Cigarette smoking increases the risk of serious cardiovascular side effects from hormonal contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use hormonal contraception, including ORTHO TRI-CYCLEN<sup>®</sup> LO are strongly advised not to smoke. <br /><br />What are the risks of using hormonal contraceptives (including ORTHO TRI-CYCLEN<sup>®</sup> LO)?

    • The serious side effects of the pill occur very infrequently, especially if you are in good health and are young. However, you should know that the following medical conditions have been associated with or made worse by the pill:
      • Blood clots in the legs or lungs, heart attacks and stroke (smoking increases the risk of having a heart attack or stroke).
      • Gallbladder disease.
      • Benign but dangerous liver tumors.
      • Breast and cervical cancer.
      • High blood pressure, although blood pressure usually returns to normal when ORTHO TRI-CYCLEN® LO is stopped.

      Call your doctor immediately if you experience any of these side effects while you are using ORTHO TRI-CYCLEN® LO:
      • Sharp chest pain, coughing blood or sudden shortness of breath.
      • Pain in the calf.
      • Crushing chest pain or tightness in the chest.
      • Sudden, severe, headache or vomiting, dizziness or fainting, disturbances of vision or speech, weakness or numbness in an arm or leg.
      • Sudden or complete loss of vision.
      • Breast lumps.
      • Severe pain or tenderness in the stomach area.
      • Difficulty in sleeping, weakness, lack of energy, fatigue or change in mood (possibly indicating severe depression).
      • Yellowing of the skin or whites of the eye along with fever, fatigue, loss of appetite, dark colored urine or light colored bowel movements.