Uses of Junel Fe 24:

• It is used to prevent pregnancy.
• It is used to treat pimples (acne).
• It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take Junel Fe 24?

For all patients taking Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate):

• If you are allergic to Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate); any part of Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate); or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have had any of these health problems: Blood clots, blood clotting problem, breast cancer or other cancer where hormones make it grow, diseased blood vessels in the brain or heart, disease of a heart valve with problems, heart disease, chest pain caused by angina, heart attack, stroke, high blood pressure, liver disease, liver tumor, very bad headache or migraine, or diabetes that affects blood flow.
• If you have had any of these health problems: Endometrial cancer, cancer of the cervix or vagina, or vaginal bleeding where the cause is not known.
• If you are taking ombitasvir, paritaprevir, and ritonavir (with or without dasabuvir).
• If you are pregnant or may be pregnant. Do not take Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate) if you are pregnant.
• If you are breast-feeding or plan to breast-feed.
• If you turned yellow during pregnancy or with estrogen-based or hormone contraceptive use.

Children:

• If your child has not had her first period.

This is not a list of all drugs or health problems that interact with Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate).

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Junel Fe 24?

• Tell all of your health care providers that you take Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate). This includes your doctors, nurses, pharmacists, and dentists. This medicine may need to be stopped before certain types of surgery as your doctor has told you. If Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate) is stopped, your doctor will tell you when to start taking Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate) again after your surgery or procedure.
• This medicine may raise the chance of blood clots, a stroke, or a heart attack. Talk with the doctor.
• Talk with your doctor if you will need to be still for long periods of time like long trips, bedrest after surgery, or illness. Not moving for long periods may raise your chance of blood clots.
• Some studies have shown the risk of breast cancer is raised in women taking birth control pills, especially at a younger age. The risk was also linked to how long the birth control pills were taken. One study showed the risk was also raised in women who took birth control pills within the past 10 years.
• If you have high blood sugar (diabetes), talk with your doctor. This medicine may raise blood sugar.
• Check your blood sugar as you have been told by your doctor.
• High blood pressure has happened with drugs like this one. Have your blood pressure checked as you have been told by your doctor.
• Have blood work checked as you have been told by the doctor. Talk with the doctor.
• Be sure to have regular breast exams and gynecology check-ups. You will also need to do breast self-exams as you have been told.
• If you are allergic to tartrazine, talk with your doctor. Some products have tartrazine.
• If you drink grapefruit juice or eat grapefruit often, talk with your doctor.
• This medicine may affect certain lab tests. Tell all of your health care providers and lab workers that you take Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate).
• Certain drugs, herbal products, or health problems could cause Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate) to not work as well. Be sure your doctor knows about all of your drugs and health problems.
• This medicine does not stop the spread of diseases like HIV or hepatitis that are passed through having sex. Do not have any kind of sex without using a latex or polyurethane condom. If you have questions, talk with your doctor.
• This medicine may raise the chance of blood clots. The chance is highest during the first year of using Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate). The chance is also highest when starting to use hormone-based birth control again after not using it for 4 weeks or more. Talk with the doctor.
• If you are taking Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate) for pimples (acne), you need to be at least 15 years of age.
• If you have any signs of pregnancy or if you have a positive pregnancy test, call your doctor right away.

How is this medicine (Junel Fe 24) best taken?

Use Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate) at the same time of day.
• Take with or without food. Take with food if it causes an upset stomach.
• If you also take colesevelam, take it at least 4 hours before or after you take Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate).
• After starting Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate), you may need to use a non-hormone type of birth control like condoms to prevent pregnancy for some time. Follow what your doctor has told you to do about using a non-hormone type of birth control.
• Do not skip doses, even if you do not have sex very often.
• If you throw up or have diarrhea, Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate) may not work as well to prevent pregnancy. Use an extra form of birth control, like condoms, until you check with your doctor.
• If you miss 2 periods in a row, take a pregnancy test before starting a new cycle.

What do I do if I miss a dose?

• If a dose is missed, check the package insert or call the doctor to find out what to do. If using Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate) to prevent pregnancy, another form of birth control may need to be used for some time to prevent pregnancy.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
• Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
• Signs of gallbladder problems like pain in the upper right belly area, right shoulder area, or between the shoulder blades; yellow skin or eyes; fever with chills; bloating; or very upset stomach or throwing up.
• Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
• Depression or other mood changes.
• Swelling.
• A lump in the breast, breast pain or soreness, or nipple discharge.
• Vaginal itching or discharge.
• Eyesight changes or loss, bulging eyes, or change in how contact lenses feel.
• Spotting or vaginal bleeding that is very bad or does not go away.
• Call your doctor right away if you have signs of a blood clot like chest pain or pressure; coughing up blood; shortness of breath; swelling, warmth, numbness, change of color, or pain in a leg or arm; or trouble speaking or swallowing.

What are some other side effects of Junel Fe 24?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Feeling more or less hungry.
• Weight gain or loss.
• Dizziness or headache.
• Upset stomach or throwing up.
• Stomach cramps.
• Bloating.
• Enlarged breasts.
• Tender breasts.
• This medicine may cause dark patches of skin on your face. Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
• Period (menstrual) changes. These include lots of bleeding, spotting, or bleeding between cycles.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Junel Fe 24?

• Store at room temperature protected from light. Store in a dry place. Do not store in a bathroom.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Consumer Information Use and Disclaimer

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else's drugs.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about Junel Fe 24 (ethinyl estradiol, norethindrone, and ferrous fumarate), please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.