ethinyl estradiol ring
Generic Name: etonogestrel/ethinyl estradiol (e-toe-noe-JES-trel/ETH-i-nil es-tra-DYE-ol)
Brand Name: NuvaRing
Cigarette smoking while taking etonogestrel/ethinyl estradiol ring increases the risk of serious heart problems. The risk increases with age (older than 35 years) and with heavy smoking (15 or more cigarettes per day). Patients who use etonogestrel/ethinyl estradiol ring are strongly advised not to smoke.
Etonogestrel/ethinyl estradiol ring is used for:
Preventing pregnancy. It may also be used for other conditions as determined by your doctor.
Etonogestrel/ethinyl estradiol ring is an estrogen/progestin combination. It works by preventing the release of eggs from the ovaries and thereby preventing pregnancy.
Do NOT use etonogestrel/ethinyl estradiol ring if:
- you are allergic to any ingredient in etonogestrel/ethinyl estradiol ring
- you are pregnant or think you may be pregnant
- you have blood clots in the legs, lungs, or eyes; or a history of heart attack, chest pain, or stroke
- you have heart valve problems with blood clotting complications
- you have known or suspected breast cancer or cancer of the lining of the uterus, cervix, or vagina, or have had vaginal bleeding of unknown causes
- you have a liver tumor or active liver disease, or a history of yellowing of the eyes or skin during pregnancy or previous birth control use
- you have headaches with neurological symptoms or will be on bed rest for a long period following surgery
Contact your doctor or health care provider right away if any of these apply to you.
Before using etonogestrel/ethinyl estradiol ring:
Some medical conditions may interact with etonogestrel/ethinyl estradiol ring. Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have high blood pressure; high cholesterol, triglycerides, or calcium levels; heart valve problems; or pancreatitis or gallbladder problems; or if you are obese
- if you have breast nodules, fibrocystic disease of the breast, an abnormal breast x-ray or mammogram, endometriosis or endometrial carcinomas, uterine fibroids, prolapsed uterus, or irregular or scanty menstrual periods
- if you have diabetes, headaches, migraine headaches, epilepsy, or a history of mental depression or toxic shock syndrome (TSS)
- if you are having surgery
- if you are a heavy smoker (15 or more cigarettes per day), especially if you are older than 35 years
Some MEDICINES MAY INTERACT with etonogestrel/ethinyl estradiol ring. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Aprepitant, azole antifungals (eg, itraconazole), barbiturates (eg, phenobarbital), bosentan, carbamazepine, felbamate, griseofulvin, HIV protease inhibitors (eg, ritonavir), hydantoins (eg, phenytoin), modafinil, nevirapine, oxcarbazepine, penicillins (eg, amoxicillin), phenylbutazone, rifampin, St. John's wort, tetracyclines (eg, doxycycline), topiramate, or troglitazone because they may decrease etonogestrel/ethinyl estradiol ring's effectiveness. Alternative forms of birth control are strongly recommended when taking any of these medicines along with this birth control medicine
- Beta-blockers (eg, atenolol), selegiline, theophyllines (eg, aminophylline), or troleandomycin because their side effects may be increased by etonogestrel/ethinyl estradiol ring
- Lamotrigine because its effectiveness may be decreased by etonogestrel/ethinyl estradiol ring
This may not be a complete list of all interactions that may occur. Ask your health care provider if etonogestrel/ethinyl estradiol ring may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use etonogestrel/ethinyl estradiol ring:
Use etonogestrel/ethinyl estradiol ring as directed by your doctor. Check the label on the medicine for exact dosing instructions. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with etonogestrel/ethinyl estradiol ring. Talk to your pharmacist if you have questions about this information.
- Wash and dry your hands before removing the ring from the pouch. The ring becomes slippery when wet, so make sure your hands are dry.
- To insert the ring, choose a comfortable position, such as lying down, squatting, or standing with one leg up. Hold the ring between your thumb and index finger and press the opposite sides of the ring together. Gently insert and push the folded ring into the vagina as far as comfortably possible. The exact position of the ring is the vagina is not important for it to work.
- Rarely, some women have inserted the ring into the bladder by mistake. Do not insert the ring into your bladder. Insert the ring into the vagina.
- You may not feel the ring once it is in place. If you feel discomfort, the ring is probably not inserted far enough in your vagina. Use your finger to gently push the ring further into your vagina. There is no danger in the ring being pushed too far up the vagina or getting lost. It can be inserted only as far as the end of the vagina. The cervix will block it from going any further.
- The ring should not interfere with sexual intercourse.
- Some women have experienced moving or gliding of the ring within the vagina due to bowel movements, straining, constipation, or coughing. If this occurs, push it back into place with your finger.
- After insertion, the ring should be left in place for 3 weeks (21 days) and then removed. It should be removed at about the same time and on the same day of the week that it was inserted. To remove the ring, wash and dry your hands thoroughly. Find a comfortable position, either standing, squatting, or lying down. Loop your finger through the ring and gently pull it out. Discard the used ring in the trash container. Do not flush it down the toilet.
- After removing the ring, wait 7 days and then insert a new ring. The new ring should be inserted at about the same time and on the same day of the week as it was inserted in the last cycle.
- If the ring is removed or falls out of the vagina and remains out for less than 3 hours, rinse the ring with lukewarm water and reinsert it. No other contraceptive measures are necessary.
