Estrogens and Progestins Oral Contraceptives (Systemic)

Brand name(s): Alesse

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. If you are using oral contraceptives for contraception you should understand how their benefits and risks compare to those of other birth control methods. This is a decision you, your sexual partner, and your doctor will make. For oral contraceptives, the following should be considered:

Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to estrogens or progestins. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet-Make certain your health care professional knows if you are on any special diet, such as a low-sodium or low-sugar diet.

Pregnancy-Oral contraceptives are not recommended for use during pregnancy and should be discontinued if you become pregnant or think you are pregnant. When oral contraceptives were accidently taken early in pregnancy, problems in the fetus did not occur. Women who are not breast-feeding may begin to take oral contraceptives two weeks after having a baby.

Breast-feeding-Oral contraceptives pass into the breast milk and can change the content or lower the amount of breast milk. Also, they may shorten a woman's ability to breast-feed by about 1 month, especially when the mother is only partially breast-feeding. Because the amount of hormones is so small in low-dose contraceptives, your doctor may allow you to begin using an oral contraceptive after you have been breast-feeding for a while. However, it may be necessary for you to use another method of birth control or to stop breast-feeding while taking oral contraceptives.

Teenagers-This medicine is frequently used for birth control in teenage females and has not been shown to cause different side effects or problems than it does in adults. Some teenagers may need extra information on the importance of taking this medication exactly as prescribed.

Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking oral contraceptives, it is especially important that your health care professional know if you are taking any of the following:

• Amiodarone (e.g., Cordarone) or
• Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
• Androgens (male hormones) or
• Anti-infectives by mouth or by injection (medicine for infection) or
• Barbiturates or
• Carbamazepine (e.g., Tegretol) or
• Carmustine (e.g., BiCNU) or
• Dantrolene (e.g., Dantrium) or
• Daunorubicin (e.g., Cerubidine) or
• Disulfiram (e.g., Antabuse) or
• Divalproex (e.g., Depakote) or
• Estrogens (female hormones) or
• Etretinate (e.g., Tegison) or
• Gold salts (medicine for arthritis) or
• Griseofulvin (e.g., Fulvicin) or
• Hydroxychloroquine (e.g., Plaquenil) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Methyldopa (e.g., Aldomet) or
• Naltrexone (e.g., Trexan) (with long-term, high-dose use) or
• Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
• Phenylbutazone (e.g., Butazolidin) or
• Phenytoin (e.g., Dilantin) or
• Plicamycin (e.g., Mithracin) or
• Primidone (e.g., Mysoline) or
• Rifabutin (e.g., Mycobutin) or
• Rifampin (e.g., Rifadin) or
• Troleandomycin (e.g., TAO)-These medicines may increase the chance of liver problems if taken with oral contraceptives; also, these medicines may decrease the effect of oral contraceptives and increase your chance of pregnancy. Use of an additional form of birth control is recommended unless directed otherwise by your health care professional

• Corticosteroids (cortisone-like medicine) or
• Theophylline-Oral contraceptives may increase the effects of these medicines and increase the chance of problems occurring

• Cyclosporine-Oral contraceptives increase the effect of cyclosporine and increase the chance of problems occurring

• Ritonavir (e.g., Norvir) or
• Troglitazone (e.g., Rezulin)-These medicines may decrease the effect of oral contraceptives and increase your chance of pregnancy. Use of an additional form of birth control is recommended unless directed otherwise by your health care professional

• Smoking, tobacco-Smoking may decrease the effect of oral contraceptives and increase the chance of causing serious blood clot, vein, or heart problems

Other medical problems-The presence of other medical problems may affect the use of oral contraceptives. Make sure you tell your doctor if you have any other medical problems, especially:

• Abnormal changes in menstrual or uterine bleeding or
• Endometriosis or
• Fibroid tumors of the uterus-Oral contraceptives usually improve these female conditions but sometimes they can make them worse or make the diagnosis of these problems more difficult

• Blood clots (or history of) or
• Heart or circulation disease or
• Stroke (or history of)-If these conditions are already present, oral contraceptives may have a greater chance of causing blood clots or circulation problems, especially in women who smoke tobacco. Otherwise, oral contraceptives may help prevent circulation and heart disease if you are healthy and do not smoke

• Breast disease (not involving cancer)-Oral contraceptives usually protect against certain breast diseases, such as breast cysts or breast lumps; however, your doctor may want to follow your condition more closely

• Cancer, including breast cancer (or history of or family history of)-Oral contraceptives may worsen some cancers, especially when breast, cervical, or uterine cancers already exist. Use of oral contraceptives is not recommended if you have any of these conditions. If you have a family history of breast disease, oral contraceptives may still be a good choice but you may need to be tested more often

• Chorea gravidarum or
• Gallbladder disease or gallstones (or history of) or
• High blood cholesterol or
• Liver disease (or history of, including jaundice during pregnancy or oral contraceptive use) or
• Mental depression (or history of)-Oral contraceptives may make these conditions worse or, rarely, cause them to occur again. Oral contraceptives may still be a good choice but you may need to be tested more often

• Diabetes mellitus (sugar diabetes)-Use of oral contraceptives may cause an increase, usually only a small increase, in your blood sugar and usually does not affect the amount of diabetes medicine that you take. You or your doctor will want to test for any changes in your blood sugar for 12 to 24 months after starting to take oral contraceptives in case the dose of your diabetes medicine needs to be changed

• Epilepsy (seizures) (or history of) or
• Heart or circulation problems or
• High blood pressure (hypertension) or
• Migraine headaches-Oral contraceptives may cause fluid build-up and may cause these conditions to become worse; however, some people have fewer migraine headaches when they use oral contraceptives

Last Revised: 03/15/2004