DROSPIRENONE-ETH ESTRA-LEVOMEF (Generic for BEYAZ)

Drospirenone 3mg, Ethinyl Estradiol 0.02mg, Levomefolate Calcium 0.451mg, Oral tablet

Grapefruit juice

· Severity: Mild

· Notes for Consumers: Grapefruit juice and grapefruit-containing foods may increase the side effects of Estrogens in some females, such as nausea, breast tenderness, headache or fluid retention. There may be no interaction. Do not significantly change your grapefruit intake while taking Estrogens. Drospirenone can increase the level of potassium in the blood. Your health care provider may need to monitor your potassium level in the first month of treatment, and as needed thereafter.

· Notes for Professionals: Drospirenone has antimineralocorticoid effects; the progestin may increase serum potassium. Consider monitoring serum potassium concentrations during the first month of dosing in high-risk patients who take strong CYP3A4 inhibitors long-term and concomitantly. Strong CYP3A4 inhibitors include grapefruit juice. Grapefruit juice contains a furano-coumarin compound, 6,7-dihydroxybergamottin that inhibits CYP3A4 in enterocytes. In addition, grapefruit juice has been reported to decrease the metabolism of some estrogens. Estrogen levels may increase by up to 30%. The clinical significance of the interaction is unknown. It is possible that estrogen induced side effects could be increased in some individuals. Patients should be advised to not significantly alter their grapefruit juice ingestion.

Drospirenone 3mg, Ethinyl Estradiol 0.02mg, Levomefolate Calcium 0.451mg, Oral tablet

Tobacco

· Severity: Major

· Notes for Consumers: Do not smoke or use tobacco products while taking this medication. Smoking while taking this medication increases the risk for serious side effects such as blood clots, heart attack, and stroke. Call emergency services right away if you experience symptoms of a blood clot in your lung: shortness of breath or chest pain. You should also call emergency services right away if you experience symptoms of a heart attack: pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded. You should also call emergency services right away if you experience symptoms of a stroke: sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision. Contact your care team right away if you experience symptoms of a blood clot in your leg: pain, swelling, or warmth in the leg.

· Notes for Professionals: Advise patients to avoid cigarette smoking while taking estrogen hormones. Cigarette smoking increases the risk of serious cardiovascular events, such as myocardial infarction, stroke, deep vein thrombosis, and pulmonary embolism. Combined hormonal contraceptives are contraindicated in females who are over 35 years of age and smoke.

Drospirenone 3mg, Ethinyl Estradiol 0.02mg, Levomefolate Calcium 0.451mg, Oral tablet

Caffeine-containing Foods/Beverages

· Severity: Mild

· Notes for Consumers: Side effects from Caffeine may get worse if you take Ethinyl Estradiol (an estrogen hormone commonly found in birth control pills). Too much Caffeine can cause effects like nausea, nervousness, or sleeplessness. Although an interaction is possible, these drugs are often used together without problems.

· Notes for Professionals: Serum concentrations of caffeine may be increased during concurrent administration with ethinyl estradiol. Patients may desire to limit products that contain high amounts of caffeine in an effort to minimize caffeine-related side effects such as nausea or tremors.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>