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What is the most important information I should know about Alesse?
• Take your pill at the same time every day starting period early birth control pills alesse. Each dose should come no morethan 24 hours after the last dose starting period early birth control pills alesse.
• Avoid smoking cigarettes while taking Alesse starting period early birth control pills alesse. Smoking greatly increasesthe risk of having a heart attack, stroke, or blood clot starting period early birth control pills alesse.
• Use another form of birth control if you miss several doses (see thepackage insert) or if you are taking drugs that decrease the effectiveness ofAlesse (see the section of this leaflet titled "What other drugs will affectAlesse?") starting period early birth control pills alesse.

What are Alesse?
• Alesse contains a combination of hormones that is used to prevent ovulation(the release of an egg from an ovary) starting period early birth control pills alesse. The pills contain a form of estrogenand a form of progesterone, which are both female hormones involved in conception starting period early birth control pills alesse.
• Alesse also have other effects that inhibit pregnancy starting period early birth control pills alesse. They cause thecervical mucous to thicken, which makes it harder for sperm to move toward theuterus, and they prevent the attachment of an egg to the uterus starting period early birth control pills alesse.
• Alesse is used to prevent pregnancy starting period early birth control pills alesse.
• Alesse may also be used for purposes other than those listed in thismedication guide starting period early birth control pills alesse.

What should I discuss with my healthcare provider before taking Alesse?
• Before taking this medication, tell your doctor if you
· have high blood pressure, angina, or heart disease;
· have had a stroke;
· have a bleeding or blood-clotting disorder;
· have breast, uterine, or another hormone-related cancer;
· have liver disease or a history of jaundice (yellowing of the skinand eyes) caused by use of birth control in the past;
· have undiagnosed, abnormal vaginal bleeding;
· have migraines;
· have asthma; or
· have seizures or epilepsy starting period early birth control pills alesse.
• You may not be able to take Alesse, or you may require a lower dose orspecial monitoring during treatment if you have any of the conditions listedabove starting period early birth control pills alesse.
• Alesse is in the FDA pregnancy category X starting period early birth control pills alesse. This means that Alesse willcause birth defects in an unborn baby starting period early birth control pills alesse. Hormonal changes during pregnancy canhave very serious negative effects on a developing baby starting period early birth control pills alesse. Do not take Alesseif you are pregnant or if you think you might be pregnant starting period early birth control pills alesse.
• The hormones in Alesse pass into breast milk and may decrease milk production starting period early birth control pills alesse. Do not take Alesse without first talking to your doctor if you are breast-feedinga baby starting period early birth control pills alesse.

How should I take Alesse?
• Take Alesse exactly as directed by your doctor starting period early birth control pills alesse. If you do not understandthese directions, ask your pharmacist, nurse, or doctor to explain them to you starting period early birth control pills alesse.
• Take the first pill in a package on the first Sunday after your periodbegins (unless otherwise directed by your doctor) starting period early birth control pills alesse.
• Take one pill every day, no more than 24 hours after your last dose starting period early birth control pills alesse. Try to take the pills at a time that you will remember every day--for examplejust before bed, with a meal, or first thing in the morning starting period early birth control pills alesse.
• Taking your pill at night may help to reduce any nausea or headache thatyou may experience because of the hormones starting period early birth control pills alesse.
• If you are on a 28-day cycle, take one pill every day starting period early birth control pills alesse. When the packruns out, throw it away starting period early birth control pills alesse. Begin a new pack the following day starting period early birth control pills alesse. The 28-day cyclecontains seven pills that are either placebos (with no active ingredients) oriron supplements starting period early birth control pills alesse. These are "reminder" pills to keep you on your regularcycle starting period early birth control pills alesse. They are taken while you are menstruating starting period early birth control pills alesse.
• If you are on a 21-day cycle, take one pill every day for 21 days, thendo not take any pills for 7 days starting period early birth control pills alesse. You should have your period during the 7 dayswith no pills starting period early birth control pills alesse. Resume your pills on the 8th day with a new package starting period early birth control pills alesse.
• Follow your doctor's instructions about using a second form of birthcontrol when you first start taking Alesse, when you are taking antibiotics,or if you miss a pill starting period early birth control pills alesse. If you are unsure what to do in any of these cases, talkto your pharmacist, nurse, or doctor about how to ensure that you will not becomepregnant starting period early birth control pills alesse.
• Store Alesse at room temperature away from moisture and heat starting period early birth control pills alesse.

