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Yasmin film-coated tablets 0.03mg/3mg Last Updated on eMC 20-Oct-2015 View changes | Bayer plc Contact details Having problems opening this PDF? Download Acrobat Reader The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine. It is written for patients and gives information about taking or using a medicine. It is possible that the leaflet in your medicine pack may differ from this version because it may have been updated since your medicine was packaged. Please click on the link to the left to view the PIL in PDF format. Text only version for the visually impaired Below is a text only representation of the Patient Information leaflet. The original may contain images or tables and can be viewed in PDF format using the link to the left. This PIL may be available from the RNIB in large print, Braille or audio CD. For further information please call the RNIB Medicine Leaflet line on 0800 198 5000. The product code(s) for this leaflet is/are: PL00010/0571. Yasmin film-coated tablets 0.03mg/3mg Due to regulatory changes, the content of the following Patient Information Leaflet may vary from the one found in your medicine pack. Please compare the 'Leaflet prepared/revised date' towards the end of the leaflet to establish if there have been any changes. If you have any doubts or queries about your medication, please contact your doctor or pharmacist. Package leaflet: Information for the user Yasmin 0.03 mg / 3 mg film-coated tablets Ethinylestradiol / Drospirenone Read all of this booklet carefully before you start taking this medicine because it contains important information for you. - Keep this booklet. You may need to read it again. - If you have any further questions, ask your doctor or pharmacist. - This medicine has been prescribed for you only. Do not pass it on to others. It may harm them. - If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4. Important things to know about combined hormonal contraceptives (CHCs): - They are one of the most reliable reversible methods of contraception if used correctly. - They slightly increase the risk of having a blood clot in the veins and arteries, especially in the first year or when restarting a combined hormonal contraceptive following a break of 4 or more weeks. - Please be alert and see your doctor if you think you may have symptoms of a blood clot (see section 2 “Blood clots”). What is in this booklet What Yasmin is and what is it used for 2 What you need to know before you take Yasmin 3 When you should not use Yasmin 3 Warnings and precautions 4 Blood clots 5 Yasmin and cancer 9 Bleeding between periods 9 What to do if no bleeding occurs during the seven pill-free days 9 Other medicines and Yasmin 10 Yasmin with food and drink 10 Laboratory tests 10 Pregnancy 10 Breast-feeding 11 Driving and using machines 11 Yasmin contains lactose 11 How to take Yasmin 11 When can you start with the first strip? If you take more Yasmin than you should 12 If you forget to take Yasmin 13 What to do in the case of vomiting or severe diarrhoea 14 Delaying your period: what you need to know 14 Changing the first day of your period: what you need to know 15 If you stop taking Yasmin 15 Possible side effects 15 How to store Yasmin 17 Contents of the pack and other information 17 What Yasmin is and what is it used for - Yasmin is a contraceptive pill and is used to prevent pregnancy. - Each light yellow tablet contains a small amount of two different female hormones, namely drospirenone and ethinylestradiol. - Contraceptive pills that contain two hormones are called “combination” pills. What you need to know before you take Yasmin General notes Before you start using Yasmin, you should read the information on blood clots in section 2. It is particularly important to read the symptoms of a blood clot – see section 2 “Blood clots”. Before you can begin taking Yasmin, your doctor will ask you some questions about your personal health history and that of your close relatives. The doctor will also measure your blood pressure and, depending upon your personal situation, may also carry out some other tests. In this booklet, several situations are described where you should stop using Yasmin, or where the reliability of Yasmin may be decreased. In such situations you should either not have sex or you should take extra non-hormonal contraceptive precautions, e.g. use a condom or another barrier method. Do not use rhythm or temperature methods. These methods can be unreliable because Yasmin alters the monthly changes of body temperature and cervical mucus. Yasmin, like other hormonal contraceptives, does not protect against HIV infection (AIDS) or any other sexually transmitted disease. When you should not use Yasmin You should not use Yasmin if you have any of the conditions listed below. If you do have any of the conditions listed below, you must tell your doctor. Your doctor will discuss with you what other form of birth control would be more appropriate. Do not take Yasmin - if you have (or have ever had) a blood clot in a blood vessel of your leg (deep vein thrombosis, DVT), your lungs (pulmonary embolus, PE) or other organs; - if you know you have a disorder affecting your blood clotting – for instance, protein C deficiency, protein S deficiency, antithrombin-III deficiency, Factor V Leiden or antiphospholipid antibodies; - if you need an operation or if you are off your feet for a long time (see section ‘Blood clots’); - if you have ever had a heart attack or stroke; - if you have (or have ever had) angina pectoris (a condition that causes severe chest pain and may be a first sign of a heart attack) or transient ischaemic attack (TIA – temporary stroke symptoms); - if you have any of the following diseases that may increase your risk of a clot in the arteries; - severe diabetes with blood vessel damage - very high blood pressure - a very high level of fat in the blood (cholesterol or triglycerides) - a condition known as hyperhomocysteinaemia - if you have (or have ever had) a type of migraine called ‘migraine with aura’; - if you have (or have ever had) liver disease and your liver function is still not normal - if your kidneys are not working well (renal failure) - if you have (or have ever had) had a tumour in the liver - if you have (or have ever had) or if you are suspected of having breast cancer or cancer of the genital organs - if you have any unexplained bleeding from the vagina - if you are allergic to ethinylestradiol or drospirenone, or any of the other ingredients of this medicine (listed in section 6). This may cause itching, rash or swelling. Additional information on special populations Use in children Yasmin is not intended for use in females whose periods have not yet started. Warnings and precautions When should you contact your doctor? Seek urgent medical attention - if you notice possible signs of a blood clot that may mean you are suffering from a blood clot in the leg (i.e. deep vein thrombosis), a blood clot in the lung (i.e. pulmonary embolism), a heart attack or a stroke (see ‘Blood clots’ section below). For a description of the symptoms