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You may experience mild side effects such as nausea, vomiting, headaches, bloating, breast tenderness, or swelling in the ankles and feet due to fluid retention. Some individuals might notice weight changes or experience spotting or irregular periods, particularly during the initial months. If these symptoms persist or worsen, it’s important to seek medical advice. Missing two consecutive periods or a single period without correct medication use may require a pregnancy test.

It is common for this medication to elevate blood pressure, so regular monitoring is advised. Report any significant changes to your healthcare provider. Serious side effects, although uncommon, include unusual changes in vaginal bleeding, such as continuous spotting or sudden heavy bleeding, and symptoms indicating high potassium levels, like muscle weakness or an irregular heartbeat.

In rare instances, this medication can cause severe blood clot-related complications leading to heart attacks, strokes, or clots in the lungs or legs. Immediate medical attention is necessary if you experience symptoms such as shortness of breath, chest pain, sudden dizziness, severe headaches, or difficulty speaking.

Be vigilant for very serious conditions such as breast lumps, severe abdominal pain, dark urine, yellowing of the skin or eyes, or mood changes, including depression or suicidal thoughts. Also, though extremely rare, watch for signs of a severe allergic reaction, including rash, swelling, severe dizziness, or trouble breathing, and seek urgent medical assistance if they occur.

This summary does not list all possible side effects. If you notice other effects, consult with your healthcare provider for further guidance.

Some medications can interact with this drug, including aromatase inhibitors like anastrozole and exemestane, atazanavir combined with cobicistat, fezolinetant, ospemifene, tamoxifen, tizanidine, tranexamic acid, and certain hepatitis C treatments (ombitasvir/paritaprevir/ritonavir, with or without dasabuvir). Drospirenone can increase potassium levels in your blood. Inform your doctor if you regularly take other medications that may also raise potassium levels, such as aliskiren, ACE inhibitors (e.g., enalapril, lisinopril), angiotensin receptor blockers (e.g., losartan, valsartan), heparin, NSAIDs (e.g., ibuprofen, naproxen), and potassium-sparing diuretics (e.g., eplerenone, spironolactone, triamterene).

Certain drugs can reduce the effectiveness of hormonal birth control by decreasing hormone levels in your body, potentially leading to pregnancy. These include griseofulvin, modafinil, rifamycins (e.g., rifampin), ritonavir, St. John's wort, and some seizure medications (e.g., barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate), as well as some HIV medications (e.g., nelfinavir, nevirapine). Consult your doctor or pharmacist for more information. Notify your doctor when starting any new medication and discuss the need for additional reliable birth control methods. Report any new spotting or breakthrough bleeding to your doctor, as these could indicate reduced effectiveness of your birth control.

This medication may affect certain lab tests, causing inaccurate results. Ensure that lab personnel and all your healthcare providers are aware that you are taking this drug.