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Experiencing nausea, vomiting, headaches, abdominal cramps, bloating, and breast tenderness is common and usually not a cause for concern. Some individuals may notice swelling in the ankles or feet due to fluid retention, or changes in weight. Spotting or irregular periods might occur, particularly in the initial months of use. Should these effects persist or worsen, it's important to consult your healthcare provider.

Monitoring your blood pressure is advisable as this medication can sometimes elevate it. If you find your readings to be consistently high, alert your healthcare provider. In rare cases, more serious side effects may develop, such as breast lumps, mood changes like depression, unusual vaginal bleeding, high potassium symptoms such as muscle weakness or irregular heartbeat, severe stomach pain, yellowing of the skin or eyes, and dark urine. Immediate medical attention is necessary if these occur.

Though extremely rare, this medication can lead to serious and sometimes fatal blood clot complications, such as heart attacks or strokes. Seek urgent medical help if you notice symptoms like shortness of breath, chest pain, sudden dizziness, severe headaches, speech difficulties, or vision changes. Additionally, a severe allergic reaction is improbable but requires emergency care if signs such as rash, swelling, or breathing troubles appear.

While this is not an exhaustive list of potential side effects, it's crucial to discuss any unusual symptoms with your healthcare provider to ensure your safety and well-being.

Certain medications can interact with this drug, potentially altering its effectiveness or causing side effects. These include aromatase inhibitors like anastrozole, exemestane, and letrozole; atazanavir/cobicistat; fezolinetant; ospemifene; tamoxifen; tranexamic acid; and some hepatitis C treatments (ombitasvir/paritaprevir/ritonavir, with or without dasabuvir). Additionally, drospirenone may increase potassium levels in your blood. Inform your doctor if you regularly take medications that can also elevate potassium, such as aliskiren, ACE inhibitors (e.g., enalapril, lisinopril), angiotensin receptor blockers (e.g., losartan, valsartan), heparin, NSAIDs (e.g., ibuprofen, naproxen), or potassium-sparing diuretics (e.g., eplerenone, spironolactone, triamterene).

Some drugs could reduce the effectiveness of hormonal birth control by lowering hormone levels, which may lead to pregnancy. These include griseofulvin, modafinil, certain rifamycins (e.g., rifampin, rifabutin), ritonavir, St. John's wort, seizure medications (e.g., barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate), and some HIV treatments (e.g., nelfinavir, nevirapine). Always inform your doctor when starting a new medication and discuss whether you need additional birth control methods. Notify your doctor if you experience unexpected spotting or breakthrough bleeding, as these may indicate reduced birth control effectiveness.

This drug might affect certain laboratory tests, like those for clotting factors and thyroid function, potentially leading to inaccurate results. Ensure all healthcare providers and lab personnel are aware you are taking this medication.