of these serious side effects please go to “How to recognise a blood clot”. Tell your doctor if any of the following conditions apply to you Talk to your doctor before taking Yasmin. In some situations you need to take special care while using Yasmin or any other combination pill, and your doctor may need to examine you regularly. If the condition develops, or gets worse while you are using Yasmin, you should also tell your doctor. - if a close relative has or has ever had breast cancer - if you have a disease of the liver or the gallbladder - if you have diabetes - if you have depression - if you have Crohn’s disease or ulcerative colitis (chronic inflammatory bowel disease); - if you have haemolytic uraemic syndrome (HUS –a disorder of blood clotting causing failure of the kidneys); - if you have sickle cell anaemia (an inherited disease of the red blood cells); - if you have elevated levels of fat in the blood (hypertriglyceridaemia) or a positive family history for this condition. Hypertriglyceridaemia has been associated with an increased risk of developing pancreatitis (inflammation of the pancreas); - if you need an operation, or you are off your feet for a long time (see in section 2 ‘Blood clots’); - if you have just given birth you are at an increased risk of blood clots. You should ask your doctor how soon after delivery you can start taking Yasmin; - If you have an inflammation in the veins under the skin (superficial thrombophlebitis); - If you have varicose veins; - if you have epilepsy (see page 9 “Other medicines and Yasmin”); - if you have systemic lupus erythematosus (SLE - a disease affecting your natural defence system); - if you have a disease that first appeared during pregnancy or earlier use of sex hormones (for example, hearing loss, a blood disease called porphyria, yellowing of the skin or eyes (jaundice), itching of the whole body (pruritis), skin rash with blisters during pregnancy (gestational herpes), a nerve disease causing sudden movements of the body (Sydenham’s chorea)) - if you have ever had a discolouration of the skin especially on the face or neck known as “pregnancy patches” (chloasma). If so, avoid direct sunlight or ultraviolet light. - if you have hereditary angioedema, products containing oestrogens may cause or worsen the symptoms. You should see your doctor immediately if you experience symptoms of angioedema such as swollen face, tongue and/or throat and/or difficulty swallowing or hives together with difficulty breathing. BLOOD CLOTS Using a combined hormonal contraceptive such as Yasmin increases your risk of developing a blood clot compared with not using one. In rare cases a blood clot can block vessels and cause serious problems. Blood clots can develop - in veins (referred to as a ‘venous thrombosis’, ‘venous thromboembolism’ or VTE); - in the arteries (referred to as an ‘arterial thrombosis’, ‘arterial thromboembolism’ or ATE); Recovery from blood clots is not always complete. Rarely, there may be serious lasting effects or, very rarely, they may be fatal; It is important to remember that the overall risk of a harmful blood clot due to Yasmin is small. HOW TO RECOGNISE A BLOOD CLOT Seek urgent medical attention if you notice any of the following signs or symptoms. Are you experiencing any of these signs? - swelling of one leg or along a vein in the leg or foot especially when accompanied by: - pain or tenderness in the leg which may be felt only when standing or walking - increased warmth in the affected leg - change in colour of the skin on the leg e.g. turning pale, red or blue What are you possibly suffering from? Deep vein thrombosis Are you experiencing any of these signs? - sudden unexplained breathlessness or rapid breathing; - sudden cough without an obvious cause, which may bring up blood; - sharp chest pain which may increase with deep breathing; - severe light headedness or dizziness; - rapid or irregular heartbeat - severe pain in your stomach; If you are unsure, talk to a doctor as some of these symptoms such as coughing or being short of breath may be mistaken for a milder condition such as a respiratory tract infection (e.g. a ‘common cold’). What are you possibly suffering from? Pulmonary embolism Are you experiencing any of these signs? Symptoms most commonly occur in one eye: - immediate loss of vision or - painless blurring of vision which can progress to loss of vision What are you possibly suffering from? Retinal vein thrombosis (blood clot in the eye) Are you experiencing any of these signs? - chest pain, discomfort, pressure, heaviness - sensation of squeezing or fullness in the chest, arm or below the breastbone; - fullness, indigestion or choking feeling; - upper body discomfort radiating to the back, jaw, throat, arm and stomach; - sweating, nausea, vomiting or dizziness; - extreme weakness, anxiety, or shortness of breath; - rapid or irregular heartbeats What are you possibly suffering from? Heart attack Are you experiencing any of these signs? - sudden weakness or numbness of the face, arm or leg, especially on one side of the body; - sudden confusion, trouble speaking or understanding; - sudden trouble seeing in one or both eyes; - sudden trouble walking, dizziness, loss of balance or coordination; - sudden, severe or prolonged headache with no known cause; - loss of consciousness or fainting with or without seizure. Sometimes the symptoms of stroke can be brief with an almost immediate and full recovery, but you should still seek urgent medical attention as you may be at risk of another stroke. What are you possibly suffering from? Stroke Are you experiencing any of these signs? - swelling and slight blue discolouration of an extremity; severe pain in your stomach (acute abdomen) What are you possibly suffering from? Blood clots blocking other blood vessels BLOOD CLOTS IN A VEIN What can happen if a blood clot forms in a vein? - The use of combined hormonal contraceptives has been connected with an increase in the risk of blood clots in the vein (venous thrombosis). However, these side effects are rare. Most frequently, they occur in the first year of use of a combined hormonal contraceptive. - If a blood clot forms in a vein in the leg or foot it can cause a deep vein thrombosis (DVT). - If a blood clot travels from the leg and lodges in the lung it can cause a pulmonary embolism. - Very rarely a clot may form in a vein in another organ such as the eye (retinal vein thrombosis). When is the risk of developing a blood clot in a vein highest? The risk of developing a blood clot in a vein is highest during the first year of taking a combined hormonal contraceptive for the first time. The risk may also be higher if you restart taking a combined hormonal contraceptive (the same product or a different product) after a break of 4 weeks or more. After the first year, the risk gets smaller but is always slightly higher than if you were not using a combined hormonal contraceptive. When you stop Yasmin your risk of a blood clot returns to normal within a few weeks. What is the risk of developing a blood clot? The risk depends on your natural risk of VTE and the type of