Common heartburn drugs may raise stroke risk

                                     

Proton pump inhibitors are a class of drugs commonly used to treat heartburn - pain in the chest or throat caused by the rising of stomach acid into the esophagus. But new research suggests this medication should be used with caution, after finding it could raise the risk of ischemic stroke.

A new study has linked the use of PPIs - drugs that treat heartburn - to greater risk of ischemic stroke.

In a study of almost 245,000 Danish adults, researchers found the risk of ischemic stroke was increased by a fifth with the use of proton pump inhibitors (PPIs).

PPIs work by reducing the amount of acid produced in the stomach, thereby reducing the "backing up" of stomach acid into the esophagus - a condition known as heartburn. Someone who has heartburn more than twice a week may have gastroesophageal reflux disease (GERD).

Lead study author Dr. Thomas Sehested, of the Danish Heart Foundation in Copenhagen, Denmark, recently presented his findings at the American Heart Association's Scientific Sessions 2016, held in New Orleans, LA.

Ischemic stroke occurs when the artery that supplies the brain with oxygen-rich blood becomes blocked, usually by a blood clot. Ischemic stroke is the most common form of stroke, accounting for around 85 percent of all strokes.

Dr. Sehested and colleagues note that previous studies have associated PPI use with vascular impairment, which led the scientists to investigate whether the drugs might raise the risk of ischemic stroke, "especially given their increasing use in the general population," notes Dr. Sehested.

Ischemic stroke risk 21 percent higher with PPI use

To reach their findings, the team analyzed data of 244,679 adults from Denmark - of an average age of 57 years - who underwent endoscopy to pinpoint the causes of their stomach pain or indigestion.

During an average of 6 years of follow-up, 9,489 patients experienced a first-time ischemic stroke.

The researchers assessed patients' use of one of four PPIs - omeprazole (Prilosec), pantoprazole (Protonix), lansoprazole (Prevacid), and esomeprazole (Nexium) - and looked at whether this was associated with ischemic stroke risk.

Overall, the team found that patients were at 21 percent greater risk of ischemic stroke when they were using PPIs, compared with when they were not using the drugs.

There was little or no greater risk of stroke with low doses of PPIs, the researchers report, and another group of medications used to treat heartburn - called H2 blockers - were not linked to increased stroke risk.

Looking at stroke risk among the highest doses of each of the four PPIs, the researchers found pantoprazole fared worst, increasing the risk of ischemic stroke by 94 percent.

Study 'questions the cardiovascular safety of PPIs'

The researchers accounted for a number of possible confounding factors, including age, gender, high blood pressure, atrial fibrillation, and use of medications that have been linked to poorer cardiovascular health.

Because the study is purely observational, the researchers are unable to prove cause and effect between PPI use and increased stroke risk. Still, they believe the results suggest patients should be cautious about using the drugs, many of which are now available over the counter.

Dr. Sehested notes that doctors should also apply caution when deciding whether to prescribe PPIs to patients and for how long. "We know that from prior studies that a lot of individuals are using PPIs for a much longer time than indicated, which is especially true for elderly patients," he adds.

The team concludes that a randomized, controlled trial of the association between PPI use and the risk of cardiovascular disease is needed.

6 Ways to Save Money on Your Prescription Medications

If you are taking a medication for a chronic condition (hypertension, high cholesterol, diabetes, etc.), there’s a chance that you might be paying more than you actually need to pay. You might be able to get the same type of drug to treat the same condition for a mere fraction of the cost. And I’m not just talking about choosing generic over brand name. There’s something that’s even better than that, something that most Singaporeans are not aware of.

1. Choosing Generic Medications

Yes, you definitely can save tons of money choosing a generic over a brand name drug. Generics have active ingredients that are chemically identical and biologically identical (this means they are made to function the same way) to their brand name counterpart. They are also manufactured and regulated under the same standards. Brand name medications are all recently patented (their “monopoly” hence gives them the ability to charge such a high price), which may imply that there is something extraordinary about their composition or formula, but many reports and studies have shown that the majority of recent brand name medications are just “me-too drugs”. These are drugs that are nearly identical to already existing drugs, but with minor changes that allow it to be classified as “novel” and hence be patentable. 

For example, when AstraZeneca’s patent for their top selling medicine Prilosec (generic name: Omeprazole) was ending, it found a way to further purify the active ingredient (changing it very slightly and insignificantly) to Esomeprazole. They gave it a new name (Nexium) and a new patent. The efficacy of the two medications are nearly identical but the new one costs a LOT more. For most conditions, generic medications are not only cheaper, they are just as good as the brand name.

