aurovela 1/20

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

If you smoke cigarettes, using combined oral contraceptives (COCs), like Junel 1/20, raises your risk for serious health problems, such as strokes, heart attacks, and blood clots. Females age 35 years and older who smoke are at even higher risk for these problems. If you smoke, talk with your provider about safer birth control alternatives.

• 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 Junel 1/20 less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen

Junel 1/20 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 Junel 1/20. 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 Junel 1/20 until 4 to 6 weeks after delivery if you're not breastfeeding your child.

People who take Junel 1/20 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. If you miss your period, make sure you get a pregnancy test to make sure you're not pregnant or contact your provider.

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

Junel 1/20 can raise your blood pressure, so make sure you monitor your blood pressure while you're taking this medication. Speak to your provider if you have high blood pressure or kidney problems, and they can help you pick a different method of birth control that's safer for you. Your blood pressure can return to normal after stopping your oral contraceptives.

• Risk factors: Prediabetes or diabetes | High triglycerides

Junel 1/20 can raise your blood sugar levels and cholesterol levels. Speak with your provider before starting oral contraceptives if you have diabetes, prediabetes, or high cholesterol. If you choose to take Junel 1/20 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 Junel 1/20. 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 Junel 1/20 and other COCs can raise your risk for breast and cervical cancer.

Don't take Junel 1/20 if you currently have or have had breast cancer because some breast cancers grow faster in the presence of estrogen. 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.

Certain medications can make Junel 1/20 get broken down faster in your body, making it less effective and can lead to pregnancy. Some examples include carbamazepine (Tegretol) and phenytoin (Dilantin). Use a back-up method or other form of birth control for at least 28 days after stopping any of these medications. Other medications can raise the amount of Junel 1/20 in your body, which can lead to more side effects. Make sure to tell your provider or pharmacist all of your medications so they can make sure they don't interact with Junel 1/20.

If you have hepatitis C and need to be treated with Viekira Pak (dasabuvir / ombitasvir / paritaprevir / ritonavir), let your provider know right away that you're taking a COC. You'll need to stop Junel 1/20 before starting Viekira Pak because taking them together can cause liver problems. You can start Junel 1/20 again 2 weeks after you stop Viekira Pak.