Common uses

This medication is used to prevent pregnancy. This medication contains 2 hormones (levonorgestrel, a progestin, and ethinyl estradiol, an estrogen). These hormones prevent pregnancy by preventing the release of an egg (ovulation) and changing the womb and cervical mucus to make it more difficult for an egg to meet sperm (fertilization) or attach to the wall of the womb (implantation).
Using this medication does not protect you or your partner against sexually transmitted diseases (e.g., HIV, gonorrhea).

Before using

Before using this medication, tell your doctor or pharmacist if you are allergic to ethinyl estradiol or levonorgestrel; or to other estrogens or progestins; or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this product, consult your doctor or pharmacist if you have: history of stroke or other blood clots (e.g., in the legs, eyes, lungs), severe high blood pressure, abnormal breast exam, cancer (especially endometrial and breast cancer), diabetes that has caused kidney/eye/nerve/blood vessel disease, severe headaches, history of heart disease (e.g., heart attack, chest pain, irregular heartbeat), heart valve disease, liver problems (e.g., liver tumor, current liver disease), current or suspected pregnancy, recent major surgery, long periods of sitting or lying down (e.g., immobility such as being bedridden), history of yellowing eyes/skin (jaundice) during pregnancy or while using birth control pills, unexplained vaginal bleeding, heavy tobacco use (especially if 35 or over).
Before using this product, tell your doctor your medical history, especially of: high blood pressure, high cholesterol or triglyceride (blood fat) levels, depression, diabetes, swelling (edema), gallbladder problems, kidney disease, migraine, obesity, irregular/missed/very light periods, recent pregnancy, thyroid problems.

Directions

Read the Patient Information Leaflet provided by your pharmacist before you start using this product and each time you get a refill. The leaflet contains very important information about when to take your pills and what to do if you miss a dose. If you have any questions, consult your doctor or pharmacist.
Take this medication by mouth once daily or as directed by your doctor. Pick a time of day that is easy for you to remember, and take your pill at the same time each day. Pregnancy is more likely if you miss a pill or take a pill late. Make sure you get a new pill pack before you finish your current pack. Also, make sure you have back-up birth control (e.g., condoms) available in case you miss a pill.
If you have been using another form of hormonal birth control (e.g., patch, another type of pill), ask your doctor or pharmacist how to switch to this product.
If you are using this medication for the first time, and you are not switching from another form of hormonal birth control (e.g., patch, ring, other birth control pills), take the first pill in the pack on the first day of your period. If your doctor directs you to start this medication on any other day, use an additional form of birth control for the first 7 days.
Continue taking 1 tablet every day. After taking the last tablet in your old pack, start a new pack the next day. There is no break between packs, and there are no "reminder" tablets (tablets without medication). Most women do not have regular periods while taking this medication. You may have some bleeding or spotting. If this happens, do not stop taking your pills.
If you vomit or have diarrhea within 4 hours after taking this medication, you may need to use a back-up method of birth control. Consult your Patient Information Leaflet for more information. (See also Missed Dose section.)
If you have any stomach upset or nausea with this medication, it may help to take it after your evening meal or at bedtime. You may choose to take this medication at another time of day that is easier for you to remember. No matter what time you choose, it is very important that you take this medication at the same time each day, 24 hours apart. Ask your doctor or pharmacist if you have any questions.

Cautions

People who have a history of cardiovascular disease, cerebrovascular disorders such as migraine headaches, a predisposition to blood clot formation, liver disease, breast cancer, and undiagnosed vaginal bleeding should avoid oral contraceptives. People who smoke increase their risk for cardiovascular disease which can be increased even moreso if they also use oral contraceptives. Pregnant women and nursing mothers should not use oral contraceptives.

Possible side effects

Nausea, vomiting, headache, stomach cramping/bloating, dizziness, vaginal discomfort/irritation, increased vaginal fluids, or breast tenderness/enlargement may occur. Acne may improve or get worse. If any of these effects persist or worsen, tell your doctor promptly.
Many women will not have regular periods while taking this medication. This is normal. Vaginal bleeding/spotting is likely to occur, especially during the first few months of use. If bleeding is unusually heavy or lasts for more than 7 days in a row, contact your doctor promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor immediately if any of these serious side effects occur: problem wearing contact lenses, dark patches on the skin (melasma), unwanted facial/body hair, swelling ankles/feet, unusual weight changes (gain or loss).
This medication may rarely cause serious (sometimes fatal) problems from blood clots (e.g., pulmonary embolism, stroke, heart attack). Seek immediate medical attention if you experience: sudden shortness of breath, chest/jaw/left arm pain, confusion, coughing up blood, sudden dizziness/fainting, pain/swelling/warmth in the groin/calf, tingling/weakness/numbness in the arms/legs, headaches that are different from those you may have experienced in the past (e.g., headaches with other symptoms such as vision changes/lack of coordination, existing migraines becoming worse, sudden/very severe headaches), slurred speech, weakness on one side of the body, vision problems/changes.
Tell your doctor immediately if any of these rare but very serious side effects occur: lump in the breast, severe pain in the stomach/abdomen/pelvis, mental/mood changes (e.g., depression, rare thoughts of suicide), persistent trouble sleeping, unusual tiredness, dark urine, yellowing eyes/skin.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of tongue, lips, throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
If you take too much

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, and vaginal bleeding.

Additional information

Do not smoke while using Alesse, especially if you are older than 35. Smoking can increase your risk of blood clots, stroke, or heart attack caused by Alesse.
Alesse will not protect you from sexually transmitted diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.

Drug interactions

Some drugs can make Alesse less effective, which may result in pregnancy. Before using Alesse, tell your doctor if you are using any of the following drugs:
acetaminophen (Tylenol) or ascorbic acid (vitamin C);
prednisolone (Orapred);
theophylline (Respbid, Theo-Dur);
cyclosporine (Neoral, Sandimmune, Gengraf);
St. John's wort;
an antibiotic;
seizure medications;
a barbiturate sedative such as secobarbital (Seconal), or phenobarbital (Luminal, Solfoton); or
HIV or AIDS medications.
This list is not complete and there may be other drugs not listed that can affect Alesse. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.