2.Choosing Formulary Medications

For many medical conditions, there are a variety of prescription drugs that belong to the same class. These essentially do the same thing, but are chemically different (unlike brand and generic which are chemically identical). The formulary is a list of medications which are published on the MOH website that are subsidized for Singaporeans and PRs. Those which are on Standard Drug List #1 are capped at $1.40 per week and $2.10 per week for Singaporeans and PRs, respectively. Those which are on Standard Drug List #2 are subsidized by 50% and by 25% of the retail price for Singaporeans and PRs, respectively. Keep in mind that each polyclinic and specialist outpatient clinic may stock different medications and implement this differently, but this formulary will at least give you a starting point. If you have a chronic medical condition, more than likely there is a medication on the formulary that you can switch to that is highly subsidized. According to MOH, the formulary covers about 90% of the total volume of medication prescriptions. For example, if you have hypertension, and you choose a generic drug, you will still have a big price difference between generic drugs of the same class. Losartan 100mg is $0.40 per pill and Candesartan 16mg is $1.10 per pill. But Losartan is on the formulary Stardard Drug List #2 while Candesartan is not. So that means if you’re Singaporean, Losartan is only $0.20 per pill. Despite both medications being generic medications, one will cost more than $400 per year and the other will only be $73. Choosing generic medications does save you money, but choosing formulary medications can save you even more!

3.Splitting your pills

Many pills cost the same despite how much active ingredient there is in the pill. For example, Amlodipine 5mg is $0.20 and Amlodipine 10mg is also $0.20. If you need only 5mg, why not just buy the 10mg and split the pill in half? Many tablets can be split in half, but do not try to split capsules or any time-released or coated medications. If the pill is not scored, always check with your doctor or pharmacist to make sure it is safe to split the pill.

4.Choosing Not to Combine Medications

Combination medications are great for convenience, but many of these tend to be brand name medications, such as Caduet, in which Pfizer just put two already available generic drugs together (Amlodipine plus Atorvastatin) to patent a “new” drug. You may want to ask your doctor whether you can take the medications separately, which may allow you to save money, especially since both generic drugs (as in this example) are on the MOH formulary list.

5.Shopping Around

As with everything, you should shop around and call your pharmacy since prices will vary. You may be wondering why prices vary in the first place. Like other commodities, the institution or business which purchases the goods have different price arrangements with the suppliers. Larger institutions, in general, have more buying power. There may be other special discounts or costs that affect the price of the medication.

6. Visit Pharmacy in Malaysia, Johor Bahru

Usually, medicine in malaysia is selling at lower price compare to Singapore. Can refer below link for reference.

Crestor, Lipitor, Nexium,Yasmin,Ventolin, Propecia and Plavix price in Johor Bahru (JB)

Why doesn’t my doctor just give me the less expensive drug?

Many people think that doctors purposely prescribe the most expensive drug because they get financial incentives. For the vast majority of doctors, this is not the case. Yes, there are some that get kickbacks, but those working in the public institutions are strictly prohibited from this (this is one reason I avoid private hospitals and clinics). The prescribing habits of doctors are just that – habits. They prescribe what they are comfortable with and what they have prescribed in the past. They also place a higher priority on what works for their patients, and have less interest in knowing what cheaper alternatives are out there. It’s like when I ask people which place has the best laksa, they each have their own preference and some places will be a lot more expensive than others. No one ever tells me the cheapest place, unless they extensively research this. There also may be a good reason why your doctor wants you on a more expensive drug. The key is to ask your doctor and engage him/her in a conversation to discuss possible less expensive alternatives. The prices of drugs prescribed for common conditions can be found on the Pharmaceutical Society of Singapore website.

Of course, the best way to save money on medications is to live a healthy lifestyle so you won’t need to be on the medications. Most chronic conditions can be managed or even reversed with lifestyle modifications. How we eat, move, sleep, think, and interact with others can significantly change our health, our savings, and our life.

Source: http://frugalinsingapore.com

Do NOT put makeup on children, say health experts

            

“Children have a 10 to 20 per cent higher absorption rate compared with adults due to their high metabolism. Unfortunately, their bodies cannot differentiate between good and bad chemicals.

KUALA LUMPUR: AN uncontrolled “backyard” cosmetics industry, where little safeguards are in place, may cause the health of the county’s future generation to be compromised.

