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This medication comes with important safety information and potential risks that should be carefully considered. Please review the following guidelines and consult your healthcare provider if you have any questions or concerns:

• Smoking and Cardiovascular Risks: If you are a woman over 35 years of age who smokes, do not use this medication. Smoking increases the risk of severe health issues, including stroke, heart attack, and blood clots, especially when using hormonal birth control methods like pills, patches, or rings. The risk escalates with age and the number of cigarettes smoked. Seek alternatives for birth control if you smoke.

• Blood Clots and Strokes: This medication can elevate the risk of blood clots, which may occur in the lungs, legs, brain, or heart. Females over 35 who smoke, those over 40 who do not smoke, individuals with recent surgery, recent childbirth, high blood pressure, obesity, high cholesterol, diabetes, or those on higher doses of estrogen are at increased risk. Seek immediate medical attention if signs of a blood clot appear.

• Irregular Bleeding: Some users may experience irregular bleeding or spotting, which is more common during the initial three months of use. Continue taking the medication as directed, but notify your healthcare provider if this becomes problematic to explore alternative options. If you miss periods, consult your provider or take a pregnancy test.

• Blood Pressure: The use of this medication can lead to increased blood pressure. It is crucial to monitor your blood pressure regularly while on this medication, especially if you have a history of high blood pressure or have used birth control for an extended period. Consult your provider if your blood pressure rises.

• Blood Sugar and Cholesterol: This medication may elevate blood sugar and triglyceride levels, posing a risk for those with prediabetes or diabetes. Consult your provider if you have a history of high blood sugar or triglycerides before starting the medication. Your provider may recommend alternative birth control or closer monitoring.

• Cancer Risks: There is a potential link between this medication and an increased risk of breast and cervical cancer. Discuss your risk factors, especially if you have a history of these cancers, with your healthcare provider.

• Liver Problems: Avoid using this medication if you have liver issues, including infections, severe scarring, or tumors. The medication may increase the risk of benign liver tumors. Seek medical advice if you develop symptoms of liver problems, such as jaundice, fever, fatigue, appetite loss, or dark urine.

• Headaches and Depression: Report new or worsening migraines or headaches to your healthcare provider. If headaches persist or worsen, discontinue use. Additionally, notify your provider if you experience depressive symptoms, as they may advise stopping the medication if depression becomes severe.

In case of an accidental overdose, particularly with iron-containing products, which is a significant risk for children under 6, seek immediate medical help or contact a poison control center. Keep this product out of children's reach.

Consult your healthcare provider if any contraindications apply, such as a history of blood clots, uncontrolled high blood pressure, certain migraines, liver problems, unexplained vaginal bleeding, or current or past breast cancer. Additionally, avoid use if taking hepatitis C medications containing ombitasvir, paritaprevir, and ritonavir.

When taking this medication, you may experience some common side effects that are generally mild. These can include nausea, vomiting, headaches, bloating, and breast tenderness. You might also notice swelling of the ankles or feet due to fluid retention, or changes in weight. Some people experience vaginal bleeding between periods (spotting) or missed/irregular periods, particularly in the first few months of use. It's important to monitor these symptoms, and if they persist or worsen, consult your healthcare provider. Additionally, keep an eye on your blood pressure, as this medication may cause it to rise.

There are also other side effects that some users report, including acne, anxiety, breast pain, and mood changes such as depression. If you encounter these issues, it's advisable to discuss them with your healthcare provider, especially if they are bothersome.

More serious side effects, although rare, require immediate medical attention. These include symptoms of a heart attack like chest pain and dizziness, signs of a stroke such as sudden numbness or difficulty speaking, and indications of blood clots in the legs or lungs, like swelling, pain, or difficulty breathing. Additionally, unusual changes in vaginal bleeding, severe abdominal pain, dark urine, or yellowing of the skin or eyes should prompt urgent medical evaluation. Lastly, though very rare, severe allergic reactions can occur, marked by rash, swelling, or difficulty breathing, necessitating immediate medical care. Always remain vigilant and seek medical advice if you experience any concerning symptoms.

Certain medications may interact with this drug, potentially affecting its effectiveness or causing unwanted effects. These include aromatase inhibitors like anastrozole and exemestane, as well as fezolinetant, ospemifene, tamoxifen, tizanidine, and tranexamic acid. Additionally, some medications may reduce the effectiveness of hormonal birth control by lowering the levels of hormones in your body, which could lead to unintended pregnancy. These drugs include griseofulvin, modafinil, certain antibiotics like rifampin and rifabutin, ritonavir, St. John's wort, medications for seizures such as barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate, and certain HIV medications like nelfinavir and nevirapine.

It is important to inform your doctor whenever you begin a new medication and discuss the need for a reliable backup birth control method. Also, notify your healthcare provider if you notice any new spotting or breakthrough bleeding, as these may indicate that your birth control is not functioning as expected. Furthermore, this medication may interfere with certain laboratory tests, such as those for blood clotting and thyroid function, leading to inaccurate results. Ensure that all healthcare professionals involved in your care are aware that you are using this medication.