Sign Out
Smoking: Cigarette smoking increases the risk of serious cardiovascular side effect from RITA. This risk increases with age and with heavy smoking (≥ 15 cigarettes per day) and is quite marked in women > 35 years of age. Women who use RITA should not smoke.
Thromboembolism: Be alert to the earliest symptoms of thromboembolic and thrombotic disorders. Should any of these occur or be suspected, discontinue the drug immediately.
MI: MI risk associated with RITA use is increased. The risk is primarily in smokers or women with other underlying risk factors for coronary artery disease such as hypertension, hypercholesterolemia, morbid obesity and diabetes. The risk is very low in women < 30 years of age.
Cerebrovascular diseases: RITA increase the risk of cerebrovascular event (thrombotic and hemorrhagic strokes), although, in general, the risk is greatest in hypertensive women > 35 years of age who also smoke.
Age: The risk of cerebrovascular and circulatory disease in RITA users is substantially increased in women ≥ 35 years of age with other risk factor (e.g. smoking, uncontrolled hypertension, hypercholesterolemia [LDL 190], obesity, diabetes).
Carcinoma: Numerous epidemiological studies have been performed on the incidence of breast, endometrial, ovarian, and cervical cancer in women using combined oral contraceptives. While there are conflicting reports, the overall evidence in the literature suggests that use of oral contraceptives is not associated with an increase in the risk of developing breast cancer, regardless of age and parity of first use. Close clinical surveillance of all women taking oral contraceptives is essential; they should be reexamined at least once a year. In all cases of undiagnosed persistent or recurrent abnormal vaginal bleeding, rule out malignancy. Monitor women with a strong family history of breast cancer or who have breast nodules, fibrocystic disease of the breast, cervical dysplasia, or abnormal mammograms.
Effects on glucose: Decreased glucose tolerance has been observed in a significant percentage of patients receiving oral contraceptives. Fasting blood glucose concentrations are not altered in most patients; however, increased plasma insulin and blood pyruvate concentrations may occur. Pre-diabetic and diabetic patients should be carefully monitored during estrogen-progestin contraceptive therapy.
Elevated blood pressure: Increased in blood pressure may occur in women receiving estrogen-progestin contraceptive therapy. Blood pressure elevations are usually minor, but clinically important hypertension may occur in some women.
Monitoring: It is good medical practice for all women to have annual history and physical examinations. Physical examination may be deferred until after initiation of oral contraceptives if requested by the patient and judged appropriated by the health care provider.
