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It is important to be aware of specific safety considerations when using this medication, especially for individuals who smoke or use tobacco products and are over the age of 35. Key points to note include:

• If you are over 35 and use tobacco products, do not use this medication. Smoking in combination with hormonal birth control, such as pills, patches, or rings, significantly raises the risk of severe health issues.
• Smoking increases the likelihood of experiencing a stroke, heart attack, blood clots, and elevated blood pressure, and these risks escalate with both age and the number of cigarettes smoked.
• It is strongly advised to avoid smoking or using tobacco while using this medication to minimize these serious health risks.

You may experience nausea, vomiting, headaches, bloating, breast tenderness, or swelling of the ankles and feet due to fluid retention. Some weight changes might also occur. Spotting or irregular periods, including missed periods, can happen, particularly in the first few months of use. These side effects are common and not usually serious, but if they persist or worsen, it's important to consult your healthcare provider.

Monitor your blood pressure regularly as this medication can cause it to rise. Report any significant changes to your doctor. Serious side effects are uncommon but can include breast lumps, mood changes such as depression, severe abdominal pain, unusual vaginal bleeding patterns, dark urine, or yellowing of the skin or eyes. Immediate medical attention is necessary if these occur.

Rarely, this medication can lead to severe blood clot issues, like heart attacks or strokes. Seek urgent care if you experience symptoms like chest pain, confusion, sudden dizziness, leg pain or swelling, difficulty speaking, breathing trouble, swift severe headaches, unusual sweating, weakness on one side of the body, or sudden vision changes.

Allergic reactions to this drug are very rare but require immediate medical help if you notice symptoms such as rash, itching, swelling of the face, tongue, or throat, severe dizziness, or breathing difficulties. This overview does not cover all potential side effects, so be sure to reach out to your healthcare provider if you observe any other unusual symptoms.