Label: information for the user
Drospirenona/Ethinylestradiol Exeltis 3 mg/0.03 mg film-coated tablets
Read this label carefully before starting to take this medicine, as it contains important information for you.
Important things you should know about combined hormonal contraceptives (CHCs):
6. Contents of the package and additional information
Drospirenona/ethinylestradiol is a contraceptive and is used to prevent pregnancy.
Each coated tablet contains a small amount of two different female hormones, known as ethinylestradiol and drospirenona.
Contraceptives that contain two hormones are known as combined contraceptives.
General Considerations
Before starting to take drospirenona/etinilestradiol, read the information about blood clots in section 2. It is particularly important that you read the symptoms of a blood clot (see section 2 “Blood Clots”).
Before starting to take drospirenona/etinilestradiol, your doctor will ask you some questions about your personal and family medical history. The doctor will also measure your blood pressure and, depending on your health status, perform other tests.
This leaflet describes several situations in which you should interrupt the use of drospirenona/etinilestradiol, or in which the effect of drospirenona/etinilestradiol may be reduced.
Do not use the rhythm or temperature method. These methods may not be reliable because drospirenona/etinilestradiol alters the monthly changes in body temperature and cervical mucus.
Drospirenona/Etinilestradiol, like other hormonal contraceptives, does not protect against HIV (AIDS) or any other sexually transmitted disease.
Do not take Drospirenona/Etinilestradiol Exeltis
Do not take drospirenona/etinilestradiol 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 other forms of contraception that would be more suitable.
Additional Information on Special Populations
Children and Adolescents
Drospirenona/Etinilestradiol is not indicated for use in women who have not yet had their first menstrual period.
Women of Advanced Age
Drospirenona/Etinilestradiol is not indicated for use after menopause.
Women with Liver Insufficiency
Do not take Drospirenona/Etinilestradiol if you suffer from liver disease. See sections “Do not take Drospirenona/Etinilestradiol Exeltis” and “Warnings and Precautions”.
Women with Renal Insufficiency
Do not take Drospirenona/Etinilestradiol if you are suffering from kidney dysfunction or acute renal insufficiency. See sections “Do not take Drospirenona/Etinilestradiol Exeltis” and “Warnings and Precautions”.
Warnings and Precautions
Consult your doctor or pharmacist before starting to take drospirenona/etinilestradiol.
When to Consult Your Doctor? Seek Urgent Medical Assistance - If you notice possible signs of a blood clot that may indicate you are suffering from a blood clot in the leg (deep vein thrombosis), a blood clot in the lung (pulmonary embolism), a heart attack, or a stroke (see section “Blood Clots” below). For a description of the symptoms of these serious adverse effects, see “How to Recognize a Blood Clot”. |
Inform Your Doctor if You Suffer from Any of the Following Conditions.
In some situations, you should take special care while taking drospirenona/etinilestradiol or any other combined hormonal contraceptive, and you may need to have regular check-ups. If the condition develops or worsens while you are taking drospirenona/etinilestradiol, you should also inform your doctor.
BLOOD CLOTS
The use of a combined hormonal contraceptive like drospirenona/etinilestradiol 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:
The recovery of blood clots is not always complete. In rare cases, there may be lasting or, very rarely, fatal effects.
It is essential to remember that the overall risk of a harmful blood clot due to drospirenona/etinilestradiol is small.
HOW TO RECOGNIZE A BLOOD CLOT
Seek Urgent Medical Assistanceif you notice any of the following signs or symptoms.
Do you experience any of these symptoms? | What you may be suffering from? |
| Deep vein thrombosis |
If unsure, consult a doctor, as some of these symptoms, such as coughing or shortness of breath, can be confused with a milder condition like 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 may be brief, with almost immediate and complete recovery, but you should still seek urgent medical assistance as you may be at risk of 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 start taking a combined hormonal contraceptive for the first time. The risk may be higher if you restart taking a combined hormonal contraceptive (the same medication or a different medication) after a break 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 drospirenona/etinilestradiol, your risk of developing a blood clot returns to normal in a few weeks.
What is the risk of developing a blood clot?
The risk depends on your natural risk of TEV 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 drospirenona/etinilestradiol is small.
- Of every 10,000 women who do not use a combined hormonal contraceptive and are not pregnant, 2 will develop a blood clot in a year.
- Of every 10,000 women who use a combined hormonal contraceptive containing levonorgestrel, noretisterone, or norgestimato, 5-7 will develop a blood clot in a year.
