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When using hormonal birth control methods like the pill, patch, or ring, it's important to be aware of increased health risks associated with smoking. Smoking can elevate the chances of experiencing severe conditions such as stroke, heart attack, blood clots, and high blood pressure. These risks are heightened if you are obese, and they further increase with age and the quantity of cigarettes you smoke.

• Avoid using this medication if you are obese.
• Do not use this medication if you smoke or use tobacco and are over the age of 35.

These precautions are critical to ensuring your safety while using hormonal birth control.

When using this medication, you might experience mild side effects such as skin irritation at the application site, nausea, vomiting, headache, bloating, breast tenderness, fluid retention leading to swollen ankles or feet, or changes in weight. Some users may notice spotting or have irregular periods, particularly during the initial months. These side effects are usually not serious, but if they persist or worsen, it's important to consult your healthcare provider.

More serious side effects require immediate attention. These include lumps in the breast, mood changes like worsening depression, unusual vaginal bleeding, signs of high blood sugar, and symptoms of liver problems such as persistent nausea, loss of appetite, or yellowing of the skin or eyes. It's crucial to monitor your blood pressure, as this medication can increase it.

Rarely, this medication may lead to severe blood clot issues like heart attack or stroke. Seek urgent medical help if you experience symptoms such as shortness of breath, chest pain, severe headaches, sudden dizziness, or any signs of a clot in the legs. Allergic reactions to this drug are uncommon but serious. Look out for rash, swelling, severe dizziness, or breathing difficulties, and seek medical assistance immediately if these occur.

Always communicate with your healthcare provider if you encounter any side effects, even those not listed here, to ensure your safety and wellbeing.

Certain medications can interact with this drug, so it's important to be aware of them. These include aromatase inhibitors like Anastrozole and Exemestane, fezolinetant, ospemifene, Tamoxifen, Tizanidine, Tranexamic Acid, and some treatments for chronic hepatitis C, such as ombitasvir/paritaprevir/Ritonavir, with or without dasabuvir. Additionally, some medications can reduce the effectiveness of hormonal birth control by lowering hormone levels, which may lead to pregnancy. Examples include griseofulvin, Modafinil, rifamycins 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.

Always inform your doctor when starting a new medication, and talk about whether you need to use an additional method of birth control. Also, let your doctor know if you experience any unexpected spotting or bleeding, as these could indicate your birth control isn't working properly. Furthermore, this medication might interfere with certain laboratory tests, like those for blood clotting factors or thyroid function, potentially leading to inaccurate results. Ensure that all healthcare providers and lab personnel are aware that you are taking this medication.