Package Leaflet: Information for the User
Etinilestradiol/Drospirenona Daily Stada 0.02 mg/3 mg film-coated tablets EFG
Read this entire leaflet carefully before you start taking this medicine, because it contains important information for you.
Important things to know about combined hormonal contraceptives (CHCs):
Contents of the Package Leaflet
Etinilestradiol/drospirenona is a contraceptive and is used to prevent pregnancy.
Each of the 21 active pink tablets contains a small amount of two different female hormones, called etinilestradiol and drospirenona.
The 7 white tablets do not contain active ingredients and are called placebo tablets.
Contraceptives that contain two hormones are called “combined” contraceptives.
General considerations
Before starting to use etinilestradiol/drospirenona, you should read the information about blood clots in section 2. It is especially important that you read the symptoms of a blood clot (see section 2 "Blood clots").
Before starting to take etinilestradiol/drospirenona, your doctor will ask you some questions about your personal and family medical history. Your doctor will also measure your blood pressure and, depending on your state of health, may perform other tests.
In this prospectus, several situations are described in which you should interrupt the use of etinilestradiol/drospirenona, or in which the effect of etinilestradiol/drospirenona may decrease. In such situations, you should not have sexual intercourse or should take additional non-hormonal contraceptive precautions, such as using a condom or another barrier method.
Do not use the rhythm method or the temperature method. These methods may not be reliable since etinilestradiol/drospirenona alters the monthly changes in body temperature and cervical mucus.
Ethinylestradiol/drospirenona, like other hormonal contraceptives, does not protect against HIV infection (AIDS) or any other sexually transmitted disease.
DO NOT TAKE Etinilestradiol/Drospirenona Daily Stada
You should not use etinilestradiol/drospirenona if you have any of the conditions listed below. Inform your doctor if you have any of the conditions listed below. Your doctor will discuss with you what other form of contraception would be more suitable.
Warnings and precautions
When should you consult your doctor? Seek urgent medical attention
To obtain a description of the symptoms of these serious side effects, see "How to recognize a blood clot". |
In some situations, you will need to be particularly careful while using ethinylestradiol/drospirenona or any other combined hormonal contraceptive, and it may be necessary for your doctor to perform regular check-ups.
Tell your doctor if you suffer from any of the following conditions:
If the condition develops or worsens while you are using ethinylestradiol/drospirenona, you should also inform your doctor.
BLOOD CLOTS
The use of a combined hormonal contraceptive like ethinylestradiol/drospirenona increases your risk of developing a blood clot compared to not using it. In rare cases, a blood clot can block blood vessels and cause serious problems.
Blood clots can form:
Recovery from blood clots is not always complete. In rare cases, there can be serious long-term effects or, very rarely, they can be fatal.
It is essential to remember that the overall risk of a harmful blood clot due to ethinylestradiol/drospirenona is small.
HOW TO RECOGNIZE A BLOOD CLOT
Seek urgent medical attention if you notice any of the following signs or symptoms.
Are you experiencing any of these signs? | What might you be suffering from? |
| Deep vein thrombosis |
If you are unsure, consult a doctor, as some of these symptoms, such as cough or shortness of breath, can be confused with a milder condition such as a respiratory infection (e.g., a "common cold"). | Pulmonary embolism |
Symptoms that occur more frequently in one eye:
| Retinal vein thrombosis (blood clot in the eye) |
| Heart attack |
Sometimes the symptoms of a stroke can be brief, with almost immediate and complete recovery, but you should still seek urgent medical attention as you may be at risk of having another stroke. | Stroke |
| Blood clots that block other blood vessels |
BLOOD CLOTS IN A VEIN
What can happen if a blood clot forms in a vein?
When is the risk of a blood clot in a vein higher?
The risk of a blood clot in a vein is higher during the first year in which you take a combined hormonal contraceptive for the first time. The risk may also be higher if you start taking a combined hormonal contraceptive (the same medication or a different one) after an interruption of 4 weeks or more.
After the first year, the risk decreases, but it is always slightly higher than if you were not taking a combined hormonal contraceptive.
When you stop taking ethinylestradiol/drospirenona, your risk of a blood clot returns to normal within a few weeks.
What is the risk of 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 ethinylestradiol/drospirenona is small.
