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Yiznell 0.02 Mg / 3 Mg Film-Coated Tablets

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Yiznell 0.02 mg/3 mg Film-Coated Tablets

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PACKAGE LEAFLET: INFORMATION FOR THE USER Yiznell 0.02 mg /3 mg Film-Coated Tablets

Ethinylestradiol and Drospirenone

Important things to know about combined hormonal contraceptives (CHCs):

•    They are one of the most reliable reversible methods of contraception if used correctly

•    They slightly increase the risk of having a blood clot in the veins and arteries, especially in the first year or when restarting a combined hormonal contraceptive following a break of 4 or more weeks

•    Please be alert and see your doctor if you thinkyou may have symptoms of a blood clot (see section 2 “Blood clots”)

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

-    Keep this leaflet. You may need to read it again.

-    If you have any further questions, ask your doctor or pharmacist.

-    This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

-    If you get any of the side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

1.    What Yiznell are and what they are used for

2.    What you need to know before you take Yiznell

3.    How to take Yiznell

4.    Possible side effects

5.    How to store Yiznell

6.    Contents of the pack and other information

1.    WHAT YIZNELL ARE AND WHAT THEY ARE USED FOR

•    Yiznell are a contraceptive pill and are used to prevent pregnancy.

•    Each of the tablets contains two different hormones called ethinylestradiol and drospirenone.

•    Contraceptive pills that contain two hormones are called “combination” pills.

2.    WHAT YOU NEED TO KNOW BEFORE YOU TAKE YIZNELL General notes

Before you start using Yiznell you should read the information on blood clots in section 2. It is particularly important to read the symptoms of a blood clot - see Section 2 “Blood clots”).

Before you can begin taking these tablets, your doctor will ask you some questions about your personal health history and that of your close relatives. The doctor will also measure your blood pressure and, depending upon your personal situation, may also carry out some other tests.

In this leaflet, several situations are described where you should stop using these tablets, or where their reliability may be decreased. In such situations you should either not have sex or you should take extra non hormonal contraceptive precautions, e.g., use a condom or another barrier method. Do not use rhythm or temperature methods. These methods can be unreliable because these tablets alter the monthly changes of body temperature and of cervical mucus.

Yiznell, like other hormonal contraceptives, does not protect against HIV infection (AIDS) or any other sexually transmitted disease.

Do not take Yiznell

You should not use Yiznell if you have any of the conditions listed below. If you do have any of the conditions listed below, you must tell your doctor. Your doctor will discuss with you what other form of birth control would be more appropriate.

•    if you have (or have ever had) a blood clot in a blood vessel of your legs (deep vein thrombosis, DVT), your lungs (pulmonary embolus, PE) or other organs;

•    if you know you have a disorder affecting your blood clotting-for instance, protein C deficiency, protein S deficiency, antithrombin-lll deficiency, Factor V Leiden or antiphospholipid antibodies;

•    if you need an operation or if you are off your feet for a long time (see section ‘Blood clots’);

•    if you have ever had a heart attack or a stroke;

•    if you have (or have ever had) angina pectoris (a condition that causes severe chest pain and may be a first sign of a heart attack) or transient ischaemic attack (TIA -temporary stroke symptoms);

•    if you have any of the following diseases that may increase your risk of a clot in the arteries:

-    severe diabetes with blood vessel damage

-    very high blood pressure

-    a very high level of fat in the blood (cholesterol or triglycerides)

-    a condition known as hyperhomocysteinaemia

•    if you have (or have ever had) a type of migraine called ‘migraine with aura’;

•    if you have (or have ever had) an inflammation of the pancreas (pancreatitis)

•    if you have (or have ever had) liver disease and your liver function is still not normal

•    if your kidneys are not working well (renal failure)

•    if you have (or have ever had) a tumour in the liver

•    if you have (or have ever had) or if you are suspected of having breast cancer or cancer of the genital organs

•    if you have any unexplained bleeding from the vagina

•    if you are allergic (hypersensitive) to ethinylestradiol or drospirenone, or any of the other ingredients of Yiznell (see Section 6, Further Information). This may cause itching, rash or swelling

Do not take these tablets if the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking these tablets.

