<p>Before you start to use this tablet: If the combined Pill is used in the presence of any of the conditions listed below you may need to be kept under close observation. Your doctor can explain this to you. Therefore, if any of these apply to you, tell your doctor before starting to use this tablet</p>

<ul>
	<li>you smoke;</li>
	<li>you have diabetes;</li>
	<li>you are overweight;</li>
	<li>you have high blood pressure;</li>
	<li>you have a heart valve disorder or a certain heart rhythm disorder;</li>
	<li>you have an inflammation of your veins (superficial phlebitis);</li>
	<li>you have varicose veins;</li>
	<li>anyone in your immediate family has had a thrombosis, a heart attack or a stroke;</li>
	<li>you suffer from migraine;</li>
	<li>you suffer from epilepsy;</li>
	<li>you or someone in your immediate family have or had high blood levels of cholesterol or triglycerides (fatty substances);</li>
	<li>anyone in your immediate family has had breast cancer;</li>
	<li>you have liver or gallbladder disease;</li>
	<li>you have Crohn&#39;s disease or ulcerative colitis (chronic inflammatory bowel disease);</li>
	<li>you have systemic lupus eryhematosus (SLE; a disease affecting the skin all over the body);</li>
	<li>you have haemolytic uraemic syndrome (HUS; a disorder of blood coagulation causing failure of the kidneys);</li>
	<li>you have sickle cell disease;</li>
	<li>you have or have had chloasma (yellowish-brown pigmentation patches on the skin, particularly of the face): if so, avoid too much exposure to the sun or ultraviolet radiation.</li>
</ul>

<p>If any of the above conditions appear for the first time, recur or worsen while using the Pill, you should contact your doctor.<br />
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<strong>The Pill and Thrombosis</strong>: A thrombosis is the formation of a blood clot, which may block a blood vessel. A thrombosis sometimes occurs in the deep veins of the legs (deep venous thrombosis). If this blood clot breaks away from the veins where it is formed, it may reach and block the arteries of the lungs, causing a so-called &quot;Pulmonary embolism.&quot; Deep venous thrombosis is a rare occurrence. It can develop whether or not you are taking the Pill. It can also happen if you become pregnant. The risk is higher in Pill-users than in non-users, but it is not as high as the risk during pregnancy.<br />
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Blood clots can also occur very rarely in the blood vessels of the heart (causing a heart attack) or the brain (causing a stroke). Extremely rarely blood clots can occur in the liver, gut, kidney or eye.<br />
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Very occasionally a thrombosis may cause serious permanent disabilities or may even be fatal.<br />
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The risk of having a heart attack or stroke increases, as you get older. It also increases the more you smoke. When using the Pill you should stop smoking, especially if you are older than about 35 years of age.<br />
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If you develop high blood pressure while using the Pill, you may be told to stop using it.<br />
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The risk of having a deep venous thrombosis is temporarily increased as a result of an operation or immobilisation (for example, when you have your leg or legs in plaster or splints). In women who use the Pill, the risk may be yet higher. Tell your doctor you are using the Pill well in advance of any expected hospitalisation or surgery. Your doctor may tell you to stop taking the Pill several weeks before surgery or at the time of immobilisation. Your doctor will also tell you when you can start taking the Pill again after you are back on your feet. If you notice possible signs of a thrombosis, stop taking the Pill and consult your doctor immediately.<br />
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<strong>The Pill and cancer</strong>: Breast cancer has been diagnosed, slightly more often in women who use the Pill than in women of the same age who do not use the Pill. This slight increase in the numbers of breast cancer diagnoses gradually disappears during the course of the 10 years after stopping use of the Pill. It is not known whether the difference is caused by the Pill. It may be that the women were examined more often, so that the breast cancer was noticed earlier. In rare cases benign liver tumours and even more rarely, malignant liver tumours have been reported in users of the Pill. These tumours may lead to internal bleeding. Contact your doctor immediately if you have severe pain in your stomach.<br />
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Cervical cancer has been reported to occur more often in women using the Pill for a long time. This finding may not be caused by the Pill but may be related to sexual behaviour and other factors.<br />
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<strong>The Pill and other Medicines</strong>: Some medicines may stop the Pill from working properly. These include medicines used for the treatment of epilepsy (eg. primidone, phenytoin, barbiturates) and tuberculosis (eg. rifampicin); and antibiotics (eg. ampcillin, tetracyclines, griseofulvin) for some other infectious diseases. Always tell the doctor, who prescribes the Pill, which medicines you are already using. Also tell any other doctor or dentist who prescribes another medicine (or the dispensing pharmacist) that you use this tablet. They can tell you if you need to take additional contraceptive precautions and if so, for how long.<br />
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<strong>The Pill and Ability to Drive</strong>: There are no observed effects.</p>