Combined oral contraceptive (drospirenone progestogen) Pregnancy: Not indicated during pregnancy — if pregnancy occurs the preparation should be withdrawn immediately. Extensive epidemiological studies have revealed neither an increased risk of birth defects in children born to women who used COCs before pregnancy nor a teratogenic effect when COCs were taken inadvertently during pregnancy; data specifically for this product in pregnancy are too limited to draw conclusions. Consider the increased risk of VTE in the postpartum period when re-starting. Breastfeeding: lactation may be influenced (reduced quantity and altered composition of milk) and small amounts of contraceptive steroids and/or metabolites may be excreted in milk and may affect the child — generally not recommended until the mother has completely weaned her child.

Ethinylestradiol with drospirenone

Brand names: Yasmin, Eloine, Yaz

A combined oral contraceptive of ethinylestradiol with drospirenone, a progestogen with anti-mineralocorticoid and anti-androgenic properties, sometimes also used for acne or premenstrual symptoms.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One tablet (ELOINE 0.02 mg/3 mg film-coated tablets) daily for 28 consecutive days — continuous tablet-taking, 24 active tablets followed by 4 placebo tablets in the last row of the blister

Route: Oral use — take every day at about the same time, if necessary with a little liquid, in the order shown on the blister pack

Frequency: Once daily, continuously; each subsequent pack is started the day after the last tablet of the previous pack. Withdrawal bleeding usually starts on day 2-3 after starting the placebo tablets and may not have finished before the next pack is started

STARTING — no preceding hormonal contraceptive in the past month: start on day 1 of the natural cycle (first day of menstrual bleeding). SWITCHING — from another combined hormonal contraceptive (COC, vaginal ring or transdermal patch): start preferably the day after the last active tablet of the previous COC, at the latest the day following its usual tablet-free or placebo interval; for a ring or patch, start preferably on the day of removal, at the latest when the next application would have been due. From a progestogen-only method (progestogen-only pill, injection, implant) or a progestogen-releasing IUS: may switch any day (implant/IUS on the day of removal; injectable when the next injection would be due) but additionally use a barrier method for the first 7 days of tablet-taking. AFTER PREGNANCY — following first-trimester abortion may start immediately with no additional measures; following delivery or second-trimester abortion start at day 21 to 28, and if starting later use a barrier method for the first 7 days (exclude pregnancy first if intercourse has already occurred). MISSED TABLETS — placebo tablets from the last (4th) row may be disregarded but should be discarded to avoid prolonging the placebo phase. For missed ACTIVE tablets: if less than 24 hours late, protection is not reduced — take the tablet as soon as remembered and continue at the usual time. If more than 24 hours late, protection may be reduced; the two governing rules are that the recommended hormone-free interval is 4 days and tablet-taking must never be discontinued for longer than 7 days, and that 7 days of uninterrupted tablet-taking are required for adequate suppression of the hypothalamic-pituitary-ovarian axis. Day 1-7: take the last missed tablet as soon as remembered (even if two tablets at once), continue at the usual time, and use a barrier method for the next 7 days; consider pregnancy if intercourse occurred in the preceding 7 days. Day 8-14: take the last missed tablet as soon as remembered and continue as usual; no extra precautions if the preceding 7 days were taken correctly, but use extra precautions for 7 days if more than 1 tablet was missed. Day 15-24: either (1) take the last missed tablet as soon as remembered, continue until the active tablets are used up, discard the 4 placebo tablets and start the next pack right away; or (2) discontinue active tablets from the current pack, take placebo tablets from the last row for up to 4 days (including the missed days) and then continue with the next pack — no extra precautions are needed provided all tablets in the 7 days before the first missed tablet were taken correctly, otherwise follow option 1 and use extra precautions for 7 days. Consider pregnancy if tablets were missed and no withdrawal bleed follows in the placebo phase. GASTRO-INTESTINAL DISTURBANCE — with severe vomiting or diarrhoea absorption may be incomplete and additional contraceptive measures should be taken; if vomiting occurs within 3-4 hours of an active tablet, take a replacement tablet as soon as possible (within 24 hours of the usual time if possible), otherwise apply the missed-tablet advice. PAEDIATRIC — no paediatric posology is stated in this SPC section.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Presence or risk of venous thromboembolism — current VTE (on anticoagulants) or history of DVT/PE; known hereditary or acquired predisposition (APC-resistance including Factor V Leiden, antithrombin-III deficiency, protein C deficiency, protein S deficiency); major surgery with prolonged immobilisation; high risk of VTE due to multiple risk factors
Presence or risk of arterial thromboembolism — current or previous ATE (e.g. myocardial infarction) or prodromal condition (e.g. angina pectoris); cerebrovascular disease (current or previous stroke, or TIA); known hereditary or acquired predisposition (hyperhomocysteinaemia, antiphospholipid antibodies); history of migraine with focal neurological symptoms; high risk of ATE due to multiple risk factors or one serious risk factor such as diabetes mellitus with vascular symptoms, severe hypertension or severe dyslipoproteinaemia
Presence or history of severe hepatic disease as long as liver function values have not returned to normal
Severe renal insufficiency or acute renal failure
Presence or history of liver tumours (benign or malignant)
Known or suspected sex-steroid influenced malignancies (e.g. of the genital organs or the breasts)
Undiagnosed vaginal bleeding
Hypersensitivity to the active substances or to any of the excipients
Concomitant use with medicinal products containing ombitasvir/paritaprevir/ritonavir and dasabuvir, glecaprevir/pibrentasvir, or sofosbuvir/velpatasvir/voxilaprevir