Warnings and precautions

Talk to your doctor or pharmacist before taking Yiznell.

In some situations you need to take special care while using these tablets or any other combination pill, and your doctor may need to examine you regularly. Tell your doctor if any of the following conditions apply to you, If the condition develops or gets worse while you are using Yiznell, you should also tell your doctor:

•    if you have Crohn’s disease or ulcerative colitis (chronic inflammatory bowel disease);

•    if you have systemic lupus erythematosus (SLE -; a disease affecting your natural defence system);

•    if you have haemolytic uraemic syndrome (HUS - a disorder of blood clotting causing failure of the kidneys);

•    if you have sickle cell anaemia (an inherited disease of the red blood cells);

•    if you have elevated levels of fat in the blood (hypertriglyceridaemia) or a positive family history for this condition. Hypertriglyceridaemia has been associated with an increased risk of developing pancreatitis (inflammation of the pancreas);

•    if you need an operation, or you are off your feet for a long time (see in section 2 ‘Blood clots’);

•    if you have just given birth you are at an increased risk of blood clots. You should ask your doctor how soon after delivery you can start taking Yiznell;

•    If you havean inflammation in the veins underthe skin (superficial thrombophlebitis);

•    If you have varicose veins.

•    if a close relative has or has ever had breast cancer

•    if you have a disease of the liver or the gallbladder

•    if you have diabetes

•    if you have depression

•    if you have epilepsy (see using other medicines)

•    if you have a disease that first appeared during pregnancy or earlier use of sex hormones (for example, hearing loss, a blood disease called porphyria, skin rash with blisters during pregnancy (gestational herpes), a nerve disease causing sudden movements of the body (Sydenham’s chorea)

•    if you have or have ever had golden brown pigment patches (chloasma), so called “pregnancy patches”, especially on the face. If this is the case, avoid direct exposure to sunlight or ultraviolet light.

•    if you have hereditary angioedema, products containing oestrogens may cause or worsen the symptoms. You should see your doctor immediately if you experience symptoms of angioedema such as swollen face, tongue and/or pharynx and/or difficulty swallowing or hives together with difficulty breathing.

When should you contact your doctor?

Seek urgent medical attention

- if you notice possible signs of a blood clot that may mean you are suffering from a blood clot in the leg (i.e. deep vein thrombosis), a blood clot in the lung (i.e. pulmonary embolism), a heart attack or a stroke (see ‘Blood clot’ (thrombosis) section below.

For a description of the symptoms of these serious side effects please go to “How to recognise a blood clot”._

BLOOD CLOTS

Using a combined hormonal contraceptive such as Yiznell increases your risk of developing a blood clot compared with not using one. In rare cases a blood clot can block blood vessels and cause serious problems.

Blood clots can develop

•    in veins (referred to as a‘venous thrombosis’, ‘venous thromboembolism’ orVTE)

•    in the arteries (referred to as an ‘arterial thrombosis’, ‘arterial thromboembolism’ or ATE).

Recovery from blood clots is not always complete. Rarely, there may be serious lasting effects or, very rarely, they may be fatal.

It is important to remember that the overall risk of a harmful blood clot due to Yiznell is small.

HOW TO RECOGNISE A BLOOD CLOT

Seek urgent medical attention if you notice any of the following signs or symptoms.

Are you experiencing any of these signs?

What are you possibly suffering from?

• swelling of one leg or along a vein in the leg or foot especially when accompanied by:

•    pain or tenderness in the leg which may be felt only when standing or walking

•    increased warmth in the affected leg

•    change in colour of the skin on the leg e.g. turning pale, red or blue

Deep vein thrombosis

•    sudden unexplained breathlessness or rapid breathing;

•    sudden cough without an obvious cause, which may bring up blood;

•    sharp chest pain which may increase with deep breathing;

•    severe light headedness or dizziness;

•    rapid or irregular heartbeat

•    severe pain in your stomach;

If you are unsure, talk to a doctor as some of these symptoms such as coughing or being short of breath may be mistaken for a milder condition such as a respiratory tract infection (e.g. a ‘common cold’).

