Background pattern
Drosfemine forte

Drosfemine forte

About the medicine

How to use Drosfemine forte

Leaflet attached to the packaging: information for the user

Drosfemine forte, 0.03 mg + 3 mg, coated tablets

Ethinylestradiol + Drospirenone

Important information about combined hormonal contraceptives

If used correctly, they are one of the most reliable, reversible methods of contraception. They slightly increase the risk of blood clots in veins and arteries, especially in the first year of use or after resuming use after a break of 4 weeks or longer. You should be vigilant and consult a doctor if you suspect that you have symptoms of blood clots (see section 2 "Blood clots").

You should carefully read the contents of the leaflet before taking the medicine, as it contains important information for the patient.

  • You should keep this leaflet so that you can read it again if necessary.
  • In case of any doubts, you should consult a doctor or pharmacist.
  • This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
  • If you experience any side effects, including any not listed in this leaflet, you should tell your doctor or pharmacist. See section 4.

Table of contents of the leaflet

  • 1. What is Drosfemine forte and what is it used for
  • 2. Important information before taking Drosfemine forte
  • 3. How to take Drosfemine forte
  • 4. Possible side effects
  • 5. How to store Drosfemine forte
  • 6. Contents of the packaging and other information

1. What is Drosfemine forte and what is it used for

Drosfemine forte is a contraceptive tablet used to prevent pregnancy. Each tablet contains a small amount of two different female hormones - ethinylestradiol and drospirenone. Contraceptive tablets that contain two hormones are called combined contraceptive tablets.

2. Important information before taking Drosfemine forte

General notes

Before starting to take Drosfemine forte, you should read the information about blood clots in section 2. It is especially important to read about the symptoms of blood clots (see section 2 "Blood clots"). Before starting to take Drosfemine forte, your doctor will ask you a few questions about your health and the health of your close relatives. Your doctor will also measure your blood pressure and, depending on your individual situation, may also perform additional tests.

Drosfemine forte, like other hormonal contraceptives, does not protect against HIV infection (AIDS) or other sexually transmitted diseases.

When not to take Drosfemine forte

You should not take Drosfemine forte if you have any of the conditions listed below. If you have any of the conditions listed below, you should inform your doctor. Your doctor will discuss with you which other contraceptive method will be more suitable for you.

Do not take Drosfemine forte

  • if you are allergic to ethinylestradiol or drospirenone or any of the other ingredients of this medicine (listed in section 6). Symptoms of hypersensitivity may include itching, rash, or swelling;
  • if you currently have (or have ever had) a blood clot in the veins of the legs (deep vein thrombosis), lungs (pulmonary embolism), or other organs;
  • if you know that you have blood coagulation disorders - for example, protein C deficiency, protein S deficiency, antithrombin III deficiency, factor V Leiden mutation, or antiphospholipid antibodies;
  • if you need to have surgery or will be immobilized for a long time (see section "Blood clots");
  • if you have had a heart attack or stroke;
  • if you have (or have had in the past) angina pectoris (a disease that causes severe chest pain and may be the first symptom of a heart attack) or transient ischemic attack (temporary stroke symptoms);
  • if you have any of the following diseases that may increase the risk of a blood clot in an artery:
    • severe diabetes with blood vessel damage,
    • very high blood pressure,
    • very high levels of fats in the blood (cholesterol or triglycerides),
    • a disease called hyperhomocysteinemia;
  • if you have (or have had in the past) a type of migraine called "migraine with aura";
  • if you have (or have had in the past) liver disease, and liver function has not returned to normal;
  • if you have kidney function disorders (kidney failure);
  • if you have (or have had in the past) liver cancer;
  • if you have (or have had in the past) breast cancer or genital cancer or if it is suspected;
  • if you have had unexplained vaginal bleeding.
  • if you have hepatitis C and are taking antiviral medicines containing ombitasvir, paritaprevir, and ritonavir, dasabuvir, glecaprevir with pibrentasvir, or sofosbuvir with velpatasvir and voxilaprevir (see section "Drosfemine forte and other medicines").

Additional information for special populations

Children and adolescents
Drosfemine forte is not intended for patients who have not yet started menstruating.
Women of advanced age
Drosfemine forte is not intended for use after menopause.
Women with liver function disorders
You should not take Drosfemine forte if you have liver disease. See also sections "Do not take Drosfemine forte" and "Warnings and precautions".
Women with kidney function disorders
You should not take Drosfemine forte if you have kidney failure or acute kidney failure. See also sections "Do not take Drosfemine forte" and "Warnings and precautions".

