Package Leaflet: Information for the User
Ethinylestradiol/Drospirenone Daily Stada 0.03 mg/3 mg film-coated tablets EFG
Read this package 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
? Do not take Ethinylestradiol/Drospirenone Daily Stada
? Warnings and precautions
? Blood clots
? Ethinylestradiol/Drospirenone Daily Stada and cancer
? Bleeding between menstrual periods
? What to do if you do not have your period during the placebo phase
? Taking Ethinylestradiol/Drospirenone Daily Stada with other medicines
? Ethinylestradiol/Drospirenone Daily Stada with food and drink
? Laboratory tests
? Pregnancy, breastfeeding, and fertility
? Driving and using machines
? Important information about some of the ingredients of Ethinylestradiol/Drospirenone Daily Stada
? When can you start with the first blister
? If you take more Ethinylestradiol/Drospirenone Daily Stada than you should
? If you forget to take Ethinylestradiol/Drospirenone Daily Stada
? What to do in case of severe nausea or diarrhea?
? Delay of menstrual period: what should you know?
? Change of the first day of your menstrual period: what should you know?
? If you stop taking Ethinylestradiol/Drospirenone Daily Stada
Ethinylestradiol/drospirenone is a contraceptive and is used to prevent pregnancy.
Each of the yellow tablets contains a small amount of two different female hormones, called ethinylestradiol and drospirenone.
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 or 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.
Additional information on special populations
Use in children
Ethinylestradiol/drospirenona is not indicated for use in women who have not yet had their first menstrual period.
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 etinilestradiol/drospirenona or any other combined hormonal contraceptive, and it may be necessary for your doctor to perform periodic checks on you.
Tell your doctor if you suffer from any of the following conditions:
If the condition develops or worsens while you are using etinilestradiol/drospirenona, you should also inform your doctor.
? if a close relative has or has had breast cancer
? if you have any liver or gallbladder disease
? if you have diabetes
? if you have depression
? if you have Crohn's disease or ulcerative colitis (chronic inflammatory bowel disease)
? if you have systemic lupus erythematosus (SLE, a disease that affects your natural defense system)
? if you have hemolytic uremic syndrome (HUS, a blood clotting disorder that causes kidney failure)
? if you have sickle cell anemia (a hereditary disease of red blood cells)
? if you have high levels of fat in the blood (hypertriglyceridemia) or a known family history of this condition. Hypertriglyceridemia has been associated with an increased risk of developing pancreatitis (inflammation of the pancreas)
? if you need an operation or spend a lot of time without getting up (see section 2 "Blood clots")
? if you have just given birth, you are at a higher risk of developing blood clots. You should ask your doctor when you can start taking etinilestradiol/drospirenona after childbirth.
? if you have inflammation of the veins that are under the skin (superficial thrombophlebitis).
? if you have varicose veins
? if you have epilepsy (see "Taking Etinilestradiol/Drospirenona Daily Stada with other medicines")
? if you have any disease that appeared for the first time during pregnancy or during previous use of sex hormones; for example, hearing loss, porphyria (a blood disease), gestational herpes (skin rash with blisters during pregnancy), Sydenham's chorea (a nervous disease in which involuntary movements appear)
? if you have or have had chloasma (brownish patches, also called "pregnancy patches", especially on the face). In that case, you should avoid direct exposure to the sun or ultraviolet rays.
BLOOD CLOTS
The use of a combined hormonal contraceptive like etinilestradiol/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 etinilestradiol/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 developing a blood clot in a vein higher?
The risk of developing 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 medicine 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 etinilestradiol/drospirenona, your risk of developing 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 developing a blood clot in the leg or lung (DVT or PE) with etinilestradiol/drospirenona is small.
Risk of developing a blood clot in a year | |
Women who do not usea combined hormonal contraceptive pill/patch/ring and are not pregnant | About 2 out of 10,000 women |
Women who use a combined hormonal contraceptive pill that contains levonorgestrel, norethisterone, or norgestimate | About 5-7 out of 10,000 women |
Women who use etinilestradiol/drospirenona | About 9-12 out of 10,000 women |
Factors that increase your risk of a blood clot in a vein
The risk of developing a blood clot with etinilestradiol/drospirenona is small, but some conditions increase the risk. Your risk is higher:
The risk of developing 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 etinilestradiol/drospirenona.
If any of the above conditions change while you are using etinilestradiol/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 etinilestradiol/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 developing a blood clot may be increased further.