Pulmonary embolism

Symptoms most commonly occur in one eye:

•    immediate loss of vision or

•    painless blurring of vision which can progress to loss of vision

Retinal vein thrombosis (blood clot in the eye)

•    chest pain, discomfort, pressure, heaviness

•    sensation of squeezing or fullness in the chest, arm or below the breastbone;

•    fullness, indigestion or choking feeling;

•    upper body discomfort radiating to the back, jaw, throat, arm and stomach;

•    sweating, nausea, vomiting or dizziness;

•    extreme weakness, anxiety, or shortness of breath;

•    rapid or irregular heartbeats

Heart attack

•    sudden weakness or numbness of the face, arm or leg, especially on one side of the body;

•    sudden confusion, trouble speaking or understanding;

•    sudden trouble seeing in one or both eyes;

•    sudden trouble walking, dizziness, loss of balance or coordination;

•    sudden, severe or prolonged headache with no known cause;

•    loss of consciousness or fainting with or without seizure.

Sometimes the symptoms of stroke can be brief with an almost immediate and full recovery, but you should still seek urgent medical attention as you may be at risk of another stroke.

Stroke

•    swelling and slight blue discolouration of an extremity;

•    severe pain in your stomach (acute abdomen)

Blood clots blocking other blood vessels


BLOOD CLOTS IN A VEIN

What can happen if a blood clot forms in a vein?

•    The use of combined hormonal contraceptives has been connected with an increase in the risk of blood clots in the vein (venous thrombosis). However, these side effects are rare. Most frequently, they occur in the first year of use of a combined hormonal contraceptive.

•    If a blood clot forms in a vein in the leg or foot it can cause a deep vein thrombosis (DVT).

•    If a blood clot travels from the leg and lodges in the lung it can cause a pulmonary embolism.

•    Very rarely a clot may form in a vein in another organ such as the eye (retinal vein thrombosis).

When is the risk of developing a blood clot in a vein highest?

The risk of developing a blood clot in a vein is highest during the first year of taking a combined hormonal contraceptive for the first time. The risk may also be higher if you restart taking a combined hormonal contraceptive (the same product or a different product) after a break of 4 weeks or more.

After the first year, the risk gets smaller but is always slightly higher than if you were not using a combined hormonal contraceptive.

When you stop Yiznell your risk of a blood clot returns to normal within a few weeks. What is the risk of developing a blood clot?

The risk depends on your natural risk of VTE and the type of combined hormonal contraceptive you are taking.

The overall risk of a blood clot in the leg or lung (DVT or PE) with Yiznell is small.

-    Out of 10,000 women who are not using any combined hormonal contraceptive and are not pregnant, about 2 will develop a blood clot in a year.

-    Out of 10,000 women who are using a combined hormonal contraceptive that contains levonorgestrel, norethisterone, or norgestimate about 5-7 will develop a blood clot in a year.

-    Out of 10,000 women who are using a combined hormonal contraceptive that contains drospirenone, such as Yiznell, between about 9 and 12 women will develop a blood clot in a year.

-    The risk of having a blood clot will vary according to your personal medical history (see “Factors that increase your risk of a blood clot” below).

Risk of developing a blood clot in a year

Women who are not using a combined hormonal pill/patch/ring and are not pregnant

About 2 out of 10,000 women

Women using a combined hormonal contraceptive pill containing levonorgestrel, norethisterone or norgestimate

About 5-7 out of 10,000 women

Women using Yiznell

About 9-12 out of 10,000 women

Factors that increase your risk of a blood clot in a vein

The risk of a blood clot with Yiznell is small but some conditions will increase the risk. Your risk is higher:

•    if you are very overweight (body mass index or BMI over 30kg/m2);

•    if one of your immediate family has had a blood clot in the leg, lung or other organ at a young age (e.g. below the age of about 50). In this case you could have a hereditary blood clotting disorder;

•    if you need to have an operation, or if you are off your feet for a long time because of an injury or illness, or you have your leg in a cast. The use of Yiznell may need to be stopped several weeks before surgery or while you are less mobile. If you need to stop Yiznell ask your doctor when you can start using it again.

•    as you get older (particularly above about 35 years);

•    if you gave birth less than a few weeks ago

The risk of developing a blood clot increases the more conditions you have.

Air travel (>4 hours) may temporarily increase your risk of a blood clot, particularly if you have some of the other factors listed.

It is important to tell your doctor if any of these conditions apply to you, even if you are unsure. Your doctor may decide that Yiznell needs to be stopped.

If any of the above conditions change while you are using Yiznell, for example a close family member experiences a thrombosis for no known reason; or you gain a lot of weight, tell your doctor.

BLOOD CLOTS IN AN ARTERY

What can happen if a blood clot forms in an artery?

Like a blood clot in a vein, a clot in an artery can cause serious problems. For example, it can cause a heart attack or a stroke.

Factors that increase your risk of a blood clot in an artery

It is important to note that the risk of a heart attack or stroke from using Yiznell is very small but can increase:

•    with increasing age (beyond about 35 years);

•    if you smoke. When using a combined hormonal contraceptive like Yiznell you are advised to stop smoking. If you are unable to stop smoking and are older than 35 your doctor may advise you to use a different type of contraceptive;

•    if you are overweight;

•    if you have high blood pressure;

•    if a member of your immediate family has had a heart attack or stroke at a young age (less then about 50). In this case you could also have a higher risk of having a heart attack or stroke;

•    if you, or someone in your immediate family, have a high level of fat in the blood (cholesterol or triglycerides);

•    if you get migraines, especially migraines with aura;

•    if you have a problem with your heart (valve disorder, disturbance of the rhythm called atrial fibrillation)

•    if you have diabetes.

If you have more than one of these conditions or if any of them are particularly severe the risk of developing a blood clot may be increased even more.

If any of the above conditions change while you are using Yiznell, for example you start smoking, a close family member experiences a thrombosis for no known reason; or you gain a lot of weight, tell your doctor.

Yiznell and cancer

Breast cancer has been observed slightly more often in women using combination pills, but it is not known whether this is caused by the treatment. For example it may be that more tumours are detected in women on combination pills because they are examined by their doctor more often. The occurrence of breast tumours becomes gradually less after stopping the combination hormonal contraceptives. It is important to regularly check your breasts and you should contact your doctor if you feel any lump.

In rare cases, benign liver tumours, and in even fewer cases malignant liver tumours have been reported in pill users.

Contact your doctor if you have unusually severe abdominal pain.

Bleeding between periods

During the first few months that you are taking these tablets, you may have unexpected bleeding. If this bleeding occurs for more than a few months, or if it begins after some months, your doctor must find out what is wrong.

What you must do if no bleeding occurs during the tablet-free days

If you have taken all the tablets correctly, have not had vomiting or severe diarrhoea and you have not taken any other medicines, it is highly unlikely thatyou are pregnant. If the expected bleeding does not happen twice in succession, you may be pregnant. Contact your doctor immediately. Only start the next strip if you are sure that you are not pregnant.

Other medicines and Yiznell

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Always tell your doctor which medicines or herbal products you are already using. Also tell any other doctor or dentist who prescribes another medicine (or the pharmacist that you use Yiznell. They can tell you if you need to take additional contraceptive precautions (for example condoms) and if so, for how long.

Some medicines can make these less effective in preventing pregnancy, or can cause unexpected bleeding. These include medicines used for the treatment of

-    epilepsy (e.g. primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine)

-    tuberculosis (e.g. rifampicin)

-    HIV infections (ritonavir, nevirapine) or other infections (antibiotics such as griseofulvin, penicillin, tetracycline)

-    high blood pressure in the blood vessels in the lungs (bosentan)

-    the herbal remedy St. John’s wort

• Yiznell may influence the effect of other medicines, e.g.

-    medicines containing ciclosporin

-    the anti-epileptic lamotrigine (this could lead to an increased frequency of seizures) Please talk to your doctor before you stop taking any of your medicines.

Yiznell with food and drink

These tablets may be taken with or without food, if necessary with a small amount of water.

Laboratory tests

If you need a blood test, tell your doctor orthe laboratory staff thatyou are taking the pill, because hormonal contraceptives can affect the results of some tests. Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

If you are pregnant, you must not take these tablets. If you become pregnant while taking these tablets you must stop immediately and contact your doctor. If you want to become pregnant, you can stop taking these tablets at any time.

Ask your doctor or pharmacist for advice before taking any medicine.

Use of these tablets is generally not advisable when breastfeeding. If you want to take the pill while you are breast-feeding you should contact your doctor.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

There is no information suggesting that use of these tablets affects driving or use of machines.

These tablets contain lactose which is a type or sugar. If you have been told by your doctor or pharmacist that you cannot tolerate or digest some sugars, talk to your doctor before taking this medicine.

3. HOW TO TAKE YIZNELL

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Each blister strip contains 21 pink tablets.

Take one tablet every day for 21 days, if necessary with a small amount of water. You may take the tablets with or without food, but you should take the tablets every day around the same time.

During the 7 days when you are not taking the tablets (the tablet-free days), bleeding should begin (so-called withdrawal bleeding). This usually starts on the 2nd or 3rd day after the last tablet.

Once you have had 7 tablet-free days, you should start with the following strip, whether your bleeding has stopped or not. This means that you should start every strip on the same day of the week, and that the withdrawal bleed should occur on the same days each month.

If you use these tablets in this manner, you are protected against pregnancy also during the 4 days when you are taking a placebo tablet.

When can you start with the first strip?

If you have not used a contraceptive with hormones in the previous month Begin taking the tablets on the first day of the cycle (that is, the first day of your period). If you start taking these tablets on the first day of your menstruation you are immediately protected against pregnancy. You may also begin on day 2-5 of the cycle, but then you must use extra protective measures (for example, a condom) for the first 7 days.

Changing from a combined hormonal contraceptive, or combined contraceptive vaginal ring or patch

You can start Yiznell preferably on the day after the last active tablet (the last tablet containing the active substances) of your previous pill, but at the latest on the day after the tablet-free days of your previous pill finish (or after the last inactive tablet of your previous pill). When changing from a combined contraceptive vaginal ring or patch, follow the advice of your doctor.

Changing from a progestogen-only-method (progestogen-only pill, injection, implant ora progestogen-releasing IUD)

You may switch any day from the progestogen-only pill (from an implant or an IUD on the day of its removal, from an injectable when the next injection would be due) but in all of these cases you must use extra protective measures (for example, a condom) for the first 7 days of tablet-taking.

After a miscarriage

Follow the advice of your doctor.

After having a baby

You can start Yiznell between 21 and 28 days after having a baby. If you start later than day 28, you must use a so-called barrier method (for example, a condom) during the first seven days of Yiznell use.

If, after having a baby, you have had sex before starting Yiznell (again), you must first be sure that you are not pregnant or you must wait until your next period.

If you are breast-feeding and want to start Yiznell (again) after having a baby Read the section on “Breast-feeding”.

Ask your doctor what to do if you are not sure when to start.

If you take more Yiznell than you should

There are no reports of serious harmful results of taking too many of these tablets.

If you take several tablets at once then you may have symptoms of nausea or vomiting. Young girls may have bleeding from the vagina.

If you have taken too many of these tablets, or you discover that a child has taken some, ask your doctor or pharmacist for advice.