Warnings and precautions

When should you contact your doctor?
You should contact your doctor immediately

  • if you notice any symptoms that may indicate the formation of blood clots, which may indicate that you have blood clots in your leg (deep vein thrombosis), blood clots in your lungs (pulmonary embolism), a heart attack, or a stroke (see below "Blood clots"). To find a description of these serious side effects, see "How to recognize blood clots".

You should tell your doctor if you have any of the following conditions.

In some cases, you should be particularly careful when taking Drosfemine forte or any other combined contraceptive tablets. You may also need to be regularly examined by your doctor. If these symptoms occur or worsen while taking Drosfemine forte, you should also tell your doctor.

  • if any of your close relatives have had breast cancer;
  • if you have liver or gallbladder disease;
  • if you have diabetes;
  • if you have depression;
  • if you have Crohn's disease or ulcerative colitis (chronic inflammatory bowel diseases);
  • if you have hemolytic uremic syndrome (a blood clotting disorder that causes kidney failure);
  • if you have sickle cell anemia (a hereditary disease of red blood cells);
  • if you have been diagnosed with high levels of fats in the blood (hypertriglyceridemia) or a positive family history for this disease. Hypertriglyceridemia is associated with an increased risk of developing pancreatitis;
  • if you need to have surgery or will be immobilized for a long time (see section 2 "Blood clots");
  • if you have just given birth, you are at increased risk of blood clots. You should consult your doctor for advice on when to start taking Drosfemine forte after giving birth;
  • if you have superficial thrombophlebitis (blood clots in the veins under the skin);
  • if you have varicose veins;
  • if you have epilepsy (see section "Drosfemine forte and other medicines");
  • if you have systemic lupus erythematosus (a disease that affects the body's natural defense system);
  • if you have had conditions that first appeared during pregnancy or previous use of sex hormones (e.g., hearing loss, a blood disease called porphyria, a skin rash with blisters during pregnancy (pregnancy pemphigoid), a nerve disease that causes sudden movements of the body (Sydenham's chorea));
  • if you have had chloasma (skin discoloration, especially on the face and neck, so-called pregnancy spots). If so, you should avoid direct exposure to sunlight or ultraviolet radiation;
  • if you experience symptoms of angioedema, such as facial swelling, tongue and/or throat swelling, and difficulty swallowing or hives that may cause difficulty breathing, you should

contact your doctor immediately. Estrogen-containing medicines may cause or worsen symptoms of hereditary or acquired angioedema.

Psychiatric disorders

Some women taking hormonal contraceptives, including Drosfemine forte, have reported depression or low mood. Depression can be severe and sometimes lead to suicidal thoughts. If mood changes and symptoms of depression occur, you should contact your doctor as soon as possible for further medical advice.

BLOOD CLOTS

The use of combined hormonal contraceptives, such as Drosfemine forte, is associated with an increased risk of blood clots, compared to not using them. In rare cases, a blood clot can block a blood vessel and cause serious complications. Blood clots can occur in the veins (called "venous thromboembolism" or "deep vein thrombosis") or in the arteries (called "arterial thromboembolism"). Not everyone who has a blood clot will fully recover, and in rare cases, the consequences of a blood clot can be permanent or even fatal.

Remember that the overall risk of having a harmful blood clot due to Drosfemine forte is small.

HOW TO RECOGNIZE BLOOD CLOTS

You should contact your doctor immediately if you notice any of the following symptoms.

