Drospirenone: The Perfect Oral Contraceptive Pill
Drospirenone is a progestin, usually in combination with Ethinyl Estradiol - an estrogen. Its popular trade names are Yaz (Drospirenone 3 mg + Ethinyl Estradiol 0.02 mg) and Yasmin ( Drospirenone 3 mg + Ethinyl Estradiol 0.03 mg) .
Not only that Drospirenone acts as a contraceptive active constituent, Drospirenone is also responsible for the combination’s additional benefits – treating acne and reducing greasiness in the skin and hair. It improves symptoms like bloating or swelling because of fluid retention. And in addition, Drospirenone also relieves menstrual pain.
Drospirenone as a progesterone
Natural progesterone has been known to have an androgenic (male hormone) effect that can cause acne and weight gain. On the contrary, Drospirenone is a synthetic progestin that is an analogue of Spironolactone which is a weak diuretic and also used as an antiandrogen. With the same characteristics as Spironolactone, Drospirenone, has also the potential to reduce body weight and even blood pressure.
Estrogen in high doses has been known to cause weight gain, particularly due to fluid retention. The more estrogen there is in a pill, the more tendency to gain weight. However, having the diuretic property same as the Spironolactone, Drospirenone increases the discharge of urine. This leads to less water retention.
Summing it up, the following are the benefits expected from a Drospirenone combination pill:
No acne problem
Less break-through bleeding or spotting
Less breast pain or soreness
No weight gain
Less menstrual pain
- Because Drospirenone is used in combination with an estrogen which has a risk for thromboembolic and cardiovascular disease, the Drospirenone + Ethiny Estradiol combination pill is contraindicated with cases of deep vein thrombosis, pulmonary embolism, heart attack, stroke and angina pectoris. Liver failure, migraine, pancreatitis, jaundice, cancer, vaginal bleeding, pregnancy and of course, hypersensitivity to the drug is also contraindicated.
- Usual side-effects are mood changes headache, stomach pain, nausea, vomiting.
- As a combination contraceptive pill, Drospireninone + Ethinly Estradiol has the same drug interactions as the other combination birth control pills. The following should be considered closely.
- Analgesics, isoniazid, anti-migraine drugs and tranquilizers may decrease the efficacy of the Drospirenone combination.
- Barbiturates as phenobarbital, primidone, carbamazepine and topiramate are examples of hepatic microsomal enzyme inducers. This type of drugs tends to lower the effectiveness of the combination pills and increases breakthrough bleeding.
- Anti-infective like ampicillin, chloramphenicol, neomycin, nitrofurantoin, penicillin V, sulphonamides and tetracycline also decreases the efficacy of contraceptives. These should not be taken with the Drospirenone combination.
- Grapefruit, clarithromycin, erythromycin, itraconazole, ketoconazole and ritonavir are CYP3A4 enzyme inhibitors. These types exaggerate the plasma concentrations of Ethinyl Estradiol that apt to increase the incidence of untoward effects.
The purpose of this article is for information only. An advice from to a medical practitioner is still a must.
MIMS On line
PPDr Philippine Pharmaceutical Directory Review 5th edition
Wilson and Gisvold Textbook of Inorganic Medicinal and Pharmaceutical Chemistry 9th edition