Risk of a blood clot in a year | |
Women who do not usea combined hormonal contraceptive and are not pregnant | About 2 out of 10,000 women |
Women who use a combined hormonal contraceptive that contains levonorgestrel, norethisterone, or norgestimate | About 5-7 out of 10,000 women |
Women who use ethinylestradiol/drospirenona | 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 ethinylestradiol/drospirenona is small, but some conditions increase the risk. Your risk is higher:
The risk of a blood clot increases with the number of conditions you have.
Long-haul flights (more than 4 hours) may temporarily increase the risk of a blood clot, especially if you have any of the other risk factors listed.
It is essential to inform your doctor if you suffer from any of the above conditions, even if you are not sure. Your doctor may decide that you should stop using ethinylestradiol/drospirenona.
If any of the above conditions change while you are using ethinylestradiol/drospirenona, for example, a close relative experiences a thrombosis without a known cause, or you gain a lot of weight, inform 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 essential to note that the risk of a heart attack or stroke due to ethinylestradiol/drospirenona is very small, but it can increase:
If you have one or more of these conditions or if any of them are particularly severe, the risk of a blood clot may be further increased.
If any of the above conditions change while you are using ethinylestradiol/drospirenona, for example, you start smoking, a close relative experiences a thrombosis without a known cause, or you gain a lot of weight, inform your doctor.
Ethinylestradiol/Drospirenona Daily Stada and cancer
Women who use combined contraceptives have a slightly higher rate of breast cancer, but it is not known if this is due to the treatment. For example, it may be that more tumors are detected in women who take combined contraceptives because they are examined by a doctor more frequently. The incidence of breast tumors decreases gradually after stopping combined hormonal contraceptives.
It is essential to have your breasts checked regularly, and you should see your doctor if you notice any lump.
In rare cases, benign liver tumors, and even more rarely, malignant liver tumors, have been reported in users of hormonal contraceptives. See your doctor if you experience severe abdominal pain.
Psychiatric disorders
Some women who use hormonal contraceptives like ethinylestradiol/drospirenona have reported depression or a depressed mood. Depression can be severe and sometimes can induce suicidal thoughts. If you experience mood changes and depressive symptoms, contact your doctor for further medical advice as soon as possible.
Bleeding between menstrual periods
During the first few months of using ethinylestradiol/drospirenona, unexpected bleeding (bleeding outside of the placebo period) may occur.
Each blister pack contains 21 active pink tablets and 7 white placebo tablets.
The two different types of colored etinilestradiol/drospirenona tablets are arranged in order. A blister pack contains 28 tablets.
Take one etinilestradiol/drospirenona tablet every day, with some water if necessary. You can take the tablets with or without food, but take them at approximately the same time every day.
Do not get confused about the tablet: take one pink tablet every day for the first 21 days, followed by one white tablet for the last 7 days. Then, start taking a new blister pack (21 pink tablets and 7 white tablets). This way, there is no break between two blister packs.
Due to the different composition of the tablets, it is necessary to start with the first tablet located in the upper left area and then take one tablet every day. To maintain the order, follow the direction of the arrows on the blister pack.
Preparing the blister pack
To help you follow the order of intake, each etinilestradiol/drospirenona blister pack contains 7 self-adhesive strips with the 7 days of the week. Choose the strip that starts with the day you take the first tablet. For example, if you take your first tablet on a Wednesday, use the strip that starts with "WED".
Then, stick the corresponding strip on the upper left part of the blister pack in the "Start" position. This way, there is a day of the week indicated above each tablet, and you can visually check if you have taken a particular tablet.
The arrows show the order in which you should take the tablets.
During the 7 days when you take the placebo tablets (the placebo days), you will usually start your period (also called withdrawal bleeding). Normally, your period will start on the second or third day after taking the last active pink tablet of etinilestradiol/drospirenona. Once you have taken the last white tablet, you should start the next blister pack, even if you have not yet finished your menstrual period. This means that you should start each blister pack on the same day of the weekthat you started the previous one, and your menstruation should take place during the same days every month.
If you take etinilestradiol/drospirenona Daily as indicated, you are also protected against pregnancy during the 7 days when you are taking the placebo tablets.
