INDICATIONS
YASMIN is indicated for the prevention of pregnancy
in women who elect to use an oral contraceptive.
Oral contraceptives are highly effective. TABLE II
lists the typical accidental pregnancy rates for users of combination
oral contraceptives and other methods of contraception. The efficacy
of these contraceptive methods, except sterilization, depends upon
the reliability with which they are used. Correct and consistent
use of methods can result in lower failure rates.
| TABLE II
Percentage of women experiencing an unintended pregnancy
during the first year of typical
use and first year of perfect use of contraception
and the percentage continuing use at the end
of the first year: United States. |
|
%
of Women Experiencing
an Accidental Pregnancy
within the First Year of Use |
% of Women
Continuing Use
at One Year3 |
Method
(1) |
Typical Use1
(2) |
Perfect Use2
(3) |
(4) |
| Chance4 |
85 |
85 |
|
| Spermicides5 |
26 |
6 |
40 |
| Periodic abstinence |
25 |
|
63 |
| Calendar |
|
9 |
|
| Ovulation method |
|
3 |
|
| Sympto-thermal6 |
|
2 |
|
| Post-ovulation |
|
1 |
|
| Withdrawal |
19 |
4 |
|
| Cap7 |
|
|
|
| Parous women |
40 |
26 |
42 |
| Nulliparous women |
20 |
9 |
56 |
| Sponge |
|
|
|
| Parous women |
40 |
20 |
42 |
| Nulliparous women |
20 |
9 |
56 |
| Diaphragm7 |
20 |
6 |
56 |
| Condom8 |
|
|
|
| Female (Reality) |
21 |
5 |
56 |
| Male |
14 |
3 |
61 |
| Pill |
5 |
|
71 |
| progestin only |
|
0.5 |
|
| combined |
|
0.1 |
|
| IUD: |
|
|
|
| Progesterone T |
2.0 |
1.5 |
81 |
| Copper T 380A |
0.8 |
0.6 |
78 |
| Lng 20 |
0.1 |
0.1 |
81 |
| Depo Provera |
0.3 |
0.3 |
70 |
| Norplant and Norplant-2 |
0.05 |
0.05 |
88 |
| Female sterilization |
0.5 |
0.5 |
100 |
| Male sterilization
|
0.15 |
0.10 |
100 |
Emergency Contraceptive Pills: Treatment
initiated within 72 hours after unprotected intercourse reduces
the risk of pregnancy by at least 75%.9
Lactational Amenorrhea Method: LAM
is highly effective, temporary method of contraception.10
Source: Trussell J, Contraceptive efficacy. In Hatcher
RA, Trussell J, Stewart F, Cates W, Stewart GK, Kowal D, Guest F,
Contraceptive Technology: Seventeenth Revised Edition. New York
NY: Irvington Publishers, 1998.
Among typical couples who initiate use of a method
(not necessarily for the first time), the percentage who experience
an accidental pregnancy during the first year if they do not stop
use for any other reason.
Among couples who initiate use of a method (not necessarily
for the first time) and who use it perfectly (both consistently
and correctly), the percentage who experience an accidental pregnancy
during the first year if they do not stop use for any reason.
Among couples attempting to avoid pregnancy, the percentage who
continue to use a method for one year.
The percents becoming pregnant in columns (2) and
(3) are based on data from populations where contraception is not
used and from women who cease using contraception in order to become
pregnant. Among such populations, about 89% become pregnant within
one year. This estimate was lowered slightly (to 85%) to represent
the percentage who would become pregnant within one year among women
now relying on reversible methods of contraception if they abandoned
contraception altogether.
Foams, creams, gels, vaginal suppositories, and vaginal film.
Cervical mucus (ovulation) method supplemented by calendar in the
pre-ovulatory and basal body temperature in the post-ovulatory phases.
With spermicidal cream or jelly.
Without spermicides.
The treatment schedule is one dose within 72 hours after unprotected
intercourse, and a second dose 12 hours after the first dose. The
Food and Drug Administration has declared the following brands of
oral contraceptives to be safe and effective for emergency contraception:
Ovral (1 dose is 2 white pills), Alesse (1 dose is 5 pink pills),
Nordette or Levlen (1 dose is 2 light-orange pills), Lo/Ovral (1
dose is 4 white pills), Triphasil or Tri-Levlen (1 dose is 4 yellow
pills).
However, to maintain effective protection against pregnancy, another
method of contraception must be used as soon as menstruation resumes,
the frequency or duration of breastfeeds is reduced, bottle feeds
are introduced, or the baby reaches six months of age.
In clinical efficacy studies of YASMIN of up to 2
years duration, 2,629 subjects completed 33,160 cycles of use without
any other contraception. The mean age of the subjects was 25.5 ±
4.7 years. The age range was 16 to 37 years. The racial demographic
was: 83% Caucasians, 1% Hispanic, 1% Black, <1% Asian, <1%
other, <1% missing data, 14% not inquired and <1% unspecified.