Side effects

Headache (common); dizziness, paraesthesia (uncommon)
Nausea, abdominal pain (common); vomiting, dyspepsia, flatulence, diarrhoea (uncommon)
Breast pain, metrorrhagia, amenorrhoea (common); breast enlargement, menstrual disorder, dysmenorrhoea, libido decreased (uncommon)
Emotional lability (common); depression, nervousness, somnolence, insomnia, anorgasmia (uncommon)
Migraine, varicose vein (common); hypertension, phlebitis, syncope (uncommon); venous thromboembolism (VTE) and arterial thromboembolism (ATE)
Increased appetite and weight increase/decrease (common/uncommon); hyperkalaemia and hyponatraemia (rare)

Interactions

Medicinal products containing ombitasvir/paritaprevir/ritonavir and dasabuvir, glecaprevir/pibrentasvir, or sofosbuvir/velpatasvir/voxilaprevir — concomitant use is contraindicated (stated in SPC §4.3 cross-referring to §4.5; the full §4.5 interaction section was not captured in this bundle — clinician to review it)

Clinical monograph

How it works

It inhibits ovulation via hypothalamic-pituitary suppression with additional cervical mucus and endometrial effects; drospirenone's anti-mineralocorticoid action counters oestrogen-related fluid retention and its anti-androgen activity benefits acne.

Prescribing in practice

Drospirenone has potassium-sparing activity, so use caution and consider potassium monitoring with other potassium-raising drugs such as ACE inhibitors, ARBs, potassium-sparing diuretics or NSAIDs.
Drospirenone-containing pills carry a higher VTE risk than levonorgestrel-containing pills; ensure the woman is counselled accordingly.
Screen against UKMEC and advise on missed-pill rules and reduced efficacy with enzyme inducers or gastrointestinal upset.

Monitoring

Monitor blood pressure and, where there is concomitant use of potassium-elevating drugs or renal impairment, serum potassium.

Counselling the patient

Tell your clinician about any blood pressure, kidney or potassium-affecting medicines you take.
Take at the same time each day and follow missed-pill advice.
Seek urgent care for symptoms of a clot such as chest pain or calf swelling.

Evidence & guidelines

MHRA and UKMEC guidance address VTE risk by progestogen type, and drospirenone's potassium effect is well established.

Reference: FSRH CHC guideline; MHRA Drug Safety Update; UKMEC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways