Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Brevicon. If you are concerned about side effects, discuss the risks and benefits of Brevicon with your doctor.

The following side effects have been reported by at least 1% of people taking Brevicon. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• Acne (usually less common after 3 months of treatment, and may improve if acne already exists)
• bloating, fluid retention
• breast pain, tenderness, or swelling
• brown, blotchy spots on exposed skin
• changes in appetite
• discomfort wearing contact lenses
• dizziness
• gain or loss of body or facial hair
• increased or decreased interest in sexual activity
• irritability
• nausea
• vaginal discharge
• vomiting
• weight gain or loss

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abdominal or stomach pain (sudden, severe, or continuing)
• breast lumps
• changes in hearing
• changes in the uterine bleeding pattern at or between periods, such as:
• breakthrough bleeding or spotting between periods
• complete stopping of menstrual bleeding that occurs over several months in a row
• decreased bleeding during periods
• prolonged bleeding at periods
• stopping of menstrual bleeding that only occurs sometimes
• headaches or migraines
• increased blood pressure
• pain and numbness, change in colour or feeling cold in the hands and feet
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• swelling of the feet, ankles, or lower leg
• swelling, pain, or tenderness in the upper abdominal area
• symptoms of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of inflammatory bowel disease (Crohn’s disease; abdominal pain, severe diarrhea, fatigue, weight loss)
• symptoms of Lupus (e.g., Fever, general feeling of being unwell, joint pain, confusion, muscle aches, skin rash)
• symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)
• vaginal infection with vaginal itching or irritation, or thick, white, or curd-like discharge
• vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

• loss of vision or change in vision (sudden)
• pains in chest, groin, or leg (especially in calf of leg)
• rash
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of a blood clot in the lung (e.g., coughing up blood, sudden/unexplained shortness of breath)
• signs of heart attack (e.g., sudden chest pain or pain radiating to back, down arm, jaw; sensation of fullness of the chest; nausea; vomiting; sweating; anxiety)
• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
• signs of stroke (e.g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Brevicon.

0.5 mg/35 µg .
Each blue circular tablet impressed "SEARLE" on one side and "BX" on the other contains 0.5 mg of norethindrone and 0.035 mg (35 µg) of ethinyl estradiol. Nonmedicinal ingredients: corn starch, FD&C Blue No. 2, lactose, magnesium stearate, and povidone.

In the 28-day pack there are 7 orange tablets, impressed "SEARLE" on one side and "P" on the other, which contain no active ingredients. Nonmedicinal ingredients: FD&C Yellow No. 6 Lake, lactose hydrous, magnesium stearate, and microcrystalline cellulose.

1 mg/35 µg
Each white circular tablet impressed "SEARLE" on one side and "BX" on the other contains 1.0 mg of norethindrone and 0.035 mg (35 µg) of ethinyl estradiol. Nonmedicinal ingredients: corn starch, lactose, magnesium stearate, and povidone.

In the 28-day pack there are 7 orange tablets, impressed "SEARLE" on one side and "P" on the other, which contain no active ingredients. Nonmedicinal ingredients: FD&C Yellow No. 6 Lake, lactose hydrous, magnesium stearate, and microcrystalline cellulose.

Do not take norethindrone - ethinyl estradiol if you:

