Drospirenone / Ethinyl Estradiol / Levomefolate (Beyaz / Safyral / Tydemy)

How Medicare covers it

Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Prevention of pregnancy in females of reproductive potential; treatment of symptoms of premenstrual dysphoric disorder (PMDD) in females who choose an oral contraceptive for birth control; treatment of moderate acne in females at least 14 years old who desire an oral contraceptive for birth control; and raising folate levels in females who choose an oral contraceptive, which lowers the risk of a neural tube birth defect if pregnancy occurs during or shortly after use.

What it is for, in depth

Beyaz is a monthly birth control pill with a built-in folate safeguard. Its 24 pink active tablets pair 3 mg drospirenone with 0.02 mg ethinyl estradiol to prevent pregnancy by suppressing ovulation, and every tablet in the pack — including the 4 light orange placebo-week tablets — carries 0.451 mg levomefolate calcium, an active folate form that raises folate levels so that if a pregnancy does happen during or soon after use, the risk of a neural tube birth defect is lower. Beyond birth control, the label also covers PMDD symptoms in women who choose a pill for contraception, and moderate acne in patients at least 14 who desire an oral contraceptive. It carries the standard combined-pill cautions — no use in smokers over 35, blood-clot warnings (with a note that drospirenone pills may carry higher VTE risk than some other progestin pills), and potassium checks because drospirenone can raise potassium.

How it works

Combination oral contraceptives lower the risk of pregnancy mainly by suppressing ovulation. Beyaz pairs drospirenone (a progestin) with ethinyl estradiol (an estrogen), and adds levomefolate calcium — a folate (vitamin B9 form) — in both the active tablets and the placebo-week tablets to raise folate levels.

How it is taken

Beyaz comes as a 28-tablet blister pack: 24 pink tablets, each with 3 mg drospirenone, 0.02 mg ethinyl estradiol, and 0.451 mg levomefolate calcium, followed by 4 light orange tablets with 0.451 mg levomefolate calcium only. Take one tablet by mouth at the same time every day, in the order directed on the blister pack.

Common side effects

['Irregular uterine bleeding or amenorrhea (missed periods) — the label calls for evaluating irregular bleeding or amenorrhea', "The label extract's adverse-reaction section does not list a separate set of common side effects; it points to the serious reactions with combined oral contraceptives that are listed under serious warnings"]

Serious warnings

['Vascular risks, including blood clots — stop Beyaz if a clot event occurs, stop it at least 4 weeks before and through 2 weeks after major surgery, and start it no earlier than 4 weeks after delivery in women who are not breastfeeding; drospirenone-containing pills may carry a higher risk of venous thromboembolism (VTE) than pills with levonorgestrel or some other progestins (see boxed warning)', 'Hyperkalemia (high potassium) — drospirenone has anti-mineralocorticoid activity; do not use in patients predisposed to high potassium, and check potassium during the first treatment cycle in women on long-term treatment with drugs that can raise potassium', 'Liver disease — stop Beyaz if jaundice occurs', 'High blood pressure — do not prescribe Beyaz for women with uncontrolled hypertension or hypertension with vascular disease', 'Carbohydrate and lipid effects — monitor prediabetic and diabetic women, and consider another method for women with uncontrolled dyslipidemia (uncontrolled blood fats)', 'Headache — evaluate a significant change in headaches and stop Beyaz if indicated']

Boxed warning

Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive (COC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, COCs, including Beyaz, should not be used by women who are over 35 years of age and smoke.

Who should be careful

['Women over 35 who smoke (contraindication — see boxed warning)', 'Women with renal impairment or adrenal insufficiency (contraindications, because of high-potassium risk)', 'Women with current or past deep vein thrombosis or pulmonary embolism, cerebrovascular or coronary artery disease, clotting disorders, or uncontrolled hypertension', 'Women with diabetes with vascular disease, or headaches with focal neurological symptoms, or migraine with or without aura if over age 35', 'Women with current or past breast cancer, liver tumors (benign or malignant), or liver disease', 'Women with undiagnosed abnormal uterine bleeding', 'People who are breastfeeding — combined oral contraceptives can reduce milk production']

