The third-generation combined oral contraceptive pill, Yasmin®, which contains 30 ug ethinyl estradiol and 3 mg of drospirenone, has been marketed as safe and effective, but the risks of arterial thrombotic events in women using Yasmin® are unknown. We report a case of retinal artery occlusion in a woman using Yasmin®, and review the literature for other cases of arterial thrombotic events in women taking Yasmin®. An extensive search using Pubmed, Ovid, and Medline, revealed three previously reported cases of arterial thrombotic events, in women using Yasmin® (see table below). Similar to the three prior cases, our case study had no known acquired or hereditary thombophilic conditions. Unlike the previous three cases, our subject did not smoke and developed her arterial thrombus late, approximately three years after initiating Yasmin®. It appears that the risk for arterial thrombotic events may occur at anytime. Large scale studies determining relative incidence, as well as post-marketing adverse effects are needed to determine risk and incidence while using Yasmin®.

Studies reporting arterial thrombotic events in women using Yasmin®

AuthorYearAge of patientType of thrombosisDays on OC before thrombosisAssociated risk factorsComments
Vaya, et al. (1) 2003 21 TIA 15 days Smoking (15/day) Apparent recovery 
Cabou, et al. (2) 2006 33 MI 15 days Smoking (6/day), surgery for ectopic pregnancy 15 days before MI Pt had taken 2nd generation OCP in the past without complications, recovered 
Girolami, et al. (3) 2007 18 Central retinal artery occlusion 10 days Smoking (8/day) No recovery, two years after event 
Shum, et al. 2008 21 Central retinal artery occlusion 3 years None Pt had taken 1st generation OCP for 2 years without complications, not yet recovered after 4 months 
AuthorYearAge of patientType of thrombosisDays on OC before thrombosisAssociated risk factorsComments
Vaya, et al. (1) 2003 21 TIA 15 days Smoking (15/day) Apparent recovery 
Cabou, et al. (2) 2006 33 MI 15 days Smoking (6/day), surgery for ectopic pregnancy 15 days before MI Pt had taken 2nd generation OCP in the past without complications, recovered 
Girolami, et al. (3) 2007 18 Central retinal artery occlusion 10 days Smoking (8/day) No recovery, two years after event 
Shum, et al. 2008 21 Central retinal artery occlusion 3 years None Pt had taken 1st generation OCP for 2 years without complications, not yet recovered after 4 months 
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Topics:
combined oral contraceptives, drospirenone/ethinyl estradiol, retinal artery occlusion, thrombus, central retinal artery occlusion, thrombosis, adverse effects, drospirenone, ectopic pregnancy, ethinyl estradiol

Disclosures: No relevant conflicts of interest to declare.

Author notes

Corresponding author

2008, The American Society of Hematology
2008
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