Do Not Use! The New Birth Control Pill Drospirenone With Ethinyl Estradiol (YASMIN)
he combination birth control conditions: * Liver tumor (benign or malig- pill of ethinyl estradiol with * Kidney problems; nant) or active liver disease; T drospirenone (YASMIN) * Liver problems; * Known or suspected preg- was approved by the Food and * Adrenal disease; nancy; Drug Administration (FDA) in * Disorders that lead to the * Heavy smoking (more than 15 April 2001. Combination birth formation of blood clots; cigarettes per day); and control pills contain the hor- * Being over age 35. mones estrogen and progestin. A number of prescription and These products are referred to as nonprescription drugs can combined hormonal oral contra- contribute to increased blood ceptives. In the case of Yasmin, There is no levels of potassium. These ethinyl estradiol is the estrogen include: and drospirenone is the proges- * Nonsteroidal anti-inflamma- tin. The difference between evidence that tory drugs (NSAIDs) such as Yasmin and the other birth ibuprofen (MOTRIN), control pills on the market is that Yasmin is naproxyn (ALEVE), and drospirenone has never before celecoxib (CELEBREX) when been marketed in the U.S. and is superior in taken long term and daily for unlike other progestins that have the treatment of arthritis and been available here. other problems; Drospirenone is a close chemi- any way to * Potassium sparing diuretics cal cousin of spironolactone such as spironolactone, (ALDACTONE), a diuretic or older triamterene (DYRENIUM), water pill that causes the body to and amiloride (MIDAMOR); retain potassium. Spironolactone * Potassium supplementation is known as a potassium sparing contraceptive that includes the use of diuretic and a 3-milligram dose of unregulated dietary supple- drospirenone, the amount in a products. ments labeled as containing daily pill, is equivalent to 25 potassium; milligrams of spironolactone. * Angiotensin converting Two facts cause us to list Yasmin * A past history of blood clots; enzyme (ACE) inhibitors such as a Do Not Use drug: (1) * Cerebral-vascular or coronary as captopril (CAPOTEN) and drospirenone causes elevated artery disease; enalapril (VASOTEC); blood levels of potassium that * Known or suspected cancer of * Angiotensin receptor blockers, may cause serious heart and other the breast; also known as angiotensin-II health problems such as a change * Cancer of the endometrium or receptor antagonists, such as in acid balance of the blood and other known or suspected losartan (COZAAR) and muscle weakness; and (2) there is estrogen-dependent cancer; valsartan (DIOVAN); no evidence that Yasmin is * Undiagnosed abnormal genital * Heparin, which is an injectable superior in any way to older bleeding; anticoagulant (blood thinner) contraceptive products. * Cholestatic jaundice (yellowing that is rarely used outside of The use of Yasmin is contrain- of the skin or eyes) of preg- the hospital. dicated (should not be used) in nancy or jaundice with prior The professional product women with the following pill use; labeling, or “package insert,” for
28 Worst Pills, Best Pills News Yasmin specifies that a blood contraceptive effectiveness and contraceptive increased the test be done during the first an increase in menstrual absorption of the progestin month of use, in order to check irregularities have been norethindrone and ethinyl potassium level if any of the associated with concomitant estradiol by approximately above listed drugs are also use of rifampin. 30 percent and 20 percent, being taken. This blood test is * Anticonvulsants such as respectively. not required for any other birth phenobarbital (LUMINAL, * ST. JOHN’S WORT. Herbal control pill currently on the SOLFOTON), phenytoin supplement preparations market. (DILANTIN), and containing St. John’s Wort Yasmin is required to contain carbamazepine (TEGRETOL) (hypericum perforatum) the following bold-faced warn- have been shown to increase may induce liver enzymes ing: the metabolism of ethinyl that may reduce the effec- Yasmin contains 3 mg of the estradiol and/or some tiveness of oral contracep- progestin drospirenone that progestins, which could result tives and emergency contra- has antimineralocorticoid in a reduction of contraceptive ceptive pills. This may also activity, including the effectiveness. result in breakthrough potential for hyperkalemia bleeding. [elevated blood levels of * Other. Ascorbic acid (vitamin potassium] in high-risk C) and acetaminophen patients, comparable to a 25 (TYLENOL) may increase mg dose of spironolactone. plasma levels of some Yasmin should not be used Women that synthetic estrogens, possibly in patients with conditions by inhibition of their me- that predispose to hyper- use these pills tabolism. kalemia (i.e. renal insuffi- In the May 1999 issue of ciency, hepatic dysfunction have a Worst Pills, Best Pills we listed and adrenal insufficiency). another type of combined birth Women receiving daily, long control pill as Do Not Use. These term treatment for chronic doubling in are products containing ethinyl conditions or diseases with estradiol and the progestin medications that may their risk of desogestrel (DESOGEN, increase serum potassium, ORTHO-CEPT). Birth control should have their serum pills containing desogestrel are potassium level checked developing referred to as third generation during the first treatment oral contraceptives and women cycle. Drugs that may blood clots. that use these pills have a increase serum potassium doubling in their risk of devel- include ACE inhibitors, oping blood clots compared to angiotensin–II receptor second generation oral contra- antagonists, potassium- * Antibiotics. Pregnancy while ceptives. The second generation sparing diuretics, heparin, taking birth control pills has oral contraceptives contain the aldosterone antagonists, and been reported when oral progestins norgestrel, NSAIDs. contraceptives were taken with levonorgestrel or norethin- Yasmin and other birth antibiotics such as ampicillin drone. control pills may interact with (AMOXIL), tetracycline the following drugs: (ACHROMYCIN, SUMYCIN), What You Can Do * Rifampin (RIMACTANE, and griseofulvin (FULVICIN, RIFADIN), a drug used for GRIFULVIN V, GRISACTIN, There is no medical reason tuberculosis. The breakdown GRIS-PEG). that you should be using Yasmin (metabolism) of ethinyl * Atorvastatin (LIPITOR), a rather than one of the older pills estradiol and some cholesterol lowering “statin” containing the progestins progestins is increased by drug. Coadministration of norgestrel, levonorgestrel or rifampin. A reduction in atorvastatin and an oral norethindrone.
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