Drospirenone (oral route)


    Brand Name

    US Brand Name

    Slynd


    Description

    Drospirenone is used to prevent pregnancy. It works by stopping a woman's egg from fully developing each month. The egg can no longer accept a sperm and fertilization (pregnancy) is prevented.

    No contraceptive method is 100 percent effective. Birth control methods such as having surgery to become sterile or not having sex are more effective than birth control pills. Discuss your options for birth control with your doctor.

    This medicine does not prevent AIDS or other sexually transmitted diseases. It will not help as emergency contraception, such as after unprotected sexual contact.

    This medicine is available only with your doctor's prescription.

    This product is available in the following dosage forms:

    • Tablet

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies on the relationship of age to the effects of drospirenone have not been performed in the pediatric population. However, pediatric-specific problems that would limit the usefulness of this medication in teenagers are not expected. This medicine may be used for birth control in teenage females but should not be used before the start of menstruation.

    Geriatric

    Appropriate studies on the relationship of age to the effects of drospirenone has not been performed in the geriatric population. This medicine is not indicated for use in elderly women.

    Breastfeeding

    Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Atazanavir
    • Boceprevir
    • Cobicistat
    • Fezolinetant
    • Tranexamic Acid

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Amobarbital
    • Amoxicillin
    • Ampicillin
    • Amprenavir
    • Apalutamide
    • Aprepitant
    • Armodafinil
    • Artemether
    • Avacopan
    • Bacampicillin
    • Belzutifan
    • Betamethasone
    • Bexarotene
    • Bosentan
    • Butabarbital
    • Butalbital
    • Carbamazepine
    • Carbenicillin
    • Cefaclor
    • Cefadroxil
    • Cefdinir
    • Cefditoren
    • Cefixime
    • Cefpodoxime
    • Cefprozil
    • Ceftazidime
    • Ceftibuten
    • Cefuroxime
    • Cenobamate
    • Clarithromycin
    • Clobazam
    • Cloxacillin
    • Colesevelam
    • Cyclacillin
    • Cyclosporine
    • Dabrafenib
    • Darunavir
    • Dexamethasone
    • Dicloxacillin
    • Dipyrone

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Amitriptyline
    • Clomipramine
    • Diazepam
    • Doxepin
    • Imipramine
    • Lamotrigine
    • Licorice
    • Lorazepam
    • Selegiline
    • Temazepam
    • Triazolam
    • Voriconazole

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following is not recommended. Your doctor may decide not to treat you with this medication, change some of the other medicines you take, or give you special instructions about the use of food, alcohol, or tobacco.

    • Tobacco

    Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

    • Caffeine

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Abnormal or unusual vaginal bleeding or
    • Adrenal insufficiency or
    • Cancer, progestin-sensitive or
    • Cervical cancer, or history of or
    • Kidney disease or
    • Liver disease (eg, liver tumor)—Should not be used in patients with these conditions.
    • Blood clots, history of or
    • Bone problems or
    • Depression, history of or
    • Diabetes—Use with caution. May make these conditions worse.
    • Diarrhea or
    • Vomiting—May decrease the absorption of drospirenone in the body.

    Proper Use

    Use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

    To make using oral contraceptives as safe and reliable as possible, you should understand how and when to take them and what effects may be expected.

    This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

    This medicine is available in blister packs. Each blister pack contains 28 tablets with different colors that need to be taken in the same order as directed on the blister pack.

    Take this medicine at the same time each day. Birth control pills work best when no more than 24 hours pass between doses.

    Do not skip or delay taking your pill by more than 24 hours. If you miss a dose, you could get pregnant. Ask your doctor for ways to help you remember to take your pills or about using another method of birth control.

    You may have light bleeding or spotting when you first take the pill.

    You may feel sick or nauseated, especially during the first few months that you take this medicine. If your nausea is continuous and does not go away, call your doctor.

    Use another form of birth control if you vomit or have diarrhea within 3 to 4 hours of using the pills until you check with your doctor.

    If you are switching from another birth control method (eg, intrauterine device, pill, transdermal patch, vaginal ring) to using Slynd™, take the medicine on the day you would have usually taken your next pill. Do not continue taking the pills from your previous birth control pack. If you have used an intrauterine device (IUD), vaginal ring, or patch, take the pill on the day the IUD, ring, or patch is removed.