combined hormonal contraceptive you are taking. The overall risk of a blood clot in the leg or lung (DVT or PE) with Yasmin is small. - Out of 10,000 women who are not using any combined hormonal contraceptive and are not pregnant, about 2 will develop a blood clot in a year. - Out of 10,000 women who are using a combined hormonal contraceptive that contains levonorgestrel, norethisterone, or norgestimate about 5-7 will develop a blood clot in a year. - Out of 10,000 women who are using a combined hormonal contraceptive that contains drospirenone such as Yasmin, between about 9 and 12 women will develop a blood clot in a year. - The risk of having a blood clot will vary according to your personal medical history (see “Factors that increase your risk of a blood clot” below). Women who are not using a combined hormonal pill and are not pregnant Risk of developing a blood clot in a year - About 2 out of 10,000 women Women using a combined hormonal contraceptive pill containing levonorgestrel, norethisterone or norgestimate Risk of developing a blood clot in a year - About 5-7 out of 10,000 women Women using Yasmin Risk of developing a blood clot in a year - About 9-12 out of 10,000 women Factors that increase your risk of a blood clot in a vein The risk of a blood clot with Yasmin is small but some conditions will increase the risk. Your risk is higher: - if you are very overweight (body mass index or BMI over 30kg/m2); - if one of your immediate family has had a blood clot in the leg, lung or other organ at a young age (eg. below the age of about 50). In this case you could have a hereditary blood clotting disorder; - if you need to have an operation, or if you are off your feet for a long time because of an injury or illness, or you have your leg in a cast. The use of Yasmin may need to be stopped several weeks before surgery or while you are less mobile. If you need to stop Yasmin ask your doctor when you can start using it again. - as you get older (particularly above about 35 years); - if you gave birth less than a few weeks ago. The risk of developing a blood clot increases the more conditions you have. Air travel (>4 hours) may temporarily increase your risk of a blood clot, particularly if you have some of the other factors listed. It is important to tell your doctor if any of these conditions apply to you, even if you are unsure. Your doctor may decide that Yasmin needs to be stopped. If any of the above conditions change while you are using Yasmin, for example a close family member experiences a thrombosis for no known reason; or you gain a lot of weight, tell your doctor. BLOOD CLOTS IN AN ARTERY What can happen if a blood clot forms in an artery? Like a blood clot in a vein, a clot in an artery can cause serious problems. For example, it can cause a heart attack or a stroke. Factors that increase your risk of a blood clot in an artery It is important to note that the risk of a heart attack or stroke from using Yasmin is very small but can increase: - with increasing age (beyond about 35 years); - if you smoke. When using a combined hormonal contraceptive like Yasmin, you are advised to stop smoking. If you are unable to stop smoking and are older than 35 your doctor may advise you to use a different type of contraceptive; - if you are overweight; - if you have high blood pressure; - if a member of your immediate family has had a heart attack or stroke at a young age (less than about 50). In this case you could also have a higher risk of having a heart attack or stroke; - if you, or someone in your immediate family, have a high level of fat in the blood (cholesterol or triglycerides); - if you get migraines, especially migraines with aura; - if you have a problem with your heart (valve disorder, disturbance of the rhythm called atrial fibrillation); - if you have diabetes. If you have more than one of these conditions or if any of them are particularly severe the risk of developing a blood clot may be increased even more. If any of the above conditions change while you are using Yasmin, for example you start smoking, a close family member experiences a thrombosis for no known reason; or you gain a lot of weight, tell your doctor. Yasmin and cancer Breast cancer has been observed slightly more often in women using combination pills, but it is not known whether this is caused by the treatment. For example it may be that more tumours are detected in women on combination pills because they are examined by their doctor more often. The risk of breast tumours becomes gradually less after stopping the combination hormonal contraceptives. It is important to regularly check your breasts and you should contact your doctor if you feel any lump. In rare cases, benign liver tumours, and in even fewer cases malignant liver tumours have been reported in pill users. Contact your doctor if you have unusually severe abdominal pain. Bleeding between periods During the first few months that you are taking Yasmin, you may have unexpected bleeding (bleeding outside the seven pill-free days). If this bleeding occurs for more than a few months, or if it begins after some months, contact your doctor as they must find out if anything is wrong. What to do if no bleeding occurs during the seven pill-free days If you have taken all the tablets correctly, have not had vomiting or severe diarrhoea and you have not taken any other medicines, it is highly unlikely that you are pregnant. If the expected bleeding does not happen twice in succession, you may be pregnant. Contact your doctor immediately. Only start the next strip if you are sure that you are not pregnant. Other medicines and Yasmin Always tell your doctor which medicines or herbal products you are already using. Also tell any other doctor or dentist who prescribes another medicine (or the pharmacist) that you take Yasmin. They can tell you if you need to take additional contraceptive precautions (for example condoms) and if so, for how long, or, whether the use of another medicine you need must be changed. medicines used for the Some medicines - can have an influence on the blood levels of Yasmin - can make it less effective in preventing pregnancy - can cause unexpected bleeding These include medicines used for the treatment of - epilepsy (e.g. primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine) - tuberculosis (e.g. rifampicin) - HIV and Hepatitis C Virus infections (so-called protease inhibitors and non-nucleoside reverse transcriptase inhibitors, such as ritonavir, nevirapine, efavirenz - fungal infections (griseofulvin, ketoconazole) - arthritis, arthrosis (etoricoxib) - high blood pressure in the blood vessels in the lungs (bosentan) - the herbal remedy St. John’s wort Yasmin may influence the effect of other medicines, e.g. - medicines containing ciclosporin - the anti-epileptic lamotrigine (this could lead to an increased frequency of seizures) - theophylline (used to treat breathing problems) - tizanidine (used to treat muscle pain and/or muscle cramps). Ask your doctor or pharmacist for advice before taking any medicine. Yasmin with food and drink Yasmin may be taken with or without