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This medication requires careful consideration due to various associated risks and special precautions. Below are important safety warnings and instructions to follow to ensure proper use and reduce potential health risks.

• Smoking and Heart Risks: If you are 35 years or older and smoke, avoid using this medication, as it significantly increases the risk of stroke, heart attack, and blood clots. Smoking also elevates blood pressure when using hormonal contraceptives like Generess Fe. Seek alternative birth control options through your healthcare provider if you smoke.

• Blood Clots and Strokes: This medication can elevate the risk of blood clots, which can lead to serious conditions such as pulmonary embolism, deep vein thrombosis, stroke, and heart attack. Seek immediate medical attention if you exhibit symptoms of a clot. High-risk groups include females over 35 who smoke, those with recent surgery, obesity, high cholesterol, diabetes, or high estrogen levels.

• Irregular Bleeding: Users may experience irregular bleeding or spotting, particularly in the initial three months. Continue taking the medication as directed, and consult your provider if bleeding is problematic or if menstruation is missed.

• High Blood Pressure: Monitoring blood pressure is crucial, as this medication may cause an increase, particularly in older females or long-term users. Consult your provider if you experience elevated blood pressure to explore safer contraceptive methods.

• High Blood Sugar and Cholesterol: This medication can increase blood sugar and triglyceride levels, posing a higher risk for individuals with prediabetes or diabetes. Discuss with your provider if you have a history of these conditions, as closer monitoring or alternative contraception might be necessary.

• Cancer Risks: There is potential risk for breast and cervical cancer with prolonged use of this medication. Discuss with your provider if you have a history of these cancers.

• Liver Issues: Avoid this medication if you have liver problems, such as infections, severe scarring, or tumors. Look out for symptoms like jaundice, fever, fatigue, appetite loss, or dark urine and stop the medication if these occur.

• Headaches and Migraines: Report any new or worsening migraines to your provider. Severe cases may require discontinuation of the medication.

• Depression: If you experience new or worsening symptoms of depression, inform your provider. Severe depression may necessitate stopping the medication.

• Contraindications: This medication should not be used in certain conditions, such as:

  • Females over 35 who smoke.
  • Current or history of blood clots, heart attacks, or strokes.
  • Uncontrolled high blood pressure or diabetes with complications.
  • Severe migraine headaches with aura or vision changes.
  • Liver problems, unexplained vaginal bleeding, or breast cancer.
  • Use with certain hepatitis C medications.

In case of overdose, particularly for iron-containing products, seek immediate medical assistance or contact a poison control center, as it can be deadly for children under 6 years old. Always keep this product out of children's reach.

When taking this medication, some common side effects may include nausea, vomiting, headaches or migraines, and mood changes such as depression. These effects are usually mild, but if they persist or worsen, it is advisable to consult with your healthcare provider. Additionally, you may experience painful periods, acne, anxiety, breast pain or tenderness, and weight gain.

More serious side effects, though rare, demand immediate medical attention. These include symptoms indicative of a heart attack, such as chest pain, stomach discomfort, sweating, nausea, and dizziness. Signs of a stroke, such as sudden numbness or weakness in the arm, leg, or face, confusion, trouble seeing, headaches, or difficulty walking, should also be urgently addressed. Blood clots, such as deep vein thrombosis (manifesting as leg cramps, swelling, pain, muscle tightness) or pulmonary embolism (evident through coughing, chest pain, trouble breathing, or a racing heart) are critical conditions requiring prompt medical care.

It is important to monitor your health while on this medication and keep an eye out for any unusual symptoms. Rarely, a serious allergic reaction can occur, presenting as rash, itching, swelling (particularly of the face, tongue, or throat), severe dizziness, or trouble breathing. If you experience any severe side effects or other symptoms not listed, contact your healthcare provider without delay to ensure your safety and well-being.

Certain medications may interact with this drug, affecting its efficacy or safety. These include aromatase inhibitors like anastrozole and exemestane, as well as medications such as fezolinetant, ospemifene, tamoxifen, tizanidine, and tranexamic acid. Additionally, some drugs can reduce the effectiveness of hormonal birth control by lowering hormone levels, potentially leading to unintended pregnancy. These drugs include griseofulvin, modafinil, certain rifamycins (e.g., rifampin, rifabutin), ritonavir, St. John's wort, and medications for seizures like barbiturates, carbamazepine, felbamate, phenytoin, primidone, and topiramate, as well as certain HIV drugs such as nelfinavir and nevirapine.

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

This medication can also interfere with specific lab tests, including those measuring blood clotting factors and thyroid function, potentially leading to inaccurate results. Ensure that all healthcare providers and lab personnel are aware that you are taking this medication.