Yaz Dosage/Direction for Use

Tablets must be taken in the order directed on the package every day at about the same time. The patient may begin using YAZ (drospirenone and ethinylestradiol) on day 1 of her menstrual cycle (ie, the first day of menstrual flow) or on the first Sunday after her period begins. If the patient's period begins on Sunday, she should start that same day. If YAZ tablets are taken later than day 1 when first starting medication, an additional (barrier) method of birth control is recommended for the first 7 days of use.
One hormone-containing light pink tablet is to be taken daily for 24 consecutive days, followed by 1 hormone-free white tablet daily for 4 consecutive days. Withdrawal bleeding usually occurs within 2 to 3 days following administration of the last hormone-containing light pink tablet (ie, while the patient is taking the hormone-free white tablets).
The patient begins each subsequent course of YAZ tablets on the same day of the week that she began her first course. She begins taking her next course immediately after completion of the last course, regardless of whether or not withdrawal bleeding is still in progress.
Management of missed tablets: The patient should be instructed to use the following chart if she misses 1 or more of her birth control pills. She should be told to match the number of tablets missed with the appropriate starting time for her dosing regimen. The risk of pregnancy increases with each hormone-containing light pink tablet missed. (See Table 12.)

Click on icon to see table/diagram/image

If the patient forgets any of the 4 hormone-free white tablets in week 4, she should be advised to safely dispose of the tablets she missed, and then to keep taking 1 tablet each day until the pack is empty. A back-up method of birth control is not required.
Special Notes on Administration: Switching from another combined hormonal contraceptive (combined oral contraceptive (COC), vaginal ring, or transdermal patch): The patient should start YAZ on the day she would normally start her next pack of combined oral contraceptive. In case a vaginal ring or transdermal patch has been used, the woman should start using YAZ preferably on the day of removal, but at the latest when the next application would have been due.
Switching from a progestin-only method (mini-pill, injection) or from a Progestin-releasing Intrauterine System (IUS): The patient may switch from the mini-pill to YAZ on any day of her cycle. Patients using a progestin injection should start YAZ on the day the next injection is due. Patients using an IUS should start YAZ on the day the IUS is removed. In all cases, the patient should be advised to use an additional (barrier) method for the first 7 days of YAZ use.
Following first trimester abortion: The patient may start using YAZ immediately. When doing so, she need not take additional contraceptive measures.
Following delivery or second trimester abortion: Patients should be advised to start YAZ on day 21 to 28 after delivery or second trimester abortion, after consulting with their physician. When starting later, the patient should be advised to use an additional (barrier) method for the first 7 days of YAZ use. However, if intercourse has already occurred, pregnancy should be excluded before the actual start of use, or the woman should be advised to wait for her next menstrual period prior to starting YAZ. When the tablets are administered in the postpartum period, the increased risk of thromboembolic disease associated with the postpartum period must be considered.
Withdrawal/breakthrough bleeding: Withdrawal bleeding usually occurs within 3 days following the last hormone-containing light pink tablet. If spotting or breakthrough bleeding occurs while taking YAZ, the patient should be instructed to continue taking YAZ as prescribed and by the regimen described previously. She should be instructed that this type of bleeding is usually transient and without significance; however, if the bleeding is persistent or prolonged, the patient should be advised to consult her physician.
Although the occurrence of pregnancy is unlikely if YAZ is taken according to directions, if withdrawal bleeding does not occur, the possibility of pregnancy must be considered. If the patient has not adhered to the prescribed dosing schedule (missed 1 or more hormone-containing tablets or started taking them on a day later than she should have), the probability of pregnancy should be considered at the time of the first missed period and appropriate diagnostic measures taken before the medication is resumed. If the patient has adhered to the prescribed regimen and misses 2 consecutive periods, pregnancy should be ruled out before continuing the contraceptive regimen.
Advice in case of vomiting: If vomiting occurs within 3 to 4 hours after a tablet is taken, absorption may not be complete. In such an event, the advice concerning management of missed tablets is applicable.