Yaz (Drospirenone and Ethinyl Estradiol) - Oral

Warning:

Yaz (drospirenone and ethinyl estradiol) may raise blood clot risk, especially for smokers assigned female at birth—who are also over 35. Talk to your healthcare provider about your risk for blood clots when deciding which birth control medication to use.

What Is Yaz?

Yaz (drospirenone and ethinyl estradiol) is a prescription medication for the prevention of pregnancy.

Yaz is also a potential treatment option for acne and symptoms of premenstrual dysphoric disorder (PMDD) in people assigned female at birth who are at least 14 years old.

As a combination birth control, Yaz contains human-made versions of naturally occurring sex hormones—estrogen and progesterone. Yaz works by influencing sex hormones. It is available by prescription in tablet form.

Drospirenone and ethinyl estradiol are available under other brand names and as generic medications.

Drug Facts

Generic Name: Drospirenone and ethinyl estradiol

Brand Name(s): Yaz, Gianvi, Loryna, Nikki, Ocella, Syeda, Vestura, Yasmin, Yaz 28, Zarah

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Monophasic contraceptive combination

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Drospirenone and ethinyl estradiol

Dosage Form(s): Tablet

What Is Yaz Used For?

The Food and Drug Administration (FDA) approved Yaz for the following:

Pregnancy Prevention

When appropriately taken every day, Yaz lowers the likelihood of pregnancy by more than 91%. However, Yaz is not the most effective option. There are many available birth control methods with an implant or intrauterine device (IUD) being the most effective at more than 99%.

Acne Vulgaris

Acne is a skin condition due to dead skin, bacteria, and oil blocking hair follicles. The blocked hair follicles lead to skin blemishes that may include pimples, blackheads, and whiteheads. With hormonal changes during puberty, many adolescents will experience acne. People assigned female at birth and at least 14 years old can use Yaz to help treat their acne. 

Although Yaz is FDA-approved for moderate acne, experts recommend it as an alternative treatment to multiple first-choice combination options of various topical products with or without oral antibiotics.

PMDD

Some people experience PMDD one to two weeks before their period (menstrual cycle). PMDD can cause distressing symptoms, such as anxiety, depression, or tiredness, negatively affecting the quality of life.

Yaz is an FDA-approved medication for PMDD. Like moderate acne, however, experts do not recommend Yaz as the first-line treatment for PMDD. In fact, the selective serotonin reuptake inhibitor medication class is the first-choice medication option.

Yaz (Drospirenone and Ethinyl Estradiol) Drug Information - Female reproductive system

How to Take Yaz

Take Yaz at the same time every day. The pill pack for Yaz contains 28 pills, including 24 hormone pills (to be taken for 24 days) followed by four pills without hormones (to be taken for the next four days). Make sure you take this medication in the order directed on the package. Do not skip any pills, as that can reduce their effectiveness.

When starting Yaz birth control pills, talk to your healthcare provider about which day to start your first pack. If you take the first hormone pill during the first 24 hours of your period, you do not need to use a backup birth control method. If you take your first pill later than the first day of your period, you should use backup birth control for the next seven tablets. Backup birth control may be needed if you have severe diarrhea or vomiting within three to four hours after taking a hormone pill.

You can also take the first pill on the Sunday after your period starts. You should use backup birth control if you have sex for the next seven days.

Ask your healthcare provider what to do if you switch to Yaz from another birth control method. In general, the following is guidance for when to start your new pack:

  • If switching from a different pill, start Yaz on the same day you started a new pack from the previous birth control.
  • If switching from a patch or vaginal ring, start Yaz when your next application is due.
  • If switching from an injection, start Yaz when your injection would have been due.
  • If switching from an intrauterine contraceptive or implant, start Yaz on the day of removal.

Once you finish your pack of pills, make sure to start the next pack on the day after your last pill.

Storage

Since Yaz is a non-controlled prescription, your healthcare provider may give you refills for up to one year from the originally written date. Once you pick up Yaz from the pharmacy, store Yaz at room temperature—77 degrees Fahrenheit (F)—with a safe storage range of 59 degrees to 86 degrees F.

