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: This medication may increase the chance of developing blood clots. If you have a history of developing blood clots or of blood clotting problems, you should not take this medication. If you experience symptoms of a blood clot such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision, or difficulty speaking, get immediate medical attention.
If you are immobilized (e.g., confined to bed for a long-term illness or accident), you will be at an increased risk of experiencing a blood clot and your doctor may recommend that you stop taking this medication for a certain period of time.
Blood pressure: You should not take this medication if you have high blood pressure that is not controlled by medication. 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.
Breast cancer: Increasing age and a strong family history of breast cancer are the most significant risk factors in developing breast cancer. Other risk factors include obesity, not having children, and a late age at the first full-term pregnancy.
The identified groups of women that may be at increased risk of developing breast cancer before menopause are long-term users of birth control pills (more than 8 years) and those who start taking it at an early age. In a few women, the use of birth control pills may speed up the growth of an existing but undiagnosed breast cancer.
If you are taking birth control pills, you should learn breast self-examination. Notify your doctor any time you detect a lump. A yearly clinical breast examination is also recommended because, if a breast cancer should develop, medications that contain estrogen may cause the cancer to grow more quickly.
Cigarette smoking and heart disease: Cigarette smoking increases the risk of serious heart disease and death. Birth control pills increase this risk, especially with increasing age. Research data support an upper age limit of 35 years for birth control pill use by women who smoke. All women are urged not to smoke while taking this medication.
Other women who are at high risk for heart disease include those with diabetes, high blood pressure, abnormal cholesterol levels, or a family history of these conditions. It is unclear whether taking birth control pills increases this risk.
For low-risk, non-smoking women of any age, the benefits of using low-dose birth control pills outweigh the possible risks of heart disease. Consequently, birth control pills may be used by these women up to the age of menopause.
Depression: Hormones, such as estrogen, have been known to cause changes in mood and symptoms of depression. If you have depression or a history of depression, 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 experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication contact your doctor as soon as possible.
Diabetes: Current low-dose birth control pills do not have a large effect on blood glucose control. If you have diabetes or are at risk for developing diabetes, discuss with your doctor whether any special monitoring is needed.
Eye disorders: Women who are taking birth control pills may experience fluid buildup in the cornea of the eye that may cause visual disturbances and changes in tolerance to rigid (i.e., hard) contact lenses. Soft contact lenses usually do not cause disturbances. If visual changes or alterations in tolerance to contact lenses occur, you may need to stop wearing them.
Fibroids: This medication may worsen fibroids, causing sudden enlargement, pain, or tenderness. If you notice these effects, contact your doctor.
Gall bladder disease: This medication can cause gall bladder disease to become worse. If you have gall bladder 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.
Inflammation of the pancreas: A small number of women who take levonorgestrel - ethinyl estradiol experience an increase in triglycerides in the blood. When triglyceride (a type of fat) levels are allowed to be high for a long period of time, inflammation of the pancreas (pancreatitis) may develop. Pancreatitis can quickly become serious and life-threatening. If you develop signs of pancreatitis (e.g., upper left abdominal pain, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen), contact your doctor as soon as possible.
Liver problems: This medication may reduce liver function and can cause liver problems. If you have active liver disease, decreasing liver function, or liver tumours, you should not take this medication. If you have a history of liver 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.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Migraine and headache: The onset or worsening of a migraine or the development of new types of recurrent, persistent, or severe headaches should be reported to your doctor.
Regular checkups: Physical examinations and follow-up visits should be done three months after starting this medication and then yearly by your doctor.
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.
Sexually transmitted infections: Birth control pills do not protect against sexually transmitted infections, including HIV or AIDS. For protection against these infections, latex condoms should be used in addition to this medication.
Surgery: Ideally, this medication should be stopped at least one month before major scheduled surgery since prolonged bed rest can increase the risk of blood clots. Inform any health care professional involved in your care that you are taking birth control pills so the risk of blood clots is reduced.
Pregnancy: Levonorgestrel - ethinyl estradiol should not be taken during pregnancy. If you become pregnant while taking this medication, contact your doctor.
Breast-feeding: It is not recommended to use birth control pills while breast-feeding. The hormonal components of the medication pass into breast milk and may reduce its quantity and quality. As well, their long-term effects on the developing child are not known.
Children: Adolescent girls who have not yet begun to menstruate and children under the age of 14 years should not take this medication.
Seniors: Postmenopausal women should not take this medication.