The US Food and Drug Administration (FDA) today approved Beyaz tablets, an estrogen/progestin combined oral contraceptive that also contains a folate (levomefolate calcium 0.451 mg).
Levomefolate calcium is a metabolite of folic acid, a water-soluble B-vitamin that helps produce and maintain new cells in the body. A known association of low folate levels and neural tube defects (e.g., spina bifida) has resulted in recommendations that women of childbearing age supplement their diet with folate.
However, a recent study concerning folic acid supplements and kids' asthma found that, "...supplemental folic acid in late pregnancy was associated with an increased risk of asthma in children, but there was no evidence to suggest any adverse effects if supplements were taken in early pregnancy." The study cautions and recommends that women correctly follow current health guidelines that women consume a supplemental dose of 400 micrograms of folic acid per day in the month preceding and during the first trimester of pregnancy to reduce the risk of neural tube defects in children.
Beyaz is based on the approved product YAZ, which contains the same doses of estrogen and progestin, and is approved for:
• Prevention of pregnancy
• Treatment of symptoms of premenstrual dysphoric disorder (PMDD) in women who choose to use an oral contraceptive for contraception and
• Treatment of moderate acne vulgaris in women at least 14 years of age, only if the patient desires an oral contraceptive for birth control.
In addition to the approved YAZ indications, Beyaz also is approved for the secondary indication in women who choose to use an oral contraceptive as their method of contraception, to raise folate levels for the purpose of reducing the risk of a neural tube defect in a pregnancy conceived while taking the product or shortly after discontinuing the product.
The primary efficacy study for Beyaz was a multicenter, double-blind, randomized, controlled U.S. trial in 379 healthy women age 18 to 40 who were treated with Beyaz or YAZ alone for up to 24 weeks. Beyaz was found to increase folate levels in women. In a German study of Beyaz, folate levels remained elevated for several weeks following discontinuation of Beyaz. Safety and efficacy data for contraception, PMDD and acne indications were obtained from previous YAZ clinical trials.
The most common side effects reported by users of combined oral contraceptives are irregular uterine bleeding, nausea, breast tenderness and headaches. Other serious side effects include vascular events (blood clots) and liver disease. Women over age 35 who smoke should not use this product as cigarette smoking increases further the risk of serious cardiovascular events. The common adverse events for Beyaz are expected to be the same as those for YAZ. There were no findings from the clinical trials with Beyaz to suggest a change in the overall safety profile compared to that of YAZ.
Both Beyaz and YAZ manufactured by Bayer HealthCare Pharmaceuticals Inc., the US-based business arm of Bayer HealthCare LLC, a subsidiary of Bayer AG.
FDA Contact: Elaine Gansz Bobo, 301-796-7567, elaine.bobo@fda.hhs.gov
