Tydemy

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

If you smoke cigarettes, using combined oral contraceptives (COCs), like Safyral, 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 Safyral less than a month after childbirth | High blood pressure | People identified as obese | Diabetes | Higher dose of estrogen

Safyral 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 Safyral. They might have you stop taking it 4 weeks before until 2 weeks after your surgery to lower your risk of blood clots.

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

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

Don't use Safyral if you have breast cancer because some types of breast cancer grow faster in the presence of estrogen, an ingredient in this birth control pill. To help with early breast cancer detection, you can do monthly breast self-checks at home and yearly breast exams with your healthcare provider. Call your healthcare provider if you notice any abnormal changes or feel lumps, pain, or swelling in your breasts.

Get medical help right away if you experience abnormal vaginal bleeding, discharge, or pain during sex, since these could be signs of cervical cancer.

• Risk factors: Liver problems or infection in the liver | Taking COCs with 50 mcg of estrogen or higher | Using COCs for longer than 8 years

Though rare, Safyral can cause liver problems, such as liver damage and liver tumors. These problems are linked more with earlier formulations of COCs that contained higher levels of estrogen (50 mcg or higher), and less so with Safyral since it only contains 30 mcg of estrogen.

Using COCs, like Safyral, can also lead to a risk for liver cancer, though this is extremely rare. The risk is higher if you've used COCs for a long time.

Don't use this medication if you already have liver problems. Call your provider right away if you experience symptoms of liver problems, such as tiredness, stomach pain, or yellowing of the skin or whites of the eyes.

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

Safyral and other COCs can raise your blood pressure. Your provider might ask you to check your blood pressure regularly. If you notice your blood pressure is higher while you're taking this medication, contact your provider. If you have uncontrolled high blood pressure, Safyral might not be the best option for you.

• Risk factors: Prediabetes or diabetes | Personal or family history of high triglycerides

COCs like Safyral might raise your blood sugar and triglyceride (fat) levels, which can lead to complications like pancreatitis. In addition, some progesterones could raise LDL levels ("bad" cholesterol). If you have diabetes, let your provider know if you experience any changes in your blood sugar. If your lipids aren't under control, you might need to use a different form of birth control. Make sure to go to all of your check-ups so your provider can monitor any changes.

Headaches are a common side effect of COCs like Safyral. But, if you experience a new migraine, a migraine that's worse than normal, or a new headache that keeps coming back or is severe, call your provider so you can be checked out.

• Risk factors: History of depression

Let your provider know if you experience symptoms of depression or worsening depression while taking Safyral. In cases of serious depression, your provider might have you stop taking it.

Certain medications can make Safyral get broken down faster in your body, making it less effective (not work as well). This can lead to pregnancy. If you're taking medication such as carbamazepine (Tegretol) and phenytoin (Dilantin), use a back-up method of birth control during and for at least 28 days after stoppingthese medications. Other medications can raise the amount of Safyral 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 Safyral.

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 Safyral before starting Viekira Pak because taking them together can cause liver problems. You can start Safyral again 2 weeks after you stop Viekira Pak.

• Risk factors: Kidney, liver, or adrenal gland problems | Taking medications that raise potassium levels | Taking medications that raise Safyral levels

Safyral contains drospirenone, which can cause high levels of potassium in some people. Taking Safyral with medications that raise potassium levels like ACE inhibitors, potassium-sparing diuretics, or potassium supplements can put you more at risk. Your provider should monitor your potassium levels during your first cycle of Safyral and regularly while taking this medication.

Contact your provider if you experience signs of high potassium like nausea, irregular heartbeat, or muscle weakness.