Instructions for use YARINA®PLUS

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

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

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

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

Composition of hormones in Yarina: ethinyl estradiol and drospirenone .

• Drospirenone has an antimineralocorticoid effect and is able to prevent weight gain and the appearance of other symptoms associated with deterioration of fluid excretion from the body.
• Drospirenone demonstrates antiandrogenic activity and helps reduce acne and oily skin.

Pharmacokinetics

Drospirenone

When taken orally, it is quickly absorbed. The highest level in the blood is reached after about an hour and a half. Bioavailability approaches 75-85%. Eating food does not affect the bioavailability of drospirenone.

albumin in the blood and does not bind to corticosteroid-binding globulin . Only about 4% of the total content in serum is present in free form.

Completely metabolized. Transformation products are represented by acid derivatives of drospirenone , which are excreted in urine and feces in a ratio of 6/5. The half-life is approximately 40 hours.

In women with moderate liver dysfunction, pharmacokinetic parameters are comparable to those in healthy women, and the half-life of drospirenone in such patients is 1.8 times longer than in healthy individuals with normal liver function. In patients with moderate liver dysfunction, the clearance of drospirenone was reduced by half compared to healthy women.

The concentration of drospirenone in the blood at steady state in women with mild renal impairment is comparable to that in healthy women. And in women with moderate renal impairment, the content of drospirenone in the blood is 35% higher than in healthy women.

There were no fluctuations in blood potassium concentrations when using drospirenone.

Ethinyl estradiol

After consumption, ethinyl estradiol is actively absorbed. The highest level in the blood, as Wikipedia indicates, is achieved in an hour and a half. Metabolized in the liver, bioavailability is about 45%. The main transformation method is aromatic hydroxylation. Approximately 98% of the molecules of the substance are bound by albumin.

It is not excreted from the body in unchanged form. Ethinyl estradiol derivatives are excreted in urine and bile. The half-life is 24 hours.

Compound

Contraindications

Contraindications to the use of Yarina tablets:

• current and past thrombosis and thromboembolism (including stroke, venous thrombosis, myocardial infarction, pulmonary embolism ), cerebrovascular changes;
• current and past pancreatitis with hypertriglyceridemia ;
• current and past pre-thrombosis conditions (including angina pectoris , ischemic attacks );
• current and past migraines with neurological symptoms;
• diabetes mellitus with vascular complications;
• risk factors for vascular thrombosis , for example, atrial fibrillation , complicated changes in heart valves, vascular diseases of the brain or heart, surgery followed by prolonged immobilization, arterial hypertension , smoking after 35 years;
• decompensated renal failure or acute renal failure;
• insufficiency of liver function or severe liver disease (until normalization of tests);
• current and past liver tumors;
• hormone-dependent malignant tumors or suspicion of them;
• bleeding from the vagina of unknown origin;
• lactation;
• 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: obesity , smoking , arterial hypertension, dyslipoproteinemia , extensive trauma, migraine , prolonged immobilization, heart valve defects, surgical interventions, hereditary predisposition to the development of thrombosis ;
• other diseases that can provoke changes in peripheral circulation or superficial phlebitis ;
• hypertriglyceridemia;
• angioedema of hereditary origin;
• liver diseases;
• postpartum period;
• diseases that arose or were complicated during pregnancy or previous use of sex hormones ( porphyria , jaundice , herpes of pregnant women, cholelithiasis, otosclerosis, Sydenham's chorea ).

Contraindications to the use of the drug Yarina

Combined oral contraceptives (COCs) should not be used if you have one of the following conditions or diseases. If any of them occurs for the first time while using the COC, the drug should be stopped immediately:

• venous or arterial thrombotic/thromboembolic events (eg deep vein thrombosis, pulmonary embolism, myocardial infarction) or cerebrovascular disorders, including a history;
• prodromal symptoms of thrombosis (for example, transient ischemic attack, angina), including a history;
• history of migraine with focal neurological symptoms;
• diabetes mellitus with vascular damage;
• the presence of severe or multiple risk factors for venous or arterial thrombosis may also be a contraindication (see APPLICATION);
• pancreatitis (including a history) associated with severe hypertriglyceridemia;
• severe liver disease (until liver function indicators normalize);
• liver tumors (benign or malignant), including history;
• known or suspected hormone-dependent malignant tumors (for example, genitals or mammary glands);
• vaginal bleeding of unknown etiology;
• pregnancy;
• hypersensitivity to the active substances or to any of the components of the drug.

