and missed a menstrual period, or if you missed two menstrual periods in a row, you could be pregnant. Check with your healthcare professional immediately to determine whether you are pregnant. Stop using ORTHO EVRAr if you are pregnant. There is no conclusive evidence that hormonal contraceptive use causes birth defects when taken accidentally during early pregnancy. Nevertheless, hormonal contraceptives, including ORTHO EVRAr, should not be used during pregnancy. You should check with your healthcare professional about risks to your unborn child from any medication taken during pregnancy. Breastfeeding: If you are breastfeeding, consult your healthcare professional before starting ORTHO EVRAr. Hormonal contraceptives are passed on to the child in the breast milk. A few adverse effects on the child have been reported, including yellowing of the skin (jaundice) and breast enlargement. In addition, combination hormonal contraceptives may decrease the amount and quality of your breast milk. Drug Interactions: Hormonal contraceptives may interact with lamotrigine, an anticonvulsant used for epilepsy. This may increase the risk of seizures, so your physician may need to adjust the dose. Some medicines and herbal products may make your hormonal contraceptive less effective, including: Barbiturates Bosentan Carbamazepine Felbamate Griseofulvin Oxcarbazepine Phenytoin Rifampin St. John's wort Topiramate Blood levels of estrogen from this hormonal contraceptive may be increased if you take certain medicines or drink grapefruit juice. Also, your hormonal contraceptive may make some other medicines less effective. You may need to use a barrier contraceptive when you take medicines or products that can make hormonal