What is Dretine and how does it work?
Dretine is a combined hormonal contraceptive (CHC) that contains two active ingredients: ethinyl estradiol (an estrogen) and drospirenone (a progestin). The primary purpose of this medication is to prevent pregnancy by interfering with a woman's reproductive cycle.
The pill's contraceptive action works in three main ways:
- Inhibiting Ovulation: It suppresses the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which prevents the monthly release of an egg from the ovaries.
- Thickening Cervical Mucus: The hormones thicken the fluid in the cervix, creating a barrier that makes it more difficult for sperm to travel to the womb.
- Altering the Uterine Lining: It also prevents the lining of the uterus from thickening enough for a fertilized egg to implant.
Drospirenone is a unique progestin in that it also possesses anti-androgenic and antimineralocorticoid properties, which can help manage certain symptoms like fluid retention and hormonal acne.
Primary uses of Dretine
While best known as a birth control pill, Dretine has additional therapeutic uses that make it a multi-purpose medication for some women.
Oral Contraception: As a combined oral contraceptive, Dretine is used to prevent pregnancy. When taken correctly and consistently, it is a highly effective method of birth control.
Treating Premenstrual Dysphoric Disorder (PMDD): Certain formulations containing drospirenone and ethinyl estradiol are FDA-approved for treating the symptoms of PMDD. PMDD is a more severe form of premenstrual syndrome (PMS) that causes intense emotional and physical symptoms in the 10 to 14 days before a woman's period.
Managing Acne: Dretine can also be used to treat moderate acne in women at least 14 years of age who wish to use an oral contraceptive. It helps reduce acne by regulating hormonal fluctuations.
Dosing and administration
Dretine is typically sold in a 28-day pack, designed for consistent daily use. The pack contains 21 active tablets containing the hormones and 7 inert, or placebo, tablets.
Administration instructions:
- Take one tablet daily as instructed on the blister pack.
- Follow the order of the tablets as indicated on the package.
- Active tablets (typically yellow) are taken for 21 days, followed by the placebo tablets for 7 days.
- During the 7-day placebo period, a withdrawal bleed similar to a menstrual period typically occurs.
- Begin the next pack immediately after completing the placebo tablets, regardless of whether bleeding has stopped.
If a dose is missed, refer to the patient information leaflet or contact your healthcare provider for specific instructions, as the recommended steps vary.
Potential side effects and risks
Like all medications, Dretine can cause side effects. It is important to discuss these risks with a healthcare provider before starting treatment.
Common side effects:
- Headache
- Nausea and vomiting
- Breast tenderness or enlargement
- Irregular or missed menstrual periods
- Mood changes, including depression
- Weight gain
Serious but less common risks:
- Increased risk of blood clots: Combined hormonal contraceptives, especially those containing drospirenone like Dretine, carry a slightly increased risk of blood clots (venous thromboembolism) compared to other combined pills. The risk is highest during the first year of use.
- Heart attack and stroke: The risk of arterial thrombosis, such as heart attack and stroke, is very small but increases with age (especially over 35) and if you smoke.
- Increased potassium levels (Hyperkalemia): Drospirenone has a mild diuretic effect, and in rare cases, can increase potassium levels, especially in those with kidney or adrenal problems.
Contraindications and risk factors
Certain conditions make Dretine unsuitable. Do not use this medication if you have a history of:
- Kidney or adrenal problems
- Liver disease or tumors
- Known blood clotting disorders
- Uncontrolled high blood pressure
- Breast cancer or other hormone-sensitive cancers
- Undiagnosed abnormal vaginal bleeding
- If you smoke and are over 35 years old
Comparison of combined oral contraceptives (Dretine vs. others)
| Feature | Dretine (drospirenone/ethinyl estradiol) | Yasmin (drospirenone/ethinyl estradiol) | Yaz (drospirenone/ethinyl estradiol) |
|---|---|---|---|
| Hormone Type | Drospirenone / Ethinyl Estradiol | Drospirenone / Ethinyl Estradiol | Drospirenone / Ethinyl Estradiol |
| Active/Placebo Pills | Typically 21 active / 7 placebo | 21 active / 7 placebo | 24 active / 4 placebo |
| Approved Uses | Contraception, PMDD, Acne | Contraception | Contraception, PMDD, Acne |
| Risk of Blood Clots | Slightly higher than some other combined pills | Slightly higher than some other combined pills | Slightly higher than some other combined pills |
| Note on formulation | Standard formulation with drospirenone. | Similar formulation to Dretine. | Different dosing schedule and hormone levels may vary by specific product. |
Important considerations before starting Dretine
Before beginning Dretine, have an in-depth conversation with your healthcare provider. It is crucial to provide a complete medical history, including any previous experience with blood clots, heart problems, migraines, or mental health disorders.
Interactions with other medications:
- Enzyme-inducing drugs: Certain medications, including some for epilepsy (e.g., primidone, phenytoin, carbamazepine), tuberculosis (e.g., rifampicin), and HIV can decrease the contraceptive effectiveness of Dretine.
- Herbal supplements: St. John's Wort is known to interact with hormonal contraceptives and reduce their efficacy.
- Hepatitis C medications: Do not use Dretine with certain Hepatitis C drug combinations, as this is contraindicated.
Your healthcare provider may also want to monitor your blood pressure and potassium levels, especially if you have underlying conditions that could predispose you to hyperkalemia.
Conclusion
Dretine is a combined oral contraceptive pill containing drospirenone and ethinyl estradiol, providing a dual benefit of preventing pregnancy while also treating conditions like PMDD and acne for some women. Its effectiveness depends on consistent and correct use, but it carries a slightly higher risk of blood clots compared to some other combined pills due to its drospirenone content. As with any prescription medication, a thorough discussion with a healthcare provider is essential to weigh the benefits against the risks based on individual health history before deciding if Dretine is the right choice for you.