food, if necessary with a small amount of water. Laboratory tests If you need a blood test, tell your doctor or the laboratory staff that you are taking the pill, because hormonal contraceptives can affect the results of some tests. Pregnancy If you are pregnant, you must not take Yasmin. If you become pregnant while taking Yasmin you must stop taking it immediately and contact your doctor. If you want to become pregnant, you can stop taking Yasmin at any time (see also page 14 “If you stop taking Yasmin”). Ask your doctor or pharmacist for advice before taking any medicine. Breast-feeding Use of Yasmin is generally not advisable when a woman is breast-feeding. If you want to take the pill while you are breast-feeding you should contact your doctor. Ask your doctor or pharmacist for advice before taking any medicine. Driving and using machines There is no information suggesting that use of Yasmin affects driving or the use of machines. Yasmin contains lactose If you cannot tolerate certain sugars, contact your doctor before you take Yasmin. How to take Yasmin Take Yasmin every day for 21 days Yasmin comes in strips of 21 pills, each marked with a day of the week. - Take your pill at the same time every day. - Start by taking a pill marked with the correct day of the week. - Follow the direction of the arrows on the strip. Take one pill each day, until you have finished all 21 pills. - Swallow each pill whole, with water if necessary. Do not chew the pill. Then have seven pill-free days After you have taken all 21 pills in the strip, you have seven days when you take no pills. So, if you take the last pill of one pack on a Friday, you will take the first pill of your next pack on the Saturday of the following week. Within a few days of taking the last pill from the strip, you should have a withdrawal bleed like a period. This bleed may not have finished when it is time to start your next strip of pills. You don’t need to use extra contraception during these seven pill-free days – as long as you have taken your pills correctly and start the next strip of pills on time. Then start your next strip Start taking your next strip of Yasmin after the seven pill-free days – even if you are still bleeding. Always start the new strip on time. During the seven pill-free days, when you take no tablets, bleeding should begin (so-called withdrawal bleeding). This usually starts on the 2nd or 3rd day after the last tablet of Yasmin. Start the following strip after the last day of the seven pill-free days, whether your bleeding has stopped or not. When can you start with the first strip? - If you have not used a contraceptive with hormones in the previous month Begin with Yasmin on the first day of your cycle (that is, the first day of your period). If you start Yasmin on the first day of your period you are immediately protected against pregnancy. You may also begin on day 2-5 of the cycle, but then you must use extra protective measures (for example, a condom) for the first 7 days. - Changing from a combination hormonal contraceptive, or combination contraceptive vaginal ring or patch You can start Yasmin preferably on the day after the last active tablet (the last tablet containing the active substances) of your previous pill, but at the latest on the day after the tablet-free days of your previous pill finish (or after the last inactive tablet of your previous pill). When changing from a combination contraceptive vaginal ring or patch, follow the advice of your doctor. - Changing from a progestogen-only-method (progestogen-only pill, injection, implant or a progestogen-releasing intrauterine system IUS) You may switch any day from the progestogen-only pill (from an implant or an IUS on the day of its removal, from an injectable when the next injection would be due) but in all of these cases use extra protective measures (for example, a condom) for the first 7 days of taking Yasmin. - After a miscarriage or abortion If you have had a miscarriage or abortion during the first three months of pregnancy, your doctor may tell you to start taking Yasmin straight away. This means that you will have contraceptive protection with your first pill. - After having a baby You can start taking Yasmin between 21 and 28 days after having a baby. If you start later than day 28, use a so-called barrier method (for example, a condom) during the first seven days of taking Yasmin. If, after having a baby, you have had sex before starting Yasmin (again), you must first be sure that you are not pregnant or wait until your next period. - If you are breast-feeding and want to start Yasmin after having a baby Read the section on “Breast-feeding”, page 10. Ask your doctor what to do if you are not sure when to start. If you take more Yasmin than you should There are no reports of serious harmful results of taking too many Yasmin tablets. If you take several tablets at once then you may have symptoms of nausea or vomiting. Young girls may have bleeding from the vagina. If you have taken too many Yasmin tablets, or you discover that a child has taken some, ask your doctor or pharmacist for advice If you forget to take Yasmin - If you are less than 12 hours late taking a tablet, the protection against pregnancy is not reduced. Take the tablet as soon as you remember and then take the following tablets again at the usual time. - If you are more than 12 hours late taking a tablet, the protection against pregnancy may be reduced. The greater the number of tablets you have forgotten, the greater is the risk of becoming pregnant. The risk of incomplete protection against pregnancy is greatest if you forget a tablet at the beginning or at the end of the strip. Therefore, you should keep to the following rules (see also the diagram on page 14): - More than one tablet forgotten in this strip Contact your doctor. - One tablet forgotten between days 1 - 7 Take the forgotten tablet as soon as you remember, even if that means that you have to take two tablets at the same time. Continue taking the tablets at the usual time and use extra precautions for the next 7 days, for example, a condom. If you have had sex in the week before forgetting the tablet you may be pregnant. In that case, contact your doctor. - One tablet forgotten between days 8 – 14 Take the forgotten tablet as soon as you remember, even if that means that you have to take two tablets at the same time. Continue taking the tablets at the usual time. The protection against pregnancy is not reduced, and you do not need to take extra precautions. If you forget more than one tablet use an additional barrier method such as a condom for 7 days. - One tablet forgotten between days 15 - 21 - You can choose between two possibilities: Take the forgotten tablet as soon as you remember, even if that means that you have to take two tablets at the same time. Continue taking the tablets at the usual time. Instead of having seven pill-free days start the next strip as soon as you have taken the last tablet. Most likely, you will have a period at the end of the second strip – but you may also have light or menstruation-like bleeding during the second