Are you experiencing any of these symptoms?What is the likely cause of the complaint?
  • swelling of the leg or swelling along a vein in the leg or foot, especially if it is accompanied by:
  • pain or tenderness in the leg, which may only be felt while standing or walking;
  • increased temperature in the affected leg;
  • change in skin color in the affected leg, such as pallor, redness, or cyanosis.
Deep vein thrombosis
  • sudden unexplained shortness of breath or rapid breathing;
  • sudden unexplained cough, which may be accompanied by coughing up blood;
  • sharp chest pain, which may worsen with deep breathing;
  • severe dizziness or fainting;
  • rapid or irregular heartbeat;
  • severe stomach pain.
Pulmonary embolism
  • chest pain, discomfort, pressure, or heaviness;
  • a feeling of squeezing or fullness in the chest, arm, or below the breastbone;
  • a feeling of fullness, indigestion, or choking;
  • discomfort in the upper body radiating to the back, jaw, throat, arm, and stomach;
  • sweating, nausea, vomiting, or fainting;
  • extreme weakness, anxiety, or shortness of breath;
  • rapid or irregular heartbeat.
Heart attack
  • sudden weakness or numbness of the face, arms, or legs, especially on one side of the body;
  • sudden confusion, speech disorders, or difficulty understanding;
  • sudden vision disorders in one or both eyes;
  • sudden walking disorders, dizziness, loss of balance, or coordination disorders;
  • sudden severe or prolonged headaches without a known cause;
  • loss of consciousness or fainting with or without seizures.
Stroke
  • swelling and slight blue discoloration of the skin of the legs or arms;
  • severe stomach pain (acute abdomen).
Blood clots blocking other blood vessels

BLOOD CLOTS IN VEINS

What can happen if a blood clot forms in a vein?

  • The use of combined hormonal contraceptives is associated with an increased risk of blood clots in the veins (venous thromboembolism), although these side effects are rare. They most often occur in the first year of using combined hormonal contraceptives.
  • If blood clots form in the veins in the leg or foot, it can lead to the development of deep vein thrombosis.
  • If a blood clot moves from the leg and settles in the lungs, it can cause pulmonary embolism.
  • In very rare cases, a blood clot can form in another organ, such as the eye (retinal vein thrombosis).

When is the risk of blood clots in a vein highest?

The risk of forming a blood clot in a vein is highest during the first year of using combined hormonal contraceptives for the first time. The risk may also be higher when resuming the use of combined hormonal contraceptives (the same or a different medicine) after a break of 4 weeks or longer. After the first year, the risk decreases, but it is always higher compared to not using combined hormonal contraceptives. If you stop taking Drosfemine forte, the risk of blood clots returns to normal within a few weeks.

What affects the risk of blood clots in veins?

The risk of blood clots associated with Drosfemine forte is small, but some factors can increase this risk. The risk is higher:

  • if you are significantly overweight (body mass index (BMI) over 30 kg/m2);
  • if someone in your close family has had blood clots in the legs, lungs, or other organs at a young age (e.g., under 50 years old). In this case, you may have hereditary blood coagulation disorders;
  • if you need to have surgery, are immobilized for a long time due to injury or illness, or have a leg in a cast. It may be necessary to stop taking Drosfemine forte for a few weeks before surgery or immobilization. If you need to stop taking Drosfemine forte, you should ask your doctor when you can resume taking the medicine;
  • with age (especially over 35 years old);
  • if you have given birth in the last few weeks.

The risk of blood clots increases with the number of risk factors present in you. Air travel (>4 hours) may temporarily increase the risk of blood clots, especially if you have another risk factor. It is essential to tell your doctor if any of these risk factors apply to you, even if you are not sure. Your doctor may decide to stop Drosfemine forte. You should inform your doctor if any of the above conditions change while taking Drosfemine forte, e.g., if someone in your close family is diagnosed with a blood clot without a known cause or if you gain weight significantly.

BLOOD CLOTS IN ARTERIES

What can happen if a blood clot forms in an artery?

Similarly to blood clots in veins, blood clots in arteries can cause severe consequences, such as a heart attack or stroke.

Factors that increase the risk of blood clots in arteries

It is essential to note that the risk of a heart attack or stroke associated with Drosfemine forte is very small, but it may increase:

  • with age (over approximately 35 years old);
  • if you smoke. While taking a hormonal contraceptive, it is recommended to quit smoking. If you cannot quit smoking and are over 35 years old, your doctor may recommend using a different type of contraception;
  • if you are overweight;
  • if you have high blood pressure;
  • if someone in your close family has had a heart attack or stroke at a young age (under 50 years old). In this case, you may also be at increased risk of having a heart attack or stroke;
  • if you or someone in your close family has been diagnosed with high levels of fats in the blood (cholesterol or triglycerides);
  • if you have migraines, especially migraines with aura;
  • if you have heart disease (valve damage, heart rhythm disorder called atrial fibrillation);
  • if you have diabetes.

