Nextstellis (drospirenone/estetrol) is a brand-name oral tablet that’s prescribed to help prevent pregnancy in adults and certain children. As with other drugs, Nextstellis can cause side effects, such as headaches and mood changes.

Nextstellis can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Nextstellis in clinical trials:

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Nextstellis use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Nextstellis’s prescribing information.

Mild side effects that have been reported with Nextstellis include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Nextstellis and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after using Nextstellis. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.

Nextstellis may cause serious side effects, although they aren’t common. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Nextstellis’s prescribing information.

If you develop serious side effects while taking Nextstellis, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

* Nextstellis has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effect specifics” section below.

† An allergic reaction is possible after using Nextstellis. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.

Nextstellis may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Can Nextstellis cause weight loss?

No, it’s not likely. Weight loss wasn’t a reported side effect in clinical trials of the drug. However, weight gain is a commonly reported side effect of Nextstellis in clinical trials.

If you have questions about weight changes while taking Nextstellis, talk with your doctor or pharmacist.

How do side effects of Nextstellis compare with those seen with Yaz?

The side effects of Nextstellis and Yaz are similar, but some side effects were reported less often with Nextstellis in clinical trials of the drug.

Nextstellis is different from other oral contraceptives because it is the only one to contain a new estrogen called estetrol, also known as E4. Estetrol is the only plant-based estrogen approved by the FDA. Yaz and other oral contraceptives contain a modified form of estrogen called ethinyl estradiol. Estetrol works differently in the body than ethinyl estradiol, which can lead to fewer side effects.

Some of the side effects reported less often with Nextstellis than Yaz include:

Nextstellis may also have less of an effect on cholesterol and triglycerides in some people. But similar to other oral contraceptives, there is still a risk of cardiovascular events, such as stroke, blood clot, or heart attack.

If you have any questions about the side effects you may experience with Nextstellis, talk with your doctor or pharmacist.

Learn more about some of the side effects that Nextstellis may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Nextstellis.

Risk of serious cardiovascular events with cigarette smoking

Nextstellis has a boxed warning about the increased risk of serious cardiovascular events due to cigarette smoking. This is the most serious warning from the Food and Drug Administration (FDA). Boxed warnings alert healthcare professionals and patients about the most serious side effects a drug may cause.

Taking Nextstellis or certain other oral contraceptives can increase the risk of serious cardiovascular events. Cardiovascular events are problems that occur in your heart or blood vessels, such as stroke, blood clot, or heart attack. Symptoms of a cardiovascular event may include:

  • Stroke. Symptoms can include:
    • slurred speech
    • numbness or weakness on one side of the body
    • confusion
  • Blood clots. Symptoms can include:
    • difficulty breathing
    • pain or swelling in the affected area
    • skin discoloration or warmth
  • Heart attack. Symptoms can include:
    • nausea
    • shortness of breath
    • sweating
    • pain in your chest, arm, neck, or shoulder

What you can do

You may have a higher risk of cardiovascular events during treatment with Nextstellis if you’ve had blood clots in the past or have certain risk factors for developing them. (To learn more, see the “Precautions for Nextstrellis” section below.)

Talk with your doctor about your risk factors before deciding which birth control option is right for you. If you smoke cigarettes and are older than age 35 years, your doctor will likely recommend other birth control options for you.

Weight gain

Weight gain is a possible side effect of Nextstellis reported in clinical trials. However, this side effect was reported less often than with other oral contraceptives.

What you can do

Talk with your doctor if you are concerned about weight changes while taking Nextstellis. They can discuss ways to help you maintain a weight that’s healthy for you.

Allergic reaction

As with most drugs, Nextstellis can cause an allergic reaction in some people. However, this side effect wasn’t reported in clinical trials.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Nextstellis. However, if your symptoms are serious and you think you’re having a medical emergency, call 911 immediately or your local emergency number.

Below is important information you should consider before taking Nextstellis.

Boxed warning: Risk of serious cardiovascular events with cigarette smoking

This drug has a boxed warning for risk of serious cardiovascular events with cigarette smoking. This is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you take Nextstellis. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These include:

Risk of blood clots: Talk with your doctor if you’ve had blood clots in the past or are at risk of developing them. Factors that may increase your risk of developing a blood clot during treatment with Nextstellis include:

  • having had a heart attack or stroke in the past
  • being over 35 years of age and smoking
  • having certain heart problems that can cause blood clots, such as atrial fibrillation
  • having uncontrolled high blood pressure
  • having recently had surgery or having surgery soon, which may limit your ability to move around
  • having given birth in the past 4 weeks and not breastfeeding

Talk with your doctor before starting Nextstellis if you have any of these risk factors. They will help determine whether Nextstellis is the best birth control option for you.