strip. You can also stop the tablets and go directly to the tablet-free period (record the day on which you forgot your tablet). If you want to start a new strip on the day you always start, make the tablet-free period less than 7 days. If you follow one of these two recommendations, you will remain protected against pregnancy. - If you have forgotten any of the tablets in a strip, and you do not have a bleeding during the first tablet-free period, you may be pregnant. Contact your doctor before you start the next strip. What to do in the case of vomiting or severe diarrhoea If you vomit within 3-4 hours of taking a tablet or you have severe diarrhoea, there is a risk that the active substances in the pill will not be fully taken up by your body. The situation is almost the same as forgetting a tablet. After vomiting or diarrhoea, take another tablet from a reserve strip as soon as possible. If possible take it within 12 hours of when you normally take your pill. If that is not possible or 12 hours have passed, you should follow the advice given under “If you forget to take Yasmin” on page 12. Delaying your period: what you need to know Although it is not recommended, you can delay your period by skipping the seven pill-free days and going straight to a new strip of Yasmin and finishing it. You may experience light or menstruation-like bleeding while using this second strip. After the usual pill-free period of 7 days start your next strip. It is advisable to consult your doctor for advice before deciding to delay your menstrual period. Changing the first day of your period: what you need to know If you take the tablets according to the instructions, then your period will begin during the seven pill-free days. If you have to change this day, make the pill-free period shorter – (but never longer – 7 days is the maximum!). For example, if you start the seven pill-free days on a Friday, and you want to change this to a Tuesday (3 days earlier) start a new strip 3 days earlier than usual. If you make the pill-free period very short (for example 3 days or less) you may not have any bleeding during this time. You may then experience light or menstruation-like bleeding. If you are not sure what to do, consult your doctor. If you stop taking Yasmin You can stop taking Yasmin whenever you want. If you do not want to become pregnant, ask your doctor for advice about other reliable methods of birth control. If you want to become pregnant, stop taking Yasmin and wait for a menstrual period before trying to become pregnant. You will be able to calculate the expected delivery date more easily. If you have any further questions on the use of this medicine, ask a doctor or pharmacist. Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them. If you get any side effect, particularly if severe and persistent, or have any change to your health that you think may be due to Yasmin, please talk to your doctor. An increased risk of blood clots in your veins (venous thromboembolism (VTE)) or blood clots in your arteries (arterial thromboembolism (ATE)) is present for all women taking combined hormonal contraceptives. For more detailed information on the different risks from taking combined hormonal contraceptives please see section 2 “What you need to know before you take Yasmin”. The following is a list of the side effects that have been linked with the use of Yasmin: Serious side effects: – see your doctor straight away Signs of a severe allergic reaction to Yasmin: - swelling of the face, lips, mouth, tongue or throat Signs of breast cancer include: - dimpling of the skin - changes in the nipple - any lumps you can see or feel. Signs of cancer of the cervix include: - vaginal discharge that smells and/or contains blood - unusual vaginal bleeding - pelvic pain - painful sex Signs of severe liver problems include: - severe pain in your upper abdomen - yellow skin or eyes (jaundice) - inflammation of the liver (hepatitis) - your whole body starts itching - If you think you may have any of these, see a doctor straight away. You may need to stop taking Yasmin Common side effects (between 1 and 10 in every 100 users may be affected): - depressive mood - headache, migraine - nausea - breast pain, breast tenderness, menstrual disorders, bleeding between periods, thick whitish vaginal discharge, vaginal yeast infection Uncommon side effects (between 1 and 10 in every 1,000 users may be affected): - breast enlargement - altered interest in sex - high blood pressure, low blood pressure - vomiting, diarrhoea - acne, severe itching, skin rash, hair loss (alopecia) - vaginal infection - fluid retention - body weight changes Rare side effects (between 1 and 10 in every 10,000 users may be affected): - hearing impairment - asthma - breast secretion - allergic reactions (hypersensitivity) - the skin conditions erythema nodosum (characterized by painful reddish skin nodules) or erythema multiforme (characterized by rash with target-shaped reddening or sores). - harmful blood clots in a vein or artery for example: - in a leg or foot (i.e. DVT) - in a lung (i.e. - heart attack - stroke - mini-stroke or temporary stroke-like symptoms, known as a transient ischaemic attack (TIA) - blood clots in the liver, stomach/intestine, kidneys or eye. The chance of having a blood clot may be higher if you have any other conditions that increase this risk (See section 2 for more information on the conditions that increase risk for blood clots and the symptoms of a blood clot). Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly (see details below). By reporting side effects, you can help provide more information on the safety of this medicine. United Kingdom Malta How to store Yasmin Keep this medicine out of the sight and reach of children. Do not store above 25 °C. Store in the original package. Do not use this medicine after the expiry date which is stated on the packaging after “Do not use after:” or “EXP”. The expiry date refers to the last day of that month. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment. Contents of the pack and other information What Yasmin contains - The active substances are drospirenone and ethinylestradiol. Each active tablet contains 0.030 milligrams ethinylestradiol and 3 milligrams drospirenone. - Other ingredients in the active tablets are lactose monohydrate, maize starch, pregelatinised maize starch, povidone K25, magnesium stearate (E470b), hypromellose (E464), macrogol 6000, talc (E553b), titanium dioxide (E171) and iron oxide yellow (E172). What Yasmin looks like and content of the pack - Yasmin tablets are film-coated tablets; the core of the tablet is coated. The tablets are light yellow, round with convex surfaces; one side is embossed with the letters "DO" in a regular hexagon. - Yasmin is available in packs of 1, 3, and 6 blisters each with 21 tablets. Not all pack sizes may be marketed. Marketing Authorisation Holder Bayer House Strawberry Hill Newbury Berkshire RG14 1JA Manufacturer 13342 Berlin Germany This medicinal product is authorised in the Member States of the EEA under the following names: - Austria, Belgium, Croatia, Denmark, Finland, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden, United Kingdom: Yasmin - France: Jasmine This booklet was last revised in July 2015