If you have more than one of the above conditions or if any of them are severe, the risk of blood clots may be even higher. You should inform your doctor if any of the above conditions change while taking Drosfemine forte, e.g., if you start smoking, someone in your close family is diagnosed with a blood clot without a known cause, or if you gain weight significantly.

Drosfemine forte and cancer

Women taking combined contraceptive tablets have been found to have a slightly higher incidence of breast cancer, but it is not known whether this is caused by the tablets. It is possible that more tumors are detected in women taking combined contraceptive tablets because they are examined by doctors more frequently. The incidence of breast tumors decreases gradually after stopping combined hormonal contraceptives. It is essential to regularly examine your breasts and contact your doctor if you feel any lump. In rare cases, women taking contraceptive tablets have been found to have benign liver tumors, and even more rarely, malignant liver tumors. If you experience unusual, severe stomach pain, you should contact your doctor.

Irregular bleeding

During the first few months of taking Drosfemine forte, you may experience unexpected bleeding (bleeding outside of the withdrawal bleeding week). If such bleeding persists for more than a few months or starts after a few months, your doctor should investigate the cause.

What to do if withdrawal bleeding does not occur

If you have taken all the tablets correctly, have not vomited, or had severe diarrhea, and have not taken any other medicines, it is unlikely that you are pregnant. If the expected withdrawal bleeding does not occur twice in a row, it may mean that you are pregnant. You should contact your doctor immediately. Do not start the next blister pack until you are sure you are not pregnant.

Drosfemine forte and other medicines

You should tell your doctor or pharmacist about all medicines and herbal products you are currently taking or have recently taken, as well as any medicines and herbal products you plan to take. You should also tell any other doctor or dentist prescribing another medicine (or pharmacist) that you are taking Drosfemine forte. They may advise you to use additional contraceptive precautions (e.g., condoms) and for how long, and whether you should change the way you take other medicines. Some medicines

  • may affect the level of Drosfemine forte in your blood
  • may make Drosfemine forte less effective in preventing pregnancy
  • may cause unexpected bleeding.

This applies to medicines used to treat:

  • 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 (e.g., griseofulvin, ketoconazole),
  • arthritis, degenerative joint disease (etoricoxib),
  • high blood pressure in the blood vessels of the lungs (bosentan);
  • herbal products containing St. John's Wort.

Drosfemine forte may affect the actionof other medicines, such as:

  • medicines containing cyclosporin,
  • the antiepileptic medicine lamotrigine (may lead to an increased frequency of seizures),
  • theophylline (used to treat respiratory disorders),
  • tizanidine (used to treat muscle pain and/or muscle spasms).

You should not take Drosfemine forte if you have hepatitis C and are taking medicines containing ombitasvir, paritaprevir, and ritonavir, dasabuvir, glecaprevir with pibrentasvir, or sofosbuvir with velpatasvir and voxilaprevir, as these medicines may cause abnormal liver function test results (elevated liver enzyme ALT). Your doctor will recommend a different type of contraception before starting these medicines. You can start taking Drosfemine forte again about 2 weeks after finishing the treatment. See section "Do not take Drosfemine forte".

Lab tests

If a blood test is necessary, you should tell your doctor or laboratory staff that you are taking contraceptive tablets, as hormonal contraceptives may affect the results of some tests.

Drosfemine forte with food and drink

Drosfemine forte can be taken with or without food, and if necessary, it can be taken with a small amount of water.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to have a baby, you should ask your doctor or pharmacist for advice before taking this medicine. Pregnancy If you are pregnant, you should not take Drosfemine forte. If you become pregnant while taking Drosfemine forte, you should stop taking it immediately and contact your doctor. If you want to become pregnant, you can stop taking Drosfemine forte at any time (see section "Stopping Drosfemine forte"). Breastfeeding Generally, Drosfemine forte is not recommended for women who are breastfeeding. If you want to take contraceptive tablets while breastfeeding, you should contact your doctor.

Driving and using machines

There is no information suggesting that taking Drosfemine forte affects your ability to drive or use machines.

Drosfemine forte contains lactose

If you have been diagnosed with an intolerance to some sugars, you should contact your doctor before taking Drosfemine forte.

