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Drospirenone and estetrol

Generic name: drospirenone and estetrol [droe-SPYE-re-none-and-ES-te-trol]
Brand name: Nextstellis
Oral tablet: (3 mg–14.2 mg)
Drug class: contraceptives

What is Drospirenone and estetrol?

Drospirenone is combined with estetrol, a hormonal contraceptive used to prevent pregnancy. This medication guide does not list all possible uses for Drospirenone or Estetrol.

Side effects of  Drospirenone  and estetrol

If you experience any of the following symptoms of an allergic reaction, seek immediate medical attention: hives, difficulty breathing, swelling of your lips, face, tongue, or throat. If you experience any of these symptoms, seek emergency medical attention immediately.

Estetrol and drospirenone can cause serious side effects. If you experience:

  • Unusual vaginal bleeding or irregular or missed periods
  • Jaundice is a yellowing of the skin and eyes.
  • A change in the frequency or intensity of migraine headaches
  • Breast lumps;
  • Symptoms of depression include sleep problems, fatigue, and mood changes.
  • High blood potassium—nausea and weakness, tingly feelings, chest pains, irregular heartbeats, or loss of mobility;
  • Low blood potassium can cause leg cramps, constipation, or irregular heartbeats. It may also lead to increased thirst, urination, or feelings of tingling or numbness.

Some of the common side effects associated with drospirenone or estetrol include:

  • Periods of irregularity or pain
  • Breast pain or tenderness
  • Mood changes
  • Headache;
  • Acne;
  • Weight gain
  • Reduced interest in sex.

There may be other side effects. For medical advice on side effects, call your doctor. The FDA can be contacted at 1-800-FDA-1088 to report side effects.

Similar/related drugs

Norethindrone, Depo-Provera, Provera, Levonorgestrel, Medroxyprogesterone, Yaz


Smoking increases your risk of blood clots and strokes. If you are over 35 and smoke, it is not recommended that you use estetrol or drospirenone.

Before you take this drug

You are at an even greater risk if you have high blood pressure, diabetes, hyperlipidemia, or are overweight. If you have diabetes or high cholesterol, you are at an even greater risk. The risk of stroke and blood clots is greatest during the first year you use birth control. You are at high risk if you use this medication again after a break of 4 weeks or more. Smoking increases your risk of blood clots and strokes. The more you smoke, the greater the risk. This medicine should not be used if you are over 35 and smoke.

If you are:

  • Untreated or uncontrolled hypertension;
  • High blood pressure and blood vessel problems
  • Heart problems (heart rhythm disorders or valve disease);
  • A history of stroke, heart attack, or blood clot.
  • A hereditary blood disorder increases the risk of blood clots.
  • Diabetes (and you have had diabetes for more than 20 years or if it has damaged your kidneys, eyes, nerves, or blood vessels);
  • A history of cancers of the breast, uterus, cervix, or vagina
  • Unusual vaginal bleeding not checked by a physician;
  • Adrenal gland disorders
  • Liver disease, or liver cancer
  • Kidney failure or kidney disease
  • Severe migraine headaches with an aura
  • If you are overweight with a BMI of 35 or more,
  • If you take any hepatitis C medication containing ombitasvir, paritaprevir, or ritonavir (Viekira), with or without dasabuvir.

Tell your doctor about any of the following:

  • Diabetes;
  • High cholesterol or triglycerides
  • Depression;
  • Jaundice during pregnancy can cause jaundice.

Do not use it if you are pregnant. Stop taking estradiol and drospirenone if you become pregnant. Estetrol and drospirenone can reduce breast milk production. You should ask your doctor if you can safely breastfeed while taking this medication.

How to take Drospirenone and estetrol?

Read all instructions or guides that come with your medication and follow all directions. Follow the directions on the label. Please read and follow the instructions for use. If you need assistance, ask your pharmacist or doctor. Drospirenone comes in two different colors. Take one pink (active pill) every day for 24 consecutive days, then four days later take the white (inactive pill). Start a new pack and repeat the daily cycle. Take your medicine every day at the same time. You may need to use a contraceptive device as an alternative when you start taking drospirenone or estetrol. You may experience bleeding during the first four months. If this bleeding is heavy or continues, tell your doctor. You will need to check your blood pressure often. Inform your doctor of any planned surgeries. Store away from moisture or heat at room temperature. Only remove a tablet from the package when you're ready to take it.

What happens if I miss the dose?

Take the pink pill as soon as you remember it, and the next pill when you normally do. (You may take two pills per day.) Take one pill a day for the remainder of the package.

If you missed 2 or more active tablets during Weeks 1 or 2, then take the missed pill as quickly as possible and take your scheduled pill for that day as well (2 pills per day). The other missed pills should be thrown away, and you can take one pill per day to finish the remaining pack. Use a backup birth control pill for at least seven days after the missed pill. If you missed two active pills in Week 3, take the missed pill as quickly as possible, and then take the scheduled pill for that day. (2 pills per day). The other missed pills should be thrown away, and you can take one pill per day until the pink pills have been consumed. The white pills are inactive and should be thrown away. Start a new package the next day. Continue taking one pill per day, even if you missed any inactive pills (white). If you have missed two or more periods, or if it has been a month since you took this medication daily and you are still not taking it, call your doctor.

What happens if I overdose?

Call 1-800-222-1222 for poison help or seek immediate medical attention.An overdose can cause nausea, vomiting, and severe headaches. It may also cause vaginal bleeding, numbness, weakness, or leg pain.

What should be avoided?

Do not smoke while taking Drospirenone and Estetrol, especially if you are over 35 years old. Dark patches of skin on your face may be caused by estetrol and drospirenone. Avoid tanning beds or sunlight. When you're outdoors, wear protective clothing and apply sunscreen (SPF 30) or higher. This medicine does not protect against sexually transmissible diseases, including HIV or AIDS. The only way to prevent these diseases is by using a condom.

Interaction with other drug

Inform your doctor of all the medications you are taking. Many drugs can interact with drospirenone or estetrol.

  • Aprepitant;
  • Bosentan;
  • Phenobarbital and other barbiturates
  • Lamotrigine;
  • John's wort;
  • An antibiotic—clarithromycin, rifabutin, rifampin, rifapentine, telithromycin;
  • Antifungal medicine: fluconazole, griseofulvin, itraconazole, ketoconazole, and voriconazole;
  • Antiviral medication for hiv or hepatitis c: boceprevir (also known as boceprevir), efavirenz (also known as etravirine), indinavir (also known as nelfinavir), nevirapine (also called nevirapine), ritonavir, and telaprevir.
  • Cancer medicine: apalutamide, enzalutamide, and mitotane;
  • A diuretic, or "water pill," is amilorid, eplerenone,  or spironolacton.
  • Seizure medicine: carbamazepine, felbamate, oxcarbazepine, phenytoin, and topiramate;
  • Steroid medicine—dexamethasone, prednisone.

This list is incomplete, and other drugs can also affect drospirenone or estetrol. These include prescription and over-the-counter medicines, vitamins, and herbal products. This list does not include all drug interactions.



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