Nextstellis

• Risk factors: Over 35 years old and smoke cigarettes

Don't smoke cigarettes or use other nicotine products while taking Nextstellis. This can raise your risk of blood clots. Blood clots can sometimes lead to serious problems, such as a heart attack or stroke. This risk is even higher if you're over 35. It also goes up with the number of cigarettes you smoke.

If you're over 35 and smoke, you shouldn't take Nextstellis. Talk to a healthcare professional about birth control options that might be safer for you.

• Risk factors: Personal or family history of blood clots | Age 40 years or older | Smoking | Age 35 or older and smoke | High blood pressure | High cholesterol | High blood sugar | People identified as obese | Not moving for a long time | Had a baby in the past 3 months

Combined hormonal birth control pills like Nextstellis have a small risk of causing blood clots. These clots can block blood flow to your legs (deep vein thrombosis, or DVT) or lungs (pulmonary embolism, or PE). Some can also raise your risk for a stroke) or heart attack.

Before starting Nextstellis, tell your prescriber about your full medical history to check your risk of blood clots. They can help decide if this birth control is safe for you.

Tell your prescriber if you have a planned surgery. You might need to stop taking Nextstellis before surgery and restart it later afterward. This helps lower your risk of blood clots.

Know the signs of a blood clot and possible serious problems.

• DVT (clot in the leg): swelling, tenderness, or pain in the leg
• PE (clot in the lungs): shortness of breath
• Vision problems (clot in the eye): double vision, sudden vision loss, trouble seeing
• Heart attack (clot near the heart): chest pain, arm pain, dizziness, cold sweat
• Stroke (clot near the brain): sudden weakness on one side of the body; face drooping; changes in speech, vision, balance, or coordination; severe headache

Stop taking Nextstellis and get emergency medical help right away if you have any of these symptoms.

• Risk factors: Taking other medications that can raise potassium levels | Kidney or liver damage | Low adrenal hormone levels

Nextstellis contains drospirenone, which can raise the potassium level in your blood. Before starting Nextstellis, tell your prescriber about all your medical conditions and the medications you take. You shouldn't take this birth control pill if you have certain kidney, liver, or adrenal gland problems. These conditions might raise your risk of high potassium. Some medications can also raise potassium.

If you're at risk, your prescriber might order a blood test during your first month of treatment to check your potassium. Tell your care team if you have unusual tiredness, muscle weakness, tingling, or numbness. These can be signs of high potassium.

Combined hormonal birth control like Nextstellis can raise your blood pressure. This is more likely to happen as you get older and use the birth control pill for a long time.

Check your blood pressure regularly while taking Nextstellis. Tell your prescriber if it stays higher than usual. They can help manage your blood pressure. And if your blood pressure isn't well controlled, they can help you find a different birth control option.

Headaches can happen while taking Nextstellis. But stop taking it and call your prescriber right away if you have migraines for the first time. Also tell them right away if your migraines become more frequent or severe or if they don't go away. Don't take Nextstellis if you have migraines with aura because this can raise your risk of stroke.

• Risk factors: Currently have or have had breast cancer | Current, long-term, or recent users of combined hormonal birth control

Based on studies, it’s not clear if there’s a link between combined hormonal birth control like Nextstellis and the risk of breast cancer or cervical cancer. But it's possible that it could affect your risk.

Nextstellis has lab-made hormones that act like estrogen and progesterone. Some cancers, like breast cancer, can be hormone-dependent. This means that the cancer can grow with the help of these hormones. Some studies suggest there's a slightly higher risk of breast cancer or cervical cancer if you’ve taken birth control pills for a long time.

To be safe, don’t take Nextstellis if you have or have had breast cancer. If you’re worried about your risk of cancer, talk to your prescriber or gynecologist. They can help you choose the best birth control option for you.

• Risk factors: History of liver damage or liver problems | Taking certain hepatitis C combination medications

Nextstellis can raise your liver enzyme levels, which might be a sign of liver damage. Although rare, combined hormonal birth control pills can also raise the risk of liver tumors. Don't take Nextstellis if you have liver problems.

Know the signs of liver problems. Watch for yellowing of your skin or the whites of your eyes, stomach pain, loss of appetite, dark urine, or unusual tiredness. Stop taking Nextstellis and call your prescriber right away if you notice these symptoms.

• Risk factors: History of gallbladder problems | Jaundice

Combined hormonal birth control like Nextstellis might raise the risk of gallbladder problems. Tell your prescriber if you’ve had gallbladder issues or jaundice (yellow skin or eyes) before. These conditions could get worse while you're taking this birth control pill.

Watch for signs of gallbladder problems. This can include jaundice, fever, chills, nausea, vomiting, pain in the upper right side of your stomach, or dark urine. Tell your care team right away if you notice any of these symptoms.

• Risk factors: Prediabetes or diabetes (high blood sugar)

Nextstellis can raise your blood sugar levels. This is because it can affect how well your body processes sugar. Tell your prescriber if you have high blood sugar or diabetes. They might recommend checking your blood sugar more often while you're taking Nextstellis. Be sure to tell your prescriber if you become much thirstier than usual or urinate more often than usual. These can be signs of high blood sugar.

• Risk factors: Personal or family history of high triglyceride levels

Nextstellis can raise your triglyceride (fat) levels. Very high triglyceride levels can raise your risk of pancreatitis (inflammation of the pancreas). If you have high cholesterol or high triglycerides, talk to your prescriber to see if Nextstellis is safe for you.

Your periods might change after you start taking Nextstellis. Spotting or breakthrough bleeding is common while you're taking the active pills, especially during the first few cycles. But it usually gets better over time. Tell your prescriber if it doesn't improve or becomes bothersome.

You might also miss your period during the 4 days you take the white inactive pills. Missing a period can be a sign of pregnancy, especially if you missed doses of Nextstellis. If you think you might be pregnant, take a pregnancy test and contact your prescriber.

Tell your prescriber if you have new or worsening depression while taking Nextstellis. Watch for signs like feeling sad, having low energy, losing interest in things you usually enjoy, or changes in your appetite. If your depression becomes severe, you might need to stop taking Nextstellis.

• Risk factors: History of hereditary angioedema | History of chloasma gravidarum (melasma) | Skin that's more sensitive to sun or ultraviolet (UV) light

Before taking Nextstellis, tell your prescriber if you have hereditary angioedema or melasma (dark patches on your face). This birth control pill might make these conditions worse. If you've had melasma before, limit your time in the sun and avoid tanning beds or other sources of UV light while taking Nextstellis.