur, the appearance of unwanted body hair (hirsutism)
• Prevention and treatment of dysmenorrhea

Sometimes, to facilitate pregnancy, doctors prescribe Duphaston after Yarina. This is necessary in order to restore the endometrium, which may become thinner while taking OCs. You need to drink Duphaston strictly after ovulation for 10 days (if the cycle is 28 days, then you drink it from the 16th to the 25th day of the cycle).

Yarina is also often prescribed by doctors for polycystic ovarian disease (cyst). The drug has proven itself well as a therapeutic measure for polycystic ovary syndrome, as well as in cases with single large tumors.

Yarina for endometriosis

Endometriosis is a female disease of the reproductive period (develops against the background of an increase in the amount of estrogen and a decrease in the amount of progesterone). At an early stage, it can be treated with hormonal drugs. Usually either Janine or Yarina is prescribed. The second drug is preferable in some respects.

Why Yarina?

• This is a newer and more active drug due to the content of a larger proportion of the main components
• Yarina's absorption period is only 1.5 hours
• The list of contraindications for the use of Yarina is much smaller than for other drugs (for example, Zhanine)
• Even after stopping taking Yarina, a positive effect of the drug is observed (hormonal balance is restored, tissue proliferation stops, neoplasms resolve)

Yarina with adenomyosis

Yarina is prescribed as part of the complex treatment of adenomyosis (internal endometriosis).

Adenomyosis is a chronic gynecological disease. At the initial stage, the pathological process is asymptomatic; over time, complications are possible, including infertility.

Main signs of the disease:

• long and heavy menstruation
• pelvic pain of varying intensity and nature

Visit your gynecologist regularly to detect pathology in a timely manner.

Yarina for uterine fibroids

Uterine fibroids are a benign tumor that develops from the muscle cells of the uterus. For a long time, the tumor may not show any signs and not cause discomfort to the woman. .

When diagnosed with uterine fibroids, Yarina is prescribed to normalize the cycle, reduce the amount of menstrual blood loss (which stops the growth of fibroids), eliminate painful sensations during menstruation, to block ovulation, to prevent malignant tumors of the uterus and ovaries, as well as to prevent anemia.

Due to the monophasic nature of Yarina, containing both estrogens and progesterones, the nutrition of the fibroid first stops, after which it stops its development and freezes.

Yarina with an ovarian cyst

The cause of cysts is hormonal imbalance. A cyst is a sac filled with fluid. As it grows, it can cause the development of polycystic ovary syndrome, and then infertility. When walking, exercising, or during sexual intercourse, cysts provoke pain in the lower abdomen.

How does Yarina work? At the level of the hypothalamic-pituitary system, the production of follicle-stimulating hormone is blocked (lack of ovulation). The permeability of cervical secretions for sperm decreases, and egg implantation also does not occur. As a result, during the period of taking OK, the female reproductive system has the opportunity to completely rest and recover.

Yarina for mastopathy

The mammary gland is very sensitive to sex hormones. Violation of their balance leads to the development of mastopathy and its unpleasant manifestations.

Oral contraceptives when taken regularly:

• reduce proliferative processes in the breast (uncontrolled cell growth with the formation of cysts, fibroadenomas, etc. does not occur) This is achieved primarily through the establishment of menstrual function and the regulation of connections in the hypothalamus - pituitary gland - ovaries - mammary glands.
• help reduce the level of estrogen in the blood (protect the breasts from their excessive influence).
• have a therapeutic effect on the organs of the woman’s reproductive system.
• reduce the risk of breast cancer by 2 times. The effect of taking it lasts for 10 years, so it is preferable to use hormonal contraceptives after 30–35 years of age.
• reduce the rate of progression of mastopathy.

Yarina for endometrial hyperplasia

Hyperplasia must be treated comprehensively. Therapy should consist of several successive stages. Yarina is used at the first stage of treatment (reception can last up to six months).

The first stage of treatment is to stop the bleeding. If the drug does not work, then curettage of the uterine cavity is performed and a number of hemostatic drugs are administered to stop the bleeding.

If necessary, blood substitutes and drugs that normalize the water-salt balance in the body are also administered. In some cases, intravenous injections of vitamins B, C, rutin and folic acid are given.

