Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.
Blood clots: All hormonal contraceptives can increase the risk of developing blood clots. Some studies show that birth control pills containing drospirenone have a higher risk of blood clots compared to other birth control pills. Tell your doctor if you have a history of blood clots or are at risk of developing blood clots. Inform your doctor if you are planning an upcoming surgery or if you will be immobilized or inactive for a prolonged period of time (i.e., through accident or illness), as there is an increased risk of blood clot formation when using combination hormone contraceptives. If you experience crushing chest pain or heaviness, pain in the calf, sudden shortness of breath, vision or speech changes, sudden severe headache, weakness or numbness in an arm or leg, or are coughing blood, get immediate medical attention as these symptoms could indicate a possible blood clot.
Blood pressure: This medication may increase blood pressure, increasing the risks of other heart problems. If you have high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. You may need to visit your doctor more frequently to have your blood pressure checked while using this medication. Occasionally, high blood pressure that develops with the use of hormone contraceptives may require stopping this medication.
Cigarette smoking and heart disease: Cigarette smoking increases the risk of serious heart disease and death. Birth control pills also increase this risk, particularly as a woman gets older. Women over 35 years of age who are heavy smokers (more than 15 cigarettes per day) should not use the birth control pill. All women are urged not to smoke while taking this medication.
Other factors that increase your risk of heart disease include diabetes, high blood pressure, high cholesterol levels, or a family history of these conditions. It is unclear whether taking the birth control pill increases this risk. For women who have a low risk of heart disease and do not smoke, the benefits of using low-dose birth control pills outweigh the possible risks of heart disease, regardless of age. These women may continue to use birth control pills up to the age of menopause.
Depression: This medication, like other birth control medications, may contribute to feelings of depression. If you have a history of depression or other emotional problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Women with a history of depression or other emotional problems may be more likely to have a recurrence while taking oral birth control medications.
Diabetes: If you have diabetes or a family history of diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you have diabetes, it may be necessary to test your blood sugar more often to detect any worsening of blood sugar control after starting birth control pills.
Epilepsy: Women with a history of epileptic seizures should speak to their doctor about the possibility of this medication increasing the numbers of epileptic seizures she may experience.
Electrolytes: This medication contains progesterone drospirenone, which may increase potassium levels in women who are at high risk for this condition. Women with reduced kidney or liver function or inadequate production of adrenal hormones are at increased risk. Women who receive other medications that can increase their potassium should have their potassium levels checked by their doctor when they first start this medication. Some of these medications include potassium supplements, ACE inhibitors, angiotensin-II receptor antagonists (e.g., candesartan, losartan), some diuretics, heparin, aldosterone antagonists (e.g., spironolactone), and nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen or naproxen).
Eye problems: Women who are taking birth control pills may experience fluid buildup in the cornea of the eye, which may cause vision changes. This fluid buildup may also mean that your contact lenses may not fit as well as they used to, especially if you have hard contact lenses. Soft contact lenses usually do not cause problems. If your contact lenses feel uncomfortable, talk to your eye doctor.
Fibroid tumours: This medication may worsen fibroid tumours (noncancerous growths in the uterus), causing sudden enlargement, pain, or tenderness. If you notice these effects, contact your doctor.
Gallbladder problems: The use of hormonal contraceptives increases the risk of gallbladder problems. If you experience symptoms of gallbladder problems, such as severe stomach or back (between the shoulder blades) pain, nausea or vomiting, contact your doctor.
Kidney disease: If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. You may need to have regular blood tests while taking this medication.
Liver disease: Although uncommon, the use of hormonal contraceptives has been associated with liver problems. See your doctor as soon as possible if you develop signs of liver problems such as yellow eyes or skin, abdominal pain, dark urine, pale stools, or itchy skin.
Migraine and headache: Women with migraines should discuss with their doctor how this medication may affect their medical condition and whether any special monitoring is needed. Tell your doctor if you notice the development of worsening migraine headaches or new types of headaches that are recurrent, persistent, or severe.
Regular checkups: You should visit your doctor yearly for a physical examination and follow-up while you are taking this medication.
Return to fertility: After stopping birth control therapy, you should delay pregnancy until at least one normal spontaneous menstrual cycle has occurred in order to date the pregnancy. An alternative birth control method should be used during this time. If you do not menstruate for 6 months or more after stopping birth control pills, notify your doctor.
Risk of cancer: The use of hormone contraceptives may increase the risk of breast and cervical cancer in women before menopause (around age 50). If you have been using hormone contraceptives for a long time (more than 8 years), started using them at an early age, or have a family history of cancer (mother or sister), you may be at an increased risk of developing cancer. Talk to your doctor about whether any special monitoring is needed.
If you are taking birth control pills, you should learn how to do a breast self-exam. Notify your doctor anytime you detect a lump. In a few women, the use of birth control pills may speed up the growth of a breast cancer that has not yet been diagnosed. A yearly clinical breast examination is also recommended because, if breast cancer should develop, medications that contain estrogen may cause the cancer to grow quickly.
Sexually transmitted infections (STIs): Birth control pills do not protect against HIV/AIDS and other sexually transmitted infections (STIs; formerly known as sexually transmitted diseases or STDs). It is recommended that latex condoms be used in combination with this medication to protect against these infections.
Pregnancy: This medication should not be used during pregnancy. If you become pregnant while taking this medication, or think that you may be pregnant, contact your doctor as soon as possible.
Breast-feeding: The hormones in this medication pass into breast milk. These hormones may reduce the quantity and quality of the breast milk. Breast-feeding women should use another form of birth control until they are no longer breast-feeding. Talk to your doctor about your options.
Children: The safety and effectiveness of using this medication have not been established for children less than 16 years of age.