Do NOT use Alesse if:

• you are allergic to any ingredient in Alesse
• you are pregnant or think you may be pregnant
• you have a history of blood clotting problems, severe blood clots (eg, in the lungs, legs, eyes), certain blood vessel problems (eg, bleeding in the brain, heart attack, stroke), or breast cancer
• you are at risk for developing severe blood clots or have certain heart problems (eg, certain heart valve problems, certain types of irregular heartbeat)
• you have chest pain caused by angina; certain types of headaches or migraines with aura; severe or uncontrolled high blood pressure; endometrial, cervical, or vaginal cancer; estrogen-dependent growths; or undiagnosed abnormal vaginal bleeding; or diabetes that affects circulation
• you have liver disease, liver tumors or cancer, or a history of yellowing of the eyes or skin caused by pregnancy or prior birth control use
• you have had surgery and are or will be confined to a bed or a chair for an extended period of time
• you are older than 35 years old and you smoke 15 or more cigarettes per day.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Alesse. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have endometriosis, growths in the uterus, abnormal mammogram, irregular menstrual periods, a lump in the breast, heart problems, diabetes, headaches or migraines, gallbladder problems, high blood cholesterol or lipid levels, high blood pressure, kidney problems, blood problems (eg, porphyria), blood in the urine, depression or other mental/mood problems, lupus, chorea, high blood calcium levels, yellowing of the eyes or skin, pancreas problems (eg, pancreatitis), seizures (eg, epilepsy), or a history of cancer
• if you are overweight, you have not yet had your first menstrual period, or you use tobacco
• if you have given birth or otherwise ended a pregnancy within the past 4 weeks.

Some medicines may interact with Alesse. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Atorvastatin, indinavir, or troleandomycin because they may increase the risk of Alesse's side effects
• Aprepitant, azole antifungals (eg, itraconazole, ketoconazole), barbiturates (eg, phenobarbital), bosentan, carbamazepine, dexamethasone, felbamate, griseofulvin, HIV protease inhibitors (eg, ritonavir), hydantoins (eg, phenytoin), modafinil, nevirapine, oxcarbazepine, penicillins (eg, amoxicillin), phenylbutazone, primidone, rifabutin, rifampin, St. John's wort, tetracyclines (eg, doxycycline), topiramate, or troglitazone because they may decrease Alesse's effectiveness, resulting in breakthrough bleeding or pregnancy
• Beta-blockers (eg, propranolol), corticosteroids (eg, prednisolone), cyclosporine, or theophylline because the risk of their side effects may be increased by Alesse
• Clofibric acid, lamotrigine, morphine, salicylic acid, or temazepam because their effectiveness may be decreased by Alesse.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Alesse may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

• Alesse may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Alesse with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Follow your doctor's instructions for examining your own breasts, and report any lumps immediately.
• If you will be having surgery or will be confined to a bed or chair for a long period of time (such as a long plane flight), notify your doctor 3 to 4 weeks ahead of time. Special precautions may need to be taken in these circumstances while taking Alesse.
• You should usually not take Alesse within 4 weeks after giving birth or otherwise ending a pregnancy. Discuss any questions or concerns with your doctor.
• Alesse may cause dark skin patches on your face. Exposure to the sun may make these patches darker. If patches develop, use a sunscreen or wear protective clothing when exposed to the sun, sunlamps, or tanning booths.
• Use of Alesse will not protect against HIV infection or prevent the spread of sexually transmitted diseases (STDs).
• Bleeding or spotting may occur while taking Alesse. Do not stop taking Alesse if this occurs. If bleeding or spotting continues for more than 7 days or is heavy, contact your doctor.
• Smoking while using Alesse may increase your risk of stroke, heart attack, blood clots, high blood pressure, or other diseases of the heart and blood vessels.
• Alesse may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Alesse.
• Taking certain antibiotics, anticonvulsants, or other medicines, as listed in the interactions section, while you are using Alesse may decrease the effectiveness of Alesse. To prevent pregnancy, use an extra form of birth control (eg, condoms) until your next period.
• If you wear contact lenses and you develop problems with them, contact your doctor.
• If you miss your period during the week of inactive pills, call your doctor immediately. A missed period may indicate that you are pregnant.
• Alesse may take time to wear off after your last dose. You may not be able to become pregnant for several months after stopping Alesse.Discuss any concerns with your doctor or pharmacist.
• Lab tests, such as PAP tests, may be performed while you use Alesse. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Alesse should not be used in children who have not had their first menstrual period; safety and effectiveness in these children have not been confirmed.
• Pregnancy and breast-feeding: Do not use Alesse if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Alesse is found in breast milk. Do not breastfeed while taking Alesse.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Acne; breast tenderness or enlargement; changes in appetite; changes in sexual interest; changes in weight; dizziness; hair loss; headache; nausea; stomach cramps or bloating; unusual spotting or bleeding; vomiting.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); breast discharge; breast lumps; calf or leg pain, swelling, or tenderness; change in amount of urine produced; change in vaginal secretions; changes in vision or speech; confusion; coughing of blood; crushing chest pain or heaviness in the chest; dark-colored urine; depression; difficulty sleeping; difficulty wearing contact lenses; fainting; fluid retention (swelling of the fingers and ankles); lack of energy; light-colored bowel movements; mental or mood changes; missed menstrual period; numbness of an arm or leg; one-sided weakness; persistent headache or migraines; persistent or recurrent abnormal vaginal bleeding; persistent or severe dizziness; severe pain or tenderness in the stomach; shortness of breath; sudden partial or complete loss of vision; sudden severe headache or vomiting; tiredness; vaginal irritation or discharge; weakness; yellowing of the skin or eyes.

 This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.