- If the ring is removed or falls out of the vagina and remains out for more than 3 hours, rinse the ring with lukewarm water and reinsert it. In this case, you may not be adequately protected from pregnancy. You must use an additional form of birth control (eg, male condoms, spermicide) until the ring has been in place for 7 days in a row.
- If the ring is removed or falls out and is lost, or if the ring becomes disconnected at the joint, you must insert a new ring and use it on the same schedule as you would have used the lost or disconnected ring.
- If you miss inserting the new ring on the scheduled day, insert it as soon as you remember. You must use a backup form of birth control until the new ring has been in place for 7 days. If you are not sure what to do if you miss inserting the new ring on the scheduled day, use an extra form of birth control (eg, condoms) and talk with your doctor.
Ask your health care provider any questions you may have about how to use etonogestrel/ethinyl estradiol ring.
Important safety information:
- Etonogestrel/ethinyl estradiol ring may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use etonogestrel/ethinyl estradiol ring with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- If you miss your period, call your doctor immediately. A missed period may indicate that you are pregnant.
- Etonogestrel/ethinyl estradiol ring may cause dark skin patches on your face. Exposure to the sun may make these patches darker. If patches develop, use a sunscreen or protective clothing when exposed to the sun, sunlamps, or tanning booths.
- Follow your doctor's instructions for examining your breasts, and report any lumps immediately.
- Etonogestrel/ethinyl estradiol ring may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using etonogestrel/ethinyl estradiol ring.
- If you will be having surgery or will be confined to a chair or bed for a long period of time (such as a long plane flight), notify your doctor 3 to 4 weeks beforehand. Special precautions may need to be taken in these circumstances while you are taking etonogestrel/ethinyl estradiol ring.
- Bleeding or spotting may occur while taking etonogestrel/ethinyl estradiol ring. Do not stop taking etonogestrel/ethinyl estradiol ring if this occurs. If bleeding or spotting continues for more than 7 days or is heavy, contact your doctor.
- Etonogestrel/ethinyl estradiol ring may increase the risk of stroke, heart attack, blood clots, high blood pressure, or similar problems. The risk may be greater if you smoke.
- Taking certain antibiotics or anticonvulsants while you are using etonogestrel/ethinyl estradiol ring, or vomiting or diarrhea may decrease the effectiveness of etonogestrel/ethinyl estradiol ring. To prevent pregnancy, use an additional form of birth control (such as condoms, spermicide, diaphragm) until your next period. If you have any questions, contact your doctor or pharmacist.
- Some women have rarely placed etonogestrel/ethinyl estradiol ring into the bladder by mistake. Contact your doctor right away if you develop persistent bladder problems (eg, difficult or painful urination) and you can not locate the ring in your vagina.
- If you wear contact lenses and you develop problems with them, contact your doctor.
- Use of etonogestrel/ethinyl estradiol ring will not prevent the spread of sexually transmitted diseases (STDs).
- Lab tests, including physical exams and blood pressure, may be performed while you use etonogestrel/ethinyl estradiol ring. You should have breast and pelvic exams, and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. Be sure to keep all doctor and lab appointments.
- Etonogestrel/ethinyl estradiol ring should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: Do not use etonogestrel/ethinyl estradiol ring if you are pregnant. If you think you may be pregnant, contact your doctor right away. Continue to use another method of birth control (such as condoms). Etonogestrel/ethinyl estradiol ring is found in breast milk. Do not breast-feed while taking etonogestrel/ethinyl estradiol ring. Do not take etonogestrel/ethinyl estradiol ring soon after delivery of a baby even if you are not breast-feeding. You should wait 4 weeks after delivery if you are not breast-feeding or 4 weeks after a second trimester abortion.
Possible side effects of etonogestrel/ethinyl estradiol ring:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Breast tenderness or enlargement; change in appetite; changes in weight; dizziness; headache; mild hair loss; nausea; nervousness; stomach cramps or bloating; vaginal spotting or breakthrough bleeding.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); absent menstrual period; breast discharge; breast lumps; calf or leg pain, swelling, or tenderness; change in the amount of urine produced; chest pain or heaviness; confusion; coughing of blood; dark urine; fainting; mental or mood changes (eg, depression); migraines; numbness of an arm or leg; one-sided weakness; pale stools; persistent, severe, or recurring headache or dizziness; persistent vaginal spotting; severe pain or tenderness in the stomach; shortness of breath; slurred speech; sudden, severe headache or vomiting; swelling of the fingers, hands, legs, or ankles; symptoms of toxic shock syndrome (eg, diarrhea, dizziness, sudden fever, sunburn-like rash on the face or body, or vomiting); unusual or severe vaginal bleeding; unusual tiredness or weakness; vaginal irritation, discharge, or change in secretions; vision changes (eg, double vision, sudden vision loss); yellowing of the skin or eyes (with or without fever).
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms of overdose may include nausea or vomiting; vaginal bleeding.Proper storage of etonogestrel/ethinyl estradiol ring:
Store etonogestrel/ethinyl estradiol ring at room temperature, below 86 degrees F (30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep etonogestrel/ethinyl estradiol ring out of the reach of children and away from pets.
- If you have any questions about etonogestrel/ethinyl estradiol ring, please talk with your doctor, pharmacist, or other health care provider.
- Etonogestrel/ethinyl estradiol ring is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take etonogestrel/ethinyl estradiol ring or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about etonogestrel/ethinyl estradiol ring. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to etonogestrel/ethinyl estradiol ring. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using etonogestrel/ethinyl estradiol ring.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.