    If you are switching from a progestin-only method (eg, implant, injection) to using Slynd™, take the medicine on the day you would have removed your implant or on the day you would have your next injection.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    Your doctor will ask you to begin your dose on the first day of your menstrual period (called Day 1 start). When you begin on a certain day it is important that you follow that schedule, even if you miss a dose. Do not change your schedule on your own. If the schedule that you use is not convenient, check with your doctor about changing it.

    • For oral dosage form (tablets):
      • For contraception (to prevent pregnancy):
        • Adults—One white tablet (active) taken at the same time each day for 24 days in a row followed by one green (inert) tablet once a day for the last 4 days per menstrual cycle.
        • Children—Use and dose must be determined by your doctor.

    Missed Dose

    Call your doctor or pharmacist for instructions.

    This medicine has specific patient instructions on what to do if you miss a dose. Read and follow these instructions carefully and call your doctor if you have any questions.

    • If you miss one white pill: Take it as soon as you can. Then take your next pill at the regular time. This means, you may take 2 pills in one day. Continue taking 1 pill every day until you finish the pack.
    • If you miss 2 or more white pills: Take a pill as soon as you can. Then take your next pill at the regular time. This means, you may take 2 pills in one day. Continue taking 1 pill every day until you finish the pack. One or more missed white pills will remain in the blister pack. Use a second form of birth control (eg, condom, spermicide) until you have been taking white pills for 7 days in a row.
    • If you miss 1 or more green pills: Take the next green pill at your regular time, every day until you finish the pack. This means 1 or more missed green pill will remain in the blister pack.
    • If you miss your pills and change your schedule, you may not have a period for that month. Make sure your doctor knows if you miss your period 2 months in a row, because you may be pregnant.

    Storage

    Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.


    Precautions

    It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may also be needed to check for unwanted effects.

    Although you are using this medicine to prevent pregnancy, you should know that using this medicine while you are pregnant could harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

    If you suspect that you may be pregnant, check with your doctor right away.

    You might have some light bleeding or spotting, especially during the first 3 months of using this medicine. This is usually normal and should not last long. However, if you have heavy bleeding or the bleeding lasts more than a few days in a row, call your doctor.

    Check with your doctor right away if you miss a menstrual period. Missed periods may occur if you skip one or more tablets and have not taken your pills exactly as directed. If you miss two periods in a row, talk to your doctor. You might need a pregnancy test.

    Do not use this medicine if you smoke cigarettes or if you are over 35 years of age. If you smoke while using birth control pills containing drospirenone, you increase your risk of having a blood clot, heart attack, or stroke. Your risk is even higher if you are over age 35, if you have diabetes, high blood pressure, high cholesterol, or if you are overweight. Talk with your doctor about ways to stop smoking. Keep your diabetes under control. Ask your doctor about diet and exercise to control your weight and blood cholesterol level.

    Using this medicine may increase your risk of having blood clotting problems. Check with your doctor right away if you have pain in the chest, groin, or legs, especially the calves, difficulty with breathing, a sudden, severe headache, slurred speech, a sudden, a sudden loss of coordination, or vision changes while using this medicine.

    This medicine may cause bone problems (eg, loss of bone mineral density). Check with your doctor right away if you have pain in the back, ribs, arms, or legs or a decrease in height.

    Using this medicine may increase your risk of having cervical cancer. Talk with your doctor about this risk. Check with your doctor right away if you experience abnormal vaginal bleeding.

    Check with your doctor right away if you have pain or tenderness in the stomach, dark urine, pale stools, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

    You may have a higher risk of an ectopic pregnancy (occurs outside the womb) if you get pregnant while using this medicine. This can be a serious and life-threatening condition. It can also cause problems that may make it harder for you to become pregnant in the future.

    This medicine may affect your blood sugar levels. Check with your doctor right away if you have increased thirst or increased urination. If you notice a change in the results of your urine or blood sugar tests, or if you have any questions, check with your doctor.

    This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to become more depressed. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. If you or your caregiver notice any of these side effects, tell your doctor right away.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    Less common

    • Heavy non-menstrual vaginal bleeding

    Incidence not known

    • Absent, missed, or irregular menstrual periods
    • confusion
    • difficult breathing
    • irregular heartbeat
    • nausea
    • nervousness
    • numbness or tingling in the hands, feet, or lips
    • stomach pain
    • stopping of menstrual bleeding
    • vomiting
    • weakness or heaviness of the legs

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common

    • Acne
    • breast pain or tenderness
    • cramps
    • decreased interest in sexual intercourse
    • headache
    • heavy bleeding
    • increased weight
    • loss in sexual ability, desire, drive, or performance
    • normal menstrual bleeding occurring earlier, possibly lasting longer than expected

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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