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Brand Name: Yaz
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Generic Name: Drospirenone 3 mg + Ethinyl Estradiol 0.02 mg
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Therapeutic Class: Fourth-generation progestin COC
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Form: 24 active tablets + 4 placebo tablets (28-day pack)
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Unique Features:
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Anti-androgenic (helps acne/hirsutism)
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Anti-mineralocorticoid (reduces bloating)
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24/4 regimen (shorter hormone-free interval)
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2. COMPOSITION
Component | Amount | Role |
---|---|---|
Drospirenone | 3 mg | Anti-androgenic progestin |
Ethinyl Estradiol | 20 μg | Estrogen component |
Lactose monohydrate | – | Filler |
Croscarmellose sodium | – | Disintegrant |
(Gluten-free formulation)
3. MECHANISM OF ACTION
✔ Contraceptive Effects:
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Inhibits ovulation (suppresses LH surge)
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Thickens cervical mucus
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Alters endometrium (prevents implantation)
✔ Therapeutic Benefits:
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Blocks androgen receptors → treats acne/hirsutism
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Antagonizes aldosterone → reduces water retention
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Stabilizes mood (used for PMDD)
4. DOSAGE & ADMINISTRATION
Standard Regimen
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1 tablet daily at same time for 24 days → 4 placebo days
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First-cycle start options:
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Day 1 start (immediate protection)
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Sunday start (use backup ×7 days)
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Missed Dose Protocol
Pills Missed | Action |
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1 pill | Take ASAP + continue normally |
2 pills | Take 2 ASAP + use backup ×7 days |
≥3 pills | Discard pack, start new + backup ×7 days |
5. INDICATIONS
✅ Contraception (Pearl Index: 0.4-1.3)
✅ Moderate acne (FDA-approved)
✅ Premenstrual Dysphoric Disorder (PMDD) (FDA-approved)
✅ Idiopathic hirsutism (off-label)
6. STORAGE CONDITIONS
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Temperature: Below 25°C
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Humidity: Keep in original blister
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Light Protection: Required
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Shelf Life: 3 years
7. KEY RECOMMENDATIONS
✔ Best for:
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Women with androgen excess symptoms
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Those needing stable hormone levels (24/4 regimen)
✔ Monitor:
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Blood pressure (risk of hypertension)
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Serum potassium (if on chronic NSAIDs/ACE inhibitors)
✔ Avoid in:
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Renal/hepatic impairment
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Adrenal insufficiency
8. IMPORTANT SAFETY NOTES
Black Box Warnings
⚠ Thromboembolic Risk:
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4-6x higher than non-users
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Greatest in first year
⚠ Smokers >35 years: Absolute contraindication
Contraindications
❌ History of VTE/ATE
❌ Migraine with aura
❌ Breast/endometrial cancer
Adverse Effects
Common (≥5%) | Serious (<1%) |
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Breakthrough bleeding | Deep vein thrombosis |
Nausea | Stroke |
Breast tenderness | Gallbladder disease |
9. COMPARISON WITH OTHER COCs
Parameter | Yaz | Yasmin | Loette |
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Progestin | DRSP | DRSP | LNG |
EE Dose | 20 μg | 30 μg | 20 μg |
Anti-Androgenic | +++ | +++ | – |
Water Retention | ↓↓ | ↓ | ↔ |
10. PATIENT COUNSELING
✔ Take with food if nausea occurs
✔ Warning signs:
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Severe leg pain
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Chest discomfort
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Visual changes
✔ For acne: Full effect in 3-6 months
CONCLUSION
Yaz offers triple benefits (contraception + acne/PMDD treatment) with improved cycle control (24/4 regimen). However, requires careful cardiovascular risk screening.
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