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Drospirenone / Ethinyl Estradiol / Levomefolate Calcium Review

Drospirenone / Ethinyl Estradiol / Levomefolate Calcium is a combination birth control pill containing 2 hormones, estrogen and progestin, that are used to prevent pregnancy.


Indications for use

This microdose monophasic contraceptive is recommended as a protection against an extremely unwanted pregnancy. In addition, oral tablets are prescribed in the following clinical conditions:

  • premenstrual syndrome;
  • climax,
  • the period of menopause;
  • acne;
  • folate deficiency;
  • hormone-dependent fluid retention in the body.


The effect of the drug on the woman’s body is determined by the dosage and the chemical composition. The active substances of synthetic origin are drospirenone, ethinyl estradiol and levomefolate calcium, which enhance the therapeutic effect of each other. The composition of these hormone tablets also includes auxiliary components.

1 active tablet contains:

  • ethinylestradiol 20 mcg;
  • drospirenone 3 mg;
  • calcium levomefolate 451 mcg

One 28-day blister contains 24 active tablets. Each active component of these oral tablets reduces the likelihood of pregnancy, directly affects the reproductive system and menstrual cycle, has therapeutic and preventive effects in the body of women of reproductive age:

Drospirenone has a depressing effect on the natural process of ovulation. The active component has an antimineralocorticoid effect, removes fluid from the body, and has anti-androgenic properties.

Ethinyl estradiol makes menstrual periods less painful, prevents oncology, inhibits the activity of sex hormones, does not cause an addictive effect.

Levomefolate calcium is actively absorbed in the female body (even better than folic acid) while satisfying the daily requirement of the female body in folias and preventing intrauterine pathologies in a progressive pregnancy.

Each package also contains 4 inactive pills, that act as vitamins. The active ingredient is levomefolate calcium, which reduces the risk of iron deficiency anemia and strengthens weakened immunity.

Mechanism of action

The monophasic oral contraceptive acts locally in the female body. With prolonged use, Drospirenone / Ethinyl Estradiol / Levomefolate Calcium oppresses the reproductive functions, but the risk of side effects in the form of obesity and increased vegetation on the body is minimal. With unregular use, contraception is unreliable because the concentration of hormones in the blood is insufficient to suppress ovulation. The principle of the action is the following: after oral intake of the required dose, ethinyl estradiol suppresses natural processes of ovulation alters the physical characteristics and the composition of cervical mucus. With irregular bleeding, drospirenone normalizes the menstrual cycle, removes fluid from the body, reduces swelling, removes signs of acne, controls the weight of the patient, restores the placebo, provides a visible weight loss effect.

Mode of application

Use the drug strictly according to the instructions, without missing a single dose. Take 1 tablet a day at the same time, with water. Start a new blister of the preparation once you have finished the previous blister.

How to take Drospirenone / Ethinyl Estradiol / Levomefolate Calcium for the first time:

Medication can be taken only on the advice of a doctor. Start taking pills from the 1st day of the menstrual period but no later than 2-5 days after the onset of menstruation. Each package contains 7 self-adhesive strips, which correspond to the days of the week. It is necessary to find out on which day the therapy began and “sign” the pill. This is required to avoid deviations from the course. The contraceptive works almost immediately, therefore an additional contraceptive (caps, condoms, etc.) is not required.

The scheme of switching from other oral contraceptives:

You can switch to this contraceptive on the next day after the previous tablet. An unscheduled visit to a specialist is recommended to exclude the risk of drug interactions. A break between the use of two preparations should not exceed 7 days. The hormonal course should be started only according to the instructions.

Switching from gestagens:

The bioavailability level of the progestogen is high, so this indicator must be monitored regularly with hormone therapy. If you decide to take such oral contraceptives, it is necessary to consult the gynecologist in advance, especially for patients with diabetes mellitus and hormone-dependent patients. A break after taking gestagenic drugs is not required. You may start taking new pills the very next day. However, during a week you’d better use additional methods of contraception.