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Yasmin kontracepcijske pilule – Uputa o lijeku Proizvođač: Ostali proizvodi Samo na recept? DA Skoči na » opis » primjena » doziranje » mjere opreza » napomene Opis Što Yasmin sadrži 1 filmom obložena tableta sadržava 0,030 mg etinilestradiola i 3,000 mg drospirenona. Pomoćne tvari: laktoza hidrat, kukuruzni škrob, modificirani kukuruzni škrob, povidon 25000, magnezij ev stearat, hidroksipropilmetilceluloza, makrogol 6000, talk, titanijev dioksid (E171), željezov oksid, žuti (E172). Kako Yasmin izgleda i sadržaj pakovanja Blago žuta, okrugla, konveksna tableta, s jednostranim izbočenjem slova „DO” u pravilnom heksagonu Yasmin filmom obložene tablete nalaze se u kutiji koja sadrži 21 tabletu u blister pakiranju. Način i mjesto izdavanja lijeka Na recept, u ljekarni. Kako čuvati Yasmin filmom obložene tablete? Yasmin filmom obložene tablete morate čuvati izvan dohvata i pogleda djece! Lijek valja čuvati na sobnoj temperaturi nižoj od 25°C. Yasmin se ne smije upotrijebiti nakon isteka roka valjanosti navedenog na pakovanju. Revizija upute Listopad, 2009. Primjena Što su Yasmin filmom obložene tablete i za što se koriste? - Yasmin je kombinirani oralni kontraceptiv i koristi se za zaštitu od začeća - Jedna tableta sadrži malu količinu dva različita ženska hormona, drospirenon i etinilestradiol - Oralni kontraceptivi koji sadrže dva hormona se nazivaju kombinirani kontraceptivi. Doziranje i način primjene Kako uzimati Yasmin filmom obložene tablete? Uzmite jednu tabletu Yasmina svaki dan, ako je potrebno s malom količinom vode. Možete uzeti tabletu sa ili bez hranom, ali trebate uzeti tabletu svaki dan u isto vrijeme. Pakiranje Yasmin filmom obloženih tableta sadrži 21 tabletu. Na pakiranju je svaka tableta označena danom kada je treba uzeti. Na primjer, ako počnete u srijedu, uzmite tabletu s oznakom SR. Slijedite znakove strelica dok ne uzmete sve tablete. Tijekom sljedećih sedam dana napravite stanku. Mjesečnica bi trebala početi unutar tih sedam dana stanke. Obično počinje dva ili tri dana nakon uzimanja posljednje tablete. Počnite uzimati tablete iz sljedećeg pakiranja osmi dan čak i ako mjesečnica još traje. To znači da sljedeće pakiranje trebate početi isti dan u tjednu te da se krvarenje treba javiti istih dana u mjesecu. Ukoliko koristite Yasmin na ovaj način, zaštićeni ste od začeća tijekom sedam dana nekorištenja tableta. Uzimanje prvoga pakiranja Yasmin filmom obloženih tableta Ako u prethodnom mjesecu niste koristili hormonski kontraceptiv: Počnite s uzimanjem Yasmin filmom obloženih tableta prvoga dana vašeg ciklusa, tj. prvi dan menstrualnog krvarenja. Uzmite tabletu označenu tim danom u tjednu i pratite strelice kako slijedi. Ako uzmete Yasmin filmom obložene tablete prvi dan ciklusa, djeluju odmah te nije potrebno primijeniti dodatne kontracepcijske metode. Također možete započeti između drugog i petog dana ciklusa, ali tada primijenite dodatnu mehaničku kontracepcijsku (npr. kondom) zaštitu prvih sedam dana prvoga ciklusa uzimanja tableta. Ako prelazite s drugoga kombiniranog oralnog kontraceptiva ili pripravka koji sadrži kombinirane kontraceptive (prsten, flaster) Možete početi uzimati Yasmin filmom obložene tablete dan nakon uzimanja posljednje tablete iz prethodnog pakiranja, što znači da nema stanke. Ako pakiranje sadrži i neaktivne tablete, možete početi s uzimanjem Yasmin filmom obloženih tableta dan nakon posljednje aktivne tablete (ako niste sigurni, pitajte liječnika ili ljekarnika). Možete početi i kasnije, ali nikada kasnije od jednoga dana nakon stanke. Ako prelazite s pripravka koji sadrži kombinirane kontraceptive (prsten, flaster) obratite se svom liječniku ili ljekarniku za savjet Ako prelazite s pripravka koje sadrže samo progesteron ( tableta koja sadrži samo progesteron, injekcija, implant itd.) Tablete možete prestati uzimati bilo koji dan i početi uzimati Yasmin filmom obložene tablete drugi dan u isto vrijeme. No, morate primjeniti dodatnu mehaničku kontraceptivnu zaštitu u prvih sedam dana uzimanja tableta. Ako prelazite s injekcija, implantanta ili intrauterinog sustava (IUS) koji otpušta progesteron Počnite uzimati Yasmin filmom obložene tablete kada je termin vaše sljedeće injekcije ili na dan kada je odstranjen implantant ili IUS. No, morate primijeniti dodatnu mehaničku kontraceptivnu zaštitu prilikom snošaja u prvih sedam dana uzimanja tableta. Ako ste imali spontani ili arteficijalni pobačaj Savjetujte se s liječnikom. Nakon poroda Ako ste rodili možete početi koristiti Yasmin najkasnije između 21. i 28. dana. Ako počnete kasnije od 28. dana morate koristiti tzv. metodu barijere (npr. kondom) tijekom prvih sedam dana primjene Yasmina. Ako, nakon poroda imate spolni odnos prije započinjanja Yasmina (iznova), morate prvo biti sigurni da niste trudni ili sačekati sljedeće menstrualno krvarenje. Neka vas vaš liječnik savjetuje u slučaju da niste sigurni kada početi Ako dojite i želite početi koristiti Yasmin (opet) nakon poroda Pročitajte odjeljak “Trudnoća i dojenje”. Ako uzmete više Yasmina nego što ste trebali Nema izvještaja o ozbiljnim štetnim utjecajima predoziranja. Ukoliko ste uzeli nekoliko tableta istovremeno, možete imati mučninu ili povraćati. Mlade djevojke mogu imati vaginalno krvarenje. Ako ste uzeli previše Yasmin filmom obloženih tableta, ili ako otkrijete daje dijete uzelo Yasmin filmom obložene tablete, upitajte liječnika ili ljekarniku za savjet. Ako ste zaboravili uzeti Yasmin Ako shvatite da ste zaboravili uzeti tabletu, a prošlo je manje od 12 sati od uobičajenoga vremena uzimanja, kontracepcijska zaštita nije smanjena. Trebate uzeti tabletu čim se sjetite i uzimati sljedeće tablete u uobičajeno vrijeme. • Ako shvatite da ste zaboravili uzeti tabletu, a prošlo je više od 12 sati od uobičajenoga vremena uzimanja, kontracepcijska zaštita može biti smanjena. Više propuštenih tableta u nizu znači veću opasnost od smanjenja kontracepcijske zaštite. Najveći rizik postoji ako propustite tablete na početku ili kraju pakiranja. Ukoliko se to dogodi, slijedite dalje navedene upute (vidi i dijagram ispod). Ako zaboravite više od jedne tablete u pakiranju Pitajte liječnika za savjet. Jedna propuštena tableta u prvom tjednu Uzmite posljednju propuštenu tabletu čim se sjetite, čak i ako to znači uzimanje dvije tablete istodobno te nakon toga nastavite s uzimanjem tableta u uobičajeno vrijeme. Primijenite mehaničku zaštitu, npr. prezervativ, sljedećih sedam dana. Ukoliko je do snošaja došlo u prethodnih sedam dana, valja razmotriti mogućnost trudnoće. Odmah se javite liječniku. Jedna propuštena tableta u drugom tjednu Uzmite posljednju propuštenu tabletu čim se sjetite, čak i ako to znači uzimanje dvije tablete istodobno te nakon toga nastavite s uzimanjem tableta u uobičajeno vrijeme. Pouzdanost kontracepcije ostala je ista. Ne trebate primijeniti dodatne kontracepcijske mjere. Jedna propuštena tableta u trećem tjednu Možete izabrati jednu od ove dvije mogućnosti bez primjene dodatnih mjera kontracepcije: 