norgestimate / ethinyl estradiol

• Risk factors: Females over 35 years old who smoke cigarettes

Smoking cigarettes while taking combined oral contraceptives (COCs), like Sprintec, can raise the risk of serious heart problems. The risk gets higher as you get older, especially if you're over 35 years old, and with the number of cigarettes smoked. Females over 35 years old who smoke shouldn't take Sprintec because of this risk.

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

Sprintec raises your risk of blood clots. These clots can occur anywhere in your body, including your lungs (pulmonary embolism or PE), legs (deep vein thrombosis or DVT), brain (stroke), and heart (heart attack). Get emergency help right away if you have any signs of a blood clot:

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

If you need to have surgery, tell your provider you're taking Sprintec. They might have you stop taking it 4 weeks before until 2 weeks after your surgery to lower your risk of blood clots. If you recently delivered a baby, you shouldn't start Sprintec until 4 weeks after delivery if you're not breastfeeding your child.

People who take Sprintec can sometimes experience irregular bleeding and spotting, especially during the first 3 months of taking this medication. Irregular bleeding can vary from slight staining to bleeding similar to a regular period. This problem might be temporary, so continue taking your medication as directed. Let your provider know if the bleeding is a problem for you and they can change your birth control. Some people might not have any bleeding while taking or after stopping Sprintec. If you missed your period(s), contact your provider or get a pregnancy test to make sure you're not pregnant.

• Risk factors: Older age | Using COCs for a long time | High blood pressure | Kidney problems

Sprintec can raise your blood pressure, so make sure you check your blood pressure while you're taking this medication. The risk is higher in females who are older and have been taking birth control for a long period of time. Sprintec can't be taken by females who have high blood pressure that's not under control or high blood pressure with blood vessel problems. Speak to your provider if this medication raises your blood pressure and they can help pick a different method of birth control that's safer for you.

• Risk factors: Prediabetes or diabetes | High triglycerides

Sprintec can raise your blood sugar and cholesterol levels. Females who have high triglycerides (a type of cholesterol) might have a higher risk of experiencing pancreatitis (inflammation of the pancreas) when taking COCs. Speak with your provider before starting Sprintec if you have diabetes, prediabetes, or high cholesterol. If you choose to take Sprintec with those health conditions, your provider will monitor you regularly.

Let your provider know if you experience new or worsening migraines or headaches while taking Sprintec. You will have to stop your medication if your migraine or headache doesn't go away or becomes severe.

• Risk factors: History of breast or cervical cancer | Taking COCs for a long time

Study results are mixed, but there's a possibility that Sprintec and other COCs can raise your risk for breast and cervical cancer.

Don't take Sprintec if you currently have or have had breast cancer because some types of breast cancer grow faster in the presence of estrogen, a hormone in this medication. The risk of developing breast cancer might be slightly higher in females who currently take COCs, have taken them within the past 6 months, or are taking them for a long time (8 years or more). You can examine your breasts regularly at home or get yearly breast exams with your healthcare provider to help with early breast cancer detection. Let your provider know if you notice any new or abnormal lumps, pain, or swelling in your breasts.

Make sure you follow up with your provider to get proper screenings for cervical cancer. Report any signs of vaginal bleeding or discharge that's not normal.

• Risk factors: Taking COCs for a long time | Hepatitis C treatment

Don't take Sprintec if you have liver problems, such as sudden liver infection caused by a virus, severe (decompensated) scarring of the liver, or liver tumors. Although rare, Sprintec can raise your risk of benign liver tumors. If you experience signs of liver problems, you should stop taking Sprintec and ask your provider for a different type of birth control. Signs of liver problems can include jaundice (yellowing of the skin or eyes), along with fever, tiredness, loss of appetite, or dark colored urine.

Talk to your provider before starting Sprintec if you are taking Viekira Pak (dasabuvir / ombitasvir / paritaprevir / ritonavir) to treat hepatitis C. This medication can cause liver problems if you are taking it together with a COC. Stop taking Sprintec and discuss other birth control options with your provider if you need to start your treatment for hepatitis C. You can restart Sprintec 2 weeks after your Viekira Pak treatment is complete.