Why is Nextstellis prescribed?

Nextstellis (Drospirenone/Estetrol) is a contraceptive that combines drospirenone, a progestin, and estetrol, an estrogen, and is intended for use by females of reproductive potential to prevent pregnancy.

Nextstellis contains two hormones: drospirenone (a progestin) and estetrol (an estrogen). These hormones work together to prevent pregnancy by:

• Inhibiting ovulation, or the release of an egg from the ovaries
• Making it more difficult for sperm to reach and fertilize an egg
• Reducing the likelihood of a fertilized egg attaching to the uterus and growing
How should I take it?

Take Nextstellis one tablet taken orally at the same time each day, with or without food. Tablets should be taken in the sequence indicated on the blister pack.

What if I missed a dose?

Check the instructions or consult your doctor or pharmacist for guidance on what to do if you miss a dose. The appropriate steps will depend on how many pills you've missed and where you are in your cycle. You may need to use a backup contraceptive method for a week while continuing to take Nextstellis.

What are the special precautions before taking Nextstellis?
Do not use Nextstellis if you have any of the following conditions, as it may not be safe for you:
• High risk of developing a blood clot
• Over the age of 35 and smoke
• Currently have or have a history of blood clots or disorder
• History of stroke
• Coronary artery disease (CAD)
• Certain heart rhythm issues, such as atrial fibrillation (AFib)
• Uncontrolled high blood pressure
• Diabetes with high blood pressure or organ damage
• Migraine headaches with aura
• Current or past breast cancer
• Liver tumors or liver disease
• Kidney issues
• Low adrenal hormone levels
• Unexplained abnormal vaginal bleeding
• Taking hepatitis C combination medications that include ombitasvir/ ritonavir/ paritaprevir
Be sure to discuss your medical history with your doctor before using Nextstellis.
Does it have any side effects?

The following side effects may improve as your body adjusts to the medication. However, if these symptoms persist or worsen, contact your doctor right away.

Common side effects may include:
• Acne
• Abnormal vaginal bleeding
• Mood changes
• Breast symptoms, such as changes in size or color, swelling or pain.
• Headache
• Increase in weight
• Decreased libido
Serious side effects may include:
• Depression
• Heart attack
• Stroke
• Deep vein thrombosis (DVT), a blood clot in the leg
• Pulmonary embolism (a blood clot in the lung)
• Retinal vein thrombosis (a blood clot in the eye)
• Severe liver issues
• Elevated potassium levels
This document does not list all possible side effects, and other effects may occur. For more information about potential side effects, consult your doctor.
Is it safe to take it with another drug?
Nextstellis may interact with the following medications:
• Antifungals: Itraconazole, Ketoconazole, Voriconazole
• Pain relievers & anti-inflammatory drugs: Acetaminophen, Acetylsalicylic acid (ASA), Celecoxib, nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., naproxen, ibuprofen)
• Blood pressure & heart medications: Aliskiren, Angiotensin converting enzyme (ACE) inhibitors (e.g., ramipril, lisinopril), angiotensin-II receptor blockers (e.g., candesartan, losartan), beta-blockers (e.g., propranolol, metoprolol), clonidine, diltiazem, verapamil
• Antibiotics: Ampicillin, Cotrimoxazole, Erythromycin, Metronidazole, Penicillin, Rifampin, Tetracyclines, Sulfonamides
• Anticonvulsants & mood stabilizers: Carbamazepine, Lamotrigine, Oxcarbazepine, Phenytoin, Phenobarbital, Topiramate
• Blood thinners: Apixaban, Dabigatran, Edoxaban, Rivaroxaban, Warfarin, Heparin
• HIV medications: non-nucleoside reverse Transcriptase inhibitors (e.g., efavirenz), Protease inhibitors (e.g., ritonavir, atazanavir)
• Cancer treatments: Anastrozole, Exemestane, Letrozole, Tamoxifen, Lenalidomide, Mitotane, Rituximab
• Stimulants: Modafinil, Caffeine, Theophylline
• Diabetes medications: Insulin, Metformin, Canagliflozin, Glyburide
• Others: St. John's Wort, Rifabutin, Lithium, Mifepristone, Grapefruit juice, Potassium-sparing diuretics, Potassium supplements.
If you take any of these medications, it's important to speak with your doctor or pharmacist. Depending on your situation, your doctor may suggest:
• Stopping one of the medications
• Switching to a different medication
• Adjusting how or when you take one or both medications
• Keeping everything as is, with close monitoring

Not all drug interactions require stopping medications. Many are managed through monitoring or adjustments.

How should I store it?

Nextstellis should be stored at room temperature, between 20°C and 25°C. It may be briefly exposed to temperatures ranging from 15°C to 30°C, such as during transport. Store the medication in a cool, dry place.

What action should I take in case of overdose?

If you have taken too much Nextstellis you may experience nausea, vomiting with severe headache seek medical help immediately by contacting your doctor or going to the emergency department.

Is it safe for pregnant or breastfeeding women?

Nextstellis is designed to prevent pregnancy and should be stopped if pregnancy occurs. It is also passed into breast milk and may reduce milk production. Breastfeeding women are recommended to use alternative contraception methods until breastfeeding is no longer needed. Consult your doctor before breastfeeding.

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