Health experts, in calling for the industry to be tightly regulated, said while cosmetics loaded with deadly chemicals are a major concern, their adverse affects on “involuntary” users, including children and unborn babies, must not be taken lightly.

A health expert, who has been studying the correlation between heavy metals and their effects on humans, said parents should refrain from applying make-up on their children at all costs because the damaging impact of harmful chemicals will be greater on them.

Universiti Kebangsaan Malaysia Medical Centre’s environmental health physician and toxicologist, Associate Professor Dr Mohd Hasni Ja’afar, said this is because children have a much higher metabolism rate and their bodies can absorb almost 100 per cent of the chemicals applied on them.

“Children have a 10 to 20 per cent higher absorption rate compared with adults due to their high metabolism. Unfortunately, their bodies cannot differentiate between good and bad chemicals.

“All they can do is to absorb whatever is being applied on their bodies... and more worryingly, the effects will become evident in the future,” he said.

Dr Hasni also has an issue with parents applying lipstick on their children, whose bodies were especially vulnerable to toxic metals found in those cosmetics.

“Your children may look adorable and beautiful with lipstick on, but the lips are considered mucous membranes and will absorb whatever chemicals put on it at an accelerated rate,” he said, adding that the relevant authorities should seriously consider a stricter monitoring mechanism for the industry.

He said mercury, now commonly found in skin-whitening products, is highly absorbent — even in topical applications — and its traces will not only accumulate in the body’s main organs, but will also be passed onto the foetus of a pregnant woman.

According to the World Health Organisation (WHO), transplacental exposure is the most dangerous stage as the developing fetal brain is sensitive to toxins and heavy metals.

Among the neurological effects are mental retardation, seizure, vision and hearing loss, delayed development, speech disorder and memory loss.

The doctor said with almost 80 per cent absorption rate, mercury will normally be deposited into the kidneys, brain and bones.

“Although mercury has about 80 per cent absorption rate, the level of absorption also depends on other factors, including age and amount of makeup applied."

Small traces of the metal in the body will be eliminated through a process known as “bio-transformation”, whereas the rest will be stored.

Dr Hasni added that high levels of mercury in the brain can also cause Minamata disease, a neurological syndrome that can disrupt cognitive abilities and motor sensors.

“What makes mercury particularly dangerous as compared with other heavy metals is that it can be passed on from mother to child... and it can continue to the next generation.

“Mercury has a significant effect on babies as their blood-brain barrier — the dynamic interface that separates the brain from the circulatory system and protects the central nervous system from harmful chemicals — is not fully developed.

“Children exposed to mercury risk developing mental problems, including intellectual disability and autism. A thorough study, however, should be done on the correlation between the exposure of heavy metals with the number of chronic illnesses in the country,” he said.

Source: http://www.nst.com.my/

Why buying medicine in Malaysia is cheaper than in Singapore ?

You may have noticed that some commonly prescribed drugs for long-term conditions such as diabetes and high blood pressure cost more in Singapore than across the Causeway in Malaysia, or other parts of the world. There are a number of reasons why the same drugs are priced differently across countries. 

Drugs fall into two broad categories – generic drugs and branded drugs. Generic drugs, which are copies of branded drugs whose patents have expired, are generally inexpensive throughout the world. Branded drugs are much more expensive because of the start-up investment, research, and marketing expenses that go into producing a new drug from scratch and bringing it onto the market.

Most pharmaceutical companies set the price for a branded drug based on a country’s ability to pay for that drug. So, it can cost more in one country than in another.

Drug makers expect countries with a high per capita GDP to pay more for branded drugs than countries with a low per capita GDP. This can lead to a huge price differential between countries. This price differential is further amplified by the difference in foreign exchange rates. 

Focused on getting a handsome return on their investments, pharmaceutical companies are keen to sell branded drugs at the highest price a market can bear. Say, for example, the best available treatment for a particular condition is surgery that costs $30,000, and there is a 5 per cent risk that the patient undergoing the surgery may die. Now, if a pharmaceutical company develops a drug that is as effective and has only a 1 per cent mortality risk, even if that drug costs 30 cents to produce, the company will price its new drug regime higher than $30,000, because the best available treatment is the benchmark, explains Dr Jeremy Lim. Dr Lim, the principal consultant at Insights Health Associates in Singapore, is the author of the book, Myth or Magic: The Singapore Healthcare System, which will be available in bookstores in mid-September. 

