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Other related names or treatments

Slynd

Other known brand names

Slynd. The active ingredient is drospirenone. There are no other currently licensed progestogen-only pill brand names containing 4 mg drospirenone in the UK. Drospirenone 3 mg is also found as a component in combined oral contraceptives such as Yasmin and Lucette, but these are different products containing an oestrogen and are not interchangeable with Slynd.

About Slynd

Slynd contains the active ingredient drospirenone 4 mg, a progestogen-only pill (POP) developed by Exeltis UK Ltd for the prevention of pregnancy. Drospirenone is a progestogen derived from spironolactone and also possesses antiandrogenic and mild antimineralocorticoid properties. Unlike many traditional progestogen-only pills, Slynd follows a 24/4 dosing schedule — 24 white active tablets followed by 4 green placebo tablets per pack — giving it a structured cycle while maintaining the benefits of a progestogen-only preparation. Slynd was first authorised in the UK in March 2021 and is a prescription-only medicine.

Slynd works primarily by inhibiting ovulation. Drospirenone suppresses follicular stimulation and the luteinising hormone (LH) surge, consistently preventing ovulation across the cycle. It also increases cervical mucus viscosity, making it harder for sperm to reach an egg, and exerts a progestational effect on the endometrium. Unlike most other progestogen-only pills, Slynd inhibits ovulation reliably even when a dose is taken up to 24 hours late, offering greater flexibility compared to traditional POPs.

Slynd is not a combined oral contraceptive and does not contain oestrogen. It does not protect against sexually transmitted infections (STIs), including HIV.

NowPatient offers Slynd following an online consultation with a prescriber.

Key facts of Slynd

• For the prevention of pregnancy (contraception) in women of reproductive age
• Slynd has some common side effects which include irregular bleeding or spotting, headache, acne, mood changes, and nausea
• It can interact with enzyme-inducing drugs (e.g. rifampicin, carbamazepine, phenytoin, St. John’s Wort) which may reduce its contraceptive effectiveness — additional or alternative contraception is recommended during and for 28 days after such treatment. If you’re not sure if it is safe to use with other treatments, discuss this with the prescribing clinician
• Slynd does not contain oestrogen and can be used by women who cannot take oestrogen-containing contraceptives
• Slynd may be suitable during breastfeeding, as only negligible amounts of drospirenone are excreted in breast milk
• Slynd should not be used during pregnancy
• Drospirenone has mild antimineralocorticoid properties (similar to spironolactone), meaning it can affect potassium levels — monitoring may be required if you have renal insufficiency or take potassium-sparing medicines
• If you are more than 24 hours late taking a white active tablet, use additional contraception (e.g. condoms) for the next 7 days
• Slynd does not protect against sexually transmitted infections

Who is Slynd suitable for?

Slynd is suitable for women of reproductive age who require oral contraception. It is particularly suitable for:

• Women who cannot or do not wish to use an oestrogen-containing contraceptive, such as those with a history of migraines with aura, a personal history of venous thromboembolism (VTE), or cardiovascular risk factors
• Women who are breastfeeding, as drospirenone passes into breast milk only in negligible amounts
• Women who prefer a pill with a 24-hour missed-pill window, rather than the traditional 3-hour window associated with most other progestogen-only pills
• Post-pubertal adolescents (after onset of menstruation) through to women up to the age of 45, based on clinical trial data

Who is Slynd not suitable for?

Slynd may not be suitable for some people. To make sure it’s safe for you, speak to the NowPatient prescribing clinician before using Slynd if you:

• Are pregnant or suspect you may be pregnant — Slynd should not be used during pregnancy
• Have or have had a serious liver disease, or your liver function values have not returned to normal
• Have severe kidney insufficiency or acute kidney failure
• Have or have had a blood clot (venous thromboembolic disorder) that is currently active
• Have or are suspected to have a sex-steroid sensitive cancer (e.g. certain types of breast cancer)
• Have unexplained vaginal bleeding
• Are hypersensitive (allergic) to drospirenone or any of the tablet excipients, including lactose — patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take Slynd
• Have severe kidney or liver impairment
• Are taking potassium-sparing diuretics, aldosterone antagonists, or other medicines that may raise potassium levels — your serum potassium should be checked during the first treatment cycle
• Have a history of or are at high risk of ectopic pregnancy
• Experience mood changes or depression after starting Slynd — contact your prescribing clinician

How and where to get Slynd?

You can buy Slynd safely and securely from NowPatient. You can start a consultation today for free and if you qualify for treatment, you only pay for the cost of the medication. Delivery is made to your home or office from our registered pharmacy.

Our service is certified, safe and effective, and we only ever treat conditions. If you book a consultation with a prescribing clinician for contraception, you can discuss whether Slynd is a suitable treatment option for you.

