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The following safety information outlines important risks and precautions associated with the use of Junel 1/20. It is crucial to understand these warnings and discuss any concerns with your healthcare provider.

• Cigarette Smoking and Heart Issues: Smoking cigarettes while using combined oral contraceptives like Junel 1/20 increases the risk of serious health problems such as strokes, heart attacks, and blood clots. This risk is especially high for females over 35 years of age who smoke. Discuss alternative birth control options with your healthcare provider if you smoke.

• Blood Clots and Strokes: Junel 1/20 may increase the risk of blood clots, which can affect various parts of the body, including the lungs, legs, brain, and heart. Immediate medical attention is necessary if signs of a blood clot appear. Individuals at higher risk include females over 35 who smoke, those over 40 who do not, individuals who have recently had surgery or childbirth, and those with high blood pressure, obesity, high cholesterol, diabetes, or a higher dose of estrogen.

• Irregular Bleeding: Users may experience irregular bleeding or spotting, particularly within the first three months. This may range from light staining to bleeding similar to a regular period. If this becomes a concern, contact your healthcare provider, who may suggest an alternative contraceptive. A missed period should prompt a pregnancy test or consultation with your provider.

• High Blood Pressure: Junel 1/20 can elevate blood pressure, necessitating regular monitoring. Users with pre-existing high blood pressure or kidney issues should discuss safer birth control options with their provider. Blood pressure typically normalizes after discontinuing the medication.

• Blood Sugar and Cholesterol Levels: This medication can increase blood sugar and cholesterol levels. Individuals with diabetes, prediabetes, or high cholesterol should consult their provider before starting Junel 1/20. Regular monitoring may be required for these conditions.

• Headaches: If you experience new or worsening migraines or severe headaches, inform your provider. Medication may need to be stopped if the headaches persist or become severe.

• Cancer Risks: There is a potential risk of breast and cervical cancer with prolonged use of Junel 1/20. Those with a personal or family history of these cancers should discuss these risks with their healthcare provider.

• Drug Interactions: Some medications can reduce the effectiveness of Junel 1/20, leading to potential pregnancy. Examples include carbamazepine and phenytoin. A backup birth control method should be used for at least 28 days after stopping these medications. Conversely, certain drugs may increase the medication's concentration in the body, resulting in more side effects. Always inform your provider or pharmacist of all medications you are taking.

Contraindications: This medication should not be used if you have the following conditions, as they may pose serious health risks:

• Current or history of blood clots, or conditions increasing clot risk
• Cerebral vascular or coronary artery disease
• Current or history of breast cancer
• Unexplained vaginal bleeding
• Jaundice during pregnancy or previous pill use
• Liver tumors or cancer
• Pregnancy
• Concurrent use of certain hepatitis C medications

Consult your healthcare provider if any of these contraindications apply to you before using Junel 1/20.

Common side effects:

• Nausea
• Vomiting
• Stomach cramps
• Bloating
• Changes in menstrual cycle
• Bleeding between periods
• Spotting
• Changes in flow
• Missed periods
• Swelling
• Breast changes
• Weight fluctuations
• Feelings of depression
• Vaginal yeast infection

Less common but important to monitor:

• Skin conditions with brown spots or patches
• Migraines
• Allergic rashes

Serious side effects:

• Signs of a heart attack
• Symptoms of a stroke
• Indications of deep vein thrombosis
• Pulmonary embolism