“The pharmaceutical company would think that, if, its drug is as effective as the current surgical treatment and has five times lower mortality risk, it deserves to charge a premium. Hence, the company would charge $30,000 plus whatever premium it deems to be appropriate,” says Dr Lim, whose previous experiences include being a senior consultant with the Ministry of Health (MOH) in Singapore, and director of research and education at SingHealth, Singapore’s largest healthcare group.

Another reason why branded drugs cost less in some countries, and more in others, is that, in certain countries, people can buy prescription drugs over the counter because of lax regulatory controls. Although laws in those countries may state that certain medicines are to be made available by prescription only, or by a registered pharmacist, in practice, it is often possible to get those drugs over the counter. This means, a patient does not have to bear the costs involved in having the drug prescribed to him.

“When it is a prescription-only drug, the administrative cost goes up because you need a doctor to prescribe the medicine, a pharmacist to dispense it and the storage of the drugs needs to be audited and monitored, and you need paper trails. The control mechanisms are tighter and they cost money,” says Dr Lim.

A third reason why drug prices vary from country to country is limited economies of scale resulting from smaller volume drug purchases. The more a healthcare provider, whether it is the government or a private hospital, buys of a particular drug, the cheaper the price gets.

Government subsidies for drugs also play a role in price differences. The Singapore government does not subsidize branded drugs unless they fall within the Standard Drug List maintained by MOH, or come under one of the government’s subsidy schemes. Patients taking a non-subsidized branded drug would therefore have to pay the full price of that drug, and hence, would end up paying more than patients in a country where that drug is heavily subsidized, Dr Lim notes.

Even within a single country, the same drug can cost differently at different hospitals. One reason for this is that hospitals buying more of a particular branded drug can benefit from economies of scale. According to Dr Lim, hospitals mark up the selling price of their drugs up to about 35 per cent to defray operating costs. 

“While this percentage formula is administratively easy for hospitals and healthcare facilities, it can lead to substantial cost pressures on patients. A 30 per cent mark-up of a one-dollar drug is 30 cents, but the same mark-up for a thousand-dollar drug is $300,” he adds.

Related link,

Crestor, Lipitor, Nexium Plavix & Propecia price in Johor Bahru (JB)

Source: http://theindependent.sg

Cialis & Viagra price in Johor Bahru, which is better?

Part 1 of 6: Overview

Three of a Kind?

Tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) are oral remedies for erectile dysfunction (ED). About half of all men over age 40 occasionally have a problem with erections, according to the Urology Care Foundation. When ED becomes an ongoing problem, many turn to oral ED medications. Results are generally favorable.

Cialis, Levitra, and Viagra are all in a similar class of drugs and work in much the same way. However, there are some differences. Read about their similarities and differences, understand their side effects, and find out if one may be right for you.

Part 2 of 6: How They Work

How They Work

Cialis, Levitra, and Viagra are all PDE-5 inhibitors. They work by blocking an enzyme called phosphodiesterase type 5 and by boosting a naturally occurring chemical called nitric oxide. This action encourages the muscles in your penis to relax. Relaxed muscles allow blood to flow freely so that when you’re aroused, you can get an erection —  and maintain it long enough to have sex.

Levitra and Viagra stay in your bloodstream for about four to six hours, while Cialis remains in your bloodstream for 17 to 18 hours or longer. The length of time a medication stays in your system may be important if you are taking other medications or have prolonged side effects.

A brand called Staxyn is another version of vardenafil (Levitra). It comes in tablet form and can be dissolved on your tongue.

All three medications have good results. However, it sometimes takes a little time and patience to get it right. If one drug doesn’t work or produces unpleasant side effects, you can try another. It may take a few adjustments to arrive at the correct dose of the correct medication. Tell your doctor if you take other over-the-counter or prescription medications or supplements. Be sure to mention any other health conditions.

Part 3 of 6: Admin Differences

How and When Comparison

Cialis, Levitra, and Viagra all require a doctor’s prescription and are available in different strengths, so you can start out with the lowest dose and adjust accordingly.

Cialis is available in a daily pill that can be taken with or without food. You should plan on taking it about 30 to 60 minutes before sex. It can stay active in your body for up to eight hours. Cialis is also available in a 24-hour dose; take it only once a day, with or without food. 

If your doctor prescribes Levitra, take it once a day on an empty stomach. It works best if you take it about 30 to 60 minutes before sex, and it can stay active for as long as eight hours.

