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It is critical to adhere to specific safety guidelines when using this medication, particularly concerning tobacco use and potential risks associated with iron-containing products.

• Smoking and Hormonal Birth Control: If you are over 35 years old and use tobacco products such as cigarettes, it is advised not to use this medication. Smoking significantly increases the risk of severe cardiovascular issues, including stroke, heart attack, blood clots, and elevated blood pressure, particularly when using hormonal birth control methods like the pill, patch, or ring. These risks amplify with age and the frequency of smoking. It is strongly recommended to avoid smoking or using any tobacco products while on this medication.

• Iron-containing Products and Children: Be aware that accidental ingestion of iron-containing products can lead to fatal poisoning in children under the age of 6. Always store such products out of children's reach to prevent accidental overdose. In the event of an overdose, it is crucial to seek immediate medical attention or contact a poison control center for assistance.

These precautions are vital to ensure the safe use of this medication. Always follow the guidance provided and consult with your healthcare professional for any concerns or questions.

When taking this medication, you may experience common side effects such as nausea, vomiting, headache, bloating, breast tenderness, or swelling in the ankles and feet due to fluid retention. Weight changes and irregular vaginal bleeding, including spotting or missed periods, might also occur, especially during the initial months of use. These effects are generally mild, but if they persist or worsen, consult your healthcare provider. Additionally, it is important to monitor your blood pressure regularly, as this medication may cause an increase.

More serious side effects, though less common, require prompt medical attention. These include lumps in the breast, significant mood changes like worsening depression, severe abdominal pain, dark urine, yellowing of eyes or skin, and unusual changes in vaginal bleeding. Rarely, this medication can cause severe blood clot-related issues such as heart attacks, strokes, or clots in the lungs or legs. Immediate medical help is crucial if you experience symptoms such as chest pain, confusion, sudden dizziness, swelling or warmth in the legs, difficulty speaking, or sudden vision changes.

Allergic reactions to this medication are rare but can be serious. Look out for symptoms like rash, itching, swelling of the face or throat, severe dizziness, or trouble breathing, and seek emergency medical assistance if they occur. Always inform your healthcare provider of any side effects you experience, as this list may not be exhaustive.

Certain medications may interact with this drug, including aromatase inhibitors like Anastrozole and Exemestane, as well as fezolinetant, ospemifene, Tamoxifen, Tizanidine, and Tranexamic Acid. Additionally, some medications can reduce the effectiveness of hormonal birth control by lowering the hormone levels in your body, which may lead to unintended 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 certain HIV medications like nelfinavir and Nevirapine.

It is important to inform your doctor when you begin taking any new medication and discuss whether you need to use additional birth control methods. Be vigilant about any new instances of spotting or breakthrough bleeding, as these could indicate reduced birth control effectiveness. Furthermore, this medication may affect the results of some laboratory tests, including those for blood clotting factors and thyroid function, potentially leading to inaccurate results. Ensure that your healthcare providers and lab technicians are aware that you are using this medication.