Desogestrel and Ethinyl Estradiol (Velivet) Risks, Warnings, and Complications

CIGARETTE SMOKING AND CARDIOVASCULAR RISKS: Smoking cigarettes while taking combined oral contraceptives increases the risk of serious cardiovascular side effects, including blood clots, stroke, and heart attack. This risk is especially high in females 35 years of age and older who smoke. You should strongly consider stopping smoking if you are on hormonal contraceptives. Talk to your doctor about other safer alternatives for pregnancy prevention if you continue to smoke.

BLOOD CLOTS AND OTHER VASCULAR PROBLEMS: Combination oral contraceptive use increases the risk of blood clots, including in the heart (heart attack), lungs (pulmonary embolism or PE), brain (stroke), and legs (deep vein thrombosis or DVT). Risk factors include smoking in women over the age of 35 years, age above 40 years, immobility due to recent surgery, childbirth less than a month ago, high blood pressure, high cholesterol, diabetes, obesity, and taking oral contraceptives with higher doses of estrogen. Seek emergency medical care if you develop signs and symptoms of a blood clot (chest pain, difficulty breathing, sudden weakness or numbness, or leg pain). Tell your doctor you are on birth control pills before any surgery. Your provider may tell you to stop taking hormonal birth control for a few weeks before and after the surgery to lower your risk of thromboembolic events (blood clots)

BREAST CANCER AND CERVICAL CANCER: Studies have not shown a consistent relationship between taking combined oral contraceptives and breast cancer risk. Similarly, it is unclear if oral contraceptives increase the risk of cervical cancer. 

Some types of breast cancer are hormonally sensitive (they grow more rapidly when exposed to estrogen). You should not take combined oral contraceptives if you have breast cancer or had breast cancer in the past. Talk to your provider about taking a progestin-only pill if you are concerned about breast cancer risk. 

Do monthly self-breast exams and yearly breast exams with your healthcare provider to aid in the early detection of breast cancer. Call your doctor without delay if you notice any changes in your breasts, such as lumps, pain, or swelling. Also, seek immediate medical attention if you experience abnormal vaginal bleeding, vaginal discharge, or painful sexual intercourse, as these can be signs of cervical cancer.

LIVER INJURY AND LIVER CANCER: Very rarely, desogestrel - ethinyl estradiol can cause liver problems, including liver damage and liver tumors. Liver problems were more likely with earlier formulations of contraceptive pills that contained high doses of estrogen. The risk of liver injury is higher if you are on treatment for a hepatitis C virus infection. Your healthcare provider may ask you to discontinue Velivet during treatment for hepatitis C virus infection. Tell your doctor right away if you develop fatigue, right upper stomach pain, or yellowing of the skin or eyes while taking desogestrel and ethinyl estradiol.

OCULAR LESIONS: There are reports of blood clots in the eye (retina) after use of oral contraceptives, which can lead to partial or complete blindness. Tell your doctor immediately if you develop loss of vision, double vision, swelling, or protrusion of the eye.

USE DURING EARLY PREGNANCY: Birth defects are extremely rare in infants born to women who used oral contraceptives before pregnancy or inadvertently during early pregnancy. Even though there are no demonstrated harmful infant effects, you should not use birth control pills to induce withdrawal bleeding as a test for pregnancy. You should also not use oral contraceptives during pregnancy to prevent a threatened abortion. If you have missed some tablets of oral contraceptives, consider the possibility of a pregnancy after the first missed period. If you have taken the pills perfectly on schedule, consider the possibility of a pregnancy after two missed periods. Discontinue taking oral contraceptives if a pregnancy is confirmed.

GALLBLADDER DISEASE: Taking desogestrel and ethinyl estradiol may cause or worsen gallbladder problems. This risk is minimal, especially with oral contraceptive formulations that contain low doses of hormones. Tell your doctor right away if you develop nausea, vomiting, stomach pain, or fever.

METABOLIC EFFECTS: Combined oral contraceptives like desogestrel-ethinyl estradiol can raise your blood sugar and triglyceride levels. Tell your provider if you have prediabetes, diabetes, or high cholesterol before starting oral contraceptives. Keep all your medical and lab appointments. Your doctor may want to monitor blood sugar and cholesterol levels.

ELEVATED BLOOD PRESSURE: Taking combined oral contraceptives can lead to an increase in blood pressure. Talk to your health care professional about checking your blood pressure readings at home. Tell your doctor if you notice high blood pressure while on oral contraceptives. If you have uncontrolled hypertension or kidney problems, your doctor may recommend other birth control methods.

HEADACHE: It is not unusual to have headaches as a side effect of combined oral contraceptives, including desogestrel - ethinyl estradiol. Tell your doctor if you develop a new pattern of headaches, for example, headaches that are severe, persistent, or recurrent.

IRREGULAR BLEEDING: It is common to have spotting or breakthrough bleeding on hormonal contraceptives, especially in the first 3 months. Tell your provider if you experience vaginal bleeding outside your period or if your period stops completely.

ECTOPIC PREGNANCY: Women who are on combined oral contraceptives are at risk of both normal and ectopic pregnancy (pregnancy outside the womb) in case of contraceptive failure. Call your doctor immediately or seek emergency medical care if you develop low back pain, cramping, and abnormal vaginal bleeding.