Before you begin the use of Apri, you should inform your doctor if you are allergic to estrogen, progestin, or any other medication.
Make sure you inform your doctor of any form of allergy that you might have (food, drugs, materials and so on).
Also, if you are yet to have a period after you start using Apri postpartum (following childbirth), you should ask your doctor for another method of contraception that you can use for the first 7 days after you begin the use of the rose-colored Apri pills. This will give the medication enough time to work. However, if you start medication on the first day of your period, you do not need to use a back-up contraception method.
During the use of this medication, you should limit the time you spend under the sun, as the medication might cause blotchy, dark areas to appear on face and skin (melasma) which is worsened by the sun.
It might take longer for you to become pregnant after you stop taking this medication (or any other form of birth control pill). You should see your doctor for more information.
The use of this medication might cause a decrease in the production of breast milk. Also, a small amount of Apri passes into breast milk and may have unwanted effects on a nursing infant. You should see your doctor for consultation before breastfeeding.
Let your doctor know your medical history before you start using this medication;
Some of the important conditions you should tell your doctor about include:
- A history of blood clots in the legs, eyes, and lungs for example
- Blood clotting disorders
- High blood pressure
- Abnormal breast exam
- Family or personal history of certain swelling disorders
- History of jaundice (yellowing eyes/skin) while using a hormonal birth control method (pill or patch) or during pregnancy.
Note: This is not a full list of all the medical conditions or history that can be affected by Apri. You should provide your doctor with the full details of your medical history before you begin the use of this medication.
Apri side effects
You should get medical help right away if you notice any symptoms of a serious allergic reaction such as severe dizziness, trouble breathing, rashes, and itching/swelling (areas such as the face, tongue or throat).
- Breast tenderness
- Swelling of the ankles/feet
- Weight change
- Vaginal bleeding between periods
- Irregular/missed periods, especially during the first few months of use.
If any of the symptoms mentioned above persists or worsens, tell your doctor as soon as possible.
If you miss two menstrual periods in a row (or if you miss one menstrual period when the pill has been used wrongly), you should consult your doctor for a pregnancy test.
Serious side effects
You should immediately call for emergency help if you show any signs of any of these symptoms:
- Lumps in breast
- Liver problems
- Mental/mood changes (new/ worsening depression)
- Severe stomach/abdominal pain
- Changes in vaginal bleeding that are unusual (continuous spotting, sudden heavy bleeding, missed periods)
- Signs of jaundice (yellowing eyes/skin)
- Dark urine
Rare side effects
Rare and serious side effects may occur due to problems caused by blood clots. You should get medical help immediately if any of the side effects listed below occur:
- Chest/jaw/left arm pain
- Sudden dizziness/fainting
- Slurred speech
- Sudden shortness of breath/rapid breathing
- Unusual sweating
- Weakness on one side of the body
- Unusual headaches (sudden/very severe headaches, vision changes/lack of coordination)
- Vision problems
Note: This list of side effects does not represent all the side effects that can be caused by the use of Apri. If you notice any unusual feeling not listed here during the use of this drug, consult your doctor immediately.
Do NOT take Apri if:
- You are allergic to any of the active or inactive ingredients in this medicine
- You are pregnant, think you might be pregnant, or are planning on becoming pregnant
- You have a history of heart attack or stroke
- You have blood clots in the legs (thrombophlebitis), brain (stroke), lungs (pulmonary embolism) or eyes
- You have a history of blood clots in the deep veins of your legs
- You have chest pain (angina pectoris)
- You have known or suspected breast cancer or cancer of the uterus lining, cervix or vagina
- You have unexplained vaginal bleeding
- You have had jaundice (yellowing of the skin or whites of the eyes) during pregnancy or previous use of a contraceptive medication
- You have a liver tumor (benign or cancerous)
- You are due to undergo major surgery with prolonged immobilization
- You suffer from headaches with focal neurological symptoms
- You have been diagnosed with high blood pressure
In addition, tell your doctor and take particular care with Apri if any of the following apply to you:
- You have breast nodules, fibrocystic disease of the breast, an abnormal breast x-ray or mammogram
- You have diabetes
- You have elevated cholesterol or triglycerides
- You have high blood pressure
- You have migraines or other headaches
- You have epilepsy
- You have depression
- You have gallbladder, heart or kidney disease
- You have a history of irregular menstrual periods
- You smoke. You are strongly advised not to smoke while using hormonal contraceptives.
Before taking Apri, tell your doctor if you are taking or have recently taken any other medicines, including those purchased over the counter without a prescription. The following medicines may interfere with the effectiveness of Apri, or cause breakthrough bleeding:
- Anticonvulsants, such as carbamazepine, felbamate, oxcarbazepine, phenytoin, rufinamide, and topiramate.
- Rifampin and rifabutin
- Certain combinations of HIV medicines (nelfinavir, ritonavir, ritonavir-boosted protease inhibitors)
- Certain non-nucleoside reverse transcriptase inhibitors (nevirapine)
- Barbiturates such as phenobarbital, topiramate (Topamax), and phenytoin (Dilitan)
- Phenylbutazone (Butazolidin)
- Bosentan (Tracleer)
- Certain antibiotics
- St John’s Wort, an herbal remedy used to treat depression
Some medicines may increase your level of the hormone Ethinyl Estradiol is used together, including:
- Ascorbic acid
- Medicines that affect how your liver breaks down other medicines (itraconazole, ketoconazole, voriconazole, and fluconazole)
- Certain HIV medicines (atazanavir, indinavir)
- Grapefruit juice