II. Indications

III. Contraindications

IV. Mechanism: Drosperinone

  1. Newer synthetic Progestin
  2. Antiandrogenic activity similar to Progesterone
  3. Lowest Androgenic Activity
    1. Marginal benefit over other low androgen OCPs
  4. Antimineralcorticoid effect (Related to Spironolactone)
    1. Only OCP Progestin with antimineralcorticoid activity
    2. Drospirenone 3 mg is equivalent to 25 mg Spironolactone

V. Efficacy

  1. Similar to other Oral Contraceptives

VI. Formulations

  1. Yaz
    1. Contains 3 mg drospirenone and 20 mcg Ethinyl Estradiol
    2. Taken for 24 active days and 4 Placebo days
  2. Yasminelle
    1. Contains 3 mg drospirenone and 20 mcg Ethinyl Estradiol
    2. Taken for 21 active days and 7 Placebo days
  3. Yasmin, Ocella or Zarah
    1. Contains 3 mg drospirenone and 30 mcg Ethinyl Estradiol
  4. Nextstellis
    1. Contains 3 mg drospirenone and 14.2 mg Estetrol (in mg, NOT mcg)
    2. Taken for 24 active days and 4 Placebo days
    3. At time of release in 2021, very expensive (approaching $200/month compared with <$10 for generics)
    4. Estetrol is a new plant-derived Estrogen (E4) formulation
      1. Based on NEST (Native Estrogen with Selective Actions in Tissues)
      2. Carries same Estrogen-related effects and contraindications
    5. References
      1. (2021) Presc Lett 28(7): 38

VIII. Monitoring: Serum Potassium in first month

  1. Indicated if concurrent use of drugs listed above

IX. Adverse Effects

  1. See Oral Contraceptive
  2. Potassium retention (see above)
  3. May be associated with higher Thromboembolism risk

X. Advantages

  1. May be associated with less weight gain than other OCP
  2. As effective as other OCPs in Acne Vulgaris
  3. May be useful in Polycystic Ovary Disease
    1. Spironolactone used for associated Hirsutism

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Related Studies

Cost: Medications

yasmin (on 3/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
YASMIN 28 TABLET Generic $0.20 each
yaz (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
YAZ 28 TABLET Generic $0.30 each
ocella (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
OCELLA 3 MG-0.03 MG TABLET Generic $0.20 each
nextstellis (on 1/1/2023 at Medicaid.Gov Survey of pharmacy drug pricing)
NEXTSTELLIS 3-14.2 MG TABLET $6.94 each