If you intend to travel with Yaz, try to keep this medication in its original packaging from the pharmacy and consider making a copy of your Yaz prescription.

Off-Label Uses

Healthcare providers may prescribe Yaz for off-label uses, meaning for conditions not specifically indicated by the FDA.

Yaz has the following off-label uses:

  • Dysmenorrhea (menstrual cramps): During monthly menstrual cycles, some people experience dysmenorrhea or cramps that are dull and throbbing in the lower stomach area.
  • Hirsutism (unwanted or excessive hair growth)
  • Menstrual suppression: Many people who get their period experience moments when they would like to suppress menstruation, which is to skip periods. The desire for menstrual suppression may be due to menstrual symptoms or life events.
  • Polycystic ovary syndrome (PCOS) symptoms: People with PCOS have cysts in their ovaries that may lead to acne, hirsutism, and irregular menstrual cycles.

How Long Does Yaz Take to Work?

Yaz may take up to seven days to start working. If you started Yaz any day other than the first day of your period, you will need an additional birth control method—like a condom—as a backup for one week to prevent pregnancy.

What Are the Side Effects of Yaz?

Like many medications, Yaz has potential side effects.

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Yaz’s common side effects are usually mild and improve within a few weeks. Some common side effects may include:

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Seek medical attention if you experience the following severe side effects:

  • Arm or leg weakness or numbness
  • Leg pain that will not go away
  • Severe chest pain
  • Speaking difficulties
  • Sudden breathing difficulties
  • Sudden and severe headaches—over your baseline headaches
  • Sudden vision changes—including partial or complete vision loss
  • Yellowing of skin or eyes (jaundice)

Long-Term Side Effects

Long-term use of Yaz might raise your risk of breast, cervical, and liver cancers. Additionally, there is a higher risk of blood clot and stroke for users who are over 35 years old.

Report Side Effects

Yaz may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Yaz Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Your doctor may ask you to begin your dose on the first day of your menstrual period (called Day 1 start) or on the first Sunday after your menstrual period starts (called Sunday start). When you begin on a certain day it is important that you follow that schedule, even if you miss a dose. Do not change your schedule on your own. If the schedule that you use is not convenient, check with your doctor about changing it. For a Sunday start, you need to use another form of birth control (eg, condom, diaphragm, spermicide) for the first 7 days.

You should begin your next and all subsequent 28-day regimens of therapy on the same day of the week as the first regimen began and follow the same schedule.

  • For oral dosage form (tablets):
    • For contraception (to prevent pregnancy), PMDD, or acne:
      • Adults and teenagers—
        • Yasmin®: One yellow tablet (active) taken at the same time each day for 21 consecutive days followed by one white (inert) tablet daily for 7 days per menstrual cycle.
        • Yaz®: One pink tablet (active) taken at the same time each day for 24 consecutive days followed by one white (inert) tablet daily for 4 days per menstrual cycle.
        • Children—Use and dose must be determined by your doctor.

Modifications

Yaz is available in a four-week pill pack with 24 pink active tablets as a combination of drospirenone 3 milligrams and ethinyl estradiol 0.02 milligrams. The pill pack also has four white placebo tablets with no medication.

There are some instances in which you may need to modify your treatment regimen or take precautions when using Yaz.

People With a High Blood Clot Risk

As previously mentioned, Yaz might raise blood clot risk, especially for smokers assigned female at birth—who are also over 35 years old. Additionally, the following medical conditions may increase your blood clot risk:

If you have these medical conditions, your healthcare provider may decide not to give you a prescription for Yaz.

Blood Thinners

If you take a blood-thinner medication, your healthcare provider usually orders regular blood tests. However, Yaz might affect your lab tests.

Adrenal Insufficiency

In adrenal insufficiency (Addison’s disease), the adrenal glands—small organs sitting on top of the kidneys—don’t make enough naturally occurring hormones called cortisol and sometimes aldosterone. Adrenal insufficiency raises the risk of dangerously high amounts of potassium, which may negatively affect the heart and muscles. Since Yaz can also increase potassium, taking Yaz should be avoided.

