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What special precautions should I follow?
The following medicines may reduce the effectiveness of Ortho tricyclen. You should use an additional method of birth control during each cycle in which any of the following medicines are used:
< br> - Ampicillin
- Barbiturates
- Carbamazepine (e.g., Tegretol)
- Griseofulvin (e.g., Fulvicin)
- Penicillin V
- Phenytoin (e.g., Dilantin)
- Primidone (e.g., Mysoline)
- Rifampin (e.g., Rifadin)
- Ritonavir (e.g., Norvir)
- Tetracyclines (medicine for infection)
- Troglitazone (e.g., Rezulin)
- Rifampin (e.g., Rifadin)
- Ritonavir (e.g. , Norvir)
- Tetracyclines (medicine for infection)
- Troglitazone (e.g., Rezulin)

What special precautions should I follow?
Pregnancy¡XOrtho tricyclen are not recommended for use during pregnancy and should be discontinued if you become pregnant or think you are pregnant. When Ortho tricyclen were accidently taken early in pregnancy, problems in the fetus did not occur. Women who are not breast-feeding may begin to take Ortho tricyclen two weeks after having a baby.

Breast-feeding¡XOrtho tricyclen pass into the breast milk and can change the content or lower the amount of breast milk. Also, they may shorten a woman's ability to breast-feed by about 1 month, especially when the mother is only partially breast -feeding.

Before Using This Medicine
Breast disease (not involving cancer)¡XOrtho tricyclen usually protect against certain breast diseases, such as breast cysts or breast lumps; however, your doctor may want to follow your condition mor closely
- Cancer, including breast cancer (or history of or family history of)¡XOrtho tricyclen may worsen some cancers, especially when breast, cervical, or uterine cancers already exist. Use o Ortho tricyclen is not recommended if you have any of these conditions. If you have a family history of breast disease, Ortho tricyclen may still be a good choice but you may need to be tested more o ften
- Chorea gravidarum or
- Gallbladder disease or gallstones (or history of) or
- High blood cholesterol or

Possible Side Effect
Ortho tricyclen may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
-
- upset stomach
- vomiting
- stomach cramps or bloating
- dia rrhea
- constipation
- gingivitis (swelling of the gum tissue)
- weight gain or weight loss
- brown or black skin patches
- acne
- swelling of the hands, feet, or lower l egs (fluid retention)
- hair growth in unusual places
- bleeding or spotting between menstrual periods
- changes in menstrual flow
- painful or missed periods
- breast tendern ess, enlargement, or discharge
- difficulty wearing contact lenses

What is this medicine
Ortho tricyclen (birth-control pills) are used to prevent pregnancy. Estrogen and progestin are two female sex hormones. Combinations of estrogen and progestin work by preventing the release of eggs f rom the ovaries (ovulation) and changing the cervical mucus and the lining of the uterus. Ortho tricyclen are a very effective method of birth control, but they do not prevent the spread of AIDS and o ther sexually transmitted diseases.

Special Information
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, Orth o tricyclen are used in certain patients with the following medical conditions:

- Amenorrhea (stopping of menses for several consecutive months)
- Dysfunctional uterine bleeding (abnorm al uterine bleeding)
- Dysmenorrhea (painful menstrual bleeding)
- Hypermenorrhea (excessive menstrual bleeding)
- Emergency contraception within 72 hours of unprotected intercourse
- Endometriosis
- Hirsutism in females
- Hyperandrogenism, ovarian
- Polycystic ovary syndrome


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