ethylnodiol diacetate / ethinyl estradiol

• Risk factors: Over the age of 35 and smoke cigarettes | Smoking 15 or more cigarettes a day

Smoking cigarettes while taking combination oral contraceptives (COCs) like Kelnor can significantly raise the risk for blood clots. Sometimes, these blood clots can lead to serious complications, including heart attack and stroke. The risk is greater if you're over 35 years old and have a history of smoking cigarettes. Talk with your prescriber about safer birth control alternatives if you smoke.

• Risk factors: People over 35 years old who smoke | People over 40 years old who don't smoke | Recent surgery with a long period of bed rest | High blood pressure | High cholesterol | Diabetes | People identified as obese | Taking COCs less than a month after childbirth | Taking a higher dose of estrogen

Combination oral contraceptives like Kelnor can raise the risk for serious blood clots. Kelnor contains ethinyl estradiol, a type of estrogen. And estrogen is linked to clot formation.

Talk with your prescriber about your risk for blood clots. Your risk is higher if you're older, if you smoke cigarettes, or if you have certain medical conditions. Bedrest after surgery also puts you at higher risk. Typically, you'll need to temporarily stop Kelnor 3 to 4 weeks before surgery, then restart it 2 weeks after or when you're no longer on bedrest. Also, your risk for clots is high after you've given birth so don't start Kelnor until 4 weeks after delivery if you're not breastfeeding or until you've stopped breastfeeding.

Blood clots can be life-threatening and they can happen anywhere in your body. Signs and symptoms of a blood clot depend on where it happens in the body.

• Brain: weakness or numbness in your arms, legs, or face on one side of the body; trouble speaking; trouble walking; blurry vision; dizziness; loss of balance, or confusion
• Eyes: trouble seeing, bulging eye, or double vision
• Heart: chest pain, sweating, nausea, or dizziness
• Lungs: trouble breathing, chest pain, or cough
• Legs: cramps, swelling, pain, or muscle tightness

Get medical attention right away if you have any signs or symptoms of a blood clot.

• Risk factors: Personal or family history of breast cancer | Taking COCs for a long time

It's not completely clear, but it's possible that COCs like Kelnor can raise the risk for breast cancer and cervical cancer. A study suggested that taking COCs for 5 years or more might put people at risk for cervical cancer. Some breast cancers also have tumor cells that can spread faster when there's estrogen around (like with COCs).

To be safe, don't take Kelnor if you have or have had breast cancer or cervical cancer. If you currently take Kelnor, you can do monthly breast self-exams and be sure to get yearly breast scans to check for early signs of breast cancer. Also remember to get appropriate screenings for cervical cancer. Let your prescriber know if you notice any signs of breast cancer (e.g., new or abnormal lumps, pain, or swelling in your breasts) or cervical cancer (e.g., unusual vaginal bleeding or discharge).

• Risk factors: Taking COCs for more than 8 years | Certain hepatitis C medications

Don't take Kelnor if you have liver problems, such as liver infection caused by a virus (e.g., hepatitis) or liver tumors. Although rare, this medication can raise your risk of getting benign liver tumors. Stop taking Kelnor and speak with your prescriber if you experience signs of liver problems, such as jaundice (yellowing of the skin or whites of the eyes), fever, tiredness, loss of appetite, or dark colored urine.

Some studies show that combination oral contraceptives like Kelnor can raise the risk for gallbladder disease and gallstones. Although the risk is low, talk to your prescriber if you have a history of gallbladder disease before you start Kelnor.

• Risk factors: Prediabetes or diabetes | High triglycerides

Kelnor can raise your blood sugar levels because it can prevent the body from processing sugar efficiently. The risk for a rise in blood sugar levels while you're taking Kelnor is higher if you have prediabetes or diabetes. Speak with your prescriber before you start Kelnor if you have a history of high blood sugar. They might recommend a different birth control method or suggest that you check your blood sugar more often if you take this medication.

Additionally, Kelnor can also affect your cholesterol levels, including your triglycerides (a type of fat). Having high triglyceride levels might lead to a higher risk of pancreatitis (inflammation of the pancreas). Speak with your prescriber before you start Kelnor if you have a history of high cholesterol levels. Your prescriber might help you choose another birth control method or check your blood work more often if you take this medication.

• Risk factors: Older age | Taking combination oral contraceptives for a long time | History of high blood pressure | Kidney problems

Birth control pills like Kelnor can cause high blood pressure. The risk is greater if you're older and if you've been taking birth control for a long period of time. Talk with your prescriber about the benefits and risks of taking Kelnor, especially if you have a history of kidney problems or high blood pressure that's not controlled. Consider using a different kind of birth control if you're at risk for high blood pressure.

If you decide to take Kelnor, make sure to check your blood pressure regularly at home. Tell your prescriber or primary care provider if your blood pressure is higher than usual. Most times, blood pressure goes back to usual after you stop taking the birth control pill.

Let your prescriber know if you experience new or worsening migraines while you're taking Kelnor. Also call your prescriber if you develop headaches that keep coming back, don't go away, or are severe. You might need to stop taking your birth control pill so that your prescriber can figure out what's causing your headaches.

• Risk factor: First 3 months of taking combination oral contraceptives

People who take Kelnor can sometimes have irregular vaginal bleeding and spotting, especially during the first 3 months of taking this medication. Irregular bleeding can range from slight staining to bleeding similar to a regular period. This problem is often temporary, so continue taking Kelnor as directed. Tell your prescriber if any vaginal bleeding doesn't stop, if it becomes heavier, or if you miss a period. They can examine you or perform blood tests to rule out other potential causes for irregular bleeding or no bleeding.

Some medications can interfere with how your body gets rid of Kelnor. This can affect the amount of Kelnor in your body, how well it works, and the risk for side effects. Let your prescriber and pharmacist know what other medications you’re taking or planning to take with Kelnor. They can check that your medications are safe to take together and make changes to your treatment plan to keep you safe if needed.

Taking certain medications like rifampin (Rifadin) can lessen the amount of Kelnor in your body. This can make your birth control work less well and put you at risk for irregular vaginal bleeding. Consider using an additional birth control method, like condoms, when you take certain medications that can make your birth control pill less effective.

Kelnor also interferes with how your body gets rid of other medications. For example, taking this birth control pill with lamotrigine (Lamictal) can make the levels of lamotrigine (Lamictal) in your body to drop and put you at risk for seizures or mood changes. In addition, thyroid replacement medications like levothyroxine might work less well when you take them with Kelnor; you might need to take a higher dose of your thyroid medication.