Brand Name

NuvaRing {Merck}

Generic Name

ethinyl estradiol and etonogestrel, pronounced ETH in il es tra DYE ole and et oh noe JES trel

---

Drug Guide

The information contained in the following drug guide is intended as an educational resource only. This guide is not exhaustive and does not contain all available information about this drug.This guide is not intended as medical advice for individual conditions or treatment.

The information provided in this guide does not replace the need for the advice and services of medical professionals or the need for medical examination. Always talk to your physician or pharmacist before taking any prescription medication or over the counter drugs (including any supplements) or before making any changes to your treatment. Only your doctor, nurse or pharmacist can provide you with safe and effective advice regarding your drug treatment.

The use of the information in this guide is at your sole risk. This information is provided "AS IS" with no warranties to accuracy or timeliness.

**All trademarks and registered trademarks are the property of their respective owners.

What is NuvaRing?

NuvaRing is a birth control device, in the form of a vaginal ring that contains the synthetic female hormones ethinyl estradiol and etonogestrel. NuvaRing works because the hormones in this ring prevent ovulation and cause changes in your cervical mucus and uterine lining, which makes it more difficult for the sperm to reach your uterus. The hormones also make it harder for a fertilized egg to attach to your uterus, thus preventing pregnancy.

NuvaRing may also be used for purposes not described in this medication guide.

.

Key Facts About NuvaRing

The NuvaRing device should be left in place for 3 full weeks. You should remove the ring after 3 weeks, on the same day of the week it was inserted, and at about the same time of day. Allow 1 full week to pass, which would be the week of your period, before inserting the new

.

NuvaRing does not protect you from sexually transmitted diseases, including HIV and AIDS. The only way to prevent these diseases is to use a condom. If your sexual partner develops HIV or a sexually transmitted disease while you are using NuvaRing, or if you have any change in sexual relationships you should tell your doctor right away.

You may need to use back up birth control, like a condom, when you first start using NuvaRing (for the first 7 days) or if you miss a dose.

You should not use a diaphragm with the NuvaRing vaginal ring.

If you smoke and are over age 35 you have a much greater risk of having a blood clot, stroke, or heart attack caused by this medicine. You should not smoke while using NuvaRing.

Before You Use NuvaRing

If you are allergic to ethinyl estradiol and etonogestrel you should not use NuvaRing.

If you have a historyuncontrolled high blood pressure, heart disease, a blood-clotting disorder, circulation problems or a previous heart attack, stroke or blood clot caused by a birth control pill you should not use NuvaRing.

Do not use NuvaRing if you have are pregnant or if you have recently had a baby.

If you have had diabetic problems with your eyes or kidneys, unusual vaginal bleeding, liver disease or liver cancer, severe migraine headaches, if you smoke and are over 35, or if you have ever had breast or uterine cancer you may not be a candidate for a NuvaRing.

Tell your doctor if you have severe migraine headaches (with aura, numbness, weakness, or vision changes), jaundice caused by pregnancy or birth control pills, diabetes, an underactive thyroid or gallbladder disease before using NuvaRing.

Tell your doctor before starting treatment with NuvaRing if you have depression, seizures or epilepsy, tuberculosis, a history of irregular menstrual cycles, toxic shock syndrome, or easy vaginal irritation.

If you have a prolapsed (dropped) uterus, bladder, or rectum or severe constipation tell your physician.

Let your doctor know if you have a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram before using NuvaRing.

If you are pregnant, think you may be pregnant, or are breast-feeding you should not use NuvaRing. The hormones in NuvaRing can pass into breast milk and may be harm to a nursing baby. NuvaRing may slow down the production of breast milk.

NuvaRing Drug Interactions

You should inform your doctor if you are taking any of the following:

• acetaminophen (Tylenol)
• antibiotics
• antifungal medications
• ascorbic acid (vitamin C)
• atorvastatin (Lipitor, Caduet)
• bosentan (Tracleer)
• dantrolene (Dantrium)
• drugs to treat hepatitis AIDS, HIV or Hepatitis
• phenobarbital (Solfoton) and other barbiturates
• seizure medications
• St. John’s wort
• tizanidine (Zanaflex)
• tranexamic acid (Cyklokapron, Lysteda).
• vaginal miconazole (Monistat)

Other drugs you take that are not listed may interact with NuvaRing. You should tell your doctor about all of the medications you use. This includes prescription drugs, vitamins, supplements and herbal products, and over the counter medications. You should not begin taking a new medication without telling your doctor first.

Directions for Using NuvaRing

Use NuvaRing exactly as your doctor has prescribed you to. Do not use it in larger or smaller amounts or for shorter or longer than recommended. NuvaRing comes with patient instructions for so you can use this medication safely and effectively. Be sure to follow these instructions carefully.

