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When using hormonal birth control, such as Kariva, it is crucial to be aware of the associated risks and necessary precautions. Below is a summary of key safety information to consider:

• Avoidance for Smokers Over 35: If you are over 35 and smoke cigarettes or use tobacco, do not use this medication. Smoking in combination with hormonal birth control significantly increases the risk of stroke, heart attack, and blood clots.

• Increased Cardiovascular Risks: Combined oral contraceptives (COCs) like Kariva can elevate the risk of severe cardiovascular events, including strokes and heart attacks, especially for women over 35 who smoke. Discuss safer alternatives with your healthcare provider if you smoke.

• Blood Clots: The use of Kariva can lead to an increased risk of blood clots, which can occur in various parts of the body such as the lungs (pulmonary embolism), legs (deep vein thrombosis), brain (stroke), and heart (heart attack). Those at higher risk include women over 35 who smoke, individuals with high blood pressure, obesity, high cholesterol, diabetes, or those who have recently had surgery or childbirth.

• Cancer Risks: There is a potential risk of breast and cervical cancer associated with long-term COC use. This risk may be higher for individuals with a personal history of breast cancer.

• Liver Issues: Kariva may cause rare liver problems, including liver damage and tumors. Do not use this medication if you have existing liver conditions, and contact your healthcare provider if you notice symptoms such as fatigue, stomach pain, or jaundice.

• Blood Sugar and Lipid Levels: COCs can increase blood sugar and triglyceride levels. If you have diabetes or a history of high triglycerides, inform your healthcare provider and monitor for any changes.

• Blood Pressure: Kariva may elevate blood pressure. Regular monitoring is advised, and those with uncontrolled high blood pressure should consider alternative birth control options.

• Headaches: Headaches can be a common side effect due to changes in estrogen levels. Contact your healthcare provider if you experience severe or recurring migraines.

• Irregular Bleeding: Spotting or breakthrough bleeding is common in the first few months of use. Report any irregular vaginal bleeding to your healthcare provider.

• Depression: Notify your healthcare provider if you notice any depressive symptoms or worsening of existing depression.

• Gallbladder Concerns: There may be an increased risk of gallbladder disease. Discuss your medical history with your healthcare provider before starting Kariva.

• Drug Interactions: Some medications can reduce the effectiveness of Kariva or increase side effects. Inform your healthcare provider or pharmacist of all medications you are taking to avoid interactions.

Contraindications: Do not use Kariva if you have a history of blood clotting problems, coronary artery or cerebrovascular disease, certain cancers, liver conditions, unexplained genital bleeding, or if you are pregnant. Additionally, avoid if you are receiving specific hepatitis C treatments. Always consult your healthcare provider for personalized advice and alternative options if any of these apply to you.

When taking this medication, you may experience some common side effects, which are usually mild and manageable. These include nausea, vomiting, stomach cramps, bloating, breast tenderness, and headaches. Some individuals may notice changes in weight, either gaining or losing a few pounds, and spotting or irregular vaginal bleeding may occur, especially in the first months. It's not uncommon for some to experience raised blood pressure, so monitoring it regularly is advised.

Occasionally, users might experience changes in mood, such as depression, or notice changes in appetite and sex drive. Skin-related effects like acne or spotty darkening and yeast infections have also been reported. While these are generally not severe, it’s essential to consult a healthcare provider if they persist or worsen.

There are rare but serious side effects that require immediate medical attention. These include symptoms of blood clots, such as chest pain, trouble breathing, or sudden dizziness, which could indicate a heart attack, stroke, deep vein thrombosis, or pulmonary embolism. Additionally, severe liver problems may manifest as yellowing of the eyes or skin and severe abdominal pain. A very serious allergic reaction, although uncommon, may present with rash, severe dizziness, or difficulty breathing. If you experience any of these issues, seek urgent medical care.

It's important to be aware that certain medications can interact with your current prescription. These include aromatase inhibitors such as Anastrozole and Exemestane, as well as drugs like fezolinetant, ospemifene, Tamoxifen, Tizanidine, and Tranexamic Acid. Some medications can decrease the effectiveness of hormonal birth control by reducing hormone levels in your body, which may lead to unintended pregnancy. Notable examples are griseofulvin, Modafinil, rifamycins (like Rifampin and Rifabutin), Ritonavir, St. John's wort, and certain medications used for seizures and HIV treatment.

When starting any new medication, inform your healthcare provider so they can assess if additional birth control methods are necessary. Report any unexpected spotting or breakthrough bleeding as these could indicate reduced effectiveness of your birth control.

Additionally, this medication might interfere with some laboratory tests, potentially leading to inaccurate results. Ensure that all healthcare professionals and lab personnel are aware of your current medication use to avoid misinterpretation of test outcomes. Always consult your doctor or pharmacist about potential interactions with other medications or supplements you are taking.