Can You Refill Yaz?
Yes, you can obtain a refill of Yaz (drospirenone 3mg/ethinyl estradiol 20mcg) if you have no new contraindications and are tolerating it well, and the CDC recommends prescribing up to 1 year of combined oral contraceptives at a time. 1
When Refills Are Appropriate
Routine refills are standard practice for patients already established on Yaz who remain healthy and have no new contraindications, as the CDC supports prescribing up to 12 months of COCs at once 1
Blood pressure monitoring is the primary safety requirement during long-term COC therapy and should be performed regularly, though measurements can be obtained in nonclinical settings 1
Combined oral contraceptives are completely reversible with no negative effect on long-term fertility and are safe throughout a woman's reproductive years 1
Absolute Contraindications That Would Prevent Refill
You cannot obtain a refill if you have developed any of these conditions:
Cardiovascular/thrombotic conditions: Active or history of DVT/PE, stroke, MI, uncontrolled hypertension (≥160/100 mmHg), thrombogenic valvular disease, or known hypercoagulopathies 1, 2
Neurological conditions: Migraines with aura or focal neurologic symptoms at any age, or any migraine if you are ≥35 years old 1, 2
Hepatic conditions: Active hepatic dysfunction, hepatic tumors (benign or malignant), or cholestatic jaundice 1, 2
Malignancy: Breast cancer or other estrogen/progestin-sensitive cancers, endometrial carcinoma 1, 2
Other: Pregnancy, undiagnosed abnormal uterine bleeding, smoking if ≥35 years old, renal dysfunction, or adrenal insufficiency 1, 2
Important Considerations for Yaz Specifically
Yaz uses a 24/4 regimen (24 active pills, 4 placebo pills) rather than the traditional 21/7 regimen, which provides better ovarian suppression due to the shortened hormone-free interval 3, 4, 5
The drospirenone component has antimineralocorticoid properties that may help prevent water retention and weight gain, distinguishing it from other progestins 3, 6, 7
Strict adherence is particularly important with 20mcg formulations like Yaz, as seven consecutive days of pill-taking is necessary to reliably prevent ovulation 1
Common Pitfalls to Avoid
Do not assume you need an in-person visit for every refill - many healthcare systems allow refills with periodic monitoring rather than requiring visits for each prescription 1
Do not discontinue arbitrarily at age 40 or 45 - the safety profile supports use throughout reproductive years in healthy, non-smoking women 1
Breakthrough bleeding is the most common adverse effect but does not indicate treatment failure or need to discontinue 1, 5
Weight gain has not been reliably linked to COC use; in fact, studies with drospirenone-containing formulations recorded weight loss that stabilized after 6 months 1, 6
Drug Interactions to Consider
Rifampin, rifabutin, certain anticonvulsants (phenytoin, carbamazepine, barbiturates, topiramate, oxcarbazepine), and griseofulvin reduce Yaz effectiveness and require alternative contraception 1
Broad-spectrum antibiotics, tetracyclines (doxycycline, minocycline), antifungals, and antiparasitics do NOT affect contraceptive effectiveness 1