Type of medicine: contraceptive (birth control)
Generic and brand names: etonogestrel/ethinyl estradiol, vaginal ring; NuvaRing
This medicine is a soft ring that you insert into your vagina to prevent pregnancy. The ring is a monthly form of birth control. The ring contains a combination of a progestin and estrogen, the same two female hormones in birth control pills. After the ring is inserted, it releases hormones into your body.
It may be used to treat other conditions as determined by your healthcare provider.
Tell your healthcare provider if you have ever had:
Tell your healthcare provider if you smoke. Smoking while you are using this medicine increases the risk of serious side effects such as heart attack, stroke, and blood clots.
Females of childbearing age: Do not take this medicine during pregnancy because it may harm the baby. Tell your healthcare provider if think you are pregnant or plan to become pregnant while taking this medicine. Do not breast-feed while taking this medicine without your healthcare provider's approval.
To insert the ring:
Each ring comes in a reclosable foil pouch. After you wash and dry your hands, remove the ring from its foil pouch. Keep the foil pouch to dispose of the ring after use. Choose the position that is most comfortable for you to insert the ring (lie down, squat, or stand with one leg up).
Hold the ring between your thumb and index finger and press the opposite sides of the ring together.
Gently push the folded ring into your vagina. The exact position of the ring in the vagina is not important for it to work.
Once inserted, keep the ring in place for 3 weeks.
To remove the ring:
Remove the ring 3 weeks after you put it in, on the same day and time as you put it in. For example, if you inserted the ring on a Sunday at about 10:00 pm, remove the ring on the Sunday 3 weeks later at about 10:00 pm.
Remove the ring by hooking your index finger under the forward rim or by holding the rim between your index and middle finger and pulling it out.
Place the used ring in the foil pouch and put it in the trash out of the reach of children and pets. Do not flush it down the toilet.
Your menstrual period will usually start 2 to 3 days after you remove the ring. To continue to have pregnancy protection, you must insert a new ring 1 week after the last one was removed, even if your menstrual period has not stopped.
Rarely, the ring can slip out of the vagina if it has not been inserted properly, or when you remove a tampon or strain to have a bowel movement.
If the ring slips out of your vagina, and it has been out less than 3 hours, you should still be protected from pregnancy. Rinse the ring with cool or lukewarm (not hot) water and put it back in as soon as possible, within 3 hours of the time it came out. If you have lost the original ring, you must insert a new ring and use it on the same schedule as you would have used the lost ring. If the ring has been out of the vagina for more than 3 hours, and it is during weeks 1 or 2 of use, you may not be protected from pregnancy even if the ring is reinserted. Use an extra method of birth control, such as condoms, until the ring has been back in place for 7 days in a row. If the ring has been out of the vagina for more than 3 hours and it is during week 3, throw the ring away and either:
Use an extra method of birth control, such as condoms, until the ring has been back in place for 7 days in a row.
Check to be sure that you are not pregnant if:
Read and follow the patient instructions that come with the ring. If you do not understand how to use the ring, ask your healthcare provider or pharmacist to explain.
If you have not been using a hormonal form of birth control, you start using the ring by inserting it into the vagina between days 1 and 5 of your menstrual period. As long as you insert the ring at this time, it doesn't matter if your period has stopped or you are still bleeding. (Day 1 is the first day of your menstrual period.) When you start using the vaginal ring, you should use an additional form of birth control, such as condoms or spermicide, until the ring has been in place for 7 days.
If you are switching from another form of hormonal birth control, such as pills, implants, injections, or a progesterone-containing IUD, the instructions for starting the ring and using extra methods of birth control are somewhat different. The instructions may also be different if you are using the ring after a live birth, abortion, or miscarriage. Talk with your healthcare provider about this.
If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.
Symptoms of an acute overdose may include: nausea, vomiting.
Smoking while you use this medicine increases your risk of side effects. The risk increases with age and the number of cigarettes smoked a day. Talk to your healthcare provider about ways to quit smoking.
You need to see your healthcare provider at least once a year for checkups while using this medicine. Do not use this medicine for longer than 1 year without a complete physical exam.
This medicine only prevents pregnancy. It does not prevent sexually transmitted diseases (STDs) such as HIV or herpes.
While using the ring, do not use a diaphragm when you need a back-up method of birth control.
If you wear contact lenses and notice a change in your vision or it becomes difficult to wear your lenses, contact your healthcare provider.
If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are using birth control hormones. You may have a greater risk of blood clots.
If you need any lab tests, tell your healthcare provider you are using the ring. Birth control hormones may change some blood test results.
Diabetics: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.
Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.
Life-threatening (Report these to your healthcare provider right away. If you are unable to reach your healthcare provider right away, get emergency medical care or call 911 for help):
Serious (report these to your healthcare provider right away):
Other: Vaginal or urinary infection, vaginal discharge or itching, headache, darkening of the skin on the face, weight gain, nausea, vomiting.
When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:
Do not use other vaginal products while using this medicine without your healthcare provider's approval.
If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.
Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.
This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.
Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.
Keep all medicines out of the reach of children.
Do not share medicines with other people.