Chloasma

Chloasma (melasma) is a dark, blotchy, and uneven skin condition that usually occurs on the face. There might be a higher risk of melasma with Yaz. So, try to limit your exposure to the sun—especially if you have a history of melasma.

Hyperkalemia

In hyperkalemia, people experience high amounts of potassium, which can be dangerous. Some medications—like certain blood pressure and over-the-counter pain relief medications—may raise your risk of hyperkalemia, especially in addition to Yaz. Your healthcare provider might order regular lab tests to monitor your potassium.

Kidney or Liver Concerns

Like adrenal insufficiency, kidney or liver medical conditions raise the risk of high potassium. Also, people with lower-functioning kidneys or liver tend to have higher amounts of drospirenone in their bodies. Avoid taking Yaz if your kidneys or liver do not work as well as they used to.

Metabolic Conditions

If you have diabetes, high cholesterol, or hypothyroidism, your healthcare provider typically orders some blood tests for you. Yaz might affect these lab tests.

Mood Conditions

If you experience a worsening mood condition, inform your healthcare provider—who may decide to discontinue Yaz.

Pregnancy and Breastfeeding

If you accidentally take Yaz early in your pregnancy, there is usually little harm to the fetus. Yaz should not be used as an abortion method. If you believe that you might be pregnant, talk with your healthcare provider about your options.

After your pregnancy, you can restart Yaz as early as four weeks after giving birth. If you are nursing your baby, Yaz might negatively affect your milk supply—especially when you're just beginning to nurse. Consider using another birth control method until you successfully wean your baby off breast milk during this nursing period.

Missed Dose

If you miss one pink tablet, take it as soon as you remember. Then, take the following tablet at the next scheduled time. If you do this, you will take two tablets in one day.

If you miss two or more pink tablets in a row, use an additional birth control method—like a condom—for backup. Missing pink tablets may cause spotting, which is temporary. However, missing two or more pink tablets in a row also raises the likelihood of a pregnancy. Contact your healthcare provider or pharmacist to help you with the next steps.

Overdose: What Happens If I Take Too Much Yaz?

Fortunately, there are no serious reports of Yaz overdoses—even in children. However, some people who take more than the prescribed dose of Yaz might experience withdrawal bleeding and nausea.

If you accidentally took multiple Yaz doses simultaneously, notify your healthcare provider—who may order lab tests to monitor your potassium and the acidity of your blood.

What Happens If I Overdose on Yaz?

If you think you have taken too much of Yaz, call a healthcare provider or the Poison Control Center (800-222-1222).

If you think you or someone else is experiencing a serious or life-threatening medical emergency after taking Yaz, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and does not cause unwanted effects. These visits will usually be every 6 to 12 months, but some doctors require them more often. Your doctor may also want to check your blood pressure while taking this medicine.

Although you are using this medicine to prevent pregnancy, you should know that using this medicine while you are pregnant could harm the unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away. Make sure your doctor knows if you have had a baby within 4 weeks before you start using this medicine.

Do not use this medicine together with medicine to treat hepatitis C virus infection, including ombitasvir/paritaprevir/ritonavir, with or without dasabuvir (Technivie®, Viekira Pak®).

Vaginal bleeding of various amounts may occur between your regular menstrual periods during the first 3 months of use. This is sometimes called spotting when slight, or breakthrough bleeding when heavier.

  • If this should occur, continue with your regular dosing schedule.
  • The bleeding usually stops within 1 week. Check with your doctor if the bleeding continues for more than 1 week.
  • If the bleeding continues after you have been taking hormonal contraceptives on schedule and for more than 3 months, check with your doctor.

Check with your doctor right away if you miss a menstrual period. Missed periods may occur if you skip one or more tablets and have not taken your pills exactly as directed. If you miss two periods in a row, talk to your doctor. You might need a pregnancy test.

If you suspect that you may be pregnant, and check with your doctor immediately.

