Warnings and precautions to be aware of prior to using Activella include the following:
Estrogen/progestin drugs may increase the risk of breast cancer. Proper screening and monitoring (as determined by your healthcare provider), such as yearly mammograms and monthly self breast exams, are recommended.
Your healthcare provider should make sure you are appropriately treated for any risk factors for heart disease, strokes, or blood clots before you take Activella. Risk factors include:
Let your healthcare provider know if you have abnormal vaginal bleeding (such as heavy bleeding or bleeding between periods) while taking Activella, as this may be a sign of precancerous or cancerous changes in the uterus. Your healthcare provider can perform the necessary tests to rule out cancer.
When possible, Activella should be stopped four to six weeks before many surgeries in order to help prevent blood clots.
Estrogen-containing drugs seem to increase the risk of dementia. In no case should Activella be used to prevent or treat dementia (it is not effective for this use).
Activella should be used with caution in women who have low calcium levels in the blood (known medically as hypocalcemia).
Women who take estrogen-containing medications like Activella have an increased risk for gallbladder disease.
Let your healthcare provider know right away if you notice any vision changes. This can signal a blood clot in the retina, a possible side effect of Activella.
If you have had jaundice (yellowing of the whites of the eyes or skin) due to estrogens or pregnancy in the past, Activella could cause similar problems to recur. If this happens, your healthcare provider will probably advise you to stop taking the drug.
If you have an underactive thyroid (hypothyroidism), Activella may increase your body's requirement for thyroid hormones. Your healthcare provider should monitor you and adjust the dose of your thyroid medications as necessary.
The hormones in Activella pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Activella and Breastfeeding).