Drospirenone (Slinda)

Uses

Precaution

Side Effects

Handling

Uses

What is Drospirenone (Slinda) for?

Slinda® (Drospirenone 4mg) tablets are progestogen-only pills, used for the prevention of pregnancy.

How should I take or use Drospirenone (Slinda)?

Do not stop taking your medication without checking with your healthcare professional.
This medication should be taken after food.
Each pack contains 24 white (active) tablets and 4 green (inactive) tablets = 28 tablets.
You should take one tablet daily for 28 days in a row, preferably at the same time every day. You must take the tablets in the correct sequence i.e. start each pack with the white (active) tablets, followed by the green (inactive) tablets.
The next pack is started after the last tablet of the previous pack. Withdrawal bleeding usually starts on day 2-3 after starting the green (inactive) tablets and may not have finished before the next pack is started.
A reliable supplementary non-hormonal contraceptive method such as condoms, are usually recommended for the first seven days of taking Slinda®, for e.g. if you start on Days 2 – 5 of your period, you should use a reliable supplementary non-hormonal contraceptive method for the first 7 days of tablet-taking. However, no additional contraceptive precautions are necessary if Slinda® is taken for the following scenarios below:

Day 1 of menstrual cycle (pregnancy should be ruled out before starting the medication).
Immediately after miscarriage or abortion
Day 21 – 28 after childbirth whether you are breastfeeding or not
When switching immediately from another progestogen-only pill (no break between switch in pills), implant, injection or intrauterine device
When switching from a combined pill (COC), vaginal ring or transdermal patch without any tablet-, ring- or patch-free break.

What should I do if I forget to take or use Drospirenone (Slinda)?

There is no action needed if you have missed the green (inactive) tablets; however, you must follow the steps below if you miss any of your 24 white (active) tablets to ensure that contraception effect is not reduced.

Within 24 hours:

Take the missed tablet as soon as remembered, then continue taking the next one at your usual time.

More than 24 hours:

If the missed tablet is during

Days 1 – 7 of the pack:

Take the missed tablet as soon as you remember, even if it means taking 2 tablets at the same time.
Continue to take your tablets at your usual time.
Use a barrier method such as a condom for the next 7 days.

Days 8 – 17 of the pack:

Take the missed tablet as soon as you remember, even if it means taking 2 tablets at the same time.
Continue to take your tablets at your usual time.
If you have taken your tablets correctly in the 7 days before the first missed tablet, there is no need to use extra contraceptive precautions. However, if this is not the case, or you have missed more than 1 tablet, use a barrier method such as a condom for the next 7 days.

Days 18 - 24 of the pack: Depending on whether you have taken your tablets correctly in the 7 days before the first missed tablet, you would have to follow the following options:

No missed tablets in the last 7 days

Take the missed tablet as soon as you remember, even if it means taking 2 tablets at the same time.

Continue to take your tablets at your usual time until the white (active) tablets are finished. Throw away the 4 green (inactive) tablets and start the next pack right away. Your menses may not come until you finish taking all the white (active) tablets of the next pack, but there is no need to worry. However, if your menses does not occur after the next pack is finished, you should take a pregnancy test to rule out pregnancy.

No additional barrier method such as a condom is necessary.

Stop the current pack and have a tablet-free period of up to 4 days (including the day you missed the tablet) - during which time a withdrawal bleed (menses) usually occurs and then continue with the next pack.

No additional barrier method such as a condom is necessary.

Missed tablets in the last 7 days

Take the missed tablet as soon as you remember, even if it means taking 2 tablets at the same time.

AND

Use a barrier method such as a condom for the next 7 days

**If you miss your period (especially with missed tablets), check with your doctor to find out if you are pregnant before continuing to take the next cycle of contraceptives.

If you vomit or suffer from diarrhea within 3 to 4 hours of taking this medication, the tablet may not be absorbed. This is considered a missed dose. You should then follow the instructions above.

Precaution

What precautions should I take when taking or using Drospirenone (Slinda)?

Inform your healthcare professional if:

You are allergic to this medication or any of the other ingredients of this medication
You are pregnant, planning to become pregnant, or breastfeeding
You are taking any other medications, including supplements, traditional medications and herbal remedies.
You have a history of or current medical conditions such as liver problems, kidney problems, high potassium levels, stroke, clotting disorders, heart diseases, migraine headaches, epilepsy (fits), diabetes or cancer.

What food or medication should I avoid when I take or use Drospirenone (Slinda)?

Some medications might interact with this medication. Check with your healthcare professional if you want to take any other medicines, supplements or herbal products.
If you see another healthcare professional, inform him that you are taking this medication before he prescribes any other medications.

Side Effects

What are some common side effects of Drospirenone (Slinda)?

Common side effects include:

Spotting or bleeding may occur between your menses during the first few months of taking Slinda®. With continued use, some patients may not have menses at all while taking Slinda®. This is normal. Inform your doctor:

If you do not have your menses AND you have not been taking your tablets correctly (i.e. missed doses) because there is a need to rule out pregnancy.
If you are having heavy and continuous bleeding as it may lead to anaemia.
If you are having any other abnormal vaginal bleeding.

Stomach discomfort such as nausea and vomiting

Take it after food to minimise gastric side effects

Breast tenderness
Headache

You may take painkillers such as Paracetamol to manage headaches

Acne
Mood changes (mood swings or low mood)

Take the medication at the same time every day to avoid huge changes in the hormone levels in your body

Weight gain
Decreased sexual drive

Inform your doctor if the side effects above become severe and bothersome.

Very rarely, this medication may cause:

Very bad, unusual headache
Sudden changes to your sight or speech
Very bad pain in your chest
Unusual pain or swelling of your legs
Dark urine or light coloured stools, nausea, vomiting, loss of appetite, stomach pain, yellowing of your eyes or skin

The symptoms of a drug allergy include one or more of the following:

Swollen face/eyes/lips/tongue
Difficulty in breathing
Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Handling

How should I store Drospirenone (Slinda)?

Keep away from children
Keep in a cool, dry place, away from direct sunlight

How do I throw away Drospirenone (Slinda) safely?

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.

Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System, and SingHealth), community pharmacies (Guardian, Unity, and Watsons), and the Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.