- Of every 10,000 women who use a combined hormonal contraceptive containing drospirenona, such as drospirenona/etinilestradiol, between 9 and 12 women will develop a blood clot in a year.
- The risk of developing a blood clot will depend on your personal history (see “Factors that increase your risk of a blood clot” below).
Risk of developing a blood clot in a year | |
Women whodo not usea combined hormonal contraceptive and are not pregnant | About 2 of every 10,000 women |
Women who use a combined hormonal contraceptive containinglevonorgestrel, noretisterone, or norgestimato | About 5-7 of every 10,000 women |
Women who use drospirenona/etinilestradiol | About 9-12 of every 10,000 women |
Factors that increase your risk of a blood clot in a vein
The risk of developing a blood clot is higher:
The risk of developing a blood clot increases the more conditions you have.
Long flights (over 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 conditions above, even if you are unsure. Your doctor may decide that you should interrupt the use of drospirenona/etinilestradiol.
If any of the conditions above change while you are using drospirenona/etinilestradiol, for example, a close relative experiences a blood clot 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 blood 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 drospirenona/etinilestradiol is very small, but it may increase:
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 further.
If any of the conditions above change while you are using drospirenona/etinilestradiol, for example, you start smoking, a close relative experiences a blood clot without a known cause, or you gain a lot of weight, inform your doctor.
Drospirenona/Etinilestradiol Exeltis and Cancer
Cancer of the breast has been observed slightly more frequently in women using combined hormonal contraceptives, but it is not known whether this is due to the treatment. For example, it may be that more tumors are detected in women taking combined hormonal contraceptives because they are examined by the doctor more frequently. The incidence of breast tumors decreases gradually after stopping combined hormonal contraceptives.
It is essential to have regular breast examinations, and you should visit your doctor if you notice any lump.
In rare cases, benign tumors in the liver and, even more rarely, malignant tumors in users of contraceptives have been reported. Visit your doctor if you have unusual, severe abdominal pain.
Mental Health Disorders
Some women who use hormonal contraceptives like drospirenona/etinilestradiol have reported depression or a depressive mood. Depression can be severe and sometimes may induce suicidal thoughts. If you experience mood changes and depressive symptoms, contact your doctor for additional medical advice as soon as possible.
Spotting
During the first few months of taking drospirenona/etinilestradiol, you may experience unexpected bleeding (bleeding outside the withdrawal week). If these bleeding persists beyond a few months or starts after a few months, your doctor should investigate the cause.
What to Do if You Do Not Have Your Period During the Withdrawal Week
If you have taken all the pills correctly, have not had severe vomiting or diarrhea, and have not taken other medications, it is very unlikely that you are pregnant.
If your expected period does not arrive in two consecutive instances, you may be pregnant. Visit your doctor immediately. Do not start the next pack until you are sure you are not pregnant.
Other Medications and Drospirenona/Etinilestradiol Exeltis
Inform your doctor or pharmacist if you are using, have used recently, or may need to use any other medication or herbal preparation. You should also inform any other doctor or dentist who prescribes another medication (or your pharmacist) that you are taking drospirenona/etinilestradiol. They may advise you to take additional non-hormonal contraceptive precautions and, if so, for how long, or modify the use of another medication that you need.
Some medications
This may occur with:
Drospirenona/etinilestradiolmay affect the effectof other medications, for example:
Do not take drospirenona/etinilestradiol if you have hepatitis C and are taking medications that contain ombitasvir/paritaprevir/ritonavir and dasabuvir, glecaprevir/pibrentasvir, or sofosbuvir/velpatasvir/voxilaprevir, as these medications may cause increases in liver enzyme levels (ALT).
Your doctor will prescribe another type of contraceptive before starting treatment with these medications.
Drospirenona/etinilestradiol can be taken again approximately 2 weeks after the end of this treatment. See section “Do not take Drospirenona/Etinilestradiol Exeltis”.
Consult your doctor or pharmacist before taking any medication.
Taking Drospirenona/Etinilestradiol Exeltis with Food and Drinks
Drospirenona/Etinilestradiol can be taken with or without food, and with some water if necessary.
Laboratory Tests
If you need a blood test, inform your doctor or the laboratory staff that you are taking a contraceptive, as hormonal contraceptives may affect the results of some tests.
Pregnancy and Breastfeeding
Pregnancy
If you are pregnant, do not take drospirenona/etinilestradiol. If you become pregnant during treatment with drospirenona/etinilestradiol, stop treatment immediately and contact your doctor.If you wantto become pregnant, you can stop takingdrospirenona/etinilestradiol at any time (see: “If you interrupt treatment with Drospirenona/Etinilestradiol Exeltis”).
