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The use of hormonal birth control, such as Quartette, requires careful consideration due to several important safety warnings. Below are key points to ensure safe use of this medication. If you have any concerns, consult your healthcare provider for guidance.

• Smoking and Heart Risks: Avoid using this medication if you smoke and are over 35 years old, as smoking significantly increases the risk of severe health issues such as strokes, heart attacks, and blood clots. The risk escalates with age and the number of cigarettes smoked. Discuss safer alternatives with your healthcare provider if you are a smoker.

• Blood Clots and Stroke: Quartette may heighten the risk of blood clots that can affect the lungs, legs, brain, and heart. Immediate medical attention is necessary if signs of a blood clot appear. Individuals at heightened risk include women over 35 who smoke, those with recent surgeries, individuals who are obese, have high cholesterol, diabetes, or are on higher doses of estrogen.

• Irregular Bleeding: Users may experience irregular bleeding or spotting, particularly during the first three months. This might be temporary, but consult your provider if it becomes problematic. Consider a pregnancy test if you miss a period to confirm you are not pregnant.

• High Blood Pressure: Quartette can increase blood pressure, especially in older women or those on long-term birth control. Monitoring blood pressure is crucial, and those with uncontrolled high blood pressure should not use Quartette. Consult your provider if your blood pressure rises.

• Blood Sugar and Cholesterol: The medication can elevate blood sugar and cholesterol levels, increasing the risk of pancreatitis in individuals with high triglycerides. If you have diabetes or prediabetes, your provider will need to monitor your condition closely while using Quartette.

• Headaches: Report any new or worsening migraines or headaches to your provider. If these symptoms persist, discontinuation of the medication may be necessary.

• Cancer Risks: There may be an elevated risk of breast and cervical cancer associated with Quartette, particularly for those with a history of breast cancer or prolonged use of COCs.

• Liver Issues: Though rare, Quartette may cause liver problems. If you have existing liver issues, avoid using this medication and contact your provider if you exhibit symptoms like fatigue, abdominal pain, or jaundice.

• Drug Interactions: Certain medications can alter Quartette's effectiveness. Inform your healthcare provider or pharmacist about all medications you're taking to avoid interactions that might reduce its efficacy or increase side effects.

Contraindications: Quartette should not be used under the following conditions without consulting a healthcare provider:

• Women over 35 years old who smoke
• History of blood clots, heart attacks, or strokes
• Uncontrolled high blood pressure
• Diabetes with complications
• Severe migraines, especially with aura
• Liver problems, tumors, or cancer
• Unexplained vaginal bleeding
• Pregnancy
• Current or past breast cancer
• Use of specific hepatitis C medications

These points highlight critical safety considerations for the use of Quartette. Always consult your healthcare provider to ensure this medication is suitable for you.

When taking this medication, you may experience some common side effects which are generally mild. These include nausea, vomiting, headaches, bloating, and breast tenderness. Some people also report swelling of the ankles or feet due to fluid retention, weight changes, acne, and menstrual cramps. It's possible to notice vaginal bleeding between periods, particularly during the initial months of use. If these effects persist or worsen, it is advisable to consult with a healthcare provider.

In some cases, the medication may cause mood changes, anxiety attacks, or migraines. There could also be an increase in blood pressure, so regular monitoring is recommended. Contact a healthcare professional if you notice any unusual changes in vaginal bleeding or develop lumps in the breast, severe stomach pain, or yellowing of the skin or eyes.

Although rare, there are severe side effects that require immediate medical attention. These include symptoms of a heart attack, such as chest pain and dizziness, and signs of a stroke, like severe headaches and vision changes. Additionally, watch for indications of deep vein thrombosis, such as leg cramps and swelling, and pulmonary embolism, which involves chest pain and difficulty breathing. Liver problems could present as jaundice and dark urine, while ectopic pregnancy may cause sharp stomach cramps and dizziness. If you experience suicidal thoughts, seek urgent medical care.

Lastly, a serious allergic reaction to this medication is uncommon but possible. Symptoms such as rash, severe dizziness, or trouble breathing demand immediate medical help. Always be observant and report any other unlisted side effects to a healthcare provider.

Certain medications can interact with this drug, potentially affecting its effectiveness or your health. These include aromatase inhibitors like anastrozole and exemestane, fezolinetant, ospemifene, tamoxifen, tizanidine, and tranexamic acid. Additionally, some drugs might reduce the efficacy of hormonal birth control by lowering hormone levels, which could lead to unintended pregnancy. Such drugs include griseofulvin, modafinil, rifamycins (e.g., rifampin, rifabutin), ritonavir, St. John's wort, and medications used for seizures (such as barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate), as well as certain HIV medications like nelfinavir and nevirapine.

It's important to inform your doctor when starting any new medication. Discuss whether you should use an additional form of birth control to ensure effectiveness. Report any unexpected spotting or breakthrough bleeding, as these could indicate reduced birth control efficacy.

Moreover, this medication might interfere with some lab tests, such as those measuring blood clotting factors and thyroid function, potentially leading to inaccurate results. Ensure that all healthcare providers and laboratory personnel are aware that you are taking this medication.