When can you start with the first blister pack
Start taking etinilestradiol/drospirenona Daily on the first day of your cycle (i.e., the first day of your menstrual period). If you start etinilestradiol/drospirenona Daily on the first day of your menstrual period, you will be immediately protected against pregnancy. You can also start on days 2-5 of your cycle, but you must use additional contraceptive methods (e.g., condoms) for the first 7 days.
You can start taking etinilestradiol/drospirenona preferably on the day after taking the last active tablet (the last tablet that contains active ingredients) of your previous contraceptive, but no later than the day after the rest days of your previous contraceptive (or after taking the last inactive tablet of your previous contraceptive). When switching from a combined vaginal ring or patch, follow your doctor's recommendations.
You can switch from the progestin-only pill at any time (if it is an implant or intrauterine system, on the day of its removal; if it is an injectable, when the next injection is due), but in all cases, use additional contraceptive measures (e.g., condoms) for the first 7 days of tablet intake.
Follow your doctor's recommendations.
You can start taking etinilestradiol/drospirenona between 21 and 28 days after having a child. If you start later, use a barrier method (e.g., condoms) for the first 7 days of etinilestradiol/drospirenona use.
If, after having a child, you have had sexual intercourse before starting to take etinilestradiol/drospirenona again, you must be sure you are not pregnant or wait for your next menstrual period.
Read the section "Breastfeeding".
Ask your doctor if you are unsure when to start.
If you take more Etinilestradiol/Drospirenona Daily Stada than you should
No cases have been reported in which an overdose of etinilestradiol/drospirenona has caused serious harm.
The symptoms that may appear if you take many tablets at the same time may include feeling unwell or vomiting or vaginal bleeding. This bleeding may occur even in girls who have not yet had their first menstrual period, if they have accidentally taken this medication.
If you have taken too many etinilestradiol/drospirenona tablets, or discover that a child has taken them, consult your doctor or pharmacist.
In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, phone 915 620 420, indicating the medication and the amount taken.
If you forget to take Etinilestradiol/Drospirenona Daily Stada
The tablets in the fourthrow of the blister pack are the placebo tablets. If you forget to take one of these tablets, it will have no effect on the effect of etinilestradiol/drospirenona. Discard the forgotten placebo tablet. If you forget to take an active pink tablet from the 1st, 2nd, or 3rdrow, do the following:
The risk of incomplete protection against pregnancy is greatest if you forget to take a pink tablet at the beginning or end of the blister pack. Therefore, you should follow these recommendations (see also the diagram below):
Consult your doctor.
Take the forgotten tablet as soon as you remember, even if it means taking two tablets at the same time. Continue taking the tablets at the usual time and use additional precautions, such as condoms, for the next 7 days. If you have had sexual intercourse in the week before forgetting the tablet, you may be pregnant. In this case, consult your doctor.
Take the forgotten tablet as soon as you remember, even if it means taking two tablets at the same time. Continue taking the tablets at the usual time. The protection against pregnancy will not decrease, and you do not need to take additional precautions.
You can choose between two options:
You will probably have your period at the end of the second blister pack, while taking the white placebo tablets, although you may experience light bleeding or spotting during the second blister pack.
If you follow one of these two recommendations, you will remain protected against pregnancy.
What to do in case of vomiting or severe diarrhea
If you vomit within 3-4 hours after taking an active pink tablet or suffer from severe diarrhea, there is a risk that the active ingredients of the contraceptive will not be fully absorbed by the body. The situation is almost equivalent to forgetting a tablet. After vomiting or diarrhea, take another active pink tablet from a reserve blister pack as soon as possible. If possible, take it within 12 hoursafter the usual time you take your contraceptive. If this is not possible or more than 12 hours have passed, follow the advice in the section "If you forget to take Etinilestradiol/Drospirenona Daily Stada".
Delaying your menstrual period: what you should know
Although it is not recommended, you can delay your menstrual period if you do not take the white placebo tablets from the fourth row and start taking a new etinilestradiol/drospirenona blister pack and finish it. You may experience light bleeding or spotting during the use of the second blister pack. Finish this second blister pack by taking the 7 white tablets from the 4th row. Then, start with the new blister pack.
You should ask your doctor for advice before deciding to delay your menstrual period.