If you forget to take Yiznell

If you miss a tablet, you must do the following:

•    If you are less than 12 hours late taking a tablet, the protection against pregnancy is not reduced. Take the tablet as soon as you remember and then take the following tablets again at the usual time.

•    If you are more than 12 hours late taking a tablet, the protection against pregnancy may be reduced. The greater the number of tablets that you have forgotten, the greater is the risk of becoming pregnant.

The risk of incomplete protection against pregnancy is greatest if you forget a tablet at the beginning or at the end of the strip. Therefore, you should keep to the following rules:

More than one tablet forgotten in this strip

Contact your doctor.

•    One tablet forgotten between days 1-7

Take the forgotten tablet as soon as you remember, even if that means that you have to take two tablets at the same time. Continue taking the tablets at the usual time and use extra precautions for the next 7 days, for example, a condom. If you have had sex in the week before forgetting the tablet you must realize that there is a risk of pregnancy.

In that case, contact your doctor.

•    One tablet forgotten between days 8-14

Take the forgotten tablet as soon as you remember, even if that means that you have to take two tablets at the same time. Continue taking the tablets at the usual time. The protection against pregnancy is not reduced, and you do not need to take extra precautions.

•    One tablet forgotten between days 15-21

You can choose between two possibilities:

1.    Take the forgotten tablet as soon as you remember, even if that means that you have to take two tablets at the same time. Continue taking the tablets at the usual time. Instead of having seven pill-free days start the next strip as soon as you have taken the last tablet. Most likely, you will have a period at the end of the second strip- but you may also have light or menstruation-like bleeding during the second strip.

2.    You can also stop the tablets and go directly to the tablet-free period (record the day on which you forgot your tablet). If you want to start a new strip on the day you always start, make the tablet-free period less than 7 days.

If you follow one of these two recommendations, you will remain protected against pregnancy.

•    If you have forgotten any of the tablets in a strip, and you do not have a bleeding in the first tablet-free period, you may be pregnant. Contact your doctor before you start the next strip.

What to do in the case of vomiting or severe diarrhoea

If you vomit within 3-4 hours of taking a tablet or you have severe diarrhoea, there is a risk that the active substances in the pill will not be fully taken up by your body. The situation is almost the same as forgetting a tablet. After vomiting or diarrhoea, you must take another tablet from a reserve strip as soon as possible. If possible take it within 12 hours of when you normally take your pill. If this is not possible or 12 hours have passed, you should follow the advice given under “If you forget to take Yiznell”. Delaying your period: what you need to know

Although it is not recommended, you can delay your period by skipping the seven pill-free days and going straight to a new strip of Yiznell and finishing it. You may experience spotting (droplets or flecks of blood) or breakthrough bleeding while

using this second strip. After the usual tablet-free period of 7 days start your next strip.

It is advisable to consult your doctor for advice before deciding to delay your menstrual period.

Changing the first day of your period: what you need to know

If you take the tablets according to the instructions, then your period will begin during the seven tablet-free days. If you have to change this day, make the tablet-free period shorter- (but never longer -7 days is the maximum). For example, if you start the seven pill-free days on a Friday, and you want to change this to a Tuesday (3 days earlier) start a new strip 3 days earlier than usual. You may not have any bleeding during this time. You may then experience spotting (droplets or flecks of blood) or breakthrough bleeding.

If you are not sure what to do, consult your doctor.

If you stop taking Yiznell

You can stop taking these tablets whenever you want. If you do not want to become pregnant, ask your doctor for advice about other reliable methods of birth control. If you want to become pregnant, stop taking these tablets and wait for a menstrual period before trying to

become pregnant. You will be able to calculate the expected delivery date more easily. If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. POSSIBLE SIDE EFFECTS

Like all medicines, this medicine can cause side effects although not everybody gets them. If you get any side effect, particularly if severe and persistent, or have any change to your health that you think may be due to Yiznell, please talk to your doctor An increased risk of blood clots in your veins (venous thromboembolism (VTE)) or blood clots in your arteries (arterial thromboembolism (ATE)) is present for all women taking combined hormonal contraceptives. For more detailed information on the different risks from taking combined hormonal contraceptives please see section 2 “What you need to know before you use Yiznell”.

