Posology : מינונים

2 DOSAGE AND ADMINISTRATION
2.1 How to Take Yaz 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 and PMDD effectiveness, Yaz 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 Yaz Plus
Instruct the patient to begin taking Yaz 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 Yaz Plus use, instruct the patient to take one pink Yaz Plus daily, beginning on Day 1 of her menstrual cycle. (The first day of menstruation is Day 1.) She should take one pink Yaz Plus daily for 24 consecutive days, followed by one light orange tablet daily on Days 25 through 28. Yaz 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. Yaz Plus can be taken without regard to meals. If Yaz Plus is first taken later than the first day of the menstrual cycle, Yaz 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 Yaz Plus use, instruct the patient to take one pink Yaz Plus daily, beginning on the first Sunday after the onset of her menstrual period. She should take one pink Yaz Plus daily for 24 consecutive days, followed by one light orange tablet daily on Days 25 through 28. Yaz 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. Yaz Plus can be taken without regard to meals. Yaz 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 Yaz Plus on the same day of the week that she began her first regimen, following the same schedule. She should begin taking her pink 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 Yaz 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 a pink Yaz Plus daily for seven consecutive days.
When switching from a different birth control pill
When switching from another birth control pill, Yaz 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, Yaz Plus should be started when the next application would have been due. When switching from an injection, Yaz Plus should be started when the next dose would have been due. When switching from an intrauterine contraceptive or an implant, Yaz Plus should be started on the day of removal.
Withdrawal bleeding usually occurs within 3 days following the last pink tablet. If spotting or breakthrough bleeding occurs while taking Yaz Plus, instruct the patient to continue taking Yaz 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 Yaz 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 Yaz Plus if pregnancy is confirmed.
The risk of pregnancy increases with each active pink 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 pink tablets on the proper day.
For postpartum women who do not breastfeed or after a second trimester abortion, start Yaz Plus no earlier than 4 weeks postpartum due to the increased risk of thromboembolism. If the patient starts on Yaz 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 Yaz Plus for 7 consecutive days.

2.3 2.3 Missed Doses
Table 1: Instructions for Yaz Plus Missed            Take it as soon as possible. Take the next tablet Doses If one pink active tablet is missed            at the regular time. 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 pink active tablets in a row are missed in    Take two tablets as soon as possible and two Week 1 or Week 2                                     tablets the next 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 pink active tablets in a row are missed in    Day 1 Start: Throw out the rest of the pack and Week 3 or Week 4                                     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 pink active tablets in a row are      Day 1 Start: Throw out the rest of the pack and missed during any week                                 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 any of the four light orange inactive tablets are   Throw away the tablets that were missed.
missed in 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 what to do about   Use nonhormonal contraception (such as the tablets they have missed:                          condoms and spermicides) anytime they have sex. Contact their healthcare provider and continue taking one active pink 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 Yaz Plus. Ensure that folate supplementation is maintained if a woman discontinues Yaz Plus due to pregnancy.