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It is important to be aware of the safety and warning information associated with this medication to ensure its safe use. Below are the key points you should consider before starting this medication:

• Smoking and Heart Health: If you are a smoker, particularly if you are over 35 years old, using hormonal birth control such as Viorele significantly increases your risk of serious cardiovascular issues, including stroke, heart attack, and blood clots. The risks escalate with the number of cigarettes smoked and age. It is crucial to discuss alternative contraceptive options with your healthcare provider if you are a smoker.

• Blood Clot Risks: Viorele can elevate your risk of developing blood clots, which may occur in different parts of the body, such as the lungs, legs, brain, and heart. Immediate medical attention is necessary if symptoms of a blood clot appear. Higher risk is associated with individuals over 35 who smoke, those over 40 who do not smoke, recent surgical patients with extended bed rest, postpartum individuals, those with high blood pressure, obesity, high cholesterol, diabetes, or those taking higher doses of estrogen.

• Cancer Risks: There is an increased possibility of breast and cervical cancer with prolonged use of Viorele and other combined oral contraceptives (COCs). Discuss your cancer risk with your healthcare provider, especially if you have a personal history of breast cancer or have used COCs for an extended period.

• Liver Concerns: Rarely, Viorele may lead to liver damage or tumors. This risk is higher with formulations containing more estrogen, but if you have existing liver issues, do not use this medication. Seek immediate medical help if you notice symptoms like fatigue, abdominal pain, or jaundice.

• Blood Sugar and Triglycerides: Viorele may raise blood sugar and triglyceride levels. This is particularly important for individuals with diabetes or a history of high triglycerides. Regular monitoring and communication with your healthcare provider are essential.

• Blood Pressure: Viorele could increase blood pressure, so regular checks are advised. If you have uncontrolled high blood pressure or kidney issues, Viorele may not be suitable.

• Headaches and Mood Changes: Report any severe or persistent headaches, particularly new migraines, and any symptoms of depression to your healthcare provider. Adjustments to your treatment may be necessary.

• Irregular Bleeding: Inform your healthcare provider if you experience irregular bleeding, especially within the first three months of use, or if your period stops altogether, as this may need further evaluation.

• Gallbladder Issues: There is a slight risk of gallbladder disease with Viorele use, particularly for those with a history of gallbladder problems.

• Drug Interactions: Certain medications can alter the effectiveness of Viorele, either lowering its efficacy or increasing side effects. Ensure your healthcare provider is aware of all medications you are taking to avoid interactions.

Contraindications: Do not use this medication if you have a history of blood clotting disorders, coronary or cerebrovascular diseases, breast or estrogen-dependent cancers, unexplained genital bleeding, liver issues, or if you are pregnant. Avoid use with hepatitis C treatments containing specific antiviral combinations.

Always consult with your healthcare provider if you have any concerns or questions regarding the use of this medication.

When using this medication, some individuals may experience common side effects, which are generally mild and manageable. These include nausea, vomiting, stomach cramps, bloating, breast tenderness, and weight changes. It's not unusual to experience headaches, minor spotting between periods, or raised blood pressure. If these effects are persistent or worsen, it may be beneficial to consult your healthcare provider.

Some users also report other side effects such as yeast infections, changes in skin pigmentation, variations in appetite, acne, or shifts in sex drive. While these effects are less common, monitoring for their persistence or severity is advisable.

There are rare but serious side effects that require immediate medical attention. These include symptoms of a heart attack, such as chest pain and dizziness, or signs of a stroke, like sudden numbness or confusion. Blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism) can manifest as leg pain or breathing difficulties. Serious liver issues may present as yellowing of the skin or eyes and should prompt urgent care. Additionally, any severe allergic reactions, characterized by rash, swelling, or breathing troubles, should be addressed immediately.

It is important to stay informed about these potential side effects and maintain regular communication with your healthcare provider to manage any concerns effectively.

Certain medications can interact with this drug, potentially affecting its efficacy or your health. Some drugs that might interact include aromatase inhibitors like anastrozole and exemestane, as well as fezolinetant, ospemifene, tamoxifen, tizanidine, and tranexamic acid. Additionally, some medications can decrease the effectiveness of hormonal birth control by reducing the levels of these hormones in your body, possibly leading to pregnancy. Examples of such medications include griseofulvin, modafinil, rifamycins (such as rifampin and rifabutin), ritonavir, St. John's wort, and certain drugs used to treat seizures, like barbiturates, carbamazepine, felbamate, phenytoin, primidone, and topiramate, as well as some HIV drugs like nelfinavir and nevirapine.

It is important to inform your doctor when starting any new medication and to discuss whether you should use additional reliable birth control methods. If you experience any new spotting or breakthrough bleeding, consult your doctor as these may indicate that your birth control is not functioning effectively. Furthermore, this medication might interfere with specific laboratory tests, such as those for blood clotting factors and thyroid function, potentially leading to inaccurate results. Ensure all healthcare professionals and lab staff are aware that you are taking this medication.