3. How to take Drosfemine forte

You should always take this medicine exactly as your doctor or pharmacist has told you. If you are not sure, you should ask your doctor or pharmacist. You should take one Drosfemine forte tablet every day, and if necessary, you can take it with a small amount of water. The tablets can be taken with or without food. The tablets should be taken every day at about the same time. The blister pack contains 21 tablets. Next to each tablet, the day of the week is indicated on which it should be taken. If, for example, you start taking the tablets on a Wednesday, you should take the tablet marked "Wed". Then you should take the tablets according to the direction of the arrows on the blister pack until all 21 tablets have been taken.

  • On the 8th day after taking the last tablet of Drosfemine forte (i.e., after the 7-day break), you should start taking the next blister pack, regardless of whether the withdrawal bleeding has stopped or not. This means that each blister pack should be started on the same day of the week, and the withdrawal bleeding should occur on the same days of each cycle.

If you take Drosfemine forte in this way, you will also be protected from pregnancy during the 7 days when you are not taking tablets. To have control over the regular intake of the contraceptive every day, you should pay attention to the arrows on the blister pack. The arrows show the order in which the tablets should be taken.

When can you start the first blister pack?

If you have not used a hormonal contraceptive in the previous month You should start taking Drosfemine forte on the first day of your menstrual cycle (i.e., the first day of your period). If you start taking Drosfemine forte on the first day of your period, you are immediately protected from pregnancy. You can also start taking the tablets between the 2nd and 5th day of your menstrual cycle, but then you should use additional contraceptive methods (e.g., condoms) for the first 7 days. Changing from a combined hormonal contraceptive or a combined contraceptive vaginal ring system or a transdermal system (patch) You should start taking Drosfemine forte the next day after taking the last active tablet (the last tablet containing active substances) of your previous contraceptive tablets, but no later than the day after the break in taking your previous tablets (or after taking the last inactive tablet of your previous contraceptive tablets). When changing from a combined contraceptive vaginal ring system or a transdermal system (patch), you should follow your doctor's advice. Changing from a progestogen-only method (progestogen-only tablet, injection, implant, or intrauterine device (IUD) releasing progestogen) You can change from a progestogen-only tablet at any time (from an implant or IUD - on the day of their removal, from injections - on the day when the next injection would be due). In all these cases, it is recommended to use additional contraceptive methods (e.g., condoms) for the first 7 days of taking Drosfemine forte. After a miscarriage You should follow your doctor's advice. After childbirth You can start taking Drosfemine forte between the 21st and 28th day after childbirth. If you start taking Drosfemine forte later than 28 days after childbirth, you should use a barrier method (e.g., condoms) for the first 7 days of taking Drosfemine forte. If you have had sexual intercourse after giving birth, before starting Drosfemine forte (again), you should make sure you are not pregnant or wait for your next menstrual period. If you are breastfeeding and want to start taking Drosfemine forte (again) after giving birth You should read the section "Breastfeeding". If you are not sure when to start the first blister pack, you should contact your doctor.

What to do if you take more Drosfemine forte than you should

There are no reports of serious harmful effects from taking too many Drosfemine forte tablets at once. If you take several tablets at once, you may experience symptoms such as nausea, vomiting, or vaginal bleeding. This type of bleeding may occur even in girls who have not yet started menstruating but have taken the medicine by mistake. If you take too many Drosfemine forte tablets or if a child accidentally swallows some tablets, you should contact your doctor or pharmacist immediately.

What to do if you forget to take Drosfemine forte

  • If it has been less than 12 hourssince you missed a tablet, your protection from pregnancy is not reduced. You should take the tablet as soon as possible and take the next tablets at the usual time.
  • If it has been more than 12 hourssince you missed a tablet, your protection from pregnancy may be reduced. The more tablets you have missed, the higher the risk of pregnancy.

The risk of reduced protection from pregnancy is highest if you miss a tablet at the beginning or end of the blister pack. Therefore, you should follow these rules (see also the diagram): Missing more than one tablet from the blister pack You should contact your doctor. Missing one tablet in the first week You should take the missed tablet as soon as possible, even if it means taking two tablets at the same time. Then you should take the tablets at the usual time and use additional contraceptive methods(e.g., condoms) for the next 7 days. If you have had sexual intercourse in the week before missing the tablet, it is possible that you are pregnant. In this case, you should contact your doctor. Missing one tablet in the second week You should take the missed tablet as soon as possible, even if it means taking two tablets at the same time. Then you should take the tablets at the usual time. Your protection from pregnancy is not reduced, and you do not need to use additional contraceptive methods. Missing one tablet in the third week There are two options to choose from:

  • 1. You should take the missed tablet as soon as possible, even if it means taking two tablets at the same time. Then you should take the tablets at the usual time. You should skip the break in taking the tablets and start the next blister pack immediately.