Side effects

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

Side effects of Yarina:

• from the genital area: discharge from the vagina or mammary glands, pain and enlargement of the mammary glands;
• from the digestive system: vomiting, abdominal pain, nausea, diarrhea ;
• from the visual side: discomfort when using contact lenses;
• disorders of nervous activity: deterioration of mood, mood changes, weakening or increased libido , headache , migraine ;
• skin: erythema nodosum , rash, urticaria, erythema multiforme ;
• from the metabolic side: weight change, water retention in the body;
• other disorders: allergic reactions.

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 be started after a seven-day break, with “ withdrawal bleeding ” usually developing. 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?

If you have not used any hormonal contraceptives in the previous month, the use of the medicine begins on the 1st day of the menstrual cycle. It is also permissible 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, a contraceptive patch or vaginal ring , then it is advisable to start using the medicine on the day following 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 consuming the final inactive tablet (for products containing 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.

The transition from contraceptives ( mini-pills containing only gestagen ) to Yarina can be done on any day (without a temporary break). Switching from an implant containing only gestagen , or a gestagen-releasing intrauterine contraceptive - on the day of its removal. Switching from the injection form - from the day on which the following procedure should 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 an abortion 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

If the medicine was taken 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 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

If vomiting or diarrhea 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 a new package without a seven-day break and take the tablets as needed. In this case, spotting or bleeding is possible.

