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Info about Etonogestrel and ethinyl estradiol vaginal ring

Brand Name(s): NuvaRing

Generic Name Etonogestrel and ethinyl estradiol vaginal ring

What is ethinyl estradiol; etonogestrel vaginal ring do?

ETHINYL ESTRADIOL; ETONOGESTREL vaginal ring (NuvaRing®) is a flexible, combined contraceptive (birth control) vaginal ring. Each ring is used to prevent ovulation and pregnancy for one month. If used properly, this drug is as effective as oral birth control pills. A generic ethinyl estradiol; etonogestrel vaginal ring is not available.

What should my health care professional know before I use ethinyl estradiol; etonogestrel vaginal ring?

They need to know if you have or ever had any of these conditions:

  • blood clots
  • blood sugar problems, like diabetes
  • cancer of the breast, cervix, ovary, uterus, vagina, or unusual vaginal bleeding that has not been evaluated by a health care professional
  • depression
  • fibroids
  • gallbladder disease
  • heart or circulation problems
  • high blood pressure
  • jaundice
  • liver disease
  • menstrual problems
  • migraine headaches
  • tobacco smoker
  • stroke
  • an unusual or allergic reaction to estrogen/progestin, other hormones, medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

Insert the ethinyl estradiol; etonogestrel vaginal ring in your vagina as directed by your health care professional and the patient information leaflet that comes with your prescription. Make certain you understand your instructions.

When you insert your vaginal ring will depend upon if you have previously used a different form of birth control, or other conditions. Be sure to ask your health care provider when you should insert your vaginal ring for the first time.

Keep an extra, unused vaginal ring available to ensure that you will not miss the first day of the next cycle.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

You usually will only need to replace your vaginal ring once a month. You should follow the exact instructions in the patient information leaflet. Speak to your health care provider on what to do if you leave your vaginal ring in for a longer or shorter period of time than you are supposed to, or if it should slip out.

What drug(s) may interact with ethinyl estradiol; etonogestrel?

  • aminocaproic acid
  • antibiotics or medicines for infections, especially rifampin, rifapentine or rifabutin
  • aprepitant
  • atorvastatin
  • barbiturate medicines for producing sleep or treating seizures (convulsions)
  • bexarotene
  • bosentan
  • carbamazepine
  • caffeine
  • cimetidine
  • clofibrate
  • cyclosporine
  • dantrolene
  • doxercalciferol
  • felbamate
  • griseofulvin
  • growth hormone
  • hydrocortisone
  • isoniazid, INH
  • itraconazole
  • medicines for anxiety or sleeping problems, such as diazepam or temazepam
  • medicines for mental depression, such as amitriptyline or imipramine
  • medicines for migraines, such as naratriptan or sumatriptan
  • medicines for diabetes, including troglitazone and pioglitazone
  • medicines for seizures, including felbamate, phenytoin, fosphenytoin, oxcarbazepine or topiramate
  • methotrexate
  • modafinil
  • mycophenolate
  • nefazodone
  • phenytoin
  • prednisolone
  • ritonavir or other medicines for the treatment of the HIV virus or AIDS
  • selegiline
  • soy isoflavones supplements
  • St. John's wort
  • tamoxifen, raloxifene or exemestane
  • theophylline
  • troleandomycin
  • warfarin

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check before stopping or starting any of your medicines.

What side effects may I notice from taking ethinyl estradiol; etonogestrel vaginal ring?

Severe side effects are relatively rare in women who are healthy and do not smoke while they are using hormonal contraceptives. On average, more women have problems due to complications from getting pregnant than have problems with hormonal contraceptives. Many of the minor side effects may go away as your body adjusts to the medicine. However, the potential for severe side effects does exist and you may want to discuss these with your health care provider.

The following symptoms or side effects may be related to blood clots and require immediate medical or emergency help:

  • chest pain
  • coughing up blood
  • dizziness or fainting spells
  • leg, arm or groin pain
  • severe or sudden headaches
  • stomach pain (severe)
  • sudden shortness of breath
  • sudden loss of coordination, especially on one side of the body
  • swelling of the hands, feet or ankles, or rapid weight gain
  • vision or speech problems
  • weakness or numbness in the arms or legs, especially on one side of the body

Other serious side effects are rare. Contact your health care provider as soon as you can if the following side effects occur:

  • breast tissue changes or discharge
  • changes in vaginal bleeding during your period or between your periods
  • chills
  • confusion
  • dizziness
  • fever
  • headaches or migraines
  • increases in blood sugar, especially if you have diabetes
  • increases in blood pressure, especially if you are known to have high blood pressure
  • lightheadedness
  • muscle aches
  • sunburn-like rash that is followed by peeling of the skin
  • symptoms of vaginal infection (itching, irritation or unusual discharge)
  • tenderness in the upper abdomen
  • unusual redness of the inside of the nose, mouth, throat, vagina, or insides of the eyelids
  • vomiting
  • yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your health care provider if they continue or are bothersome):

  • breakthrough bleeding and spotting that continues beyond the 3 initial cycles
  • breast tenderness
  • mild stomach upset
  • mood changes, anxiety, depression, frustration, anger, or emotional outbursts
  • increased or decreased appetite
  • increased sensitivity to sun or ultraviolet light
  • nausea
  • skin rash, acne, or brown spots on the skin
  • tiredness
  • weight gain

What should I watch for while taking ethinyl estradiol; etonogestrel vaginal ring?

Visit your health care provider for regular checks on your progress. You should have a complete check-up every 6 to 12 months. If you have any unusual vaginal bleeding contact your prescriber or health care professional for advice. If you miss a period, the possibility of pregnancy must be considered. See your prescriber or health care provider as soon as you can.

NuvaRing may interfere with the correct placement of a diaphragm. A diaphragm is not recommended as a back-up method of contraception with NuvaRing® use.

If you are using hormonal contraceptives for the treatment of acne, hirsutism (male-like hair growth), endometriosis or other hormone related problems, it may take several months of continued treatment to notice improvement in your symptoms or condition.

Tobacco smoking increases the risk of getting a blood clot or having a stroke while you are using ethinyl estradiol; etonogestrel, especially if you are more than 35 years old. You are strongly advised not to smoke.

Hormonal contraceptives can increase your sensitivity to the sun and you may burn more easily. Use sunscreen and protective clothing during long periods outdoors. Tanning booths should be used with caution.

If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye care specialist.

In some women, tenderness, swelling, or minor bleeding of the gums may occur. Notify your dentist if this happens. Brushing and flossing your teeth regularly may help limit this. See your dentist regularly and inform your dentist of the medicines you are taking.

You may get a vaginal yeast infection. If you have never had a yeast infection before, see your prescriber or other health care provider to confirm the problem. If you have had yeast infections in the past and are comfortable with self-medicating the problem, get and use a nonprescription medication to treat the yeast infection.

Using the ethinyl estradiol; etonogestrel vaginal ring for contraception does not protect you against HIV infection (AIDS) or any other sexually transmitted diseases.

If you are going to have elective surgery, you may need to stop using your hormonal vaginal ring one month beforehand. Consult your health care professional for advice prior to scheduling the surgery.

Where can I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 °C (59 and 86 °F) for up to 4 months. The product will expire after 4 months of removal from refrigerated storage in the pharmacy. Avoid storing in direct sunlight. Keep container tightly closed. Throw away any unused medicine after the expiration date.


(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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