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Please be advised of the following important safety information regarding the use of this medication:

• Tobacco Use Warning: Individuals over the age of 35 who smoke or use tobacco should not use this medication. Smoking can significantly increase the likelihood of severe health issues such as stroke, heart attack, blood clots, and high blood pressure when using hormonal birth control methods like the pill, patch, or ring. The risk is higher with increased age and the quantity of cigarettes smoked. It is strongly advised to refrain from smoking or using tobacco while on this medication.

• Iron Product Safety: Accidental overdose of products containing iron is a major cause of fatal poisoning in children under 6 years of age. It is crucial to keep this product out of the reach of children. In the event of an overdose, seek immediate medical assistance or contact a poison control center without delay.

Please ensure you adhere to these precautions to mitigate potential risks associated with this medication.

While using this medication, you may experience common side effects such as nausea, vomiting, headaches, bloating, breast tenderness, fluid retention leading to swollen ankles or feet, and changes in weight. You might also notice spotting or irregular periods, particularly in the initial months. These are generally mild, but if they persist or worsen, consult a healthcare professional.

This medication can sometimes increase blood pressure, so it's important to monitor it regularly. Inform your healthcare provider if you notice an increase in your readings. More serious side effects, although less common, include lumps in the breast, mood changes like worsening depression, severe abdominal pain, unusual vaginal bleeding, dark urine, or yellowing of the skin or eyes. Immediate medical attention is necessary if any of these occur.

Rarely, this medication can lead to serious, potentially life-threatening blood clots, resulting in conditions like heart attacks, strokes, or clots in the lungs or legs. Seek urgent medical help if you experience chest pain, confusion, sudden dizziness, leg pain or swelling, speech difficulties, shortness of breath, severe headaches, unusual sweating, weakness on one side, or vision changes.

Allergic reactions to this drug are very rare but require immediate medical intervention. Symptoms include rash, itching or swelling of the face, tongue, or throat, severe dizziness, and difficulty breathing. If you notice any other unusual effects, contact your healthcare provider for advice.

Certain medications can interact with this drug. These include aromatase inhibitors like Anastrozole and Exemestane, as well as fezolinetant, ospemifene, Tamoxifen, Tizanidine, and Tranexamic Acid. Additionally, some combination treatments for chronic hepatitis C, such as ombitasvir/paritaprevir/Ritonavir, with or without dasabuvir, may also interact.

Some drugs can reduce the effectiveness of hormonal birth control by lowering hormone levels in your body. This can increase the risk of pregnancy. Drugs that might have this effect include griseofulvin, Modafinil, certain antibiotics like rifamycins (Rifampin, Rifabutin), ritonavir, St. John's wort, and certain medications used to treat seizures, such as barbiturates, Carbamazepine, Felbamate, Phenytoin, Primidone, and Topiramate. HIV medications like nelfinavir and Nevirapine can also have this effect.

It's important to inform your doctor when you begin taking any new medication and discuss whether you need to use additional birth control methods. Notify your doctor if you experience any unusual spotting or bleeding, as this could indicate your birth control is not working effectively.

Furthermore, this medication might affect certain lab tests, such as those for blood clotting factors and thyroid function, potentially leading to incorrect results. Ensure that all healthcare providers and lab personnel are aware that you are taking this medication.