YAZ
Combination product
Combination of Drospirenone and Ethinyl estradiol.
Each component keeps its own pharmacology page; the combination itself adds no new mechanism.
Components (2)
FDA label
Read the full label on DailyMed ↗
BOXED WARNING Cigarette smoking increases risk of serious cardiovascular events from combination oral contraceptive use; women over 35 who smoke should not use.
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Contraception | Females of reproductive potential | 1 tablet QD | 1 tablet QD (24 active + 4 inert per 28-day cycle) | 1 tablet QD |
| Premenstrual dysphoric disorder (PMDD) in those choosing an oral contraceptive | Females of reproductive potential | 1 tablet QD | 1 tablet QD | 1 tablet QD |
| Moderate acne vulgaris (if desiring an oral contraceptive) | Women ≥14 yr who have achieved menarche | 1 tablet QD | 1 tablet QD | 1 tablet QD |
Renal Contraindicated in renal impairment
Hepatic Contraindicated in hepatic disease
If ≥2 active tablets missed, follow missed-dose instructions and use back-up contraception for 7 days
Instructions
- Take 1 tablet daily at the same time each day, in the order on the blister pack
- Can be taken without regard to meals
- Use non-hormonal back-up for first 7 days if not started on Day 1
- Start no earlier than 4 weeks postpartum (non-breastfeeding) due to thromboembolism risk
- Severe vomiting/diarrhea may reduce absorption — use additional contraception
Available strengths
- tab 3/0.02, 3/0.03 mg
Contraindications
- Renal impairment
- Adrenal insufficiency
- High risk of arterial or venous thrombotic disease (incl. smokers >35, DVT/PE, cerebrovascular/coronary disease, thrombogenic valvular/rhythm disease, thrombophilias, uncontrolled hypertension, diabetes with vascular disease, migraine with aura or migraine if >35)
- Undiagnosed abnormal uterine bleeding
- Current or prior breast cancer or other estrogen/progestin-sensitive cancer
- Liver tumors (benign or malignant) or liver disease
- Concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
Cautions
- Thromboembolic/vascular events — DRSP-containing COCs may carry higher VTE risk than levonorgestrel COCs; stop 4 wk before through 2 wk after major surgery
- Hyperkalemia — anti-mineralocorticoid activity; do not use if predisposed; check potassium in first cycle if on potassium-raising drugs
- Liver disease — discontinue if jaundice
- Hypertension; carbohydrate/lipid effects (monitor diabetics, dyslipidemia)
- New/worsening headache or migraine — evaluate and discontinue if indicated
Adverse reactions
- Headache/migraine
- Menstrual irregularities
- Nausea/vomiting
- Breast pain/tenderness
- Mood changes
- Fatigue (PMDD)
Pregnancy Discontinue during pregnancy; no increased risk of birth defects found in epidemiologic studies
Lactation DRSP present in human milk; combined hormonal contraceptives can reduce milk production
Cost
YAZ
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 3/0.02 mg | tab | 30 qd | not offered | |
| 3/0.03 mg | tab | 30 qd | not offered |
NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. YAZ is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.
Part D rank #182.