1. Uzmite posljednju propuštenu tabletu čim se sjetite, čak i ako to znači uzimanje dvije tablete istodobno te nakon toga nastavite uzimanje tableta u uobičajeno vrijeme. Sljedeće pakiranje započnite odmah nakon što potrošite prethodno, tj. Ne radite stanku između pakiranja. Malo je vjerojatno da ćete imati krvarenje dok ne potrošite drugo pakiranje, ali mogu se pojaviti točkasta ili probojna krvarenja u dane uzimanja tableta. Ili 2. Prekinite s uzimanjem tableta iz trenutnoga pakiranja, napravite stanku od sedam dana (uključujući i dane kada ste propustili tabletu) te nakon toga nastavite s novim pakiranjem. Ukoliko ste propustili tablete iz pakiranja i nakon toga nemate očekivanu mjesečnicu u prvoj stanci, možda ste trudni. Morate se savjetovati s liječnikom prije nego što počnete uzimati tablete iz sljedećega pakiranja. Više od jedne propuštene tablete u ciklusu Savjetujte se s liječnikom. Patite od gastro-intestinalnih poremećaja (npr. povraćanje, teški proljev) Ukoliko povraćate unutar 3-4 sata od uzimanja tablete ili imate teški proljev, moguće je da aktivni sastojci Yasmin filmom obloženih tableta ne budu potpuno apsorbirani. Situacija je slična onoj kad zaboravite uzeti tabletu. Nakon povraćanja ili proljeva, morate uzeti drugu tabletu čim prije. Ako je moguće uzmite je unutar 12 sati od vremena u kojem inače uzimate tabletu. Ako to nije moguće ili je prošlo 12 sati, slijedite savjet iz odjeljka „Ako ste zaboravili uzeti Yasmin” Želite odgoditi mjesečnicu Odgađanje mjesečnice se ne preporučuje. Mjesečnicu možete odgoditi ako započnete s primjenom sljedećega pakiranja Yasmin filmom obloženih tableta odmah nakon trenutnoga pakiranja, bez sedmodnevne stanke. Možete iskusiti točkasto krvarenje za vrijeme uzimanje drugog pakiranja. Možete nastaviti s uzimanjem tableta iz toga pakiranja sve dok ga ne ispraznite. Počnite sa sljedećim pakiranjem nakon uobičajene stanke od sedam dana. Savjetujte se s vašim liječnikom prije odluke o odgađanju mjesečnice Ukoliko uzimate tablete kako je propisano, mjesečnicu ćete imati otprilike na isti dan svaka četiri tjedna (u vrijeme sedmodnevne pauze).. Ukoliko to želite promijeniti, skratite, nikako ne produljujte razdoblje neuzimanja tableta. Na primjer, ako vaša mjesečnica obično počinje u petak, a želite da počinje u utorak (tri dana ranije), trebate započeti s uzimanjem tableta iz sljedećega pakiranja tri dana ranije nego inače. Ukoliko je stanka vrlo kratka (npr. tri dana ili kraće), moguće je da nemate krvarenje tijekom stanke. Mogu se pojaviti probojna ili točkasta krvarenja tijekom uporabe sljedećega pakiranja. Ako niste sigurni kako postupiti, pitajte svog liječnika za savjet. Ako ne želite više uzimati Yasmin Yasmin filmom obložene tablete možete prestati uzimati kad god želite. Ukoliko ne želite zatrudnjeti, pitajte svog liječnika o pouzdanoj kontracepcijskoj metodi. Mjere opreza Prije nego počnete uzimati Yasmin filmom obložene tablete Prije nego počnete uzimati Yasmin, vaš liječnik će vam postaviti pitanja o vašem zdravlju i zdravlju vaših najbližih srodnika. Također, liječnik će vam izmjeriti krvni tlak, i ovisno o vašem stanju, može tražiti dodatne pretrage. U ovoj uputi, opisano je nekoliko stanja u kojima trebate prekinuti primjenu Yasmina, ili kad je pouzdanost Yasmina smanjena. U takvim situacijama, ili ne biste trebali imati odnos ili bi trebali koristiti dodatne nehormonske kontracepcijske mjere, npr. kondom ili neku drugu metodu barijere. Ne koristite metode mjerenja temperature ili ovulacije. Ove metode su nepouzdane jer Yasmin utječe na promjene tjelesne temperature i cervikalne sluzi tijekom ciklusa. Yasmin, kao ostali hormonski oralni kontraceptivi, ne štiti od HIV infekcije (AIDS) ili bilo koje druge spolno prenosive bolesti. Kada ne smijete uzimati Yasmin? - ako imate ili ste ikada imali poremećaje u cirkulaciji krvi: stanja povezana s trombozom (stvaranjem krvnih ugrušaka) u krvnim žilama nogu (duboka venska tromboza), pluća (embolija pluća), ili drugih dijelova tijela - ako imate ili ste imali srčani ili moždani udar - ako imate ili ste ikada imali stanja koja ukazuju na prve znakove srčanog udara (kao što su angina pectoris ili bol u prsnom košu) ili moždanog udara (kao što su tranzitorna ishemična ataka ili mali reverzibilni moždani udar) - ako imate bolest koja može povećati rizik od nastanka tromboze u arterijama. Ovo se odnosi na sljedeće bolesti: šećerna bolest s oštećenjima krvnih žila;vrlo visok krvni tlak vrlo visoka razina masti u krvi (kolesterol ili trigliceridi) – ako imate poremećaj zgrušavanja (na primjer, nedostatak proteina C) - ako imate ili ste imali određeni oblik migrene ( s tzv. žarišnim neurološkim simptomima) ako imate ili ste imali Pankreatitis (upala gušterače) ako imate ili ste imali bolest jetre - ako imate tešku insuflcijenciju bubrega ili akutno zatajenje bubrega - ako imate ili ste ikada imali tumor jetre ako imate (ste imali) ili postoji sumnja da imate karcinom dojke ili genitalnih organa ako imate neobjašnjiva vaginalna krvarenja ako ste hiperosjetljivi (alergični) na etinilestradiol ili drospirenon ili na bilo koji od sastojaka Yasmin filmom obloženih tableta. Znakovi mogu biti, svrbež, crvenilo ili oteklina. Kada trebate biti posebno oprezni s Yasminom Ako se kombinirani kontraceptiv primjenjuje kada postoji bilo koje od niže navedenih stanja, vaš liječnik će procijeniti vaš omjer koristi i rizika primjene Yasmina . Možda će biti potreban strogi nadzor. Stoga, ako se bilo koje od ovih stanja odnosi na vas, obavijestite liječnika prije početka uporabe Yasmin filmom obloženih tableta. Također, ako se neka od sljedećih stanja razviju ili pogoršaju tijekom primjene Yasmina morate se javiti vašem liječniku: - ako netko u vašoj bližoj obitelji ima ili je imao karcinom dojki - ako imate bolest jetre ili žuči - ako imate dijabetes - ako patite od depresije - ako imate Crohnova bolest ili ulcerozni kolitis (kronična upala crijeva) - ako imate hemolitičko-uremijski sindrom (poremećaj zgrušavanja krvi koji izaziva oštećenje bubrega) - ako imate anemiju srpastih stanica (nasljedni poremećaj crvenih krvnih stanica) ako imate epilepsiju (vidi također Uzimanje drugih lijekova s Yasminom) - ako imate sistemski lupus eritematodus (bolest koja oštećuje kožu cijelog tijela) - ako imate bolest koja se pojavila prvi put za vrijeme trudnoće ili prethodne primjene spolnih hormona (npr. gubitak sluha, metabolička bolest porfirija, bolest kože -trudnički herpes, neurološka bolest s iznenadnim pokretima tijela- Sydenhamova koreja) - ako imate ili ste ikada imali kloazmu (žućkasto - smeđa pigmentacija na dijelovima kože, tzv. trudničke pigmentacije, osobito na licu); u tom slučaju izbjegavajte izlaganje suncu ili ultraljubičastom zračenju. - ako imate nasljedni angioedem, lijekovi koji sadrže estrogene mogu potaknuti ili pogoršati simptome angioedema. Odmah se trebate javiti liječniku ako primjetite simptome poput natečenog lica, jezika i/ili faringsa i/ili otežano gutanje ili osip te otežano disanje. Javite se liječniku ako primjetite neka od ovih stanja - promjene vašeg zdravlja, posebno uključujući stanja spomenuta u ovoj uputi (vidi odjeljak Kada ne biste smjeti