Do not use this medicine if you smoke cigarettes or if you are over 35 years of age. If you smoke while using birth control pills containing drospirenone, you increase your risk of having a blood clot, heart attack, or stroke. Your risk is even higher if you are over age 35, if you have diabetes, high blood pressure, high cholesterol, or if you are overweight. Talk with your doctor about ways to stop smoking. Keep your diabetes under control. Ask your doctor about diet and exercise to control your weight and blood cholesterol level.

Using this medicine may increase your risk of having blood clotting problems, especially in the first 6 months of use. This risk may be higher if you are using a birth control pill containing drospirenone and ethinyl estradiol. Check with your doctor right away if you have pain in the chest, groin, or legs, especially the calves, difficulty with breathing, a sudden, severe headache, slurred speech, a sudden, unexplained shortness of breath, a sudden loss of coordination, or vision changes while using this medicine.

Check with your doctor immediately if you wear contact lenses or if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want an eye doctor to check your eyes.

Check with your doctor right away if you have pain or tenderness in the upper stomach, dark urine or pale stools, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Check with your doctor before refilling an old prescription, especially after a pregnancy. You will need another physical examination and your doctor may change your prescription.

Make sure any doctor or dentist who treats you knows that you are using this medicine. The results of some medical tests may be affected by this medicine. You may also need to stop using this medicine at least 4 weeks before and 2 weeks after having major surgery.

This medicine may cause skin discoloration. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn’t Take Yaz?

Avoid Yaz if you have the following:

  • Abnormal uterine bleeding during menstrual periods
  • Adrenal insufficiency
  • Estrogen or progestin sensitive cancer
  • High blood clot risk
  • Kidney concerns
  • Liver concerns
  • Pregnancy

What Other Medications Interact With Yaz?

Talk with your healthcare provider or pharmacist if there are any changes to your medications. Yaz can interact with the following drugs:

  • Potassium-increasing medications: Since Yaz can raise the amount of potassium in your body, use caution when taking Yaz with other medications that also raise potassium.
  • CYP3A4-inducing medications: CYP3A4 is a protein in the liver that helps break down Yaz. Some medications influence CYP3A4 to break down Yaz more quickly. Therefore, Yaz may not work as well. Use an addition birth control method—like a condom—as backup while taking these medications and after taking them for 28 days.
  • Lamictal (lamotrigine): Lamotrigine is an anti-seizure medication. Yaz might lower the amount of lamotrigine in the body. This raises the risk of seizures.

What Medications Are Similar?

There are many types of birth control methods and medications. Yaz is a combination birth control. Medications within the combination birth control medication group are classified into four categories:

  • Estrogen amounts: A combination birth control medication may have three different amounts of estrogen, which are 0.02 milligrams (low), 0.03 milligrams to 0.035 milligrams (regular), or 0.05 milligrams (high). Yaz has 0.02 milligrams of estrogen. So, Yaz is a low-dose estrogen combination birth control.
  • Hormone changes: A combination birth control can be monophasic, biphasic, or triphasic. A monophasic combination birth control doesn’t change the amounts of estrogen or progestin in the pill pack. The progestin amount will change once in a biphasic combination birth control pill pack. So, there are two different progestin strengths in one pill pack for a biphasic combination birth control. As for the triphasic combination birth control pill pack, there are three hormone changes, including progestin or estrogen. Some people prefer biphasic or triphasic combination birth control, which more closely mimics the hormonal changes during a menstrual period. Yaz is a monophasic combination birth control.
  • Pill pack type: There are four different types of pill packs. A pill pack can be a 21, 24, or 28-day pack. A combination birth control can also be classified as an extended cycle pill pack with more tablets. Yaz is a 24-day pack.
  • Progestin type: Progestin mimics the naturally occurring sex hormone—progesterone. There are eight different types of progestin. Yaz has drospirenone as its progestin type.