Viagra works best on an empty stomach. Keep in mind that high-fat foods can interfere with Viagra, resulting in it taking longer to work. Take the pill about 30 to 60 minutes before sex. It usually stays active for about four to five hours. However, it can sometimes last eight hours or more.

All three medications are generally very effective when taken as directed.

Part 4 of 6: Side Effects

Side Effects

The side effects of these oral ED medications are similar. Most men have only mild side effects, but persistent problems should be reported to your doctor.

Potential side effects of Cialis include:

• back pain
• muscle aches
• headache
• upset stomach
• stuffy or runny nose

Potential side effects of Levitra and Viagra include:

• changes in vision
• flushing
• headache
• upset stomach
• stuffy or runny nose

Rarely, these medications can cause dizziness or fainting. Another rare complication is an erection that won’t go away (priapism). An erection lasting longer than four hours requires immediate medical intervention.

Part 5 of 6: Interactions

Interactions

Each drug comes with the possibility of negative drug interactions. As PDE-5 inhibitors that work on the body in similar ways, the drugs come with similar interactions. However, they also have some differences. Read about how other medications and chemicals may interact with each drug.

Nitrates

Viagra, Cialis, and Levitra are all contraindicated with nitrates. Contraindication means that mixing the two could lead to potential harm. Nitrates work by widening arteries. This increases blood flow and reduces strain on the heart. All three ED drugs increase the effects of nitrates, which can lead to a problematic decrease in blood pressure (hypotension).

Alpha-Blockers

Similar to nitrates, alpha-blockers improve blood flow. This class of drug helps to keep blood vessels relaxed and open. Alpha-blockers can be used to treat high blood pressure. Because they help relax other parts of the body, they can also be used to help urine flow in men with prostate cancer. All three ED medications can further lower blood pressure if used with alpha-blockers. The National Institutes of Health (NIH) urges caution if using PDE-5 inhibitors along with alpha-blockers.

Other Antihypertensives

Cialis, Levitra, and Viagra all dilate blood vessels, which can cause a drop in blood pressure. They all come with the risk of lowering blood pressure. According to the NIH, Viagra has been shown to further lower blood pressure when used with amlodipine. Furthermore, Cialis has been shown to further lower blood pressure when used with amlodipine, angiotensin II receptor blockers, bendrofluazine, enalapril, and metoprolol. The NIH states that, in general, Levitra may also further lower blood pressure when used with antihypertensives.

Alcohol

Alcohol is another chemical that dilates blood vessels. According to the NIH, neither Viagra nor Levitra strengthened the hypotensive effects of alcohol. However, when it’s mixed with substantial amounts of alcohol, Cialis could lead to potential low blood pressure symptoms when you stand up. These symptoms include dizziness and headache. The NIH also points out that Cialis and Levitra, when taken with alcohol, do not lead to a change in the levels of alcohol or the drug in the blood.

Ritonavir and CYP3A4 Inhibitors

According to the NIH, the amounts of Viagra in the blood are increased when taken with CYP3A4 inhibitors, including ritonavir. Ritonavir is an HIV medication used to reduce levels of the virus in a person’s blood. The NIHsuggests that a person taking Viagra and CYP3A4 inhibitors shouldn’t exceed a dose of 25 milligrams (mg) of Viagra in a 48-hour period.

Part 6 of 6: Outlook

Outlook

Each of these three popular ED medications has been shown to help men with ED when they’re used appropriately. Talk to your doctor about these medications. You and your doctor can make decision based on side effects, administration, drug interactions, and other factors that can help determine which drug may be best for you.

Source: http://www.healthline.com

Price Enquiry ( call or whatapps):

Ben- 0127334511

Do you know the right way to treat nosebleeds?

Nosebleeds are caused most commonly by dry air and nose picking. Photo: TNS

Nosebleeds, also called epistaxes, involve bleeding from the inside of your nose.

The lining of your nose contains many tiny blood vessels that lie close to the surface and are easily damaged.

The two most common causes of nosebleeds are dry air – when your nasal membranes dry out, they’re more susceptible to bleeding and infections – and nose picking.

Many people have occasional nosebleeds, particularly younger children and older adults, and although nosebleeds may be scary, they’re generally only a minor annoyance and aren’t dangerous.

Most nosebleeds aren’t serious and will stop on their own or by following self-care steps.

Self-care steps for occasional nosebleeds include:

• Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding.

Sitting forward will help you avoid swallowing blood, which can irritate your stomach.

• Gently blow your nose to clear out any clotted blood. Spray a nasal decongestant in the nose.