At the end of the consultation, the clinician will decide if a treatment plan is suitable for you. If it is, the clinician will issue you with a prescription which can then be ordered, paid for and delivered directly to your chosen address by NowPatient.

Dosage and strength for Slynd

Slynd comes in calendar packs containing 28 film-coated tablets: 24 white active tablets (4 mg drospirenone each) and 4 green placebo tablets. The white active tablet is round with the letters “E” and “D” debossed on opposite sides. The green placebo tablet has “E” and “4” on opposite sides.

The recommended dose is one tablet taken orally each day at approximately the same time, following the order on the blister strip: 24 consecutive white active tablets, then 4 green placebo tablets. Tablets can be taken with or without food. It is important to maintain a 24-hour interval between tablets.

The first tablet should be taken on day 1 of your menstrual cycle (the first day of your period). No additional contraception is needed when starting on day 1. If switching from another contraceptive method, follow the guidance provided in the patient leaflet or by your prescribing clinician.

Missed tablets: If you are fewer than 24 hours late taking a white active tablet, take it as soon as you remember and continue as normal — contraceptive protection is not reduced. If you are more than 24 hours late, take the missed tablet as soon as you remember (even if this means taking two tablets at once), then continue at your usual time. Use a barrier method (e.g. condoms) for the next 7 days. If vomiting or severe diarrhoea occurs within 3–4 hours of taking a tablet, treat this as a missed tablet.

What happens if you use too much Slynd?

There have been no reports of serious harmful effects from overdose of drospirenone. Symptoms may include nausea, vomiting, and slight vaginal bleeding. There is no specific antidote, and treatment should be supportive.

Because drospirenone is a spironolactone analogue with antimineralocorticoid properties, serum potassium and sodium levels, and evidence of metabolic acidosis, should be monitored in cases of overdose.

If you have taken too much or experience significant discomfort, stop taking Slynd and speak to your doctor or reach out to one of our prescribing clinicians. In a serious situation, contact your doctor or seek emergency medical attention.

What are the side effects of Slynd?

Side effects of Slynd are split into common and serious.

Common side effects include:

• Irregular menstrual bleeding or spotting (metrorrhagia or vaginal haemorrhage)
• Headache
• Acne
• Breast discomfort or pain
• Nausea or abdominal pain
• Changes in libido or mood
• Weight gain

Uncommon side effects include:

• Depression or depressed mood — contact your prescribing clinician if you experience mood changes shortly after starting treatment
• Dizziness
• Anxiety
• Amenorrhoea (absence of periods) — this becomes more common with longer use
• Fatigue
• Vomiting or diarrhoea
• Alopecia (hair loss)
• Hyperkalaemia (raised potassium) — particularly relevant in women with renal insufficiency or taking potassium-sparing medicines
• Hot flushes or hypertension
• Ovarian cyst

Serious side effects include:

• Venous thromboembolism (blood clots in veins) — while the risk with progestogen-only preparations is low, seek immediate medical attention if you experience leg swelling, pain, redness, breathlessness, or chest pain
• Ectopic pregnancy — if you have lower abdominal pain or missed periods, seek medical advice promptly
• Liver tumours (rare) — seek medical attention if you experience severe upper abdominal pain, liver enlargement, or signs of internal bleeding
• Suicidal behaviour — depression is a known risk factor; women should be advised to contact their physician if they experience suicidal thoughts

If you experience any serious side effects, you should contact your doctor or local health advice line.

If you experience a serious allergic reaction with the signs shown below, you should contact your local emergency services:

• Your lips, mouth, throat or tongue suddenly become swollen
• You’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
• Your throat feels tight or you’re struggling to swallow
• Your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• You suddenly become very confused, drowsy or dizzy
• Someone faints and cannot be woken up

Always report adverse effects to the reporting system run by your national medicines regulator. You can read more about this here: How and where do I report side effects of my medication?

Information about using Slynd with other medications

Drospirenone is metabolised in part by CYP3A4. The following drug interactions are clinically significant:

• Enzyme-inducing drugs (e.g. rifampicin, carbamazepine, phenytoin, primidone, barbiturates, bosentan, topiramate, griseofulvin, oxcarbazepine, St. John’s Wort): These drugs increase the clearance of drospirenone and may reduce contraceptive efficacy. Use additional or alternative non-hormonal contraception during treatment and for 28 days after stopping. For long-term enzyme-inducing drug use, consider a non-hormonal method of contraception
• HIV/HCV antiviral medicines (e.g. ritonavir, nelfinavir, nevirapine, efavirenz, boceprevir, telaprevir): Effects on drospirenone levels are variable and may be clinically significant. Consult the prescribing information of the antiviral and consider additional barrier contraception
• CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, fluconazole, clarithromycin, erythromycin, verapamil, diltiazem, grapefruit juice): These can increase drospirenone plasma concentrations, although the clinical significance is not fully established
• Potassium-sparing medicinal products (e.g. aldosterone antagonists, potassium-sparing diuretics, ACE inhibitors at high risk): Because drospirenone has antimineralocorticoid activity, serum potassium levels should be checked during the first treatment cycle when used concurrently
• Cyclosporine: Hormonal contraceptives may increase cyclosporine plasma concentrations
• Lamotrigine: Hormonal contraceptives may reduce lamotrigine plasma concentrations, potentially affecting seizure control

Let your prescribing clinician know about all medications, supplements, and herbal products you are taking before starting Slynd.

