Oral Contraceptives Health Article

Side Effects

Serious side effects are rare in healthy women who do not smoke cigarettes. In women with certain health problems, however, oral contraceptives may cause problems such as liver cancer, noncancerous liver tumors, blood clots, or stroke. Health care professionals can help women weigh the benefits of being protected against unwanted pregnancy against the risks of possible health problems.

The most common minor side effects are nausea; vomiting; abdominal cramping or bloating; breast pain, tenderness or swelling; swollen ankles or feet; tiredness; and acne. These problems usually go away as the body adjusts to the drug and do not need medical attention unless they continue or they interfere with normal activities.

Other side effects should be brought to the attention of the physician who prescribed the medicine. Check with the physician as soon as possible if any of the following side effects occur:

• menstrual changes, such as lighter periods or missed periods, longer periods, or bleeding or spotting between periods
• headaches
• vaginal infection, itching, or irritation
• increased blood pressure

Women who have any of the following symptoms should get emergency help right away. These symptoms may be signs of blood clots:

• sudden changes in vision, speech, breathing, or coordination
• severe or sudden headache
• coughing up blood
• sudden, severe, or continuing pain in the abdomen or stomach
• pain in the chest, groin, or leg (especially in the calf)
• weakness, numbness, or pain in an arm or leg

Oral contraceptives may continue to affect the menstrual cycle for some time after a woman stops taking them. Women who miss periods for several months after stopping this medicine should check with their physicians.

Other rare side effects may occur. Anyone who has unusual symptoms while taking oral contraceptives should get in touch with her physician.

Interactions

Oral contraceptives may interact with a number of other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes oral contraceptives should let the physician know all other medicines she is taking and should ask whether the possible interactions can interfere with drug therapy.

These drugs may make oral contraceptives less effective in preventing pregnancy. Anyone who takes these drugs should use an additional birth control method for the entire cycle in which the medicine is used:

• ampicillin
• penicillin V
• rifampin (Rifadin)
• tetracyclines
• griseofulvin (Gris-PEG, Fulvicin)
• corticosteroids
• barbiturates
• carbamazepine (Tegretol)
• phenytoin (Dilantin)
• primidone (Mysoline)
• ritonavir (Norvir)

In addition, taking these medicines with oral contraceptives may increase the risk of side effects or interfere with the medicine's effects:

• theophylline—effects of this medicine may increase, along with the chance of unwanted side effects
• cyclosporine—effects of this medicine may increase, along with the chance of unwanted side effects
• troleandomycin (TAO)—chance of liver problems may increase. Effectiveness of oral contraceptive may also decrease, raising the risk of pregnancy

The list above does not include every drug that may interact with oral contraceptives. Be sure to check with a physician or pharmacist before combining oral contraceptives with any other prescription or nonprescription (over-the-counter) medicine.

As with any medication, the benefits and risks should be discussed with a physician.

BOOKS

Beers, Mark H. and Robert Berkow, eds. The Merck Manual of Diagnosis and Therapy, 17th ed. Whitehouse Station, NJ: Merck and Company, Inc., 1999.

PERIODICALS

"Physician Group Supports Safety, Availability of Over-the-Counter Emergency Option" Medical Letter on the CDC and FDA (March 18, 2001).

"Current Perspectives on OC Formulations" Family Practice News (January 15, 2001): 2.

OTHER

Medline Plus Health Information, U.S. National Library of Medicine. <http://www.nlm.nih.gov/medlineplus>.

Deanna M. Swartout-Corbeil, R.N.