Consult your doctor or pharmacist before taking any medication.
In general, it is not recommended to take drospirenona/etinilestradiol during breastfeeding. If you want to take the contraceptive while breastfeeding, you should consult your doctor.
Consult your doctor or pharmacist before taking any medication.
Driving and Operating Machinery
There is no information to suggest that the use of drospirenona/etinilestradiol has any effect on your ability to drive or operate machinery.
Drospirenona/Etinilestradiol Exeltis contains lactose.
If your doctor has told you that you have a lactose intolerance, consult them before taking this medication.
Follow exactly the administration instructions of this medication as indicated by your doctor or pharmacist. If in doubt, consult your doctor or pharmacist again.
Take one drospirenone/ethinyl estradiol tablet every day, with some water if necessary. You can take the tablets with or without food, but at approximately the same time every day.
The blister pack contains 21 film-coated tablets. The day of the week when you should take the tablet is printed next to each tablet. For example, if you start on a Wednesday, you should take a tablet with "MIE" next to it. Follow the direction of the arrow on the blister pack until you have taken all 21 tablets.
Do not take any tablets for 7 days after that. During these 7 days when no tablets are taken (called the withdrawal week), menstruation should occur. Menstruation, also known as withdrawal bleeding, usually starts on the second or third day of the withdrawal week.
On the eighth day after taking the last drospirenone/ethinyl estradiol tablet (i.e., after the 7-day withdrawal period), you should start with the next blister pack, even if menstruation has not yet finished. This means that you should start each blister pack on the same day of the week as the previous one and that menstruation should occur on the same days each month.
By taking drospirenone/ethinyl estradiol in this way, you are also protected against pregnancy during the 7 days when no tablets are taken.
When can you start with the first blister pack?
Start taking drospirenone/ethinyl estradiol on the first day of your cycle (i.e., the first day of your menstruation). If you start drospirenone/ethinyl estradiol on the first day of your menstruation, you will be protected immediately against pregnancy. You can also start on days 2-5 of your cycle, but you should use additional contraceptive methods (e.g., a condom) during the first 7 days.
You can start taking drospirenone/ethinyl estradiol preferably the day after taking the last active tablet of your previous contraceptive, but no later than the day after the withdrawal week of your previous contraceptive (or after taking the last inactive tablet of your previous contraceptive). When switching from a vaginal combined contraceptive ring or patch, follow your doctor's recommendations.
You can switch from the progestin-only pill on any day (if it is an implant or IUD, on the day of removal; if it is an injectable, on the day of the next injection), but in all cases, it is recommended that you use additional contraceptive methods (e.g., a condom) during the first 7 days of taking tablets.
Follow your doctor's recommendations.
You can start taking drospirenone/ethinyl estradiol between 21 and 28 days after giving birth. If you start later than day 28, you should use one of the barrier methods (e.g., a condom) during the first 7 days of taking drospirenone/ethinyl estradiol.
If, after giving birth, you have already had sex before starting to take drospirenone/ethinyl estradiol (again), you should 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 Drospirenone/Ethinyl Estradiol Exeltis than you should.
No serious cases of overdose of drospirenone/ethinyl estradiol have been reported.
The symptoms that may appear if you take many tablets at once may be feeling unwell, vomiting, or vaginal bleeding. This bleeding can occur even in girls who have not yet had their first menstrual period, if they accidentally take this medication.
If you have taken too many drospirenone/ethinyl estradiol tablets, or if you discover that a child has taken them, consult your doctor or pharmacist immediately or call the Toxicology Information Service 91 562 04 20 indicating the medication and the amount used.
If you forget to take Drospirenone/Ethinyl Estradiol Exeltis.
The risk of incomplete protection against pregnancy is maximum if you forget to take a tablet at the beginning of the blister pack (1st row) or at the end of week 3 (3rd row of the blister pack). Therefore, you should take the following measures (see also the diagram below):
Consult your doctor.
Take the forgotten tablet as soon as you remember, even if this means taking two tablets at once. Continue taking the following tablets at the usual time and useadditional precautions, such as a condom, for the next 7 days. If you had sex in the week before forgetting the tablet, you may be pregnant. In that case, consult your doctor.
Take the forgotten tablet as soon as you remember, even if this means taking two tablets at once. Continue taking the following tablets at the usual time. The protection against pregnancy is not reduced, and you do not need to take additional precautions.
You can choose between two options:
You will probably have menstruation (withdrawal bleeding) at the end of the second blister pack, 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 should you do in case of vomiting or intense diarrhea?