Pharmacological properties of the drug Yarina

The contraceptive effect of combined oral contraceptives (COCs) is based on the interaction of various factors, important of which are suppression of ovulation and changes in cervical secretion. In addition to preventing pregnancy, PDAs have a number of positive effects that are taken into account when choosing a contraceptive method. The menstrual cycle becomes regular, menstruation is less painful, and bleeding decreases. The latter reduces the incidence of iron deficiency anemia. In addition to contraception, drospirenone also exhibits other positive effects, in particular antimineralocorticoid activity, which prevents weight gain and the occurrence of other symptoms associated with fluid retention in the body. It prevents sodium retention caused by estrogen, provides good tolerability and improves the condition of premenstrual syndrome. In combination with ethinyl estradiol, drospirenone has a positive effect on the lipid profile, increasing HDL levels. Drospirenone has an antiandrogenic effect, manifested by a positive effect on the skin, reducing acne and sebum production. Also, drospirenone does not interfere with the ethinyl estradiol-induced increase in the level of sex steroid binding globulin (SHBG), which is necessary for the binding and inactivation of endogenous androgens. Drospirenone does not have androgenic, estrogenic, glucocorticoid and antiglucocorticoid activity, which, in combination with antimineralocorticoid and antiandrogenic properties, indicates the similarity of the pharmacological and biochemical profile of drospirenone with the natural hormone progesterone. The risk of developing endometrial and ovarian cancer has been proven to reduce when using COCs. It has been established that when using COCs in high doses (50 mcg ethinyl estradiol), the risk of ovarian cysts, pelvic inflammatory diseases, benign diseases of the mammary glands and ectopic pregnancy is reduced. Whether this applies to CCP in low doses has not been definitively established. The results of standard nonclinical studies of repeated use toxicity, genotoxicity, carcinogenicity and reproductive toxicity do not indicate the existence of any specific risk to the human body. However, it should be noted that sex steroids may promote the growth of certain hormone-dependent tissues and pre-existing tumors. Drospirenone After oral administration, drospirenone is rapidly and completely absorbed. The maximum serum concentration is 37 ng/ml, achieved approximately 1–2 hours after a single oral dose. Bioavailability is about 76–85%. Concomitant food intake does not affect the bioavailability of the drug. Drospirenone binds to plasma albumin, but does not bind to SHPS and SHBG. Only 3–5% of its total amount in the blood serum is in a free state, 95–97% is nonspecifically bound to albumin. The increase in SHPS caused by ethinyl estradiol does not affect the binding of drospirenone to plasma proteins. The average volume of distribution of drospirenone is 3.7–4.2 L/kg. Drospirenone is completely metabolized. The main metabolites in the blood plasma are the acid forms of drospirenone, which are formed when the lactone ring opens, and 4,5-dihydro-drospirenone-3-sulfate. Both metabolites are formed without the participation of the P450 system. In small quantities, drospirenone is metabolized by cytochromes P450 3A4 ( in vitro ). The clearance rate of drospirenone in serum is approximately 1.2–1.5 ml/min/kg. No direct interaction between drospirenone and ethinyl estradiol has been identified. The concentration of drospirenone in the blood serum decreases in two phases. In the terminal phase, the half-life is about 31 hours. Drospirenone is not excreted unchanged. Metabolites are excreted in urine and bile in a ratio of 1.2 to 1.4; The half-life is approximately 1.7 days. The pharmacokinetics of drospirenone are not affected by the concentration of SHPS. After daily administration, the concentration of the drug in the blood serum increases 2-3 times, reaching an equilibrium concentration during the second half of the administration cycle. Ethinyl estradiol When administered orally, ethinyl estradiol is rapidly and completely absorbed. The maximum concentration is almost 95 pkg/ml and is achieved within 1–2 hours. During absorption and initial passage through the liver, ethinyl estradiol is significantly metabolized, resulting in an average oral bioavailability of about 45%. Ethinyl estradiol binds strongly and nonspecifically to plasma albumin (about 98%) and causes an increase in the concentration of GSPC. The volume of distribution is approximately 2.8–8.6 l/kg. Ethinyl estradiol is metabolized mainly by aromatic hydroxylation, however, a large number of hydroxyl and methyl metabolites are additionally formed, including both free metabolites and conjugates with glucuronides and sulfates. Clearance is 2.3–7 ml/min/kg. Serum ethinyl estradiol levels decrease in two phases with half-lives of about 1 and 10–20 hours, respectively. The drug is not excreted from the body unchanged; ethinyl estradiol metabolites are excreted in urine and bile in a ratio of 4:6. The half-life of metabolites is about 1 day. Serum concentrations of ethinyl estradiol increase slightly after oral administration. The maximum concentration is about 114 pg/ml and is achieved at the end of the cycle. Accordingly, due to the variability of serum half-life and daily dosing of the drug, the equilibrium concentration of ethinyl estradiol in the blood serum is achieved in approximately a week.

Interaction

The use of drugs that stimulate the work of hepatic microsomal enzymes may cause an increase in the excretion of sex hormones , which causes breakthrough bleeding or weakening the reliability of contraception. These drugs include Phenytoin, Primidone, barbiturates, Rifampicin, Carbamazepine, Rifabutin and others.

Penicillins and tetracycline can reduce the enterohepatic circulation of estrogen , thereby reducing the concentration of ethinyl estradiol . During the period of use of drugs that affect microsomal enzymes , and for about a month after completion of their use, barrier contraception should be used.

Combined contraceptives may change the metabolism of other drugs, causing their concentrations in the blood and tissues to increase or decrease.