If any of the above conditions change while you are using etinilestradiol/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 incidence 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 examined 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 suffer from severe abdominal pain.
Psychiatric disorders
Some women who use hormonal contraceptives like etinilestradiol/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 medical advice.
Each blister pack contains 21 active yellow tablets and 7 white placebo tablets.
The two different types of colored tablets of etinilestradiol/drospirenona are arranged in order. A blister pack contains 28 tablets.
Take one tablet of etinilestradiol/drospirenona every day, with some water if necessary. You can take the tablets with or without food, but always at approximately the same time every day.
Do not get confused about the tablet: take a yellow tablet for the first 21 days, and then a white tablet for the last 7 days. Then you should start taking a new blister pack (21 yellow tablets and 7 white tablets). This way, there is no week of rest 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 blister pack of etinilestradiol/drospirenona 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, you need to 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 certain 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). Usually, your period will start on the second or third day after taking the last active yellow 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 that your menstruation should take place during the same days every month.
If you take etinilestradiol/drospirenona as indicated, you will also be 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 on the first day of your cycle (i.e., the first day of your menstrual period). If you start etinilestradiol/drospirenona 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) during the first 7 days.
You can start taking etinilestradiol/drospirenona preferably 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 changing from a combined vaginal ring or patch, follow your doctor's recommendations.
You can change from the progestin-only pill at any time (if it is an implant or intrauterine system, on the same day it is removed; if it is an injection, when the next injection is due), but in all cases, use additional contraceptive methods (e.g., condoms) during the first 7 days of tablet-taking.
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) during the first 7 days of taking etinilestradiol/drospirenona.
If, after having a child, you have already 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 not sure when to start.
If you take more Ethinylestradiol/Drospirenona Diario Stada than you should
No cases have been reported where an overdose of etinilestradiol/drospirenona has caused serious harm.
The symptoms that may appear if you take many tablets may include feeling unwell or vomiting, or vaginal bleeding. This bleeding may appear 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 91 562 04 20, indicating the medication and the amount used.
If you forget to take Ethinylestradiol/Drospirenona Diario 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 reliability of etinilestradiol/drospirenona. Discard the forgotten placebo tablet.
If you forget to take an active yellow tablet from the 1st, 2nd, or 3rdrow, do the following:
The risk of incomplete protection against pregnancy is highest if you forget to take a yellow 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 yellow 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 yellow 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 Ethinylestradiol/Drospirenona Diario Stada".
Delaying your menstrual period: what you should know
Although it is not recommended, you can delay your period if you do not take the white placebo tablets from the fourth row and start taking a new blister pack of etinilestradiol/drospirenona 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 period will start during the placebo week. If you need to change this 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 usually 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 interval of taking placebo tablets 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 not sure how to proceed, consult your doctor.
If you stop treatment with Ethinylestradiol/Drospirenona Diario Stada
You can stop taking etinilestradiol/drospirenona whenever you want. If you do not want to become pregnant, consult your doctor about other effective methods of birth control. If you want to become pregnant, stop taking etinilestradiol/drospirenona and wait until your period before trying to become pregnant. This way, you will be able to calculate the estimated date of delivery more easily.
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 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 up to 1 in 1,000 women):
The chances 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 potentially life-threatening urticaria with difficulty breathing (see also the section "Warnings and Precautions").
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 leaflet. 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 expiry date that appears on the packaging after "EXP:". The expiry date is the last day of the month indicated.
Medicines should not be disposed of via 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 will help protect the environment.
Composition of Ethinylestradiol/Drospirenone Daily Stada:
Active Tablets
The active ingredients are 0.03 mg of ethinylestradiol and 3 mg of drospirenone.
The other components are:
Tablet core: lactose monohydrate, corn starch, pregelatinized corn starch, crospovidone, povidone, polysorbate 80, magnesium stearate.
Tablet coating: partially hydrolyzed polyvinyl alcohol, titanium dioxide (E-171), macrogol 3350, talc, and yellow 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.
Appearance of the Product and Package Contents
The active tablets are film-coated, round, yellow tablets.
The placebo tablets are film-coated, round, white tablets.
Ethinylestradiol/Drospirenone Daily Stada is available in packs of 1, 2, 3, 6, and 13 units (blisters), each containing 28 tablets (21 active tablets and 7 placebo tablets).
Only some pack 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
This leaflet was last approved in: 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