Pregnancy rates in the clinical trials were less than one per 100
woman-years of use.
DOSAGE AND ADMINISTRATION
To achieve maximum contraceptive effectiveness, YASMIN
(drospirenone and ethinyl estradiol) must be taken exactly as directed
at intervals not exceeding 24 hours.
YASMIN consists of 21 tablets of a monophasic combined
hormonal preparation plus 7 inert tablets. The dosage of YASMIN
is one yellow tablet daily for 21 consecutive days followed by 7
white inert tablets per menstrual cycle. A patient should begin
to take YASMIN either on the first day of her menstrual period (Day
1 Start) or on the first Sunday after the onset of her menstrual
period (Sunday Start).
Day 1 Start. During the first cycle of YASMIN use,
the patient should be instructed to take one yellow YASMIN daily,
beginning on day one (1) of her menstrual cycle. (The first day
of menstruation is day one.) She should take one yellow YASMIN daily
for 21 consecutive days, followed by one white inert tablet daily
on menstrual cycle days 22 through 28. It is recommended that YASMIN
be taken at the same time each day, preferably after the evening
meal or at bedtime. If YASMIN is first taken later than the first
day of the menstrual cycle, YASMIN should not be considered effective
as a contraceptive until after the first 7 consecutive days of product
administration. The possibility of ovulation and conception prior
to initiation of medication should be considered.
Sunday Start. During the first cycle of YASMIN use,
the patient should be instructed to take one yellow YASMIN daily,
beginning on the first Sunday after the onset of her menstrual period.
She should take one yellow YASMIN daily for 21 consecutive days,
followed by one white inert tablet daily on menstrual cycle days
22 through 28. It is recommended that YASMIN be taken at the same
time each day, preferably after the evening meal or at bedtime.
YASMIN should not be considered effective as a contraceptive until
after the first 7 consecutive days of product administration. The
possibility of ovulation and conception prior to initiation of medication
should be considered.
The patient should begin her next and all subsequent
28-day regimens of YASMIN on the same day of the week that she began
her first regimen, following the same schedule. She should begin
taking her yellow tablets on the next day after ingestion of the
last white tablet, regardless of whether or not a menstrual period
has occurred or is still in progress. Anytime a subsequent cycle
of YASMIN is started later than the day following administration
of the last white tablet, the patient should use another method
of contraception until she has taken a yellow YASMIN daily for seven
consecutive days.
When switching from another oral contraceptive, YASMIN
should be started on the same day that a new pack of the previous
oral contraceptive would have been started.
Withdrawal bleeding usually occurs within 3 days following
the last white tablet. If spotting or breakthrough bleeding occurs
while taking YASMIN, the patient should be instructed to continue
taking her YASMIN as instructed and by the regimen described above.
She should be instructed that this type of bleeding is usually transient
and without significance; however, if the bleeding is persistent
or prolonged, the patient should be advised to consult her physician.
Although the occurrence of pregnancy is unlikely if
YASMIN is taken according to directions, if withdrawal bleeding
does not occur, the possibility of pregnancy must be considered.
If the patient has not adhered to the prescribed dosing schedule
(missed one or more active tablets or started taking them on a day
later than she should have), the probability of pregnancy should
be considered at the time of the first missed period and appropriate
diagnostic measures taken before the medication is resumed. If the
patient has adhered to the prescribed regimen and misses two consecutive
periods, pregnancy should be ruled out before continuing the contraceptive
regimen.
The risk of pregnancy increases with each active yellow
tablet missed. For additional patient instructions regarding missed
pills, see PATIENT INFORMATION: WHAT TO DO IF YOU MISS PILLS section.
If breakthrough bleeding occurs following missed tablets, it will
usually be transient and of no consequence. If the patient misses
one or more white tablets, she should still be protected against
pregnancy provided she begins taking yellow tablets again on the
proper day.
In the nonlactating mother, YASMIN may be initiated
4 weeks postpartum, for contraception. When the tablets are administered
in the postpartum period, the increased risk of thromboembolic disease
associated with the postpartum period must be considered. (See CONTRA
INDICATIONS , WARNINGS, and PRECAUTIONS concerning thromboembolic
disease.)
HOW SUPPLIED
YASMIN 28 Tablets (drospirenone and ethinyl estradiol)
are available in packages of 3 BLISTER packs (NDC 50419-402-03).
Each pack contains 21 active yellow round, unscored,
film coated tablets each containing 3 mg drospirenone and 0.03 mg
ethinyl estradiol, and 7 inert white round, unscored, film coated
tablets.
Store at 25° C (77°F); excursions permitted
to 15°-30°C (59°-86°F) [See USP Controlled Room
Temperature].
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