Changing the first day of your menstrual period: what you should know
If you take the tablets as instructed, your menstrual period will start during the placebo week. If you want to change that day, reduce the number of placebo days – when you take the white placebo tablets – (but never increase them - 7 at most!). For example, if you normally start taking the placebo tablets on Fridays and want to change it to Tuesdays (3 days earlier), start a new blister pack 3 days earlier than usual. If you make the placebo interval very short (e.g., 3 days or less), you may not have bleeding during these days. Then, you may experience light bleeding or spotting.
If you are unsure how to proceed, consult your doctor.
If you stop treatment with Etinilestradiol/Drospirenona Daily Stada
You can stop taking etinilestradiol/drospirenona whenever you want. If you do not want to become pregnant, consult your doctor about other effective birth control methods. If you want to become pregnant, stop taking etinilestradiol/drospirenona and wait until your menstrual period before trying to become pregnant. This way, you can more easily calculate the estimated date of delivery.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like all medicines, this medicine can cause adverse effects, although not all people suffer from them. If you experience any adverse effect, especially if it is severe and persistent, or if you have any change in health that you think may be due to ethinylestradiol/drospirenone, consult your doctor.
All women who take combined hormonal contraceptives are at a higher risk of developing blood clots in the veins (venous thromboembolism (VTE)) or blood clots in the arteries (arterial thromboembolism (ATE)). For more detailed information on the different risks of taking combined hormonal contraceptives, see section 2 "What you need to know before taking Ethinylestradiol/Drospirenone Daily Stada".
The following is a list of adverse effects related to the use of ethinylestradiol/drospirenone.
Frequent Adverse Effects(may affect up to 1 in 10 women):
Uncommon Adverse Effects(may affect up to 1 in 100 women):
Rare Adverse Effects(may affect between 1 and 10 in 1,000 women):
The likelihood of having a blood clot may be higher if you have any other condition that increases this risk (see section 2 for more information on conditions that increase the risk of blood clots and symptoms of a blood clot)
Contact a doctor immediately if you experience any of the following symptoms of angioedema: swelling of the face, tongue, and/or throat, and/or difficulty swallowing or urticaria potentially with difficulty breathing (see also the "Warnings and Precautions" section)
Reporting Adverse Effects
If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is an adverse effect that is not listed in this prospectus. You can also report them directly through the national reporting system included in the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine
Keep this medicine out of the sight and reach of children
This medicine does not require special storage conditions
Do not take this medicine after the expiration date that appears on the packaging after "CAD:". The expiration date is the last day of the month indicated
Medicines should not be thrown away through wastewater or household waste. Deposit the packaging and medicines you no longer need at the SIGRE Point in the pharmacy. In case of doubt, ask your pharmacist how to dispose of the packaging and medicines you no longer need. This way, you will help protect the environment
Composition of Ethinylestradiol/Drospirenone Daily Stada
Active Tablets:
The active ingredients are 0.02 mg of ethinylestradiol and 3 mg of drospirenone
The other components are:
Tablet core: lactose monohydrate, pregelatinized corn starch, povidone, sodium croscarmellose, polysorbate 80, magnesium stearate
Tablet coating: partially hydrolyzed polyvinyl alcohol, titanium dioxide (E-171), macrogol 3350, talc, yellow iron oxide (E-172), red iron oxide (E-172), black iron oxide (E-172)
Placebo Tablets:
Tablet core: lactose, povidone, magnesium stearate
Tablet coating: partially hydrolyzed polyvinyl alcohol, titanium dioxide (E-171), macrogol 3350, talc
Product Appearance and Package Contents
The active tablets are film-coated, round, pink tablets
The placebo tablets are film-coated, round, white tablets
Ethinylestradiol/Drospirenone Daily Stada is available in boxes of 1, 2, 3, 6, and 13 packages (blisters), each containing 28 tablets (21 active tablets and 7 placebo tablets)
Only some package sizes may be marketed
Marketing Authorization Holder and Manufacturer
Marketing Authorization Holder
Laboratory STADA, S.L.
Frederic Mompou, 5
08960 Sant Just Desvern (Barcelona)
Spain
info@stada.es
Manufacturer
Laboratorios León Farma, S.A.
Pol. Ind. Navatejera
La Vallina s/n
24193-Villaquilambre (León)
Spain
Date of the Last Revision of this Prospectus: September 2022
Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es