• Pinch your nose. Use your thumb and index finger to pinch both nostrils shut, even if only one side is bleeding. Breathe through your mouth.

Continue to pinch for five to 10 minutes. This manoeuvre puts pressure on the bleeding point on the nasal septum and often stops the flow of blood.

• Repeat. If the bleeding doesn’t stop, repeat these steps for up to a total of 15 minutes.

After the bleeding has stopped, to keep it from starting again, don’t pick or blow your nose and don’t bend down for several hours. Keep your head higher than the level of your heart.

Tips to help prevent nosebleeds include:

• Keeping the lining of the nose moist. Especially during colder months when air is dry, apply a thin, light coating of petroleum jelly (Vaseline) or antibiotic ointment (bacitracin) with a cotton swab three times a day. Saline nasal spray also can help moisten dry nasal membranes.

• Trimming your child’s fingernails. Keeping fingernails short helps discourage nose picking.

• Using a humidifier. A humidifier will counteract the effects of dry air by adding moisture to the air.

Seek emergency medical care if nosebleeds:

• Follow an injury, such as a car accident

• Involve a greater than expected amount of blood

• Interfere with breathing

• Last longer than 30 minutes even with compression

• Occur in children younger than age two

Don’t drive yourself to an emergency room if you’re losing a lot of blood. Call your local emergency number or have someone drive you.

Talk to your doctor if you’re having frequent nosebleeds, even if you can stop them fairly easily. Frequent nosebleeds are those that occur more than once a week. It’s important to determine the cause. – Mayo Clinic News Network/Tribune News Service

Yasmin 21s @RM45 in Johor Bahru

Yasmin is used for:

Preventing pregnancy. It may also be used for other conditions as determined by your doctor.

Yasmin is a progesterone and estrogen combination birth control pill. It works by preventing ovulation, thickening the mucus in the cervix, and changing the lining of the uterus.

Do NOT use Yasmin if:

• you are allergic to any ingredient in Yasmin
• you are pregnant or think you may be pregnant
• you have a history of blood clotting problems, severe blood clots (eg, in the lungs, legs, eyes), certain blood vessel problems (eg, bleeding in the brain, heart attack, stroke), or breast cancer
• you have certain heart problems (eg, heart valve problems, certain types of irregular heartbeat); chest pain caused by angina; certain blood problems (eg, porphyria); certain types of headaches or migraines with aura; severe or uncontrolled high blood pressure; diabetes that affects circulation; endometrial, cervical, or vaginal cancer; estrogen-dependent growths; or undiagnosed abnormal vaginal bleeding
• you have kidney disease, adrenal disease, liver disease or liver tumors, or a history of yellowing of the eyes or skin caused by pregnancy or prior birth control use
• you have had surgery and are or will be confined to a bed or a chair for an extended period of time
• you are older than 35 years old and you smoke 15 or more cigarettes per day

How to use Yasmin:

Use Yasmin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with Yasmin. Talk to your pharmacist if you have questions about this information.
• Take Yasmin by mouth with or without food.
• Talk with your doctor about how you should start to take your first pack of Yasmin. If you begin to take Yasmin during the first 24 hours of your period, you do not need to use an extra form of birth control. If you begin to take Yasmin on the Sunday after your period starts, you will need to use an extra form of birth control for 7 days after you start taking Yasmin.
• If you are switching from another birth control pill to Yasmin, start Yasmin on the same day that would have started a new pack of your previous birth control pills. Talk with your doctor if you have any questions about how to switch from another form of hormonal birth control to Yasmin.
• Take Yasmin at the same time every day, not more than 24 hours apart. After taking the last pill in the pack, start taking the first pill from a new pack the very next day.
• For Yasmin to be effective, it must be taken every day. Do not skip doses even if you do not have sex very often. Do not skip pills if you are spotting, bleeding, or nauseated. If you have these side effects and they do not go away, check with your doctor.
• If you miss 1 dose of Yasmin, take it as soon as you remember. Take your next dose at the regular time. This means you may take 2 doses on the same day. You do not need to use a backup form of birth control if you only miss 1 pill. If you miss more than 1 dose, read the extra patient leaflet that comes with Yasmin or contact your doctor for instructions. You must use a backup form of birth control if you miss more than 1 dose. If you are not sure how to handle missed doses, use an extra form of birth control (eg, condoms) until you talk with your doctor.

Ask your health care provider any questions you may have about how to use Yasmin.