What to Know About Yaz (Drospirenone and Ethinyl Estradiol)

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Yaz is a combination birth control pill that contains a synthetic estrogen (ethinyl estradiol) and a progestin (drospirenone). When used daily, Yaz can reduce the likelihood of pregnancy by more than 99%.

The drug costs anywhere from $15 to $80 per pack and is available under multiple other generic names, including Gianvi, Loryna, Nikki, Vestura, Jasmiel, and by its chemical name drospirenone/ethinyl estradiol. Drospirenone and ethinyl estradiol are also sometimes combined with the B vitamin levomefolate, sold under the brand names Safyral and Beyaz.

Medicaid and private insurance plans will often cover the cost of monthly treatment.

Close-Up Of Blister Pack On Table
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Uses

In addition to preventing pregnancy, Yaz has a number of non-contraceptive uses. Chief among these is the treatment of a severe form of PMS known as premenstrual dysphoric disorder (PMDD).

PMDD is a distressing condition that affects 3% to 8% of women, severely impacting their moods and their relationships at home and work. The combined use of ethinyl estradiol and drospirenone, combined with fewer placebo pill days (four days instead of seven) appears to be more effective against PMDD than other types of oral contraceptives.

Yaz is also licensed to treat moderate acne by blocking the male hormones that cause acne breakouts. If you decide to take an oral contraceptive, have started menstruating, and are least 14 years old, Yaz may offer dual benefits in preventing pregnancy and clearing up acne-prone skin.

Though combined birth control pills like Yaz aren't prescribed specifically for these benefits, they can also provide protection against a number of related and non-related conditions, such as:

  • Ovarian cancer
  • Endometrial cancer
  • Colorectal cancer
  • Benign cysts in the breast
  • Certain ovarian cysts
  • Vaginal dryness and painful intercourse
  • Osteoporosis
  • Excessive body hair (hirsutism)

Before Taking

Before prescribing oral contraceptives, your doctor will assess your health history to see if there is a reason you should not take Yaz. Always talk to your doctor about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, some may be outright contraindicated while taking Yaz.

Precautions and Contraindications

Combination oral contraceptives (COCs) such as Yaz should not be used by women over 35 years old who smoke. Cigarette smoking increases the risk of serious cardiovascular events that can occur with COCs.

Drospirenone can increase blood potassium levels and should not be used if you have a kidney, liver, or adrenal disorder. Potassium is a dietary mineral critical to the function of nerve and muscle cells, including those of the heart and circulatory system.

In addition, Yaz should not be used by people with:

  • A history of a heart attack, blood clots, stroke, transient ischemic attack, coronary artery disease (such as angina pectoris), or retinal thrombosis
  • Very high blood cholesterol or triglyceride levels
  • Pancreatitis associated with high levels of fatty substances in the blood
  • Uncontrolled high blood pressure
  • Diabetes-related kidney, eye, nerve, or circulatory disorders
  • Known or suspected breast cancer, cervical cancer, ovarian cancer, and any other cancer influenced by hormones
  • Abnormal uterine bleeding
  • Jaundice (yellowing of the eyes and skin), liver disease, or a liver tumor
  • Migraine headaches
  • Pregnancy or suspected pregnancy
  • Major surgery scheduled

For people taking direct-acting antivirals for hepatitis C, Yaz is not recommended because ethinyl estradiol has been associated with liver complications. Progestin-only pills may be a more appropriate choice if you are being treated for hepatitis C and desire an oral contraceptive.

The FDA notes that some studies have shown a three-fold increase in blood clots among women who take combination oral contraceptives (COCs) that contain drospirenone, whereas other studies have found no increased risk. Even so, the FDA asserts that the risk of blood clots from the pill is very low, and is much lower with COCs than in either pregnancy or in the postpartum period.

Other Combination Oral Contraceptives (COCs)

Combination oral contraceptives have both synthetic estrogen and progestin, making them different from progestin-only birth control pills, like the "mini pill." Only people who can tolerate estrogen should take COCs.

Combination pills are monophasic (where the active pills all have the same dose) or multiphasic (where the dose in the active pills varies by location in the cycle). Yaz is monophasic, with 24 active pills and 4 inert pills.