• are allergic to norethindrone, ethinyl estradiol, or any ingredients of the medication
• are or may be pregnant
• have eye damage resulting from blood vessel disease of the eye, such as a partial or complete loss of vision
• have had a Heart Attack
• have Coronary Artery Disease or Angina
• have, have had, or may have Breast Cancer
• have too much or too little lipoprotein in the blood
• have migraine Headaches
• have or have had pancreatitis (inflammation of the pancreas) as a result of high levels of triglycerides
• have heart valve disease with complications
• have an irregular heart rhythm
• have or have had liver disease, jaundice (yellowing of the skin or eyes), or liver problems during pregnancy
• have multiple risk factors for a blood clot, such as:
• Diabetes with blood vessel damage
• heavy smoking (more than 15 cigarettes per day) and age over 35
• inherited blood clotting problems
• major surgery
• prolonged bed rest
• severe high blood pressure (blood pressure of 160/100 or higher)
• have or have had cancerous or non-cancerous liver tumours
• have or have had cerebrovascular disorders (e.g., Stroke)
• have or have had Thrombophlebitis or thromboembolic disorders (blood clotting problems)
• have, may have, or have had endometrial cancer (cancer of the lining of the uterus)
• have or may have a tumour dependent on estrogen
• have undiagnosed abnormal vaginal bleeding
• are taking a combination of medications to treat Hepatitis C virus that contain ombitasvir, paritaprevir, ritonavir, and dasabuvir, with or without ribavirin

There may be an interaction between norethindrone - ethinyl estradiol and any of the following:

• acitretin
• Amiodarone
• ampicillin
• Anastrozole
• antihypertensive medications (medications that are used to treat high blood pressure)
• Apixaban
• Aprepitant
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Clobazam, Diazepam, Lorazepam)
• Bosentan
• Celecoxib
• Cholestyramine
• clofibrate
• Clozapine
• Cobicistat
• Colestipol
• conivaptan
• corticosteroids (e.g., Dexamethasone, Hydrocortisone, Prednisone)
• Cyclosporine
• dabigatran
• Dabrafenib
• Deferasirox
• dehydroepiandrosterone
• diabetes medications (e.g., chlorpropamide, Glyburide, insulin, Metformin,  Rosiglitazone)
• Dronedarone
• Enzalutamide
• Exemestane
• Exenatide
• Heparin
• hepatitis C antivirals (e.g., asunaprevir, ombitasvir, paritaprevir, ritonavir, dasabuvir)
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• hyaluronidase
• imatinib
• Lenalidomide
• Lomitapide
• low-molecular-weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Metronidazole
• mifepristone
• Mitotane
• Modafinil
• mycophenolate
• nefazodone
• Nitrofurantoin
• Norfloxacin
• other estrogens (e.g., conjugated estrogen, estradiol, ethinyl estradiol)
• penicillin
• other progestins (e.g., Dienogest, Levonorgestrel, medroxyprogesterone)
• proguanil
• Prucalopride
• rifabutin
• rifampin
• Ropinirole
• St. John's wort
• saw palmetto
• Selegiline
• seizure medications (e.g., Carbamazepine, Gabapentin, Levetiracetam, Phenytoin, Topiramate)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• siltuximab
• soybean
• sulfonamides (e.g., sulfamethoxazole)
• tetracyclines (e.g., Minocycline, Tetracycline)
• thalidomide
• theophyllines (e.g., Aminophylline, Oxtriphylline, Theophylline)
• Thyroid replacements (e.g., dessicated thyroid, Levothyroxine)
• Tizanidine
• Tocilizumab
• Tranexamic acid
• tretinoin
• Ulipristal
• Ursodiol
• vitamin C (ascorbic acid)
• voriconazole
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Brevicon. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Brevicon.

Blood Clots: Brevicon may increase the chance of blood clot formation, causing reduction of blood flow to organs or the extremities. If you have a history of clotting you may be at increased risk of experiencing blood clot-related problems such as heart attack, stroke, or clots in the deep veins of your leg. Discuss with your doctor how Brevicon may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Brevicon, and whether any special monitoring is needed.

If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision or difficulty speaking, contact your doctor immediately.

Breast cancer: Increasing age and a strong family history are the most significant risk factors for the development of breast cancer. Other established risk factors include Obesity, not having had children, and a late age at first full-term pregnancy. The identified groups of women that may be at increased risk of developing breast cancer before Menopause are women who have used birth control pills for more than 8 years or who started using them at an early age. For a few women, the use of birth control pills may accelerate the growth of an existing but undiagnosed breast cancer.

