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Vestura is a combination oral contraceptive containing drospirenone (3 mg) and ethinyl estradiol (0.02 mg). It is taken on a 24/4 schedule (24 active pills, 4 placebo pills). It prevents pregnancy primarily by suppressing ovulation, and also by thickening cervical mucus and altering the uterine lining.

Common side effects include nausea, headache, breast tenderness, spotting or breakthrough bleeding, and mood changes. Most side effects improve after the first few cycles. Contact a provider promptly if you experience chest pain, leg pain or swelling, severe headache, or vision changes, as these may signal a serious event.

Drospirenone has mild antimineralocorticoid activity, which means it can have a slight diuretic effect and may reduce water retention and bloating compared with some other progestins. However, this property also means potassium levels should be monitored in certain patients, such as those with kidney or adrenal concerns.

Combined hormonal contraceptives, including Vestura, are generally not recommended for people with uncontrolled hypertension because estrogen can raise blood pressure and increase cardiovascular risk. Your provider will review your blood pressure history and current readings before issuing a refill.

If you miss one active pill, take it as soon as you remember and take the next pill at the regular time. If you miss two or more active pills in a row, take the most recently missed pill and use a backup method of contraception for the next seven days. Refer to the full prescribing information or contact your provider for detailed missed-dose guidance.

Several medications can reduce the effectiveness of Vestura or change hormone levels, including certain anticonvulsants (such as carbamazepine), rifampin, and some HIV medications. St. John's Wort, an herbal supplement, can also lower contraceptive efficacy. Always inform your provider about all medications and supplements you take.

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