The following is a list of the side effects

•    Common side effects (between 1 and 10 in every 100 users may be affected):

•    mood swings

•    headache

•    abdominal pain (stomach ache)

•    acne

•    breast pain, breast enlargement, breast tenderness, painful or irregular periods

•    weight gain

   Uncommon side effects (between 1 and 10 in every 1,000 users may be affected):

•    Candida (fungal infection)

•    cold sores (herpes simplex)

•    allergic reactions

•    increased appetite

•    depression, nervousness, sleep disorder

•    feeling of ‘pins and needles’, giddiness (vertigo)

•    problems with vision

•    irregular heart beat or unusually fast heart rate

•    a blood clot (thrombosis) in a vessel of the leg or the lungs (pulmonary embolism),

•    high blood pressure, low blood pressure, migraine, varicose veins

•    sore throat

• nausea, vomiting, inflammation of stomach and/or intestine, diarrhoea, constipation

•    sudden swelling of the skin and/or mucous membranes (e.g. tongue or throat), and/or difficulty swallowing or hives together with difficulty breathing (angioedema), hair loss (alopecia), eczema, itching, rashes, dry skin, oily skin disorders (seborrheic dermatitis), neck pain, limb pain, muscle cramps

•    bladder infection

• breast lump (benign and cancer), milk production while not pregnant (galactorrhea), ovarian cysts, hot flushes, absence of periods, very heavy periods, vaginal discharge, vaginal dryness, lower abdominal (pelvic) pain, abnormal cervical smear (Papanicolaou or Pap smear), decreased interest in sex

•    fluid retention, lack of energy, excessive thirst, increased sweating

•    weight loss.

•    Rare side effects (between 1 and 10 in every 10,000 users may be affected):

•    asthma

•    hearing impairment

•    blockage of a blood vessel by a clot formed elsewhere in the body

•    erythema nodosum (characterized by painful reddish skin nodules)

•    erythema multiforme (rash with target-shaped reddening or sores).

•    harmful blood clots in a vein or artery for example: o in a leg or foot (i.e. DVT)

o in a lung (i.e. PE) o heart attack o stroke

o mini-stroke or temporary stroke-like symptoms, known as a transient ischaemic attack (TIA)

o blood clots in the liver, stomach/intestine, kidneys or eye.

The chance of having a blood clot may be higher if you have any other conditions that increase this risk (See section 2 for more information on the conditions that increase risk for blood clots and the symptoms of a blood clot)

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

You can also report side effects directly via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

5.    HOW TO STORE YIZNELL

Keep this medicine out of the sight and reach of children.

Do not use Yiznell after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.

Store below 25°C

Do not use Yiznell if you notice that the pack is damaged.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

6.    CONTENTS OF THE PACK AND OTHER INFORMATION What Yiznell contains

The active substances are ethinylestradiol and drospirenone

Each film-coated tablet contains 0.020 milligrams ethinylestradiol and 3 milligrams

drospirenone.

The other ingredient(s) are: Lactose monohydrate, corn starch, pregelatinised starch and magnesium stearate.

The film coating for the tablets contains hypromellose (E464), titanium dioxide (E171), Talc (E553b) and Iron oxide red (E172).

What Yiznell 0.02 mg/3 mg Film-Coated Tablets look like and contents of the pack

Each blister contains 21 film-coated tablets.

The tablet is a pink, round, biconvex film coated tablet, plain on one side and embossed with “DR1” on the other side.

Yiznell are available in packs of 1, 3, 6 and 13 blisters each with 21 tablets.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Lupin (Europe) Limited

Victoria Court

Bexton Road

Knutsford

Cheshire

WA16 0PF

United Kingdom

This leaflet was last revised in 03/2014

MP/DRUGS/28/6/2010    ID#: 232151