Major interactions

["The label extract's interaction section advises checking the labeling of all other drugs being taken for interactions with hormonal contraceptives or enzyme changes, and does not name specific interacting drugs in the extract", 'Drugs that can raise serum potassium — potassium is checked during the first treatment cycle in women on long-term treatment with such drugs, because drospirenone can raise potassium', 'Hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir — Beyaz must not be used with them, because of the potential for ALT (liver enzyme) elevations']

Cost and saving notes

Beyaz and its equivalents (Safyral, Tydemy) sit on Tier 2 in most of the Part D plans that list them — a low-cost tier — and about a third of plans list the combination. Ask the plan about prior authorization if it applies, and check Extra Help if your income is limited. The 2027 Part D out-of-pocket cap is $2,400 for the year, and the Medicare Prescription Payment Plan can spread drug costs across the year.

Why it is in its tier

Drospirenone / Ethinyl Estradiol / Levomefolate (Beyaz / Safyral / Tydemy) sits on Tier 2 in 76.98% of the plans that list it (1361 of 1768 listing plans). Tier 2 is the generic tier — low copays. The data-visible drivers: It is a generic product, and the CMS dashboard puts its average Part D spending at about $636 per beneficiary for 2024 — a relatively low-cost drug, which matches where plans place it. Only 32.17% of Part D plans list it at all, so many readers will find their plan does not list it and covers a similar drug instead. The tier shown is the most common one; individual plans vary.

Sources

• BEYAZ (DROSPIRENONE/ETHINYL ESTRADIOL/LEVOMEFOLATE CALCIUM AND LEVOMEFOLATE CALCIUM) KIT [BAYER HEALTHCARE PHARMACEUTICALS INC.] — DailyMed
• MedlinePlus — National Library of Medicine
• MedlinePlus Drug Information

What official patient guides say

Ethinyl estradiol, drospirenone, and levomefolate oral contraceptives (Beyaz, Safyral, and Tydemy) — in the packaged forms, 28-tablet packs: Beyaz with 24 active tablets (3 mg drospirenone / 0.02 mg ethinyl estradiol / 0.451 mg levomefolate calcium) followed by 4 levomefolate-only tablets, and Safyral and Tydemy with 21 active tablets (3 mg drospirenone / 0.03 mg ethinyl estradiol / 0.451 mg levomefolate calcium) followed by 7 levomefolate-only tablets — come as tablets to take by mouth, taken once a day on the days specified by your doctor, at the same time on those days; your doctor will tell you when you should start taking your oral contraceptive (it is usually started on the first day of your menstrual period or on the first Sunday after bleeding begins), you will probably be told to use another method of birth control during the first 7 days that you take your oral contraceptive, you will probably experience withdrawal bleeding similar to a menstrual period while you are taking the inactive tablets and should start taking your new packet on schedule even if you are still bleeding, and if you vomit or have diarrhea while you are taking it, it may not work as well — if this happens, contact your doctor about what to do, as you may be told to use a back-up method for 7 days — and unless your doctor tells you otherwise, continue your normal diet. If you miss doses of your oral contraceptive, you may not be protected from pregnancy and you may need to use a backup method of birth control for 7 days or until the end of the cycle; every brand of oral contraceptives comes with specific directions to follow if you miss one or more doses, so carefully read the directions in the manufacturer's information for the patient that came with your oral contraceptive when you first start taking it, and if you have any questions, call your doctor or pharmacist. Keep the medication in the container it came in, tightly closed and out of reach of children, stored at room temperature and away from excess heat and moisture (not in the bathroom), and keep all appointments with your doctor and the laboratory — you should have a complete physical examination every year, including blood pressure measurements, breast and pelvic exams, and a Pap test, and before having any laboratory test, tell your doctor and the laboratory personnel that you are taking ethinyl estradiol, drospirenone, and levomefolate oral contraceptives.

Source: MedlinePlus Drug Information

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 8.30988 per unit (BEYAZ 28 TABLET) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 1,768 list Drospirenone / Ethinyl Estradiol / Levomefolate (Beyaz / Safyral / Tydemy) — 32.2% of plans. Most of those plans put it on Tier 2: 1,361 plans, 77.0% of the plans that list it. Other plans place it on Tier 3 (301 plans), Tier 4 (79 plans) or Tier 1 (27 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 2; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 2; Aetna Medicare Value Plus (PPO) puts it on Tier 2. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.