Interactions of the drug Yarina

Use with other drugs may result in breakthrough bleeding and/or decreased contraceptive effectiveness. Interactions with drugs that induce microsomal enzymes may occur. These include, for example, phenytoin, barbiturates, primidone, carbamazepine, rifampicin and (possibly) oxcarbazepine, topiramate, felbamate, ritonavir, griseofulvin, as well as medicines containing St. John's wort. This interaction may cause an increase in the clearance of sex hormones. Some clinical studies suggest that ethinyl estradiol levels may be reduced by certain antibiotics (eg penicillin and tetracycline antibiotics). When treating with any of the above drugs, it is necessary to temporarily use a barrier method of contraception in addition to taking COCs or choose another method of contraception. When treating with drugs that induce microsomal enzymes, the barrier method should be used throughout the entire period of treatment with the corresponding drug and for another 28 days after stopping its use. When treating with an antibiotic (with the exception of rifampicin and griseofulvin), the barrier method must be used for another 7 days after its discontinuation. If the barrier method is still being used, and the tablets in the PDA package have already run out, taking the tablets from the next package should be started without the usual break. The main metabolites of drospirenone in blood plasma are formed without the participation of the cytochrome P450 system. Therefore, it is unlikely that inhibitors of this enzyme system affect the metabolism of drospirenone. Oral contraceptives may affect the metabolism of other drugs. Taking this into account, the concentrations of active substances in blood plasma and tissues (for example, cyclosporine) may change. in vitro inhibition and in vivo in female volunteers taking omeprazole, simvastatin and midazolam as marker substances, it was found that the effect of drospirenone 3 mg on the metabolism of other drugs is unlikely. Other types of interaction Theoretically, with simultaneous administration of Yarina and angiotensin II receptor antagonists, potassium-sparing diuretics and aldosterone antagonists, the concentration of potassium in the blood serum may increase. In interaction studies of drospirenone (in combination with estradiol) with ACE inhibitors or indomethacin, no clinically or statistically significant changes in serum potassium concentrations were noted. Note : To determine the potential for interaction with drugs that are taken concomitantly with COCs, it is necessary to read the instructions for the medical use of these drugs. Impact on laboratory test results Taking contraceptives may affect the results of some laboratory tests, including biochemical parameters of liver, thyroid, adrenal and kidney function, plasma levels of proteins (carriers), such as SHBG and lipid/lipoprotein fractions, parameters of carbohydrate metabolism, as well as parameters of coagulation and fibrinolysis. Usually such changes are within normal limits. Drospirenone causes an increase in plasma renin and aldosterone levels, induced by its moderate antimineralocorticoid activity.

special instructions

Before starting or resuming use of the drug, you need to familiarize yourself with your personal and family history, conduct a gynecological and general medical examination, and exclude the presence of pregnancy. The structure and scope of research, as well as the regularity of examinations, are determined in each individual case individually. Standard follow-up examinations must be carried out at least once a year.

The patient should be informed that the drug does not protect against HIV infection and other sexually transmitted diseases.

A relationship has been established between taking combined contraceptives and an increase in the incidence of vascular thrombosis and thromboembolism, including pulmonary artery thrombosis , venous thrombosis, myocardial infarction , and cerebrovascular disorders.

The risk of venous thromboembolism is highest in the 1st year of taking such drugs. An increased risk occurs after initial use of oral contraceptives or resumption of their use.

Arterial thromboembolism , the risk of which also increases when taking drugs like Yarina, can lead to vascular occlusion, stroke or heart attack . Signs of a stroke: weakness or loss of sensation in the face or limbs, problems with speech and its understanding, confusion, sudden loss of vision, dizziness, gait disturbance, causeless headache, loss of balance, loss of consciousness. Other signs of vascular occlusion: swelling, sudden pain, blue discoloration of the limbs, sharp pain in the abdomen.

Signs of a heart attack : heaviness, discomfort, pain, pressure, feeling of tightness in the arm or chest; discomfort radiating to the cheekbone, back, arm, larynx, stomach; nausea, cold sweat, vomiting or dizziness, anxiety, weakness, shortness of breath , tachycardia .

Arterial thromboembolism can be fatal.

The risk of thrombosis and thromboembolism increases:

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

An increase in the frequency and severity of migraine during the 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 there is an increased likelihood of developing pancreatitis when taking medications like Yarina.

In women with hereditary angioedema, 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.

As a consequence of withdrawal, some patients may develop bleeding when taking a break or stopping taking the pills.

Taking Yarina can change the results of a number of laboratory tests, for example, indicators of the liver, kidneys, adrenal glands, thyroid gland, the content of carrier proteins, the state of coagulation , carbohydrate metabolism and fibrinolysis .

