YAZ and the novel progestin drospirenone.
Drospirenone is a novel progestin that is structurally related to 17 alpha-spirolactone and has antimineralocorticoid and antiandrogenic activity. A 3-mg dose of drospirenone was first used in combination with ethinyl estradiol (EE) 30 microg in a combination oral contraceptive (COC) that is administered for 21 days, followed by a 7-day hormone-free interval (HFI) (drospirenone/30EE, or Yasmin). The 21/7 regimen is considered to be the standard regimen for COC delivery. A formulation with the metabolic benefit of COCs containing a lower estrogen dose has been developed combining drospirenone 3 mg with EE 20 microg and using a regimen of 24 days of active pills, followed by a 4-day HFI (drospirenone/20EE-24/4), or YAZ (Bayer HealthCare Pharmaceuticals Inc., Wayne, New Jersey). Since drospirenone has a half-life of > 30 hours, its activity extends for a prolonged time into the shortened HFI. This new COC has been shown to provide effective contraception and to have a good safety profile. Two large noninterventional studies have recently evaluated the safety of drospirenone/30EE in 2 areas of special interest: hyperkalemia and thromboembolic events. Use of a drospirenone-containing COC was not associated with an increased risk of either type of disorder in comparison with COCs containing other progestins. Drospirenone/20EE-24/4 provides a low dose of EE in combination with drospirenone in an effective and safe COC that is administered using a regimen with a shortened HFI. Drospirenone/20EE-24/4 is the only COC with 3 indications: contraception and the treatment of premenstrual dysphoric disorder in women who wish to use a COC for birth control, and the treatment of moderate acne in women who are at least 14-years-old, have achieved menarche and wish to use a COC for birth control.
Mishell
Daniel R
DR
Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA. mishell@usc.edu
D000152:Acne Vulgaris / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000736:Androstenes / Q000008:administration & dosage* / Q000737:chemistry; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage* / Q000737:chemistry; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000008:administration & dosage* / Q000737:chemistry; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects; D015394:Molecular Structure; D017060:Patient Satisfaction; D011293:Premenstrual Syndrome / Q000188:drug therapy
D000736:Androstenes; D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; C534342:drospirenone and ethinyl estradiol combination; D004997:Ethinyl Estradiol; C035144:drospirenone