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The following safety information outlines important warnings and contraindications associated with the use of Junel 1/20, a combined oral contraceptive (COC). It is crucial for users to consider these details and discuss any concerns with their healthcare provider.

• Cigarette Smoking and Cardiovascular Risks: Using Junel 1/20 can significantly increase the risk of serious cardiovascular events such as strokes, heart attacks, and blood clots, particularly in females over 35 who smoke. If you smoke, consult your healthcare provider to explore safer contraceptive options.

• Blood Clots and Stroke Risks: There is an elevated risk of blood clots, which may lead to pulmonary embolism, deep vein thrombosis, stroke, or heart attack. Those at higher risk include females over 35 who smoke, individuals over 40, those with recent surgery, high blood pressure, obesity, high cholesterol, diabetes, or those starting Junel 1/20 shortly after childbirth.

• Irregular Bleeding: Users may experience irregular bleeding or spotting, especially in the first three months. This may vary from light spotting to bleeding similar to a period. Continue taking the medication as prescribed, and consult your provider if bleeding becomes problematic. If you miss a period, take a pregnancy test or contact your provider.

• High Blood Pressure: Junel 1/20 may raise blood pressure. Regular monitoring is advised, and individuals with pre-existing high blood pressure or kidney problems should discuss alternative birth control methods with their provider.

• High Blood Sugar and Cholesterol: The medication can elevate blood sugar and cholesterol levels. Individuals with diabetes, prediabetes, or high cholesterol should have regular monitoring if they use Junel 1/20.

• Headaches and Migraines: Report any new or worsening headaches or migraines to your provider. Discontinuation of the medication may be necessary if these symptoms persist or become severe.

• Cancer Risks: Some studies suggest a potential increased risk of breast and cervical cancer with prolonged use of COCs like Junel 1/20. Those with a personal or family history of these cancers should exercise caution.

• Drug Interactions: Certain medications, such as carbamazepine and phenytoin, may reduce the effectiveness of Junel 1/20. Use additional contraception for 28 days after stopping these medications. Inform your healthcare provider of all medications to avoid adverse interactions.

Contraindications: Do not use Junel 1/20 if you have:

• A history of blood clots or conditions predisposing to clotting
• Cerebral vascular or coronary artery disease
• Current or past breast cancer
• Unexplained vaginal bleeding
• Jaundice during pregnancy or previous birth control use
• Liver tumors or cancer
• Pregnancy
• Concurrent use of certain hepatitis C medications

Consult your healthcare provider promptly if any of these conditions apply to you before starting Junel 1/20.

Common side effects:

• Nausea
• Vomiting
• Stomach cramps
• Bloating
• Bleeding between periods
• Spotting
• Changes in menstrual flow
• Missed periods
• Swelling
• Breast changes
• Weight fluctuations
• Mental depression
• Vaginal yeast infections

Less common but important to monitor:

• Skin conditions with brown spots or patches
• Migraines
• Allergic rashes

Serious side effects:

• Heart attack symptoms (chest pain, stomach discomfort, sweating, nausea, dizziness)
• Stroke signs (sudden numbness or weakness, confusion, vision problems, headache, difficulty walking)
• Deep vein thrombosis (leg cramps, swelling, pain, muscle tightness)
• Pulmonary embolism (cough, chest pain, trouble breathing, racing heart)