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It's common to experience mild side effects such as nausea, vomiting, headaches, bloating, breast tenderness, swelling in the ankles or feet due to fluid retention, or changes in weight. Some individuals may also notice vaginal spotting or irregular periods, particularly during the initial months of use. These effects are generally manageable, but if they persist or worsen, it's important to consult a healthcare professional.

Monitoring your blood pressure is advisable, as this medication can sometimes lead to an increase. Alert your healthcare provider if you notice elevated readings. Be aware of potentially serious side effects, which include breast lumps, mood changes like depression, severe stomach pain, unusual vaginal bleeding, dark urine, or yellowing of the skin or eyes. Immediate medical attention is crucial if you experience any of these symptoms.

Rarely, this medication can cause serious blood clot-related issues such as heart attack, stroke, or clots in the lungs or legs. Seek urgent care if you experience chest or jaw pain, confusion, sudden dizziness or fainting, calf pain, difficulty speaking, shortness of breath, severe headache, unusual sweating, weakness on one side, or sudden vision changes.

Allergic reactions to this medication are very rare, but require immediate medical assistance if symptoms like rash, swelling of the face or throat, severe dizziness, or trouble breathing occur. If you notice any effects not listed here, reach out to a healthcare professional for guidance.

Some medications that can interact with this drug include aromatase inhibitors like anastrozole and exemestane, fezolinetant, ospemifene, tamoxifen, tizanidine, tranexamic acid, and certain combinations used for chronic hepatitis C, such as ombitasvir/paritaprevir/ritonavir, with or without dasabuvir. Additionally, some medications might reduce the effectiveness of hormonal birth control by lowering hormone levels in your body, which could lead to pregnancy. Examples include griseofulvin, modafinil, rifamycins like rifampin and rifabutin, ritonavir, St. John's wort, as well as certain seizure medications like barbiturates, carbamazepine, felbamate, phenytoin, primidone, and topiramate, and some HIV medications like nelfinavir and nevirapine.

Ensure you inform your doctor when starting any new medication and discuss whether you should use an additional, reliable form of birth control. If you experience any unusual spotting or breakthrough bleeding, let your doctor know, as these could indicate that your birth control is not functioning effectively. This drug may also affect certain lab tests, such as those for blood clotting and thyroid function, potentially leading to inaccurate results. Be sure to inform lab technicians and all your healthcare providers that you are taking this medication.