Contraindications

You should know that Yarina is prohibited for:

• Intolerance to the drug components
• Pancreatitis
• Threat of thrombosis
• Thrombosis, thromboembolism
• Angina and ischemic attacks
• Myocardial infarction
• Diabetes mellitus
• Vascular pathologies
• Hormonal tumors
• Diseases of the liver, kidneys (+ their poor functioning)
• Migraine + neurological disorders
• Pregnancy or lactation
• Vaginal bleeding of unknown origin
• Diabetes
• Circulatory disorder
• Edema of the mucous membranes (Quincke's edema)
• Menopause (after 40, 45 with caution)
• Smoking (especially after 35)

Side effects

Side effects from Yarina may be as follows:

• Sometimes, when taking Yarina, intermenstrual bleeding of unknown origin may occur.
• Spotting in the middle of the cycle
• Decreased libido
• Headache, dizziness, migraine
• Weight fluctuations (weight loss or weight gain)
• Nausea, vomiting, diarrhea (diarrhea), stomach pain
• Apathy, depression, mood swings
• Breast enlargement
• Breast tenderness
• Allergy to the components of the drug (rash, redness, hives, eczema and other allergic reactions)
• Stagnation of fluid in the body

• Changes in blood pressure, thromboebolism
• Bronchial asthma
• Liver dysfunction (jaundice, cholestasis)
• Difficulty absorbing glucose

• Hyperkalemia, hypertriglyceridemia

Yarina and the thrush. Some women on forums write that they developed thrush while stopping or starting taking the drug. What to do if this happens?

• take Mikoflucan once
• drink Yarina to the end
• after a week's pass, switch to another OK
• you can use candles for girls (Hexicon D, Polizhenax Virgo), as well as sprays (Epigen Intim, Panavir-inlight)
• pay attention to digestion; if there is a problem, taking probiotics (hilak forte, bactistatin) is recommended

It should be remembered that the consequences of taking Yarina are individual for everyone: some lose weight, some gain weight, some have no changes in weight. Some people's hair falls out, while for others it becomes thicker.

Therefore, the side effects are individual for everyone. And for some they may not exist at all.

Therefore, asking “Do Yarina make you lose weight”, “Is it possible to lose weight after Yarina” or “Do Yarina make you fat”, “Is it possible to gain weight from Yarina” is pointless to ask. Because there is no correct answer.

To avoid side effects and weight fluctuations, you need to choose the right drug. And for this you should make an appointment with a good gynecologist, undergo an examination and take tests.

Instructions for use

How to take Yarina correctly? From what day should I take it?

The rules for taking Yarina are the same as for most COCs with 21 active tablets. You drink Yarina every day at the same time, with a small amount of water, for 21 days. Afterwards, take a break for 7 days (at this time withdrawal bleeding occurs - menstruation). On the 8th day you start drinking a new package.

ATTENTION! A break from taking Yarina is possible only if you have completed 21 active tablets. It is impossible to interrupt taking OK in the middle of a pack, this can cause severe disruptions in the functioning of the body. You should also consult your doctor about discontinuing the drug.

How to drink Yarina for the first time?

If you have never taken COCs before

You should start taking Yarina on the first day of your period (cycle). This is necessary so that at the end of menstruation you do not have to use additional contraceptives, because Yarina begins to act on the seventh day. If you started taking it on the 2-3rd day of your cycle, then after your period, for a few days it is better to use a condom to be safe.

ATTENTION! If you start drinking OK for the first time, you first need to consult a doctor, undergo an examination and take tests, this is necessary in order to choose the right contraceptive. The right remedy for you is a guarantee of a good start on birth control pills, without complications.

If you are switching from another oral medication

You finish the package, take a break for 7 days (if there are 21 tablets in the blister) and on the 8th day you start taking Yarina.

After childbirth, abortion (second trimester) and miscarriage

Usually, taking OK can be started after 21 days, if there are no complications. But everything is very individual, so you need specialist advice.

If the abortion was done in the early stages (first trimester), then you can start taking Yarina immediately.

Yarina's compatibility

Yarina and alcohol. The instructions do not say whether you can drink alcohol while taking Yarina. The compatibility of these substances is acceptable within reasonable limits. You can indulge in 1-2 glasses of wine from time to time. However, it is worth remembering that drugs such as oral contraceptives place additional stress on the liver. Alcohol does the same thing. Plus, vomiting or diarrhea may develop due to alcohol consumption, and this negatively affects the absorption of the drug. Alcohol also affects the central nervous system, causes drowsiness, and impairs memory. You may simply forget to take your pill.

ATTENTION! Oral contraceptives are contraindicated in cases of liver dysfunction.