Posology : מינונים

2 DOSAGE AND ADMINISTRATION
2.1 How to Take Yasmin Plus
Take one tablet by mouth at the same time every day. The failure rate may increase when pills are missed or taken incorrectly.
To achieve maximum contraceptive effectiveness, Yasmin Plus must be taken as directed, in the order directed on the blister pack. Single missed pills should be taken as soon as remembered.
2.2 How to Start Yasmin Plus
Instruct the patient to begin taking Yasmin Plus either on the first day of her menstrual period (Day 1 Start) or on the first Sunday after the onset of her menstrual period (Sunday Start).
Day 1 Start
During the first cycle of Yasmin Plus use, instruct the patient to take one orange Yasmin Plus daily, beginning on Day 1 of her menstrual cycle. (The first day of menstruation is Day 1.) She should take one orange Yasmin Plus daily for 21 consecutive days, followed by one light orange tablet, containing levomefolate alone, daily on Days 22 through 28.
Yasmin Plus should be taken in the order directed on the package at the same time each day, preferably after the evening meal or at bedtime with some liquid, as needed. Yasmin Plus can be taken without regard to meals. If Yasmin Plus is first taken later than the first day of the menstrual cycle, Yasmin Plus should not be considered effective as a contraceptive until after the first 7 consecutive days of product administration. Instruct the patient to use a non-hormonal contraceptive as back-up during the first 7 days. The possibility of ovulation and conception prior to initiation of medication should be considered.
Sunday Start
During the first cycle of Yasmin Plus use, instruct the patient to take one orange Yasmin Plus daily, beginning on the first Sunday after the onset of her menstrual period. She should take one orange Yasmin Plus daily for 21 consecutive days, followed by one light orange tablet, containing levomefolate alone, daily on Days 22 through 28. Yasmin Plus should be taken in the order directed on the package at the same time each day, preferably after the evening meal or at bedtime with 
some liquid, as needed. Yasmin Plus can be taken without regard to meals. Yasmin Plus should not be considered effective as a contraceptive until after the first 7 consecutive days of product administration. Instruct the patient to use a non-hormonal contraceptive as back-up during the first 7 days. The possibility of ovulation and conception prior to initiation of medication should be considered.
The patient should begin her next and all subsequent 28-day regimens of Yasmin Plus on the same day of the week that she began her first regimen, following the same schedule. She should begin taking her orange tablets on the next day after ingestion of the last light orange folate tablet, regardless of whether or not a menstrual period has occurred or is still in progress. Anytime a subsequent cycle of Yasmin Plus is started later than the day following administration of the last light orange tablet, the patient should use another method of contraception until she has taken an orange Yasmin Plus daily for seven consecutive days.
When switching from a different birth control pill
When switching from another birth control pill, Yasmin Plus should be started on the same day that a new pack of the previous oral contraceptive would have been started.
When switching from a method other than a birth control pill
When switching from a transdermal patch or vaginal ring, Yasmin Plus should be started when the next application would have been due. When switching from an injection, Yasmin Plus should be started when the next dose would have been due. When switching from an intrauterine contraceptive or an implant, Yasmin Plus should be started on the day of removal.
Withdrawal bleeding usually occurs within 3 days following the last orange tablet. If spotting or breakthrough bleeding occurs while taking Yasmin Plus, instruct the patient to continue taking Yasmin Plus by the regimen described above.
Counsel her that this type of bleeding is usually transient and without significance; however, advise her that if the bleeding is persistent or prolonged, she should consult her healthcare provider.
Although the occurrence of pregnancy is low if Yasmin Plus is taken according to directions, if withdrawal bleeding does not occur, consider the possibility of pregnancy. If the patient has not adhered to the prescribed dosing schedule (missed one or more active tablets or started taking them on a day later than she should have), consider the possibility of pregnancy at the time of the first missed period and take appropriate diagnostic measures. If the patient has adhered to the prescribed regimen and misses two consecutive periods, rule out pregnancy. Discontinue Yasmin Plus if pregnancy is confirmed.
The risk of pregnancy increases with each active orange tablet missed. If breakthrough bleeding occurs following missed tablets, it will usually be transient and of no consequence. If the patient misses one or more light orange tablets, she should still be protected against pregnancy provided she begins taking a new cycle of orange tablets on the proper day.
For postpartum women who do not breastfeed or after a second trimester abortion, start Yasmin Plus no earlier than 4 weeks postpartum due to the increased risk of thromboembolism. If the patient starts Yasmin Plus postpartum and has not yet had a period, evaluate for possible pregnancy, and instruct her to use an additional method of contraception until she has taken Yasmin Plus for 7 consecutive days.
2.3 Missed Doses

Table 1: Instructions for Yasmin       Take it as soon as possible. Take Plus Missed Doses If one orange        the next tablet at the regular time.
active tablet is missed                This means two tablets may be taken in one day. A back-up birth control method is not required if the patient has sex.
If two orange active tablets in a      Take two tablets as soon as row are missed in Week 1 or            possible and two tablets the next Week 2                                 day. Then take one tablet a day until the pack is finished.
Additional nonhormonal contraception (such as condoms and spermicide) should be used

as back-up if the patient has sex within 7 days after missing tablets.
If two orange active tablets in a     Day 1 Start: Throw out the rest of row are missed in Week 3              the pack and start a new pack that same day.
Sunday Start: Keep taking one tablet every day until Sunday. On
Sunday, throw out the rest of the pack and start a new pack that same day.
Additional nonhormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets. The patient may not have their period this month but this is expected. However, if they miss their period two months in a row, they should call their healthcare provider because they might be pregnant.

If three or more orange active        Day 1 Start: Throw out the rest of tablets in a row are missed during    the pack and start a new pack that any week                              same day.
Sunday Start: Keep taking one tablet every day until Sunday. On
Sunday, throw out the rest of the pack and start a new pack that same day.
Additional nonhormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets.
The patient may not have their period this month but this is expected. However, if they miss their period two months in a row,
they should call their healthcare provider because they might be pregnant.
If any of the seven light orange      Throw away the tablets that were inactive tablets are missed in        missed.
Week 4:                               Keep taking one tablet each day until the pack is empty. They do not need a back-up method.
Finally, if they are still not sure   Use nonhormonal contraception what to do about the tablets they     (such as condoms and have missed:                          spermicides) anytime they have sex. Contact their healthcare
provider and continue taking one active orange tablet each day until otherwise directed


2.4 Advice in Case of Gastrointestinal Disturbances
In case of severe vomiting or diarrhea, absorption may not be complete and additional contraceptive measures should be taken. If vomiting occurs within 3-4 hours after tablet-taking, this can be regarded as a missed tablet.
2.5 Folate Supplementation
The U.S. Preventive Services Task Force recommends that women of childbearing age consume supplemental folic acid in a dose of at least 0.4 mg (400 mcg) daily.1 Consider other folate supplementation that a woman may be taking before prescribing Yasmin Plus. Ensure that folate supplementation is maintained if a woman discontinues Yasmin Plus due to pregnancy.