Your doctor will let you know which day of your menstrual cycle you should insert the first NuvaRing. Use back up birth control for the first 7 days.

Leave the NuvaRing in place for 3 weeks. At the end of the 3 week period you can remove the ring. Insert the next ring after 1 full week has passed, on the same day of the week it was inserted at the previous month. Try to insert it at the same time of day as well.

If you only use the NuvaRing during intercourse it will not prevent pregnancy.

You do not need to remove the NuvaRing during intercourse. If the ring is bothersome during intercourse you can remove it, rinse it in warm water and reinsert it after intercourse. Do not leave it out for longer than 3 hours. If your NuvaRing has been out of your vagina for more than 3 hours, you may either insert a new ring and start a new 3-week cycle, or you may wait 7 days, and have a menstrual period, before you insert a new ring. Use back-up birth control until the new or replaced ring has been in place for 7 days in a row.

You should begin your period during the week you are not wearing the NuvaRing. When your week without the NuvaRing is up you should insert the new one, even if you have not ended your menstrual period yet.

If you undergo surgery or medical tests, or if you will be on bed rest, you may need to stop using the NuvaRing for a short period of time. Your doctor will let you know when you can use it again. Be sure to tell any physician or surgeon you see that you are using this vaginal ring.

NuvaRings which are unused should be stored at room temperature and away from moisture, heat, and light. When you dispose of your used NuvaRing be sure to place it in the foil pouch it came in and throw it away where both children and pets cannot get to it. Never flush the NuvaRing down a toilet.

If your NuvaRing ever falls out during the 3-week wearing time you can rinse it with warm water and reinsert it. If it happens to slide down into the lower part of the vagina you may use a clean finger to push it in farther.

You should not leave the NuvaRing in place for longer than a 3 week period.

Let your doctor know if you get off the proper schedule for use and non-use of the NuvaRing.

Do not wear more than one vaginal ring or NuvaRing at a time.

NuvaRing Side Effects

Contact your doctor at once if you have a serious side effect such as:

• allergic reaction including breathing difficulties, hives and swelling of your face, lips, throat or tongue
• breast lump
• chest pain or a heavy feeling with pain spreading to your arm or shoulder, nausea, sweating and a general ill feeling
• clay colored stools
• depression symptoms
• headache that is severe or sudden and may include confusion and problems you’re your vision, speech, or balance
• jaundice or a yellowing of your skin or eyes
• nausea and upper stomach pain
• numbness and weakness that is sudden, or on one side of your body
• pattern or severity change in migraine headaches
• pain and swelling, warmth, or redness in one or both legs
• swelling in your hands, ankles or feet
• urine which is very dark
• wheezing and cough along with rapid breathing and coughing up blood

Less serious side NuvaRing effects may include:

• appetite and weight changes
• bloating
• breast pain, tenderness and swelling
• contact lens problems
• darkening of facial skin
• decreased libido
• dizziness
• freckles
• hair growth that is increased
• headache (mild)
• loss of scalp hair
• nausea (mild)
• nervousness
• tired feeling
• vaginal discharge or itching
• vomiting

It should be noted that this is not a complete list of possible side effects of NuvaRing. You should contact your physician for a complete list and medical advice regarding these effects.

NuvaRing Description and Dosing

NuvaRing is a non-biodegradable, flexible, transparent, colorless to almost colorless, combination contraceptive vaginal ring containing two active components, a progestin, etonogestrel (13-ethyl-17-hydroxy-11-methylene-18,19-dinor-17-pregn-4-en-20-yn-3-one) and an estrogen, ethinyl estradiol (19-nor-17-pregna-1,3,5(10)-trien-20-yne-3, 17-diol).

Ingredients in NuvaRing

Each NuvaRing, containing etonogestrel and ethinyl estradiol is individually packaged in a reclosable aluminum laminate sachet consisting of three layers, from outside to inside: polyester, aluminum foil, and low-density polyethylene. The ring should be replaced in this reclosable sachet after use for convenient disposal.

Back to Top

The information contained in this drug guide is intended as an educational resource only. This guide is not exhaustive and does not contain all available information about this drug.This guide is not intended as medical advice for individual conditions or treatment.

The information provided in this guide does not replace the need for the advice and services of medical professionals or the need for medical examination. Always talk to your physician or pharmacist before taking any prescription medication or over the counter drugs (including any supplements) or before making any changes to your treatment. Only your doctor, nurse or pharmacist can provide you with safe and effective advice regarding your drug treatment.

The use of the information in this guide is at your sole risk. This information is provided "AS IS" with no warranties to accuracy or timeliness.

**All trademarks and registered trademarks are the property of their respective owners.