If you are taking birth control pills, learn how to perform a breast self-examination. Notify your doctor any time you detect a lump. A yearly clinical breast examination is also recommended because, if breast cancer develops, medications that contain estrogen may cause it to grow quickly.

Depression: Hormones, such as estrogen, have been known to cause mood swings and symptoms of depression. If you have had clinical depression in the past, you may be more likely to experience it again while taking Brevicon. If you have depression or a history of depression, discuss with your doctor how Brevicon may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Brevicon, and whether any special monitoring is needed.

If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking Brevicon contact your doctor as soon as possible.

Diabetes: Current low-dose birth control pills affect glucose control very little. If you have diabetes or a family history of diabetes, monitor your blood glucose closely to detect any worsening of blood sugar control after starting birth control pills.

Epilepsy: Women with a history of epileptic seizures should speak to their doctor about the possibility of Brevicon increasing the numbers of epileptic seizures they may experience.

Eyes: Women who are pregnant or who take birth control pills may experience fluid build-up in the cornea of the eye, which may cause visual disturbances and changes in tolerance to contact lenses, especially rigid contact lenses. Wearers of soft contact lenses usually do not experience difficulties. If you experience visual changes or alterations in tolerance to contact lenses, you may need to stop wearing the lenses temporarily or permanently.

Fibroids: If you have fibroids (leiomyomata), your doctor should closely monitor your condition. If sudden enlargement, pain, or tenderness occurs, contact your doctor to see if you need to stop taking the medication.

Headache: Birth control pills may cause the development or worsening of migraine symptoms. If you have a history of migraine headache, discuss with your doctor how Brevicon may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Brevicon, and whether any special monitoring is needed.

Heart disease: Cigarette smoking increases the risk of serious heart disease and death. Taking birth control pills increases this risk, especially with increasing age. Studies show evidence that women who smoke and are over 35 years old should not use birth control pills.

Other women who have a high risk for heart disease include those with diabetes, high blood pressure, or abnormal cholesterol levels, or those with a family history of these conditions. Whether taking birth control pills increases this risk is unclear.

For low-risk, non-smoking women of any age, the benefits of birth control pill use outweigh the possible cardiovascular risks of low-dose pills.

Liver function: If you have reduced liver function or have had liver problems, discuss with your doctor how Brevicon may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Brevicon, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Brevicon.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Other cancers: There is some evidence that long-term use of oral contraceptives may increase the risk of cervical cancer or liver cancer. There is some debate about how significant this risk is. If you have concerns, discuss this with your doctor.

Regular check-ups: You should have a yearly physical examination and follow-up visit with your doctor.

Return to fertility: After stopping birth control therapy, you should delay pregnancy until at least one normal menstrual cycle has occurred in order to date the pregnancy. An alternative birth control method (e.g., condoms) should be used during this time.

If you do not menstruate for 6 months or more after stopping birth control pills, notify your doctor.

Sexually transmitted infections: Birth control pills do not protect against sexually transmitted infections, including HIV/AIDS. For protection against these, use latex condoms.

Stroke: Brevicon increases the risk of a stroke or "mini-strokes" occurring. If you experience signs of a stroke or mini-stroke, such as confusion, difficulty speaking, loss of coordination, sudden headache, or vision changes, contact your doctor as soon as possible.

Surgery: Certain situations such as long-term bed confinement may make blood clots more likely. Discuss with your doctor the risks and benefits of temporarily stopping Brevicon. If you are scheduled for surgery, let all doctors involved in your care know that you are taking Brevicon.

Pregnancy: The hormones in birth control pills can affect the developing fetus if taken by a woman who is pregnant. If you become pregnant while taking Brevicon, contact your doctor immediately.

Breast-feeding: The use of birth control pills while breast-feeding is not recommended. The hormonal components of the medication pass into breast milk and may reduce the quantity and quality of the breast milk. The long-term effects on the developing child are not known.