See also Warning section.
Before using this medication, tell your doctor or pharmacist if you are allergic to ethinyl estradiol, norethindrone acetate, or ferrous fumarate; or to other estrogens, progestins or iron products; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
This medication should not be used if you have certain medical conditions. Before using this product, consult your doctor or pharmacist if you have:
- history of stroke or other blood clots (e.g., in the legs, eyes, lungs)
- severe high blood pressure
- abnormal breast exam
- cancer (especially endometrial or breast cancer)
- diabetes that has caused kidney/eye/nerve/blood vessel disease
- severe headaches
- history of heart disease (e.g., heart attack, chest pain)
- heart valve disease
- liver problems (e.g., liver tumor, active liver disease)
- current or suspected pregnancy
- recent major surgery
- long periods of sitting or lying down (e.g., immobility such as being bedridden)
- history of yellowing eyes/skin (jaundice) during pregnancy or while using birth control pills
- unexplained vaginal bleeding
- heavy tobacco use (especially if 35 or over)
Before using this product, tell your doctor your medical history, especially of:
- high blood pressure
- high cholesterol or triglyceride (blood fat) levels
- swelling (edema)
- gallbladder problems
- kidney disease
- irregular/missed/very light periods
- recent pregnancy
- thyroid problems
Do not smoke cigarettes or use tobacco. Hormonal birth control (e.g., pills, injections, devices) combined with smoking significantly increases your risk for stroke, blood clots, high blood pressure, and heart attacks, especially in women older than 35. For more details, ask your doctor or pharmacist, or consult the Patient Information Leaflet that comes with this product.
If you have diabetes, this medication may make it harder to control your blood sugar levels. Monitor your blood sugar regularly as directed by your doctor. Tell your doctor the results and any symptoms such as increased thirst/urination. Your anti-diabetic medication or diet may need to be adjusted.
Notify your doctor beforehand if you will be having surgery or will be confined to a chair/bed for a long time (e.g., a long plane flight). You may need to stop the medication for a time or take special precautions.
This medication may cause blotchy, dark areas on your skin (melasma). Sunlight may worsen this effect. Avoid prolonged sun exposure, sunlamps, and tanning booths. Use a sunscreen, and wear protective clothing when outdoors.
If you are nearsighted or wear contact lenses, you may develop vision problems or trouble wearing your contact lenses. Contact your eye doctor if these problems occur.
It may take longer for you to become pregnant after you stop taking birth control pills. Consult your doctor.
This medication must not be used during pregnancy. If you become pregnant or think you may be pregnant, tell your doctor immediately. If you have just given birth or had a pregnancy loss/abortion after the first 3 months, talk with your doctor about reliable forms of birth control, and find out when it is safe to start using birth control that contains a form of estrogen, such as this medication.
This medication passes into breast milk. This may affect milk production and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.