What happens if I miss a dose?
• Missing a pill increases the risk of becoming pregnant starting period early birth control pills alesse.
• Follow the exact directions on your package information insert concerningmissed doses starting period early birth control pills alesse. If you do not have a package information insert, call your pharmacist,doctor, or nurse to find out what to do starting period early birth control pills alesse.
• In general:
• If you miss one dose, take it as soon as you remember or take two pillsat the time of your next regularly scheduled dose starting period early birth control pills alesse. There is little likelihoodthat ovulation will occur starting period early birth control pills alesse. You may, however, want to use a second method ofbirth control such as a condom or a spermicidal cream, jelly, or foam for atleast seven consecutive days following the missed tablet to ensure protectionfrom pregnancy starting period early birth control pills alesse.
• If you miss two tablets in a row, take the two missed tablets as soonas you remember or with your next regularly scheduled dose (three total) starting period early birth control pills alesse. Or,you may take two tablets each for the next two regularly scheduled doses (onemissed tablet plus one regularly scheduled tablet for 2 days in a row) starting period early birth control pills alesse. Chancesare much greater that you may ovulate so you must use another form of birthcontrol for at least 7 days following the missed tablets starting period early birth control pills alesse. It is even betterto use a second method of birth control until your next period starting period early birth control pills alesse.
• If you miss three tablets in a row, throw away the package and starta new package on the 7th day after the last day you took a pill starting period early birth control pills alesse. Use anothermethod of birth control until you have taken a pill for 7 days in a row starting period early birth control pills alesse. Yourperiod should occur during the 7 days without pills starting period early birth control pills alesse. If it doesn't, have a pregnancytest before beginning a new package of pills starting period early birth control pills alesse.
• Read all of the information in your package information insert starting period early birth control pills alesse. It mayhave slightly different instructions in the case of missed pills starting period early birth control pills alesse. Talk to yourpharmacist, nurse, or doctor if you have any questions starting period early birth control pills alesse.

What happens if I overdose?
• Death is not likely to occur from an overdose of Alesse starting period early birth control pills alesse. Consult a doctor,an emergency room, or a poison control center for advice starting period early birth control pills alesse.
• Symptoms of an overdose include nausea, vomiting, and menstrual bleeding starting period early birth control pills alesse.

What should I avoid while taking Alesse?
• Avoid smoking starting period early birth control pills alesse. Smoking greatly increases your risk of a heart attack,stroke, or blood clot formation starting period early birth control pills alesse.
• Alesse do not protect you from sexually transmitted diseases--includingHIV and AIDS starting period early birth control pills alesse. Using a condom is the only way to protect yourself from thesediseases starting period early birth control pills alesse.

What are the possible side effects of Alesse?
• If you experience any of the following serious side effects, stop takingAlesse and seek emergency medical attention:
· an allergic reaction (difficulty breathing; closing of your throat;swelling of your lips, tongue, or face; or hives);
· a blood clot in the lung (shortness of breath or pain in the chest);
· a blood clot in an arm or leg (pain, redness, swelling, or numbnessof an arm or leg);
· high blood pressure (severe headache, flushing, blurred vision); or
· liver damage (yellowing of the skin or eyes, nausea, abdominal painor discomfort, unusual bleeding or bruising, severe fatigue) starting period early birth control pills alesse.
• Other, less serious side effects may be more likely to occur starting period early birth control pills alesse. Continueto take Alesse and talk to your doctor if you experience
· headache or dizziness;
· nausea, vomiting, or diarrhea;
· breakthrough bleeding; or
· breast tenderness starting period early birth control pills alesse.
• These side effects may disappear or be less noticeable after 3 to 6 monthsof birth control use starting period early birth control pills alesse. Ask your doctor or pharmacist for advice if you find anyside effect very bothersome starting period early birth control pills alesse.
• The side effects listed below generally occur very rarely and are notconsidered serious starting period early birth control pills alesse. If you experience any of the following, talk to your doctor:
· depression,
· changes in weight or appetite,
· vaginal yeast infection,
· changes in your menstrual cycle,
· oily skin or acne,
· changes in your sex drive,
· lethargy or fatigue,
· bloating,
· changes in your skin color, or
· changes in your blood sugar starting period early birth control pills alesse.
• Side effects other than those listed here may also occur starting period early birth control pills alesse. Talk to yourdoctor about any side effect that seems unusual or that is especially bothersome starting period early birth control pills alesse.

What other drugs will affect Alesse?
• Some drugs may decrease the effectiveness of Alesse, which may resultin pregnancy starting period early birth control pills alesse. Use a second form of birth control if you are taking
· a penicillin antibiotic such as amoxicillin (Amoxil, Polymox, Trimox,Wymox, Utimox, A-Cillin, Larotid, Augmentin, others), ampicillin (Principen,Omnipen, Penamp, Polycillin, Amplin, Amcill, Totacillin, others), bacampicillin(Spectrobid), carbenicillin (Geocillin), cloxacillin (Cloxapen, Tegopen), dicloxacillin(Dynapen, Dycill, Pathocil), nafcillin (Nafcil, Nallpen, Unipen), oxacillin(Bactocill, Prostphlin), or penicillin (Veetids, Pen Vee K, Bicillin, Permapen,others);
· a tetracycline antibiotic such as demeclocycline (Declomycin), doxycycline(Doryx, Doxy, Vibramycin, Vibra-Tabs, others), minocycline (Minocin), or tetracycline(Sumycin, Teracyn, Achromycin, Robitet, Panmycin, others);
· a barbiturate such as amobarbital (Amytal), butabarbital (Butisol),mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal,Solfoton);
· rifampin (Rifadin);
· phenytoin (Dilantin);
· carbamazepine (Tegretol); or
· griseofulvin (Grisactin, Grifulvin V, Fulvicin PG) starting period early birth control pills alesse.
• Drugs other than those listed here may also interact with Alesse starting period early birth control pills alesse. Talkto your doctor and pharmacist before taking any prescription or over-the-countermedicines starting period early birth control pills alesse.

Where can I get more information?
• Your pharmacist has additional information about Alesse written for healthprofessionals that you may read starting period early birth control pills alesse.

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