Periodic check-ups are recommended during treatment. Investigations, including mammography, should be carried out in accordance w/ currently accepted screening practices, modified to the clinical needs of the individual. Discontinue therapy if jaundice or deterioration in liver function, significant increase in BP, new onset of severe migraine-type headache & pregnancy occurs; VTE develops. Leiomyoma (uterine fibroids) or endometriosis, risk factors for thromboembolic disorders & estrogen dependent tumours, eg, 1st degree heredity for breast cancer; HTN, liver disorders (eg, liver adenoma), DM w/ or w/o vascular involvement, cholelithiasis, migraine or severe headache, SLE, history of endometrial hyperplasia, epilepsy, asthma, otosclerosis. Increased risk of CV morbidity in the 1st yr of use, venous thrombosis & pulmonary embolism; breast cancer; endometrial hyperplasia & carcinoma on prolonged periods; ovarian cancer in hysterectomised women on long-term use. Temporarily stop 4-6 wk earlier if prolonged immobilisation is liable following elective surgery, particularly abdominal or orthopaedic surgery to the lower limbs. Breakthrough bleeding & spotting may occur during the 1st mth of treatment. Fluid retention. Preexisting hypertriglyceridemia. Observe diabetic patients closely or those w/ predisposition to diabetes. Patients known to have residual endometriosis post-hysterectomy. Abnormal vag bleeding. Monitor BP & thyroid function. Not indicated during pregnancy & lactation.
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