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The use of this medication requires careful consideration of certain safety and warning information to manage potential risks effectively. Below are key precautions and guidelines to follow:

• Cigarette Smoking and Heart Health: If you are over 35 and smoke, using combined hormonal contraceptives (CHCs) such as Annovera (segesterone acetate / ethinyl estradiol) can significantly increase your risk of developing serious blood clots, heart attacks, or strokes. Seek alternative birth control options with your healthcare provider if this applies to you.

• Blood Clot Risk: Annovera may elevate your risk of blood clots, which can affect the eyes, heart, and brain. Those with conditions like high blood pressure, high blood sugar, or a personal or family history of blood clots should consult a healthcare provider before use. Be vigilant for symptoms of clots and notify a professional if they occur.

• High Blood Pressure: This medication can increase blood pressure. It should not be used if you have uncontrolled high blood pressure or related blood vessel damage. Regular monitoring is advised if you have controlled blood pressure.

• Blood Sugar and Cholesterol Levels: Annovera may raise blood sugar and triglyceride levels. Individuals with diabetes, especially those over 35 or with high blood pressure, should consult their primary care provider to assess safety before use. Regular monitoring of blood sugar is recommended.

• Liver and Gallbladder Issues: Long-term use of CHCs may heighten the risk of liver problems or tumors and gallbladder issues. If you experience symptoms like jaundice, stomach pain, or dark urine, seek medical advice promptly.

• Menstrual Changes: Users may experience changes in their menstrual cycle, such as breakthrough bleeding or missed periods. If you miss two consecutive periods, take a pregnancy test and inform your healthcare provider if abnormal bleeding persists.

• Depression: Monitor for mood changes or symptoms of depression, especially if you have a history of the condition, and consult a healthcare professional if needed.

• Toxic Shock Syndrome (TSS): Although rare, TSS has been linked to vaginal ring use. Watch for signs like flu-like symptoms or headaches, especially if using a tampon concurrently. Remove Annovera and seek immediate medical attention if symptoms occur.

• Cancer Risks: There is some evidence suggesting a potential increase in the risk of breast and cervical cancer with prolonged CHC use. Discuss any concerns and report symptoms such as lumps or unusual bleeding to your healthcare provider.

Contraindications:

• Do not use if you have a high risk of blood clots, history of stroke or heart attack, are over 35 and smoke, or have certain migraines.
• Avoid if you have uncontrolled high blood pressure, diabetes with complications, liver diseases, or are pregnant.
• Refrain from use if you have a history of breast cancer or unexplained vaginal bleeding.
• Certain hepatitis C medications may interact adversely with this contraceptive; consult your healthcare provider if applicable.

In case of an overdose or if any severe reactions occur, seek emergency medical help immediately. Always consult your healthcare provider to ensure this medication is suitable for you, considering your specific health conditions and lifestyle factors.

When using this medication, some individuals may experience mild side effects, which are generally not cause for concern, but should still be monitored. Commonly reported effects include headaches or migraines, affecting 39% of users, along with nausea and vomiting in 25%. Some may experience vaginal discomfort, such as rash or pain while urinating, indicative of yeast infections (15%), and stomach pain is noted in 14%. Period cramps, breast tenderness, and vaginal discharge are also common, with 13%, 10%, and 12% of users experiencing these respectively. Symptoms of urinary tract infections, such as frequent urge to urinate, are seen in 10% of cases. Additionally, diarrhea and changes in menstrual bleeding patterns might occur.

It is crucial to be aware of the more severe side effects, which, although rare, require immediate medical attention. These include signs of a stroke, such as confusion, numbness on one side, and vision changes, or a heart attack, characterized by dizziness and chest pain. Pulmonary embolism, marked by difficulty breathing and fast heartbeat, and deep venous thrombosis, indicated by leg cramps and swelling, are serious conditions to watch for. Liver problems may present as yellowing of the skin or eyes and dark urine. Additionally, toxic shock syndrome, a potentially fatal bacterial infection, may manifest through flu-like symptoms and sudden skin redness.

In rare cases, an allergic reaction may occur, presenting with symptoms such as rash, itching, and swelling, particularly of the face or throat, which require urgent medical help. Always remain attentive to your body's reactions and consult a healthcare provider if any unusual or severe symptoms arise.

Certain medications and products may interact with this drug, affecting its effectiveness. Notably, aromatase inhibitors like Anastrozole and Exemestane, fezolinetant, ospemifene, Tamoxifen, Tizanidine, and Tranexamic Acid are known to interact. It is important to avoid using oil-based or silicone-based vaginal lubricants or medications, as they can reduce the effectiveness of this product. Water-based vaginal products do not have this effect. Consult your doctor or pharmacist if you have any questions.

Additionally, some medications can decrease the levels of hormonal birth control in your body, potentially leading to pregnancy. Such medications include griseofulvin, Modafinil, certain rifamycins (like Rifampin and Rifabutin), Ritonavir, St. John's wort, and drugs used to treat seizures (such as barbiturates, Carbamazepine, Felbamate, Phenytoin, Primidone, Topiramate), as well as some HIV medications (like nelfinavir and Nevirapine). Always inform your doctor when starting a new medication and discuss the potential need for additional non-hormonal birth control methods. If you experience spotting or breakthrough bleeding, notify your doctor, as these can indicate that your birth control may not be fully effective.

This medication may also interfere with various laboratory tests, potentially leading to incorrect results. Ensure that all healthcare professionals involved in your care are aware that you are using this medication.