May cause nonreversible androgenic effects (e.g. weight gain, acne, seborrhea, hirsutism, edema, hair loss, voice change), benign intracranial hypertension (pseudotumor cerebri), peliosis hepatis and benign hepatic adenoma with prolonged treatment (may not be apparent until complicated by acute, potentially life-threatening intra-abdominal hemorrhage), or thromboembolic events (e.g. sagittal sinus thrombosis, stroke reported). May increase risk of atherosclerosis and coronary artery disease due to blood lipid changes (decreased HDL and increased LDL). Caution in diabetes mellitus, edematous conditions (e.g. cardiovascular disease, migraine, seizure disorder, renal impairment), hepatic impairment (use not recommended in severe hepatic impairment), renal impairment (use not recommended in severe renal impairment), or history of porphyria. Breast cancer should be ruled out prior to treatment for fibrocystic disease. May cause fluid retention.