Most likely, your period will occur at the end of the second blister pack, but you may also experience some bleeding or spotting during the second blister pack.

  • 2. You can also stop taking the tablets from the blister pack and start the 7-day break in taking the tablets immediately (you should note the day you missed the tablet). If you want to start the new blister pack on the day you always start taking the tablets, you can shorten the tablet-free period to less than 7 days.

If you follow one of these two recommendations, you will still be protected from pregnancy. If you have missed any of the tablets in the blister pack and have not had withdrawal bleeding during the first break, it may mean that you are pregnant. Before starting the next blister pack, you should contact your doctor. Missing more than one tablet from the blister pack You should contact your doctor for advice.

What to do if you vomit or have severe diarrhea

If you vomit within 3 to 4 hours of taking a tablet or have severe diarrhea, there is a risk that the active substances from the tablet will not be fully absorbed into your body. This situation is almost the same as missing a tablet. After vomiting or diarrhea, you should take another tablet from the reserve blister pack as soon as possible. If possible, you should take it within 12 hoursof the usual time of taking the tablet. If this is not possible or more than 12 hours have passed, you should follow the instructions described in the section "If you forget to take Drosfemine forte".

Delaying your period: what you need to know

Although it is not recommended, you can delay your period by skipping the break in taking the tablets and starting the next blister pack of Drosfemine forte immediately, until you finish it. During the second blister pack, you may experience some bleeding or spotting. After the usual 7-day break in taking the tablets, you should start the next blister pack. Before deciding to delay your period, you can consult your doctor for advice.

4. Possible Side Effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. If any side effects occur, especially severe and persistent ones, or changes in health that the patient considers related to the use of Drosfemine Forte, they should consult their doctor.
In all women taking combined hormonal contraceptives, there is an increased risk of blood clots in the veins (venous thromboembolism) or blood clots in the arteries (arterial thromboembolism). For detailed information on the various risk factors associated with the use of combined hormonal contraceptives, please refer to section 2 "Important information before taking Drosfemine Forte".
Below is a list of side effects associated with the use of Drosfemine Forte:

Severe Side Effects

The patient should immediately contact their doctor if they experience any of the following symptoms of angioedema: swelling of the face, tongue, and/or throat, and/or difficulty swallowing or hives potentially with difficulty breathing (see also section 2 "Warnings and precautions").

Other Side Effects

Common side effects (may affect up to 1 in 10 patients):

  • menstrual disorders, intermenstrual bleeding, breast pain, breast tenderness,
  • headache, depressive mood,
  • migraine,
  • nausea,
  • thick, white vaginal discharge and vaginal yeast infection.

Uncommon side effects (may affect up to 1 in 100 patients):

  • breast enlargement, changes in libido,
  • high blood pressure, low blood pressure,
  • vomiting, diarrhea,
  • acne, skin rash, severe itching, hair loss (alopecia),
  • vaginal infection,
  • fluid retention and changes in body weight.

Rare side effects (may affect up to 1 in 1,000 patients):

  • allergic reactions (hypersensitivity), asthma,
  • breast discharge,
  • hearing disorders,
  • skin disease - erythema nodosum (characterized by painful red lumps on the skin) or erythema multiforme (characterized by a rash with redness resembling a target or ulcers),
  • blood clots in a vein or artery, for example:
  • in the leg or foot (e.g., deep vein thrombosis),
  • in the lungs (e.g., pulmonary embolism),
  • heart attack,
  • stroke,
  • mini-stroke or transient stroke-like symptoms, known as a transient ischemic attack,
  • blood clots in the liver, stomach, intestine, kidney, or eye.

The likelihood of blood clots may be higher if the patient has any other risk factors (see section 2 for further information on risk factors for blood clots and symptoms of blood clots).

Reporting Side Effects

If any side effects occur, including any side effects not listed in the leaflet, the patient should tell their doctor or pharmacist. Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products, Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products
Al. Jerozolimskie 181C
02-222 Warsaw
Phone: +48 22 49 21 301
Fax: +48 22 49 21 309
Website: https://smz.ezdrowie.gov.pl
Reporting side effects will help to gather more information on the safety of the medicine.

