Wednesday, December 07, 2011

Older Is Better, even with oral contraceptives

New stories, including this one,
Bayer Withheld Yasmin Data From U.S., Former Agency Chief Tells Court - Bloomberg
highlight the elevated risks with the new oral contraceptives. The one under major scrutiny is drospirenone, also known as Yaz or Yasmin.

First, the most important thing: The increased risk of blood clots is small. Your risk of blood clots is probably still higher if you are pregnant. Yes. Your risk of blood clots is higher being pregnant, than being on Yaz or Yasmin. So, patients: Please do not suddenly stop your OCP suddenly. Talk to your doctor first.

When you do talk to your doctor, consider switching to an older contraceptive. One of my mantras in prescribing is that older drugs are usually better, as we know more about their safety. One of my mentors told me, "Never be the first or last to prescribe a new drug." I tend to use norethindone, but any older oral contraceptive will do.

I never understood the hype of Yaz and Yazmin. The drug companies just did a good job marketing it as an acne drug. The truth is, most OCPs work for acne. It appears that Bayer also did a good job of hiding drospirenone's side effects. How many times will we hear this story?