Cyclical variations in the balance of chemicals, particularly of intermediate products in the reaction, give oscillations in the flame, with a typical temperature variation of about 100 C (212 F), or between "cool" and full ignition
You should change the refill when you notice it has stopped producing vapour or if you notice deterioration in the taste or quality of the vapour
Adverse Reactions/Side Effects The following adverse reactions reported with the use of hormonal contraception are discussed elsewhere in the labeling: Changes in Menstrual Bleeding Patterns [see Warnings and Precautions (5.3)] Ectopic Pregnancies [see Warnings and Precautions (5.4)] Thrombotic and Other Vascular Events [see Warnings and Precautions (5.5)] Liver Disease [see Warnings and Precautions (5.8)] 6.1 Clinical Trials Experience Adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice, because clinical trials are conducted under widely varying conditions
Click here for the full MOP4 statement
Soule EK, Barnett TE, Curbow BA, Moorhouse MD, Weiler RM