Cancer that is hormone sensitive: If you currently have or have had any type of cancer that is sensitive to hormones, such as breast cancer or cervical cancer, you should not take Nextstellis. Treatment with Nextstellis could worsen your condition. This is because Nextstellis contains estrogen, and these cancers rely on estrogen to develop and grow. If you have or have had cancer in the past, talk with your doctor about what birth control options would be best for you.

Lipid disorders: Taking Nextstellis can increase cholesterol and triglyceride levels in your blood. If you already have high cholesterol or triglycerides, taking Nextstellis could worsen your condition. Having a lipid disorder may put you at a higher risk of cardiovascular problems, such as heart attack, blood clots, or stroke. If you have a lipid disorder, talk with your doctor about what birth control options would be best for you.

Kidney, liver, or adrenal gland problems: Nextstellis can cause hyperkalemia. This is a high level of potassium in your blood. If you already have existing problems with your kidneys, liver, or adrenal glands, you may be at a higher risk of this side effect. Your doctor may monitor your potassium levels more closely during treatment with Nextstellis.

Chloasma: Chloasma is a condition that causes dark patches on your skin during pregnancy, especially on the face. If you have had chloasma in the past or have any kind of sun sensitivity, talk with your doctor before taking Nextstellis. They may recommend a different birth control option for you.

High blood pressure: If you have high blood pressure, taking Nextstellis could worsen your condition. Having high blood pressure can also increase your risk of serious cardiovascular problems, such as stroke, heart attack, or blood clots. Your doctor may monitor you more closely during treatment with Nextstellis or recommend a different birth control option for you.

Liver tumors or liver disease: If you have or have had a liver tumor or liver disease in the past, talk with your doctor before taking Nextstellis. They may recommend a different birth control option for you.

Hereditary angioedema: Hereditary angioedema is a genetic condition that causes episodes of fluid retention and swelling. If you have hereditary angioedema, taking Nextstellis could worsen this condition. Talk with your doctor to determine if Nextstellis is the best treatment option for you.

Migraine episodes with aura: If you get certain kinds of migraine headaches, you should not take Nextstellis. Talk with your doctor before taking Nextstellis if you have a history of migraine. They will help determine if Nextstellis is the best birth control option for you.

Gallbladder disease: Taking Nextstellis may increase your risk of developing gallbladder disease. Talk with your doctor before taking Nextstellis if you have had gallbladder problems in the past. They will help determine if Nextstellis is the best birth control option for you.

Obesity: It’s not known whether Nextstellis is safe or effective in people with obesity. Talk with your doctor to determine if Nextstellis is the right birth control option for you.

Allergic reaction: If you’ve had an allergic reaction to Nextstellis or any of its ingredients, your doctor will likely not prescribe Nextstellis. Ask your doctor what other medications may be better options for you.

Pregnancy: Nextstellis is a hormone birth control used to help prevent pregnancy. You should not take it during pregnancy. There is no known harm if it’s taken in early pregnancy (before you know you are pregnant). If you think you may be pregnant, talk with your doctor right away.

Breastfeeding: Nextstellis isn’t recommended while breastfeeding. Nextstellis and other drugs that contain estrogen can reduce the production of breast milk. Nextstellis may also pass into your breast milk. Your doctor will likely recommend another form of birth control that doesn’t contain estrogen while you are breastfeeding. If you have questions about birth control options while breastfeeding, talk with your doctor.

Alcohol consumption: There are no known interactions between Nextstellis and alcohol. Talk with your doctor or pharmacist if you have any questions about drinking alcohol while taking Nextstellis.

Like most medications, Nextstellis can cause side effects. Most are mild and will go away on their own after a few days to weeks. Nextstellis can also cause some serious side effects. You should talk with your doctor if you have any side effects that last, are bothersome, or are serious.

If you’d like to learn more about Nextstellis, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Nextstellis: For details about other aspects of Nextstellis, refer to this article.
  • A look at your condition: For details about pregnancy prevention, see our women’s health hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.