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You may experience mild side effects such as nausea, vomiting, headache, bloating, and breast tenderness. Swelling of the ankles or feet due to fluid retention and weight changes are also possible. Some individuals might notice vaginal spotting between periods, especially during the initial months of use. This is generally normal. However, if these side effects persist or worsen, it’s important to inform your healthcare provider.

A change in menstrual cycle is expected; instead of having a period during the active pill months, you will have it once every three months during the inactive pill week. If you miss your period during this time, consult your healthcare provider to rule out pregnancy. Monitoring your blood pressure is advised since this medication may cause an increase. Report any high readings to your healthcare provider.

Be vigilant for serious side effects such as breast lumps, mood changes, severe stomach pain, unusual vaginal bleeding, dark urine, or yellowing of the eyes or skin. These require prompt medical attention. Rare but serious blood clot issues may occur, including symptoms like chest pain, sudden dizziness, or trouble speaking. Seek immediate medical help if you experience these symptoms.

Though rare, a severe allergic reaction can happen, characterized by a rash, itching, swelling, severe dizziness, or difficulty breathing. Immediate medical intervention is necessary for such reactions. This overview does not cover all potential side effects, so consult your healthcare provider if you notice any other unusual symptoms.

There are certain products that can interact with this medication, including aromatase inhibitors like anastrozole and exemestane, fezolinetant, ospemifene, tamoxifen, tizanidine, tranexamic acid, and some treatments for chronic hepatitis C, such as ombitasvir/paritaprevir/ritonavir, with or without dasabuvir.

Some medications can reduce the effectiveness of hormonal birth control by lowering hormone levels in your body, which may increase the risk of pregnancy. These include griseofulvin, modafinil, certain antibiotics like rifampin and rifabutin, ritonavir, St. John's wort, seizure medications such as barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate, and some HIV medications like nelfinavir and nevirapine.

Always inform your doctor when you begin using any new medication and discuss whether you need to use additional birth control methods. If you experience any unexpected spotting or breakthrough bleeding, contact your doctor, as this may indicate that your birth control is not functioning effectively.

Be aware that this medication may affect certain laboratory tests, such as those for blood clotting and thyroid function, potentially leading to inaccurate results. Ensure that all healthcare providers and lab personnel are aware that you are using this medication.