estimates are not precise, but for women who do not use a contraceptive pill about one case of VTE per 10 000 is expected each year - by comparison, about six cases of VTE are expected to occur in every 10 000 pregnancies in healthy women who take Yasmin, between 3 and 4 cases of VTE are expected to occur in every 10 000 women each year the previous estimate was between 2 and 4 cases in every 10 000 women each year, all these estimates relate to women who are otherwise in good health.all COCs, including Yasmin, should be prescribed with caution to obese women (BMI >30), or those with a higher baseline risk of VTE for other reasons.any prescribing decision should take into account each woman’s personal risk factors and any contraindications, including her experience with other contraceptive formulations.levonorgestrel-containing pills have the lowest thrombotic risk and are the safest pill for a woman who wants to start or switch contraception prescribers should be aware of the updated information when discussing the most suitable type of contraceptive for a woman who wants to start or switch contraception.the risk of VTE in association with drospirenone-containing pills, including Yasmin, is higher than that for levonorgestrel-containing ‘second generation’ pills and may be similar to the risk for ‘third-generation’ pills that contain desogestrel or gestodene.Product information for Yasmin, as for all COCs, already contains extensive warnings about the risk of VTE and these have been updated to reflect the totality of the evidence.Īdvice for healthcare professionals includes: Furthermore, it suggests that the level of the risk may be similar to that for third-generation COCs that contain desogestrel or gestodene. These data strengthen and confirm the original findings, and have enabled firmer conclusions about the relative risk associated with drospirenone-containing pills.Īll epidemiological studies have some limitations in their methods however, the totality of the available evidence now clearly shows that the risk of VTE for drospirenone-containing COCs, including Yasmin, is higher than the risk for levonorgestrel-containing second-generation COCs. Recent unpublished re-analyses of data from the Danish stud圓 directly compared VTE risk for drospirenone-containing pills, levonorgestrel-containing pills, and desogestrel/gestodene-containing pills. Both corroborated the findings of the Danish 3 and Dutch4 studies of an increased risk of VTE in association with use of drospirenone-containing pills relative to levonorgestrel-containing pills. Two further studies were recently published: one using the US PharMetrics database and the other using the UK General Practice Research Database. However, in 2009, a Danish cohort study and a Dutch case-control study of the risk of VTE in association with a number of COCs found the risk with drospirenone-containing pills to be higher than the risk associated with levonorgestrel-containing pills. The results of two early prospective cohort studies suggested no difference in risk of VTE between Yasmin and levonorgestrel-containing pills or ‘other’ COCs. ![]() Evidence of the level of VTE risk associated with Yasmin has been accruing since then. Yasmin contains drospirenone, a relatively new progestogen, and was first licensed in 2000. ![]() The excess risk of VTE is highest during the first year a woman ever starts or switches their COC. ![]() Overall, these studies have shown that women who use pills that contain desogestrel or gestodene have a slightly higher risk of developing VTE than do those who use levonorgestrel-containing pills. The incidence of VTE in association with the use of levonorgestrel-containing, desogestrel-containing, or gestodene-containing pills has been studied extensively. For a given dose of oestrogen, the absolute incidence of VTE varies according to the type of progestogen in the pill but is, for all COCs, very small. Venous thromboembolism (VTE) in association with use of combined oral contraceptives (COCs) is not a new issue.
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