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This safety and warning guide is designed to inform you about the potential risks and necessary precautions when using this medication. Please read carefully and discuss any concerns with your healthcare provider.

• Medication Interactions: Inform your healthcare provider or pharmacist about all medications and supplements you are currently taking before beginning norethindrone. This will help identify any potential interactions.

• Ectopic Pregnancy or Ovarian Cyst: There is a slight risk of an ectopic pregnancy if you become pregnant while on norethindrone. This condition is serious. Seek immediate medical attention if you experience lower abdominal or shoulder pain, which may indicate an ectopic pregnancy.

• Irregular Vaginal Bleeding: Irregular bleeding is a common effect of progestin-only pills (POPs) like norethindrone. On rare occasions, it may suggest a more serious issue such as an infection or cancer. Consult your healthcare provider if you experience irregular bleeding or if there is an absence of bleeding, to rule out pregnancy.

• Possible Cancer Risk: While some studies have linked combination birth control pills to an increased risk of breast or ovarian cancer, it is unclear if norethindrone or other POPs pose the same risk. Discuss any concerns about cancer risks with your healthcare provider.

Contraindications: The following conditions indicate you should not use this medication due to potential serious health risks:

• Pregnancy
• Confirmed or suspected breast cancer
• Unexplained bleeding between periods
• Liver tumors (benign or cancerous)
• Acute liver disease

If any of these contraindications apply to you, consult your healthcare provider before using this medication.

When using this medication, some individuals may encounter common side effects such as nausea, vomiting, headaches, bloating, breast tenderness, or weight gain. Additionally, spotting or irregular periods can occur. These effects are usually mild, but if they persist or worsen, it is advisable to consult your healthcare provider.

There are some rare but serious side effects that warrant immediate medical attention. These include lumps in the breast, significant mood changes like new or worsening depression, severe stomach or abdominal pain, and unusual changes in vaginal bleeding patterns. Also, watch for symptoms such as dark urine and yellowing of the eyes or skin, as these could indicate a serious condition.

Though rare, an ectopic pregnancy, which may present as stomach pain and spotting, is a serious side effect that requires urgent care. Furthermore, any signs of a severe allergic reaction, such as a rash, itching or swelling (especially of the face, tongue, or throat), severe dizziness, or difficulty breathing, should prompt immediate medical attention. Always report any side effects you experience to your healthcare provider to ensure your safety and well-being.