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What should I discuss with my healthcare provider before using dienogest and estradiol (Natazia)?

Do not use this medication if you are allergic to dienogest or estradiol, or if you have:

• a history of heart attack, stroke, blood clot, or coronary artery disease;
• a blood-clotting disorder, untreated or uncontrolled high blood pressure;
• a hormone related cancer such as breast or uterine cancer;
• abnormal vaginal bleeding;
• problems with your eyes, kidneys, or circulation caused by diabetes;
• liver disease or liver cancer;
• severe migraine headaches;
• a heart valve or heart rhythm disorder; or
• if you smoke and you are over 35 years old.

To make sure you can safely take this medicine, tell your doctor if you have any of these other conditions:

• a history of depression;
• high blood pressure, heart disease, congestive heart failure, high cholesterol or triglycerides;
• diabetes;
• underactive thyroid; or
• a history of jaundice caused by birth control pills.

The hormones in this medication can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast feeding a baby.

How should I take dienogest and estradiol (Natazia)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Take your first pill on the first day of your period or on the first Sunday after your period begins. Follow the directions on your prescription label. The 28 day birth control pack contains five different colors of pills. Take one pill each day in the exact order directed on the blister pack.

Take one pill every day, no more than 24 hours apart. When the pills run out, start a new pack the following day. Get your prescription refilled before you run out of pills completely.

You may need to use back up birth control, such as condoms or a spermicide, when you first start using this medication. Follow your doctor's instructions. Do not take two different kinds of birth control pills at the same time.

If you are switching to this medication from another birth control pill, start taking dienogest and estradiol on the first day of your withdrawal bleeding and stop taking the other birth control pills. If you were taking progestin only pills before, start taking dienogest and estradiol on the day you would have taken your next pill.

If you are switching from a birth control implant, intrauterine device (IUD), vaginal ring, or skin patch, start taking dienogest and estradiol on the day the other birth control device is removed.

If you are switching from a birth control injection, start taking dienogest and estradiol on the day you would have received your next scheduled injection.

You may have breakthrough bleeding. Tell your doctor if this bleeding continues or is very heavy.

Use a back up birth control if you are sick with severe vomiting or diarrhea. Vomiting within 4 hours after your dose is the same as missing a pill.

If you need surgery or medical tests or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are using birth control pills.

Store at room temperature away from moisture and heat.

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