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What are the most common side effects of norethindrone acetate/ethinyl estradiol and ferrous fumarate?

The most common side effects of norethindrone acetate/ethinyl estradiol and ferrous fumarate are listed below. Tell your health care provider if you have any of these side effects that bother you.

• Headache (see below)
• Nausea and vomiting
• Period cramps
• Breast tenderness
• Mood changes
• Weight gain
• Painful periods or bleeding between periods
• Trouble wearing contact lenses

There may be other side effects of norethindrone acetate/ethinyl estradiol and ferrous fumarate that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of norethindrone acetate/ethinyl estradiol and ferrous fumarate?

While less common, the most serious side effects of norethindrone acetate/ethinyl estradiol and ferrous fumarate are described below, along with what to do if they happen.

Severe Allergic Reactions. Norethindrone acetate/ethinyl estradiol and ferrous fumarate may cause allergic reactions, which can be serious. Stop taking norethindrone acetate/ethinyl estradiol and ferrous fumarate and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Blood Clots. Norethindrone acetate/ethinyl estradiol and ferrous fumarate may cause blood clots in your veins or arteries and could cause venous thromboembolism (VTE), stroke, heart attack, a blood clot in the lungs (pulmonary embolism), or a blood clot in the eyes. Stop taking norethindrone acetate/ethinyl estradiol and ferrous fumarate and get emergency help right away if you have any of the following signs of blood clots. 

• Chest pain or pressure
• Fast or abnormal heartbeat
• Trouble breathing
• Pain in your back, jaw, throat, or arm
• Sweating, upset stomach, vomiting, or dizziness
• Sudden weakness on one side of your body
• Sudden and severe headache
• Slurred speech or trouble understanding speech
• Pain, swelling, or tenderness in your arm or leg
• Vision loss
• Bulging eyes 
• Double vision

Liver Problems. Norethindrone acetate/ethinyl estradiol and ferrous fumarate may cause changes to your liver function, including liver tumors and an increase in your liver enzymes. Call your health care provider right away if you have any of the following symptoms of liver problems.

• Nausea or vomiting
• Stomach or belly pain
• Fever
• Weakness or unusual tiredness
• Itching
• Loss of appetite
• Light-colored poop
• Dark-colored urine
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Increased Blood Pressure (Hypertension). Norethindrone acetate/ethinyl estradiol and ferrous fumarate may increase your blood pressure or make it worse if you have a history of high blood pressure. Keep all appointments with your health care provider. Call your health care provider if your blood pressure increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your health care provider right away if you have any of the following symptoms of severely high blood pressure.

• Sudden severe headache
• Chest pain
• Dizziness or confusion
• Trouble breathing
• Nausea or vomiting
• Blurry or other changes to vision
• Anxiety
• Buzzing in the ears
• Nosebleed
• Feeling of skipped heartbeats

Gallbladder Problems. Taking norethindrone acetate/ethinyl estradiol and ferrous fumarate can cause gallbladder problems, including cholecystitis and cholelithiasis (also known as gallstones). Call your health care provider right away if you have any of the following symptoms.

• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
• Fever
• Pain in your upper stomach area
• Clay-colored stool (poop)

Headache or Migraine. Stop taking norethindrone acetate/ethinyl estradiol and ferrous fumarate and call your health care provider right away if you get new headaches/migraines that keep coming back or cause you a lot of pain.

Changes in Menstrual Bleeding. Norethindrone acetate/ethinyl estradiol and ferrous fumarate can cause irregular bleeding, spotting, or light bleeding between periods, especially during the first three months of use. For some people, periods may stop. Call your health care provider right away if you continue to have spotting or breakthrough bleeding between periods or if you have spotting after having regular cycles while taking norethindrone acetate/ethinyl estradiol and ferrous fumarate.

Depression. Norethindrone acetate/ethinyl estradiol and ferrous fumarate may cause changes in mood, including depression. Stop taking norethindrone acetate/ethinyl estradiol and ferrous fumarate and call your health care provider right away if you have new or increased feelings of depression or other unusual changes in mood or behavior.

Cancer. Norethindrone acetate/ethinyl estradiol and ferrous fumarate is a combination birth control pill that contains two hormones. Certain cancers, including breast cancer and cervical cancer, are types of cancers that may be sensitive to hormones. Make sure you keep all appointments with your health care provider.