Nextstellis (drospirenone/estetrol) is a prescription oral tablet used to help prevent pregnancy in people of any age who can become pregnant. Nextstellis can cause mild and serious side effects, including irregular periods and depression.

Some people may experience mild to serious side effects during their Nextstellis treatment. Examples of the drug’s commonly reported side effects include:

Mild side effects have been reported with Nextstellis. These include:

  • acne
  • breast pain, swelling, or tenderness
  • headache
  • irregular periods, including spotting between periods, less frequent periods, or stopped periods
  • painful periods, including cramps
  • mood changes, such as feeling more angry, anxious, or irritable
  • low libido (sex drive)
  • weight gain
  • mild allergic reaction*†

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop taking Nextstellis unless your doctor recommends it.

Nextstellis may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after taking Nextstellis, but this side effect wasn’t reported in studies.

Serious side effects have been reported with Nextstellis. These include:

If you develop serious side effects while taking Nextstellis, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after taking Nextstellis, but this side effect wasn’t reported in studies.

Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Nextstellis, visit MedWatch.

Get answers to some frequently asked questions about Nextstellis’s side effects.

Is weight loss possible with Nextstellis?

It’s unlikely. Weight loss wasn’t reported as a side effect in studies of Nextstellis. However, weight gain was reported in the drug’s studies.

If you’re concerned about weight changes while taking Nextstellis, talk with your doctor. They can recommend ways to manage your weight.

Does Nextstellis cause long-term side effects?

It’s possible. Nextstellis has a boxed warning about the risk of serious cardiovascular events that may lead to long-term problems. For details, see the “Side effects explained” section below.

In addition, long-term treatment with hormonal birth control may increase the risk of high blood pressure or breast cancer. (Nextstellis is a type of hormonal birth control.) But it isn’t known for certain whether long-term treatment with Nextstellis increases these risks.

Talk with your doctor to learn more about possible side effects of Nextstellis and how long they may last.

Learn more about some of the side effects Nextstellis may cause.

Risk of serious cardiovascular events with cigarette smoking

Nextstellis has a boxed warning about the risk of serious cardiovascular events with cigarette smoking. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Cardiovascular events weren’t specifically reported in studies of Nextstellis. But this is a known risk when taking hormonal birth control, including Nextstellis. The risk of cardiovascular events may be highest for people who are over the age of 35 years and smoke cigarettes. For this reason, doctors usually will not prescribe Nextstellis for people with these factors.

Cardiovascular events affect your heart and blood vessels. Examples of these events and related symptoms include:

  • blood clots, which may cause symptoms such as:
    • swelling or pain in the affected area
    • skin warmth or discoloration
    • difficulty breathing
  • stroke, which may cause symptoms such as:
    • confusion
    • slurred speech
    • weakness or numbness on one side of your body
  • heart attack, which may cause symptoms such as:
    • shortness of breath
    • nausea
    • pain in your neck, shoulder, chest, or arm

What might help

If you have symptoms of a blood clot during Nextstellis treatment, contact your doctor right away. But if your symptoms seem life threatening or related to a stroke or heart attack, call 911 or a local emergency number right away.

Depression

Depression was a rare side effect reported in studies of Nextstellis. Depression may cause symptoms such as:

  • changes in appetite
  • feeling anxious, hopeless, or sad
  • fatigue (low energy)
  • loss of interest in activities you used to enjoy
  • sleep changes, such as insomnia (difficulty sleeping) or sleeping more than usual

If you’ve had depression in the past, this could increase your risk of this side effect when taking Nextstellis.

What might help

If you’ve ever had depression, talk with your doctor before taking Nextstellis. They can help determine whether Nextstellis is a safe treatment option for you.

If you have symptoms of depression while taking Nextstellis, talk with your doctor. They may have you stop taking the drug and suggest alternative birth control options instead.

Allergic reaction

Like most drugs, Nextstellis can cause an allergic reaction in some people. But this side effect wasn’t reported in studies.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an oral antihistamine, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Nextstellis, they’ll decide whether you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Nextstellis, they may have you switch to a different treatment.

Keeping track of side effects

During your Nextstellis treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Nextstellis affects you. They can then use this information to adjust your treatment plan if needed.

Below is important information you should consider before taking Nextstellis.

Boxed warning: Risk of serious cardiovascular events with cigarette smoking

Nextstellis has a boxed warning for the risk of serious cardiovascular events with cigarette smoking.

Cardiovascular events affect your heart and blood vessels. Examples of these events include blood clots, stroke, and heart attack.

To learn more about this warning, see the “Side effects explained” section above.

Other warnings

Nextstellis can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Nextstellis is a good treatment option for you.

Talk with your doctor about your health history before you take Nextstellis. Be sure to tell them if any of the following factors apply to you:

Alcohol and Nextstellis

There are no known interactions between alcohol and Nextstellis. It should be safe to drink alcohol during Nextstellis treatment.

If you have questions about consuming alcohol during Nextstellis treatment, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Nextstellis

Before starting Nextstellis treatment, it’s important to talk with your doctor if you’re pregnant, breastfeeding, or planning to become pregnant or to breastfeed.

Pregnancy

Nextstellis is prescribed to help prevent pregnancy. You should not take this drug while pregnant.

If you think you’ve become pregnant while taking Nextstellis, talk with your doctor right away. They can give you a pregnancy test and discuss your options with you.

Breastfeeding

Nextstellis is generally considered safe to take while breastfeeding. But taking the drug while breastfeeding may decrease breast milk production. This could make it difficult to breastfeed.

If you’re breastfeeding or planning to do so, talk with your doctor about your options.

Like most drugs, Nextstellis can cause a number of side effects that range from mild to serious. However, most are temporary and go away after a few days to weeks. If you have questions about side effects that Nextstellis can cause, talk with your doctor.

Examples of questions to help get you started include:

  • How do the side effects of Nextstellis compare with those of other types of hormonal birth control?
  • Could other medications I take raise my risk of side effects from Nextstellis?
  • Do any of my health conditions increase my risk of side effects from Nextstellis?

To learn more about Nextstellis, see this article.

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.