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This safety and warning information is essential for those considering or currently using Pirmella 1/35. It outlines potential risks, necessary precautions, and specific instructions for individuals with certain conditions or lifestyles. If you have any questions or concerns, please consult your healthcare provider.

• Cigarette Smoking and Heart Risks: Using Pirmella 1/35 while smoking cigarettes significantly increases the risk of serious heart conditions, such as heart attack and stroke, especially for women over 35 years old. Discuss alternative birth control options with your healthcare provider if you are a smoker.

• Blood Clot Risk: Pirmella 1/35 may lead to serious, potentially life-threatening blood clots due to its ethinyl estradiol content. This risk is elevated for women over 35 who smoke, individuals over 40 who do not smoke, those who have recently had surgery with prolonged bed rest, women who start COCs within a month after childbirth, people with high blood pressure, obesity, high cholesterol, diabetes, or those taking higher doses of estrogen. Be vigilant for symptoms of blood clots and seek immediate medical attention if they occur.

• Cancer Risk: The relationship between Pirmella 1/35 and increased risk of breast and cervical cancer is uncertain. However, prolonged use (over 5 years) may heighten the risk of cervical cancer. Avoid this medication if you have a history of breast or cervical cancer. Ensure regular screenings and consult your provider if you notice signs of these cancers.

• Liver Issues: Avoid Pirmella 1/35 if you have liver problems, such as viral hepatitis or liver tumors. This medication can increase the risk of benign liver tumors. Discontinue use and consult your provider if you experience symptoms like jaundice, fever, fatigue, loss of appetite, or dark urine.

• Gallbladder Concerns: Some evidence suggests Pirmella 1/35 may increase the risk of gallbladder disease. Discuss your medical history regarding gallbladder issues with your provider before starting this medication.

• Blood Sugar and Triglycerides: Pirmella 1/35 can elevate blood sugar and triglyceride levels. This poses a higher risk for individuals with prediabetes or diabetes. Consult your provider to assess your risk and possibly consider alternative birth control methods.

• Blood Pressure: This medication may raise blood pressure, particularly in older individuals or those with a history of kidney issues or uncontrolled hypertension. Regularly monitor your blood pressure and discuss the risks versus benefits of using Pirmella 1/35 with your provider.

• Headaches: Inform your provider if you develop new or worsening migraines or headaches while taking Pirmella 1/35. Discontinuation may be necessary if symptoms persist or worsen.

• Irregular Bleeding: Irregular bleeding or spotting is common during the first three months of using Pirmella 1/35. If bleeding persists, becomes heavier, or you miss a period, contact your provider for evaluation.

• Drug Interactions: Be aware that certain medications can alter how your body processes Pirmella 1/35, affecting its efficacy and side effects. Discuss all medications you are taking with your provider.

Contraindications: Do not use Pirmella 1/35 if you have or have had:

• Deep vein thrombosis (DVT), pulmonary embolism (PE), or other clotting disorders
• Cerebrovascular disease
• Coronary artery disease
• Specific heart valve issues
• Uncontrolled high blood pressure
• Diabetes with vascular complications
• Specific headaches with neurological symptoms
• Long-term post-surgical bed rest
• Breast cancer history
• Endometrial or other estrogen-dependent tumors
• Unexplained vaginal bleeding
• Jaundice in pregnancy or during birth control use
• Liver tumors or problems
• Pregnancy
• Currently taking hepatitis C medications containing ombitasvir, paritaprevir, ritonavir, with or without dasabuvir.

Always consult your healthcare provider to ensure Pirmella 1/35 is safe for you.

Common side effects:

• Nausea
• Vomiting
• Abdominal cramps
• Bloating
• Changes in menstrual cycle
• Spotting
• Change in flow
• Missed periods
• Swelling
• Brown patches on the face
• Tender or swollen breasts
• Fluctuations in weight
• Migraines

Less common but important to monitor:

• Vaginal yeast infections
• Discomfort when wearing contact lenses
• Mood changes
• Fatigue
• Rashes

Serious side effects:

• Heart attack
• Stroke
• Deep vein thrombosis
• Pulmonary embolism
• Liver problems