Yaz side effects: Yaz is a birth control pill very similar to Yasmin with the only difference being a slightly lower dose of the progestin drospirenone. Yaz side effects therefore closely mirror Yasmin side effects. Yaz contains the estrogen ethinyl estradiol in a 3 mg dose combined with drospirenone at a 20 µg dose. Each 28 pill package contains 24 of the hormone containing combination pills and for inert pills used for timing. Typically women will have menstrual flow during the for inert pills. Indications for Yaz include birth control, premenstrual dysphoric disorder, dysmenorrhea, polycystic ovarian disease, endometriosis, and treatment of moderate acne vulgaris.
Black box warning: the progestin in Yaz has recently been noted to be more frequently associated with deep vein thrombosis and pulmonary embolism than the progestin used in other birth control pills. Noting the risk of serious cardiovascular side effects especially in cigarette smoking and especially women over age 35 which increases with the number of cigarette cigarette smoked. Yaz is contraindicated in smokers over 35 years old.
Common Yaz side effects: the most common Yaz side effects are related to their estrogenic effects and include irregular bleeding, nausea and vomiting, breast tenderness, and emotional lability. Hyper pigmentation of the skin of the central face and around the nipples called the mask of pregnancy or chloasma is fairly common as a Yaz side effect. Vaginal yeast infections, acne, abdominal pain or bloating, nausea and vomiting, fluid retention, and intolerance of wearing contact lenses are fairly common Yaz side effects. Headache, weight gain, depression, decreased sex drive, and elevation of blood pressure are noted not infrequently. Metabolic changes including glucose intolerance and elevation of blood sugar occur commonly.
Serious Yaz side effects: serious Yaz side effects include a number of thromboembolic type problems including deep vein thrombosis, myocardial infarction, and thrombotic stroke. Cerebral hemorrhage is also noted as serious Yaz side effect. Several serious Yaz side effects are related to its affect on the hepatobiliary system and include cholestasis, all bladder disease and can even lead pancreatitis. A type of benign liver tumor called hepatic adenoma has been noted with Yaz use. Serious allergic type reactions including erythema multiforme and anaphylactoid reactions have been noted as Yaz side effects. Hyperkalemia, I lesions, exacerbation of chorea and porphyria, hypertension, and depression are also listed as serious Yaz side effects.
Contraindications, cautions and drug interactions: Yaz is contraindicated for use with the HIV drug fosamprenavir. Use of Yaz should be avoided in alternative considered with a long list of medications of which only some of the more common are listed here intentionally. Refer to the manufacturers prescribing guidelines for complete list of cautions, drugs to avoid, and potential drug interactions. In general use of Yaz should be avoided in an alternative used if possible in combination with the barbiturates, carbamazepine, dexamethasone, the rifampin, St. John’s wort, pioglitazone, phenytoin, and with fibric can acid products. Modification of treatment should be considered with a long list of medications in combination with Yaz and again only some of the more commonly used medications are noted in this review. These include warfarin, heparin’s, the sulfonylureas, tacrolimus, theophylline, the ace inhibitors, the angiotensin receptor blockers, and the nonsteroidal anti-inflammatory medications. The list of medications where caution is advised for use with Yaz is very extensive and includes a large number of dietary and supplemental products. These include vitamin C or ascorbic acid, chasteberry, ginseng, grapefruit, green tea, saw palmetto and red Clover. Some of the more commonly used medications where caution a monitoring is recommended include nitrofurantoin, the macrolides, the cephalosporins and penicillins, most other antibiotics, and tacrine.
Pregnancy and lactation: as with all oral contraceptives Yaz is considered category X for use during pregnancy and is contraindicated. The safety of Yaz for use during lactation is considered conditional and the individual patients situation needs to be considered.
Pharmacology: both the ethinyl estradiol and drospirenone are primarily metabolized in the liver through the CYP 450 system. The half-life of drospirenone is 30 hours and a half-life of ethinyl estradiol is 26 hours.
With the recent clarification and documentation of the increased risk of thromboembolic events in drospirenone containing oral contraceptives including Yaz and Yasmin the use of these products for both contraception and other indications is likely to diminish.
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