Other monophasic oral contraceptives include:

  • Brevicon, Modicon, Wera, Balziva, Briellyn, Gildagia, Philith, Zenchent (ethinyl estradiol and norethindrone)
  • Estarylla, Previfem, Sprintec (ethinyl estradiol and norgestimate)
  • Safyral, Beyaz (Drospirenone, ethinyl estradiol, and levomefolate)
  • Cryselle, Elinest, Ogestrel (ethinyl estradiol and norgestrel)
  • Apri, Desogen, Juleber, Reclipsen, Solia (ethinyl estradiol and desogestrel)
  • Levora, Altavera, Daysee, Lessina (ethinyl estradiol and levonorgestrel)
  • Seasonique, Amethia, Ashlyna, Jolessa, Quasense, Introvale (a 91-day combination of ethinyl estradiol and levonorgestrel)
  • Amethyst (a 365-day ethinyl estradiol and levonogestrel pill, previously marketed as Lybrel)

Dosage

Yaz comes in a blister pack of 28 pills: There are 24 light pink pills containing the active hormones, and four white pills that are inactive (placebos). Yaz is taken once daily with or without food. It should be taken at the same time every day, preferably after the evening meal or at bedtime.

The pills can be started in one of two ways:

  • Method 1: Take the first pill on the Sunday immediately following the start of your period even if you're still bleeding. If your period starts on a Sunday, take your first pill then. Be sure to use a backup method of contraception, such as a condom, until you have taken seven pills.
  • Method 2: Take your first pill during the first 24 hours of the start of your period. With this method, you do not need to use a backup method as the pill is effective from the first dose.

If you experience stomach upset after taking Yaz, try taking it with food or your evening meal.

Side Effects

Side effects of Yaz are typically mild to moderate and tend to resolve within two to three months as your body begins to adjust to the hormones.

Common

  • Stomach upset
  • Nausea
  • Vomiting
  • Breast tenderness
  • Spotting or bleeding between periods
  • Headaches

If these symptoms don't resolve within a few weeks or impact your quality of life, contact your doctor to see if another oral contraceptive may work better for you.

Severe

  • Bloating
  • Fluid retention
  • Dark patches of skin (melasma)
  • Reduced libido
  • High blood sugar (typically in people with diabetes)
  • Increased cholesterol and triglycerides
  • Depression (typically in those with a history of depression)

Maintain contact with your doctor and notify them if you note any of these signs or symptoms. High blood sugars and depression can become life-threatening, as can any fluid retention severe enough to cause shortness of breath.

Warnings and Interactions

The combined use of Yaz and certain medications can lead to excessively high levels of potassium, known as hyperkalemia. Symptoms of hyperkalemia range from vomiting and heart palpitations to chest pains and respiratory distress.

To avoid this, doctors will need to closely monitor potassium levels for at least the first month of treatment if you take any of the following medications regularly:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Potassium-sparing diuretics such as Aldactone (spironolactone) and Midamor (amiloride)
  • ACE inhibitors such as Capoten (captopril), Vasotec (enalapril), and Zestril (lisinopril)
  • Angiotensin receptor blockers such as Cozaar (losartan), Diovan (valsartan), and Avapro (irbesartan)
  • Potassium supplements
  • Heparin

Because of a risk of blood clots, heart attacks and strokes, you should call your doctor immediately if you develop any of these symptoms:

  • Sudden sharp or crushing chest pain, shortness of breath, or coughing up blood
  • Lightheadedness, nausea, vomiting, or rapid, irregular heartbeat
  • Sudden severe or worsening headache, confusion, vision changes, numbness, or trouble walking
  • Pain or tenderness in the leg, which may be red, warm, and worse with walking

Numerous prescription medications can interfere with Yaz, or vice versa. You should always let your doctor or pharmacist know that you are taking Yaz, so they can advise you about whether you need a different medication or a backup form of birth control, like condoms or spermicide.

In addition, these non-prescription items may cause problems with the effectiveness of Yaz:

  • Grapefruit juice
  • The herbal remedy St. John's Wort
  • Antacids (which should be taken two hours before or after Yaz)
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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bayer Inc. Product monograph part III: Yaz Updated March 2, 2017.

  2. Casper RF. Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) (Beyond the Basics). UpToDate. Updated February 24, 2021.

  3. U.S. Food and Drug Administration. Yaz: product insert. Updated April 2012.

  4. Menon RM, Badri PS, Wang T, et al. Drug-drug interaction profile of the all-oral anti-hepatitis C virus regimen of paritaprevir/ritonavir, ombitasvir, and dasabuvir. Journal of Hepatology. 2015;63(1):20-29. doi: https://doi.org/10.1016/j.jhep.2015.01.026

  5. U.S. Food and Drug Administration. FDA Drug Safety Communication: Updated information about the risk of blood clots in women taking birth control pills containing drospirenone. Content reviewed Oct 13, 2018.

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