Why might Slynd not work for Contraception?

Slynd may be less effective in the following circumstances:

• Missed tablets — if any white active tablet is taken more than 24 hours late, contraceptive protection may be reduced
• Severe gastrointestinal disturbances such as vomiting or diarrhoea within 3–4 hours of taking a tablet may impair absorption — treat as a missed tablet and use additional contraception
• Concurrent use of enzyme-inducing drugs (see interactions section above)
• Incorrect use of the pack — always take tablets in order as directed on the blister

The Pearl Index (a measure of contraceptive failure rate) for Slynd in European clinical trials was 0.73 per 100 women-years, indicating high efficacy when used correctly. If you believe you may be pregnant at any point during treatment, perform a pregnancy test and seek medical advice.

Can Slynd be used long term?

Slynd can be used for as long as your clinician recommends it and contraception is required. Clinical data from trials of up to 13 cycles support its continued tolerability and efficacy. There is currently no maximum duration of use specified in its licensed indication.

One consideration for long-term use is potential effects on bone mineral density, as Slynd reduces circulating oestradiol levels. This is of particular relevance in adolescents during the critical period of bone development, although the long-term clinical impact is not yet fully established. Your prescribing clinician will review your treatment periodically.

How to store Slynd

• Keep Slynd out of the sight and reach of children
• Do not use this medicine after the expiry date shown on the carton and blister pack. The expiry date refers to the last day of that month
• Store below 25°C in a cool, dry place
• Do not dispose of unused Slynd tablets in wastewater or household waste. Ask your pharmacist how to properly dispose of medicines you no longer use. This medicine may pose a risk to the aquatic environment. These steps help protect the environment

Is there a herbal Slynd?

No. Herbal Slynd does not exist. If you have been marketed such a product, it may be counterfeit or unsafe.

Should I avoid any particular food or drink when using Slynd?

You can eat and drink normally while taking Slynd. The tablets can be taken with or without food and food does not affect the absorption of drospirenone.

However, you should be aware that grapefruit juice can increase plasma concentrations of drospirenone as it acts as a CYP3A4 inhibitor. While the clinical significance is not fully established, it is advisable to discuss this with your clinician if you consume grapefruit juice regularly.

Excessive alcohol consumption should also be avoided for general health reasons and because it may impair tablet-taking adherence.

What lifestyle changes can I make to support safe and effective Contraception?

• Take your tablet at the same time each day: Setting a daily phone reminder can help maintain the 24-hour interval and minimise the risk of missed tablets
• Use barrier methods for additional protection: Slynd does not protect against sexually transmitted infections. Condoms should be used if there is any risk of STIs
• Review your medicines regularly: Always tell your prescribing clinician about any new medicines, supplements, or herbal products as some can reduce Slynd’s effectiveness
• Be aware of your bleeding pattern: Irregular bleeding or spotting is common, especially in the first few months. If bleeding is very frequent or heavy, speak to your clinician
• Monitor your mood: Depression and mood disturbances have been reported with hormonal contraceptives. If you experience low mood or depressive symptoms shortly after starting Slynd, contact your clinician
• Attend regular check-ups: Your prescribing clinician should review your contraception annually and whenever your circumstances change (e.g. new health conditions or medicines)
• Don’t smoke: Smoking increases cardiovascular risk, and women using hormonal contraceptives who smoke are at increased risk of adverse cardiovascular events

Alternatives to Slynd

Alternatives for contraception include:

Other progestogen-only pills (POPs)

• Cerelle or Cerazette (desogestrel 75 mcg) — another POP that inhibits ovulation; 12-hour missed-pill window
• Micronor or Noriday (norethisterone 350 mcg) — traditional POP; 3-hour missed-pill window; does not consistently inhibit ovulation

Combined oral contraceptives (COCs)

• Yasmin or Lucette (drospirenone 3 mg + ethinylestradiol 30 mcg) — combined pill also containing drospirenone
• Microgynon 30 or Rigevidon (levonorgestrel + ethinylestradiol) — standard combined pill

Long-acting reversible contraception (LARC)

• Nexplanon (etonogestrel implant) — highly effective; lasts up to 3 years
• Mirena or Levosert (levonorgestrel IUS) — highly effective; lasts up to 5–8 years
• Copper intrauterine device (IUD) — hormone-free option

Your prescriber will help decide which option is most suitable for your medical history, lifestyle, and personal preferences.