<p><strong>Vascular risks</strong>: Stop this contraceptive pill if a thrombotic event occurs. Stop at least 4 weeks before and through 2 weeks after major surgery. Start no earlier than 4 weeks after delivery, in women who are not breastfeeding. COCs containing DRSP may be associated with a higher risk of venous thromboembolism (VTE) than COCs containing levonorgestrel or some other progestins. Before initiating this contraceptive pill in a new COC user or a woman who is switching from a contraceptive that does not contain DRSP, consider the risks and benefits of a DRSP-containing COC in light of her risk of a VTE.<br />
<br />
<strong>Hyperkalemia</strong>: DRSP has antimineralocorticoid activity. Do not use in patients predisposed to hyperkalemia. Check serum potassium concentration during the first treatment cycle in women on long-term treatment with medications that may increase serum potassium concentration.<br />
<br />
<strong>Liver disease</strong>: Discontinue this contraceptive pill if jaundice occurs.<br />
<br />
<strong>High blood pressur</strong>e: Do not prescribe this contraceptive pill for women with uncontrolled hypertension or hypertension with vascular disease.<br />
<br />
<strong>Carbohydrate and lipid metabolic effects</strong>: Monitor prediabetic and diabetic women taking this contraceptive pill. Consider an alternate contraceptive method for women with uncontrolled dyslipidemia.<br />
<br />
<strong>Headache</strong>: Evaluate significant change in headaches and discontinue this contraceptive pill if indicated.<br />
<br />
<strong>Uterine bleeding</strong>: Evaluate irregular bleeding or amenorrhea</p>