If you have vomiting within 3-4 hours after taking a tablet or have intense diarrhea, there is a risk that the active principles of the contraceptive will not be fully absorbed by the body. This is similar to what happens when you forget a tablet. After vomiting or diarrhea, you should take a tablet from a spare blister pack as soon as possible. If possible,within 12 hoursafter the usual time when you take your contraceptive. If this is not possible or more than 12 hours have passed, follow the advice in the section "If you forgot to take Drospirenone/Ethinyl Estradiol Exeltis".
Delayed menstrual period: what should you know?
Although not recommended, you can delay your menstrual period (withdrawal bleeding) if you start taking a new blister pack of drospirenone/ethinyl estradiol instead of continuing with the withdrawal week and finish it. You may experience light bleeding or spotting during the use of the second blister pack. After the usual withdrawal week,startthe next blister pack.
You should ask your doctor for advice before deciding to delay your menstrual period.
Change in the first day of your menstrual period: what should you know?
If you take the tablets as instructed, your menstrual period will start duringthe withdrawal week corresponding to the withdrawal period. If you need to change the day, reduce the number of withdrawal days (but never increase it! – 7 is the maximum). For example, if your withdrawal days usually start on Fridays and you want to change to Tuesdays (3 days earlier), you should start a new blister pack 3 days earlier than usual. If you make the withdrawal period very short (e.g., 3 days or less), you may not experience bleeding during these days. Then you may experience light bleeding or spotting.
If you are unsure how to proceed, consult your doctor.
If you interrupt treatment with Drospirenone/Ethinyl Estradiol Exeltis.
You can stop taking drospirenone/ethinyl estradiol when 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 takingdrospirenone/ethinyl estradiol and waituntil your menstrual periodbefore trying to become pregnant.This way, you can calculate your estimated due date more easily.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like all medicines, this medicine may cause side effects, although not everyone will experience them.
If you experience any side effect, especially if it is severe and persistent, or if you have any health change that you think may be due to drospirenona/etinilestradiol, consult your doctor.
All women taking 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 starting to take Drospirenona/Etinilestradiol Exeltis”.
Contact a doctor immediately if you experience any of the following angioedema symptoms: facial swelling, tongue, and/or throat swelling, and/or difficulty swallowing or urticaria with possible difficulty breathing (see also “Warnings and precautions”).
The following list ofside effects has been associatedwith the useofdrospirenona/etinilestradiol.
Frequent side effects(may affect up to 1 in 10 patients):
Infrequent side effects(may affect up to 1 in 100 patients):
Rare side effects(may affect up to 1 in 1,000 patients):
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).
Reporting side effects:
If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through the Spanish System for the Pharmacovigilance of Medicines for Human Use:https://www.notificaram.es. By reporting side effects, you can contribute to providing more information on the safety of this medicine.
Keep this medication out of the sight and reach of children.
This medication does not require special conditions for conservation.
Do not take this medication after the expiration date that appears on the packaging after CAD or EXP. The date is the last day of the month indicated.
Medications should not be disposed of through drains or in the trash. Dispose of the packaging and medications you no longer need at the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and medications you no longer need. By doing so, you will help protect the environment.
Composition of Drospirenona/Ethinylestradiol Exeltis
The active principles are 0.03 mg of ethinylestradiol and 3 mg of drospirenona.
The other components are:
Tablet core: lactose monohydrate, cornstarch, pregelatinized cornstarch, crospovidone, povidone, polisorbate 80, magnesium stearate.
Coating: partially hydrolyzed polyvinyl alcohol, titanium dioxide (E-171), macrogol 3350, talc, iron oxide yellow (E-172).
Appearance of Drospirenona/Ethinylestradiol Exeltis and content of the packaging
It is presented in the form of coated tablets, round, yellow in color.
It is available in boxes of 1, 2, 3, 6, and 13 blisters, each containing 21 tablets.
Only some packaging sizes may be commercially marketed.
Holder of the marketing authorization and responsible for manufacturing
Holder of the marketing authorization
Exeltis Healthcare, S.L.
Pol. Ind.Miralcampo, Avda. de Miralcampo 7, 19200
Azuqueca de Henares,
Guadalajara, Spain
Responsible for manufacturing
Laboratorios León Farma, S.A.
Pol. Ind. Navatejera, C/ La Vallina, s/n
24193 - Villaquilambre, León
Spain
Last review date of this leaflet:November 2023
The detailed and updated information on this medication is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS)https://www.aemps.gob.es/
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