The drug does not affect the ability to drive vehicles.

Pharmacodynamics

Yarina® is a low-dose monophasic oral combined estrogen-progestogen contraceptive drug.

The contraceptive effect of Yarina® is mainly achieved by suppressing ovulation and increasing the 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, the intensity and duration of bleeding decreases, resulting in a reduced risk of iron deficiency anemia. There is also evidence of a reduced risk of endometrial and ovarian cancer.

Drospirenone contained in Yarin® has an antimineralocorticoid effect and is able to prevent weight gain and the appearance of other symptoms (for example, edema) associated with estrogen-dependent fluid retention. Drospirenone also has antiandrogenic activity and helps reduce acne (blackheads), oily skin and hair. This effect of drospirenone is similar to the effect of natural progesterone produced by the 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. When used correctly, the Pearl index (an indicator reflecting the number of pregnancies in 100 women using a contraceptive during the year) is less than 1. If pills are missed or used incorrectly, the Pearl index may increase.

Yarina's analogues

Level 4 ATC code matches:
Ovidon

Rigevidon

Non-Ovlon

Mercilon

Yarina Plus

Miniziston 20 fem

Novinet

Microgynon

Janine

Lindineth

Cyclo-Proginova

Regulon

Logest

Midiana

Belara

Femoden

Jess Plus

Jess

Zoely

The most common analogues: Dailla, Regulon, Vidora, Jess, Midiana, Claira, Janine, MODELL, Dimia, Simicia .

The price of Yarina's analogues is usually less affordable than the price of the described drug.

Which is better: Midiana or Yarina?

Midiana and Yarina are complete analogues in 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?

Novinet 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?

Regulon and Yarina are analogs and only slightly differ in the structure of the active ingredients. 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?

Klaira, unlike Yarina, 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?

Diana 35 and Yarina are analogues 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 and Yarina Plus are that the latter drug additionally contains calcium levomefolate , which reduces folate in the body of the woman and fetus in the event of an unplanned pregnancy. The prices of the drugs are comparable.

Janine or Yarina - which is better?

Zhanine 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.

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

Reviews about Yarina

Reviews from doctors about Yarin are quite restrained in characterizing the drug, which has its own advantages and disadvantages.

The online forum reports that a fairly large number of women who took Yarina hormonal pills developed a variety of side effects: from acne and other skin changes to severe vascular disorders. Other reviews reported that birth control pills, on the contrary, have a beneficial effect on the condition of the skin and are recommended for polycystic ovary syndrome .

Reviews from doctors about tablets for endometriosis indicate positive treatment results with continuous dosing. This regimen of use contributes to the suppression of menstrual function, inhibits retrograde blood flow to the pelvic organs and stimulates regression in endometrioid heterotopias . The duration of treatment for endometriosis is at least six months.

Reviews of Yarin after discontinuation are usually satisfactory, but sometimes changes may appear in the form of weight gain or the appearance of acne . There are a number of reports that there are no periods after withdrawal. The situation is considered normal if there are no periods within 4-5 days after stopping taking birth control pills. But if they do not appear within a week, you should consult a gynecologist for advice.

Yarina and pregnancy after her

The forum and numerous reviews indicate that pregnancy after discontinuation of the drug is not accompanied by deviations in its course or pathological changes in the development of the fetus.

Yarina price, where to buy cheap

The price of birth control pills Yarina (No. 21) in Ukraine does not fluctuate depending on the region - both in Odessa and in the city of Kharkov it is 240-290 hryvnia.

How much does it cost in Russian pharmacies?

The price of Yarina tablets (No. 21) in Russia is 810-890 rubles. The cost of a package of 63 tablets can reach 2,300 rubles.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Yarina plus tab.
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Pharmacy24

• Yarina plus N28 tablets - 3 packs Promotion of Bayer Pharma AG, Nimecchina/Bayer Weimar GmbH i Co.
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• Yarina plus tablets Yarina plus tablets No. 28 Germany, Bayer Pharma

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