Difference between drospirenone-containing oral contraceptives and other oral contraceptives related to risk of venous thromboembolism.

We wish to comment on the Dinger and Shapiro commentary article published in the January 2012 issue of this Journal.1 Following the publication of papers regarding the risk of venous thromboembolism (VTE) with combined oral contraceptives (COCs) we would like to share some information regarding comparison between drospirenonecontaining COCs and other COCs in Croatia. This short study was conducted during the 3-year period 2008–2010 using data on drug utilisation and data on side effects from the Agency for Medicinal Products and Medical Devices of Croatia (HALMED). The total female population aged 15–49 years was about 1 050 000. Like other COCs in Croatia, drospirenone/ethinylestradiol (DRSP/ EE) is issued on private prescription in pharmacies. They are usually prescribed by gynaecologists, but may also be prescribed by other specialists. The DRSPcontaining COC, Yasmin®, existed in the Croatian market from 2005, but the new DRSP-containing COC, Yaz®, was introduced in 2010. Total consumption of COCs in the 3-year period 2008–2010 amounted to 1 274 745 strips of tablets, 504 107 (39.5%) DRSP-containing COCs and 770 638 (60.5%) other COCs (Table 1). Assuming that, with negligible exceptions, the women concerned used their contraceptives regularly during the whole year (corresponding to 13 ‘pilldriven’ cycles) their number would have been 38 778 for DRSP-containing COCs and 59 280 for other COCs. We collected data on the COC prescription rate in Croatia and assessed whether there might be a link with the incidence of VTE. During that period the HALMED recorded 138 side effects and