Based on these categories, the following birth control medications are the same as Yaz:

  • Jasmiel
  • Lo-Zumandimine
  • Loryna
  • Nikki
  • Vestura
  • Ethinyl estradiol 0.02 milligrams and drospirenone 3 milligrams

Although there are so many different birth control methods and medications, some people might prefer Yaz for the following reasons:

  • Yaz is a brand name medication. Although there is no difference in efficacy between brand name medications and their generic versions, some people still prefer brand names.
  • Yaz has a low amount of estrogen. Lower amounts of estrogen might lessen potential ethinyl estradiol-related side effects—like bloating and breast tenderness.
  • Yaz has the same estrogen and progestin strengths for all active tablets. Since each tablet in Yaz has the same amount of estrogen and progestin, there is a lower risk of side effects from hormonal changes.
  • Yaz has 24 active tablets. Compared to pill packs with 21 active tablets, some people may experience fewer hormonal changes with Yaz.
  • Yaz has drospirenone as its progestin type. Drospirenone is the newest type of progestin. It’s the fourth generation of progestin. Some people prefer Yaz to relieve acne and premenstrual symptoms. Yaz is also FDA-approved for PMDD.

You should not take multiple combination birth control medications at the same time. If you have any questions, please ask your healthcare provider or pharmacist.

Frequently Asked Questions

  • Will my insurance cover Yaz?

    Most insurance tends to cover combination birth control medications. Since Yaz is a brand-name medication, however, your copay might be higher than compared to a generic medication or other versions that are exactly the same as Yaz.

  • What if I threw up a few hours after taking Yaz?

    If you threw up within three to four hours of taking Yaz, treat this as a missed tablet. Take another dose as soon as possible.

  • What if I have trouble remembering to take Yaz every day?

    If you tend to forget to take Yaz every day, there is a higher likelihood of a pregnancy. So, find ways to help you remember to take Yaz at the same time every day. If it’s tough to remember to take your dose, then speak with your healthcare provider to discuss other options.

  • Will I gain weight with Yaz?

    There is a misperception about Yaz and weight gain. Ethinyl estradiol might cause bloatedness. However, this is usually a temporary side effect. Ethinyl estradiol might also cause water retention. Switching to a lower-dose estrogen combination birth control may lessen this side effect if this is a concern. On the other hand, Progestin may increase your appetite, which might lead to weight gain without a balance of diet and exercise.

  • Can I get cancer from Yaz?

    After long-term use of Yaz for more than eight years, there is a higher risk of liver cancer—which is extremely rare, with 1 in 1 million Yaz users having liver cancer from this medication. Yaz might also raise breast and cervical cancer risks. However, Yaz lowers the risk for endometrial, ovarian, and colorectal cancers.

How Can I Stay Healthy While Taking Yaz?

As you are taking Yaz, stay in touch with your healthcare provider about the following:

  • Difficulties remembering to take Yaz: Your healthcare provider can discuss other birth control methods with you if you find it hard to remember to take Yaz every day.
  • Medication changes: If there are any changes to your medications, notify your healthcare provider. Some medications might lessen Yaz’s effectiveness or vice versa.
  • Missed doses: If you miss two or more active pink tablets in a row, notify your healthcare provider or pharmacist to discuss the next steps.
  • Pregnancy: Tell your healthcare provider if you believe you are pregnant.
  • Sexually transmitted infections (STIs): If you suspect that you have an STI, notify your healthcare provider to determine the next steps. Since Yaz doesn’t prevent STIs, your healthcare provider may also discuss safer sex practices, such as using a condom.
  • Side effects: If you experience bothersome or worrisome side effects, your healthcare provider might help you determine the next steps—such as switching to another birth control or stopping Yaz.
  • Worsening mood condition: Inform your healthcare provider if you are experiencing a worsening mood condition.

Also, consider the following healthy lifestyle choices.

  • Diet and exercise: Since progestin might increase your appetite, having a healthy diet and regular exercise may prevent weight gain.
  • Stop smoking: Since smoking can raise your risk for a blood clot and stroke—especially if you are over 35 years old, consider quitting this habit.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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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.
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By Ross Phan, PharmD, BCACP, BCGP, BCPS
Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.