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When considering the use of this medication, it is crucial to be aware of the potential for significant bone density reduction, which may not fully recover after discontinuation. The likelihood of bone loss is heightened with prolonged use and in individuals who smoke. Adolescents and young adults are in a critical period for bone development, and the use of this medication can elevate the risk of developing osteoporosis, leading to fragile bones and fractures later in life. It is essential to discuss with your healthcare provider the potential risks and benefits of this medication compared to other contraceptive options.

Key points to consider:

• Avoid using this medication for more than two years for birth control or endometriosis treatment unless no other alternatives are viable.
• Consider your bone health, especially if you are in your teenage or young adult years.
• Discuss thoroughly with your doctor to make an informed decision about your treatment plan.

When taking this medication, you may experience mild side effects such as nausea, bloating, headaches, changes in appetite, weight gain, tiredness, swelling, acne, hot flashes, or breast tenderness. It's common to notice vaginal bleeding between periods or irregular periods, especially at the start of treatment. Some individuals may also experience pain, swelling, redness, or bruising at the injection site. These side effects are generally mild, but if they persist or worsen, consult your healthcare provider.

In some cases, your periods might stop entirely after about a year of using this medication, but they usually return once you stop the treatment. If you miss a period and have also missed an injection, or if more than 14 weeks pass between injections, consider taking a pregnancy test if you suspect pregnancy.

There are more serious side effects that require immediate attention, such as persistent nausea or vomiting, mood changes like depression, changes in sexual interest, swelling of ankles or feet, bone pain, unusual vaginal bleeding, severe abdominal pain, or unusual fatigue. Additionally, if you notice dark urine, yellowing of the skin or eyes, or experience seizures, seek medical help promptly.

This medication can increase the risk of breast cancer, so report any breast lumps or nipple discharge to your doctor immediately. Rare but severe issues like blood clots, which can lead to heart attacks, strokes, or clots in the lungs, legs, or eyes, require urgent medical attention. Symptoms to watch for include shortness of breath, chest pain, unusual sweating, confusion, dizziness, pain or warmth in the legs, severe headaches, trouble speaking, or sudden vision changes.

Allergic reactions to this drug are rare but serious. If you experience rash, itching, swelling, severe dizziness, or difficulty breathing, seek emergency medical care. Always report any other unexpected effects to your healthcare provider.

One medication that can interact with this drug is Warfarin. Additionally, some medications may reduce the effectiveness of hormonal birth control by lowering the levels of birth control hormones in your body, which could lead to pregnancy. These medications include griseofulvin, Modafinil, certain antibiotics like rifamycins (such as Rifampin and Rifabutin), Ritonavir, St. John's wort, seizure medications (such as barbiturates, Carbamazepine, Felbamate, Phenytoin, Primidone, and Topiramate), and some HIV medications (such as nelfinavir and Nevirapine), among others.

It's important to inform your doctor when you begin any new medication and discuss whether you should use an additional, reliable form of birth control. Also, let your doctor know if you experience any unexpected spotting or breakthrough bleeding, as these could indicate that your birth control is not functioning effectively.

This medication might interfere with certain laboratory tests, such as hormone level tests, blood clotting factor tests, and thyroid or liver function tests, potentially causing inaccurate results. Ensure that lab personnel and all your healthcare providers are aware that you are taking this medication.