Use of birth control pills after childbirth:

The risk of a drop in estrogen in the blood after taking such medication is minimal, but there are specific features of oral administration. For example, after giving birth, you can continue taking pills on days 21-28, while using additional methods of contraception during the following week. Tablets contain hormones, so it is contraindicated to disrupt their concentration in the blood.


An overdose has not yet been observed or described. Theoretically, an overdose of the drug can cause:

  • dyspepsia;
  • nausea;
  • vomiting;
  • vaginal bleeding.

It is recommended to carry out symptomatic treatment. Antidote has not yet been identified.


Drospirenone / Ethinyl Estradiol / Levomefolate Calcium is contraindicated to patients with both hepatic and renal failure, with progressive thromboembolism, and increased the sensitivity of the female body to active substances of synthetic origin. This contraceptive is not prescribed in angioedema, and other medical contraindications stated below:

  • malignant tumors;
  • migraine attacks;
  • diabetes;
  • lactose intolerance;
  • a propensity to uterine bleeding;
  • pregnancy and breastfeeding periods;
  • chronic liver disease.

With caution:

In the presence of the following diseases/conditions and risk factors, the potential risks and the expected benefits of using birth control pills should be assessed:

  • risk factors for thrombosis and thromboembolism: smoking, obesity, controlled arterial hypertension, migraine without focal neurological symptoms, uncomplicated heart valve defects, hereditary predisposition to thrombosis;
  • violations of peripheral circulation: diabetes mellitus without vascular complications, systemic lupus erythematosus, hemolytic uremic syndrome, Crohn’s disease and ulcerative colitis, sickle cell anemia, phlebitis of superficial veins;
  • hereditary angioedema;
  • hypertriglyceridemia;
  • jaundice;
  • itching associated with cholestasis;
  • cholelithiasis;
  • otosclerosis with hearing impairment;
  • porphyria;
  • pregnant sores;
  • Sydenham’s chorea);
  • postpartum period.

Side effects

The most common side effects of Drospirenone / Ethinyl Estradiol / Levomefolate Calcium are as follows:

  • nausea;
  • pain in the mammary glands;
  • irregular uterine bleeding, bleeding from the genital tract of an unspecified genesis;
  • arterial and venous thromboembolism;
  • migraine;
  • mood swings, depression;
  • reduction or loss of libido;
  • venous or arterial thromboembolism;
  • erythema multiforme.
  • liver tumors.


Before you start taking hormonal birth control pills, you need to study the drug interaction. For example, the simultaneous administration of several contraceptives at once causes the risk of uterine bleeding. In addition, the combination with medical drugs that induce microsomal enzymes of the liver can cause an increase in clearance of sex hormones. The contraceptive may also reduce the therapeutic effect of antibiotics of the fourth generation.

Compatibility with alcohol

To exclude the symptoms of intoxication, it is not recommended to combine Drospirenone / Ethinyl Estradiol / Levomefolate Calcium with alcohol. The presence of ethanol in the blood plasma leads to severe poisoning, and the patient complains of nausea, dizziness, vomiting, acute allergic reactions, changes in the chemical composition of urine.

What if I miss a dose?

Missing active tablets can be preceded by the inattention of women or increased employment. However, this is not an excuse for a female body, therefore, if possible, it is required to take the missed dose. Time and day of the week do not matter, even if you have to take two active pills at the same time. This is important not to deviate from the prescribed course and not to reduce the contraceptive effect of the drug.

Missing inactive tablets is not a problem, the patient can simply throw the unused medication away and continue the prescribed dosing scheme. In this case, the planned effect of calcium is somewhat reduced but it does not bring enormous harm to health. So, such a pill can be discarded.

Breastfeeding and pregnancy

If an adult woman takes a contraceptive during pregnancy, she can observe bleeding or mask of pregnancy. Therefore, to reduce the risk of complications, the use of Drospirenone / Ethinyl Estradiol / Levomefolate Calcium must be discontinued. The risk of intrauterine pathologies is minimal, so if desired, a progressive pregnancy can be saved.

Breastfeeding should be temporarily abandoned since the synthetic components of the drug in high concentration are excreted in breast milk and can damage the baby’s health. However, it is important to use a reliable contraception method since the risk of repeated pregnancy is not excluded during a breastfeeding period.

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