When should the combined oral contraceptive not be used at all (absolute contraindications)?
The pill and other combined hormonal preparations (estrogen-progestin preparations) should not be used by women with any of the diseases or conditions listed below. If any of the following occur for the first time while you are taking a hormonal contraceptive you should stop using the preparation immediately and consult your doctor. Use a non-hormonal method of contraception until your symptoms have been investigated.
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Past or present history of venous thrombosis (deep vein thrombosis, pulmonary embolism).
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Past or present history of arterial thrombosis (e.g. stroke, heart attack) or related manifestations (e.g. angina pectoris or temporary circulatory disturbances in the brain, which can be indicated by transient impairment of vision, for example).
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Presence of one or more severe risk factors for arterial thrombosis: diabetes with vascular changes, severe hypertension, severe disorders of lipid metabolism.
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Inherited or acquired disposition to venous or arterial thrombosis such as APC resistance, antithrombin III deficiency.
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Past or present history of severe liver disease until the liver function values have returned to normal.
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Past or present history of liver tumors (benign or malignant).
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Known or suspected malignant diseases of the genital organs or the breasts if these are influenced by sex hormones.
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Unexplained vaginal bleeding.
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History of migraine with focal neurological symptoms.
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Hypersensitivity to any of the active ingredients of the preparation.
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Precautions
In certain situations hormonal contraceptives should only be used under particularly close medical supervision. Your doctor can explain this to you in more detail. Be sure to inform your doctor if you suffer from any of the following diseases or if any of the following apply to you:
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Smoking
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Diabetes
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Significant overweight
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High blood pressure
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Diseases of the heart valves or certain cardiac rhythm disorders
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Inflammation of the veins (superficial phlebitis)
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Varicose veins
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Thrombosis, heart attack or stroke in close relatives
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Migraine
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Epilepsy
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High blood fat levels (cholesterol or triglycerides) or close relatives with high blood fat levels
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Breast cancer in a close relative
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Liver or gall bladder diseases
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Chronic bowel disease (Crohn's disease or ulcerative colitis)
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Systemic lupus erythematosus (a disease of the immune system)
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Hemolytic-uremic syndrome (a blood disease that causes kidney damage)
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Patchy, yellowish-brown discoloration of the skin, particularly of the face, or occurrence during a previous pregnancy (chloasma). In this case prolonged exposure to sunlight and UV radiation should be avoided.
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If any of the above occurs for the first time, recurs or deteriorates while you are using a hormonal contraceptive you should consult your doctor.
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