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When considering the use of this medication, it's important to be aware of specific safety warnings and precautions:

• If you are over 35 years old and smoke cigarettes or use tobacco, you should not use this medication. Smoking can significantly increase the risk of serious health issues such as stroke, heart attack, blood clots, and high blood pressure when combined with hormonal birth control methods like pills, patches, or rings. The likelihood of these complications rises with age and the amount of tobacco used. It is advisable to avoid smoking or using tobacco while on this medication.

• Be aware that iron-containing products can lead to accidental overdose, which is a significant cause of fatal poisoning in children under 6 years of age. To prevent such incidents, always store this product out of children’s reach.

• In the event of an overdose, it is crucial to seek medical assistance immediately or contact a poison control center for guidance.

You may experience mild side effects such as nausea, vomiting, headache, bloating, breast tenderness, or swelling in the ankles and feet due to fluid retention. Sometimes, weight changes and spotting or irregular periods might occur, particularly during the initial months of use. These effects are generally manageable, but if they persist or worsen, consult a healthcare professional.

Monitoring your blood pressure is important, as this medication can cause it to rise. Notify your healthcare provider if you observe high readings. Be aware of more serious side effects, such as lumps in the breast, changes in mood like depression, severe abdominal pain, or unusual changes in vaginal bleeding. These require prompt medical attention.

Rarely, the medication may lead to severe complications from blood clots, including heart attack, stroke, or clots in the lungs or legs. Seek immediate medical help if you experience chest or jaw pain, sudden dizziness, swelling or warmth in the calf, difficulty speaking, shortness of breath, intense headaches, or any sudden changes in vision or weakness on one side of the body.

Allergic reactions to this drug are uncommon but can be serious. If you notice symptoms such as rash, swelling, severe dizziness, or difficulty breathing, get medical assistance immediately. If you experience any other unusual effects, reach out to a healthcare provider for advice.

Some medications that could interact with this drug include aromatase inhibitors (like anastrozole and exemestane), fezolinetant, ospemifene, tamoxifen, tizanidine, tranexamic acid, and specific combination medications for chronic hepatitis C (such as ombitasvir/paritaprevir/ritonavir, with or without dasabuvir). Additionally, certain drugs may reduce the effectiveness of hormonal birth control by lowering the levels of birth control hormones in your body, potentially leading to pregnancy. These include griseofulvin, modafinil, rifamycins (like rifampin and rifabutin), ritonavir, St. John's wort, and medications for seizures (such as barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate), as well as certain HIV medications (like nelfinavir and nevirapine), among others.

Inform your doctor when starting any new medication, and discuss whether you should use an additional reliable form of birth control. Also, notify your doctor if you experience any unexpected spotting or breakthrough bleeding, as these could indicate that your birth control is not functioning effectively. This medication might also affect certain laboratory tests (such as those for blood clotting factors and thyroid function), potentially resulting in inaccurate test results. Ensure that lab personnel and all your healthcare providers are aware that you are using this medication.