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This medication comes with important safety warnings that highlight potential risks and precautions. It’s essential to carefully review these warnings and consult with a healthcare professional if you have any concerns or need further guidance.

• Smoking and Blood Clots: Use of combined hormonal birth control, such as Nextstellis, while smoking increases the risk of blood clots, which can lead to severe complications like heart attacks or strokes. This risk escalates with age, particularly for those over 35 years old. Individuals who smoke or use tobacco should not use this medication.

• Blood Clots and Complications: There is a risk of blood clots forming when using combined hormonal birth control, which can obstruct blood flow to critical body parts, causing severe health issues. Risk factors include a personal or family history of blood clots, age over 35 years combined with smoking, obesity, immobility, and recent childbirth.

• High Potassium Levels: Nextstellis contains drospirenone, which may increase potassium levels. Those with liver, kidney issues, or on medications that elevate potassium should undergo blood tests in the initial birth control cycle.

• High Blood Pressure: Regular blood pressure monitoring is advised during Nextstellis use, as it may cause elevations. Discontinue use and inform your healthcare provider if your blood pressure becomes unmanageable.

• Migraines: Cease taking Nextstellis if you develop new, persistent, or severe migraines, or if existing migraines worsen, especially with aura, as this increases stroke risk.

• Cancer Risks: While studies are inconclusive, hormonal birth control may influence breast and cervical cancer risks. Individuals with a history of these cancers should exercise caution.

• Liver or Gallbladder Issues: This medication can elevate liver enzyme levels. Those with liver or gallbladder problems should not take Nextstellis due to potential exacerbation of these issues.

• High Blood Sugar: Nextstellis may increase blood sugar levels, warranting caution for those with diabetes or high blood sugar. Monitor for signs of elevated blood sugar, such as increased thirst and urination.

• High Cholesterol: Since Nextstellis can heighten cholesterol levels, particularly triglycerides, those with high cholesterol should discuss risks with their prescriber and watch for signs of pancreatitis.

• Thyroid Hormone Therapy Adjustments: The estrogen in Nextstellis may affect thyroid hormone therapy, necessitating possible dose adjustments.

• Irregular Bleeding: Changes in menstrual bleeding patterns are common initially. Notify your healthcare provider if bleeding persists or worsens.

• Depression: Any symptoms of depression or worsening conditions should be reported to your prescriber, who may advise discontinuation if necessary.

• Worsening of Other Conditions: If you have hereditary angioedema or chloasma, consult your healthcare professional as Nextstellis may aggravate these conditions. Limit sun exposure if you have a history of chloasma.

Contraindications: Do not use this medication if you have a high risk of blood clots, are over age 35 and smoke, have a history of blood clots or certain heart conditions, uncontrolled high blood pressure, specific forms of diabetes, migraines with aura, a history of breast cancer, liver tumors, kidney issues, low adrenal hormone levels, unexplained vaginal bleeding, or if you are taking certain hepatitis C medications. Discuss with your healthcare provider if these apply to you.

When taking this medication, you may experience some common side effects that are typically mild and temporary. These include nausea, vomiting, headaches, abdominal cramps, bloating, and breast tenderness. Some individuals may notice changes in weight, mood swings, or swelling in the ankles or feet due to fluid retention. Irregular vaginal bleeding or spotting, particularly in the initial months, is also possible. Should any of these persist or become bothersome, it’s advisable to consult your healthcare provider.

In addition to these common side effects, some users report menstrual cramps, acne, or a decreased desire for sexual activity. While these effects are generally manageable, it’s important to monitor them and discuss any concerns with a healthcare professional.

It’s crucial to be aware of more serious side effects, which are less common but require immediate medical attention. These include symptoms of high potassium levels like muscle weakness or irregular heartbeat, as well as unusual changes in vaginal bleeding patterns. Rarely, this medication may cause life-threatening blood clots, which can lead to heart attacks, strokes, or deep vein thrombosis. Be alert for signs such as chest pain, sudden dizziness, severe headaches, or difficulty speaking. Seek urgent care if you experience any symptoms of serious liver problems, such as yellowing of the skin or eyes, or mental health changes like severe depression or suicidal thoughts.

Though a severe allergic reaction is rare, immediate medical attention is necessary if you notice a rash, severe dizziness, or difficulty breathing. Always inform your healthcare provider about any unusual side effects you experience.

Some medications can interact with this drug, including aromatase inhibitors like anastrozole and exemestane, as well as atazanavir/cobicistat, fezolinetant, ospemifene, tamoxifen, tizanidine, and tranexamic acid. Drospirenone, a component of this medication, may increase your potassium levels. It is important to inform your doctor if you are taking other medications that also elevate 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 medications can reduce the effectiveness of hormonal birth control by lowering hormone levels in your body, potentially leading to pregnancy. These include griseofulvin, modafinil, rifamycins (e.g., rifampin), ritonavir, St. John's wort, medications for seizures (e.g., barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate), and certain HIV drugs (e.g., nelfinavir, nevirapine). Consult your doctor or pharmacist for further information.

Always inform your doctor when starting a new medication and discuss whether you should use an additional reliable form of birth control. Notify your doctor if you experience any new spotting or breakthrough bleeding, as this could indicate reduced effectiveness of your birth control. Additionally, this medication may influence the results of certain lab tests, so ensure that all healthcare providers and laboratory personnel are aware of your medication use.