uzimati Yasmin i Prije nego počnete uzimati Yasmin; ne zaboravite na stanja povezana s vašom bližom obitelji) - napipali ste kvržicu u dojci - uzimat ćete druge lijekove (vidi odjeljak Uzimanje drugih lijekova s Yasminom) - imobilizacija ili operativni zahvat (obavijestite liječnika najmanje četiri tjedna unaprijed) - neuobičajena, teška vaginalna krvarenja - ako zaboravite popiti tablete u prvom tjednu, a imali ste snošaj sedam dana prije, - teški proljev - niste dobili mjesečnicu dva puta zaredom ili ako sumnjate da ste trudni (ne počinjite novo pakiranje dok vam liječnik to ne savjetuje). Yasmin i tromboza Venska tromboza Uporaba kombiniranih oralnih kontraceptiva, uključujući Yasmin, povećava rizik od nastanka venske tromboze ( stvaranje krvnog ugruška u krvnoj žili) u usporedbi sa ženom koja ne koristi kombinirane oralne kontraceptive. Rizik je najviši tijekom prve godine korištenja kombiniranog oralnog kontraceptiva. Rizik od nastanka tromboembolije također je povećan ukoliko promijenite oralni kontraceptiv. Isto tako ukoliko prestanete uzimati oralni kontraceptiv tijekom duljeg vremenskog razdoblja kod ponovnog početka uzimanja oralnog kontraceptiva rizik od nastanka venske tromboembolije je veći u usporedbi s rizikom koji postoji tijekom dugotrajnog uzimanja oralnog kontraceptiva. Iz ovog razloga važno je uzimati oralni kontraceptiv kako je propisano. Rizik od nastanka venske tromboze u korisnica kombiniranih oralnih kontraceptiva raste s: - dobi - ako ste pretili - ako netko iz vaše bliže obitelji ima krvni ugrušak (tromboza) u nozi, plućima ili drugim organima u mlađoj dobi - ako morate na operaciju (kiruršku), produljeno razdoblje imobilizacije, ili ako ste imali ozbiljnu nezgodu. Važno je da kažete vašem liječniku unaprijed kako koristite Yasmin jer upotrebu tada treba prekinuti. Vaš liječnik će vam reći kada možete ponovo početi koristiti Yasmin. To je najčešće dva tjedna nakon oporavka. Arterijska tromboza Uporaba kombiniranih oralnih kontraceptiva je povezana s povišenim rizikom od nastanka arterijske tromboze (začepljenje arterije), na primjer, u krvnim žilama srca ( srčani udar) ili mozga (moždani udar). Rizik od nastanka arterijske tromboze u korisnica kombiniranih oralnih kontraceptiva raste: - ako pušite, čvrsto vam se savjetuje da prestanete pušiti ukoliko koristite Yasmin, osobito ako ste stariji od 35 godina - ako imate povišenu razinu masti u krvi (kolesterol ili trigliceride) - ako ste pretili - ako je netko iz vaše bliže obitelji imao srčani ili moždani udar u mlađoj dobi - ako imate povišeni krvni tlak - ako imate migrenu - ako imate problema sa srcem (insuficijencija zalistaka, poremećaj ritma srca). Prestanite odmah koristiti tablete i obavijestite liječnika ako zapazite moguće znakove tromboze, kao što su: - oštru bol u nogama i/ili otjecanje nogu - oštru bol u prsnom košu koja se širi u lijevu ruku - iznenadni gubitak daha - neuobičajen kašalj bez očiglednog uzroka - svaki neuobičajen, teški ili produljeni napad glavobolje ili migrene - djelomični ili potpuni gubitak vida ili dvostruki vid - nejasno izgovaranje riječi ili nemogućnost govora - vrtoglavicu ili nesvjesticu - slabost, čudan osjećaj, ili ukočenost u bilo kojem dijelu tijela. Yasmin i karcinom Karcinom dojke nešto je češće dijagnosticiran u žena koje uzimaju oralne kontraceptive u odnosu na žene iste dobi koje se njima ne koriste, ali je nepoznato je li to uzrokovano primjenom lijeka. Razlog može biti i to što su žene češće kontrolirane, pa se karcinom dojke češće otkriva. Učestalost karcinoma dojke postepeno pada nakon prestanka uzimanja kombiniranih oralnih kontraceptiva. Važno je da redovito pregledate dojke i kontaktirate liječnika ukoliko napipate kvržicu. U rijetkim je slučajevima u žena koje uzimaju oralne kontraceptive zabilježen benigni tumor jetre, a još rjeđe maligni. Ti tumori mogu dovesti do unutarnjega krvarenja. Ako osjetite oštru bol u trbuhu, odmah se obratite liječniku. Intermenstrualno krvarenje Tijekom prvih nekoliko mjeseci primjene Yasmina, možete imati neočekivano krvarenje (izvan pauze od sedam dana). Ako krvarenje traje duže od nekoliko mjeseci, ili se pojavi nakon nekoliko mjeseci, Vaš liječnik mora ispitati uzrok. Što trebate učiniti ako izostane krvarenje u razdoblju pauze Ako ste točno uzimali tablete, niste povraćali ili imali teški proljev, te niste uzimali neke druge lijekove, mala je vjerojatnost da ste trudni. Ako se očekivano krvarenje ne pojavi dva puta zaredom, možda ste trudni. Odmah se javite liječniku. Ne započinjite novo pakiranje dok niste potpuno sigurni da niste trudni. Uzimanje drugih lijekova s Yasminom Uvijek recite liječniku, koji vam je prepisao Yasmin, koje lijekove ili biljne pripravke već koristite. Također recite drugom liječniku koji vam je prepisao neki drugi lijek ili ljekarniku koji vam izdaje lijek da koristite Yasmin. Oni će vas upozoriti trebate li koristiti dodatne mjere zaštite (na primjer kondome) i ako da, koliko dugo. Neki lijekovi mogu smanjiti učinkovitost Yasmina u sprječavanju začeća, ili mogu uzrokovati neočekivano krvarenje. To uključuje lijekove koji se koriste za liječenje epilepsije ( npr. primidone, fenitoin, barbiturati, karbamazepin, okskarbamazepin) i tuberkuloze (npr. rifampicin), ili HIV infekcije (ritonavir) ili druge infektivne bolesti (grizeofulvin, ampicilin, tetraciklini), i biljni lijek gospina trava. Ako želite koristiti biljni lijek koji sadrži gospinu travu dok koristite Yasmin trebate prvo pitati vašeg liječnika. Yasmin može utjecati na učinak drugih lijekova, npr. lijekova koji sadrže ciklosporin, ili antiepileptik lamotrigin (povećava se učestalost napadaja). Prije uzimanja bilo kojeg lijeka obratite se liječniku ili ljekarniku za savjet. Laboratorijski testovi Ako radite krvne pretrage, recite liječniku ili laboratorijskom osoblju da uzimate kombinirani oralni kontraceptiv jer to može utjecati na rezultate nekih testova. Trudnoća i dojenje Yasmin filmom obloženim tabletama ne smiju se koristiti trudnice, ili žene koje misle da bi mogle biti trudne. Ukoliko zatrudnite dok uzimate Yasmin, a uzimate Yasmin filmom obložene tablete, trebate odmah prestati uzimati Yasmin i obratiti se liječniku. Yasmin filmom obložene tablete općenito se ne preporučuju tijekom dojenja. Ako želite uzimati oralni kontraceptiv tijekom dojenja, molimo vas da se posavjetujte s liječnikom. Prije uzimanja bilo kojeg lijeka obratite se liječniku ili ljekarniku za savjet. Upravljanje vozilima i strojevima Nisu zapaženi nikakvi učinci. Ostala upozorenja Yasmin sadržava laktozu. Ako Vam je liječnik rekao da imate bolest nepodnošenja nekih šećera, prije nego što počnete uzimati ovaj lijek posavjetujete se sa svojim liječnikom. U slučaju bilo kakvih ne jasnoća ili pitanja u vezi s primjenom Yasmina obratite se svom liječniku ili ljekarniku. Moguće nuspojave Kao i svi drugi lijekovi, Yasmin može izazvati nuspojave. Ako primijetite bilo koju nuspojavu potrebno je obavijestiti liječnika ili ljekarnika. Napomene Ime i adresa nositelja odobrenja za stavljanje u promet gotovog lijeka Bayer d.o.o., Radnička cesta 80, Zagreb, Hrvatska Ime i adresa proizvođača lijeka Bayer Schering Pharma AG, Berlin, Njemačka