5. How to Store Drosfemine Forte

The medicine should be stored out of sight and reach of children.
There are no special precautions for storing the medicine.
Do not use this medicine after the expiry date stated on the blister and carton. The expiry date refers to the last day of the month.
Medicines should not be disposed of via wastewater. The patient should ask their pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Package Contents and Other Information

What Drosfemine Forte Contains

  • The active substances of the medicine are ethinylestradiol and drospirenone. Each tablet contains 0.03 mg of ethinylestradiol and 3 mg of drospirenone.
  • The other ingredients are: lactose monohydrate, corn starch, maltodextrin, magnesium stearate, hypromellose 3cP, talc, titanium dioxide (E171), polysorbate 80, yellow iron oxide (E172).

What Drosfemine Forte Looks Like and What the Package Contains

Each blister of Drosfemine Forte contains 21 yellow, round, film-coated tablets.
Drosfemine Forte is available in packs containing 1, 3, or 6 blisters, each of 21 tablets.
Not all pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

SUN-FARM Sp. z o.o.
ul. Dolna 21
05-092 Łomianki

Manufacturer

mibe GmbH Arzneimittel
Münchener Straße 15
06796 Brehna
Germany
SUN-FARM Sp. z o.o.
ul. Dolna 21
05-092 Łomianki
Date of last revision of the leaflet:04.2023

  • Country of registration
  • Active substance
  • Prescription required
    Yes
  • Manufacturer
  • Importer
    mibe GmbH Arzneimittel Sun-Farm Sp. z o.o.

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Ekaterina Agapova

Neurology8 years of experience

Dr. Ekaterina Agapova is a neurologist specialising in the diagnosis and treatment of neurological conditions and chronic pain. She provides online consultations for adults, combining evidence-based medicine with a personalised approach.

She offers expert care for:

  • Headaches and migraines, including tension-type and cluster headaches.
  • Neck and back pain, both acute and chronic.
  • Chronic pain syndromes – fibromyalgia, neuropathic pain, post-traumatic pain.
  • Mononeuropathies – carpal tunnel syndrome, trigeminal neuralgia, facial nerve palsy.
  • Polyneuropathies – diabetic, toxic, and other types.
  • Multiple sclerosis – diagnosis, monitoring, long-term support.
  • Dizziness and coordination disorders.
  • Sleep disturbances – insomnia, daytime sleepiness, fragmented sleep.
  • Anxiety, depression, and stress-related conditions.

Dr. Agapova helps patients manage complex neurological symptoms like pain, numbness, weakness, poor sleep, and emotional distress. Her consultations focus on accurate diagnosis, clear explanation of findings, and tailored treatment plans.

If you’re struggling with chronic pain, migraines, nerve disorders, or sleep problems, Dr. Agapova offers professional guidance to restore your well-being.

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Doctor

Yevgen Yakovenko

General surgery11 years of experience

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Doctor

Jonathan Marshall Ben Ami

Family medicine8 years of experience

Dr. Jonathan Marshall Ben Ami is a licensed family medicine doctor in Spain. He provides comprehensive care for adults and children, combining general medicine with emergency care expertise to address both acute and chronic health concerns.

Dr. Ben Ami offers expert diagnosis, treatment, and follow-up for:

  • Respiratory infections (cold, flu, bronchitis, pneumonia).
  • ENT conditions such as sinusitis, ear infections, and tonsillitis.
  • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
  • Urinary tract infections and other common infections.
  • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
  • Acute conditions requiring urgent medical attention.
  • Headaches, migraines, and minor injuries.
  • Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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Doctor

Salome Akhvlediani

Pediatrics11 years of experience

Dr Salome Akhvlediani is a paediatrician providing online consultations for children of all ages. She supports families with preventive care, diagnosis, and long-term management of both acute and chronic conditions.

Her areas of focus include:

  • Fever, infections, cough, sore throat, and digestive issues.
  • Preventive care – vaccinations, regular check-ups, and health monitoring.
  • Allergies, asthma, and skin conditions.
  • Nutritional advice and healthy development support.
  • Sleep difficulties, fatigue, and behavioural concerns.
  • Ongoing care for chronic or complex health conditions.
  • Guidance for parents and follow-up after medical treatment.

Dr Akhvlediani combines professional care with a warm, attentive approach – helping children stay healthy and supporting parents at every stage of their child’s growth.

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