Prescription medicine
Ethinyl estradiol and etonogestrel Brand names: Nuvaring, Eluryng, Enilloring
Ethinyl estradiol and etonogestrel (Nuvaring) is a prescription medicine with an FDA approval on record since 2001. FDA's NDC Directory lists it from 5 generic labelers, and pharmacies paid $46.35 per ring (Etonogestrel-ee vaginal ring) in the October 7, 2026 NADAC survey.
- Generic listed
- Boxed warning
Check it at the source: the ethinyl estradiol and etonogestrel FDA label on DailyMed (effective November 14, 2025, Organon LLC); the NDA 21187 record on Drugs@FDA; every ethinyl estradiol and etonogestrel label on DailyMed.
Highlights of the record
FDA label of November 14, 2025; NDC Directory, Drugs@FDA and Orange Book, October 8, 2026; NADAC October 7, 2026
CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS.
Cigarette smoking increases the risk of serious cardiovascular events from combination hormonal contraceptive (CHC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, CHCs, including NuvaRing, should not be used by women who are over 35 years of age and smoke. [See Contraindications (4) .] WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS See full prescribing information for complete boxed warning. Women over 35 years old who smoke should not use NuvaRing. ( 4 ) Cigarette smoking increases the risk of serious cardiovascular events from combination hormonal contraceptive (CHC) use.
Used for
From the label: indications and usageFOR VAGINAL USE ONLY NuvaRing ® is indicated for use by females of reproductive age to prevent pregnancy.
Forms and strengths
- 0.015 mg / 0.12 mg
- 0.12 mg / 0.015 mg
Extended-release insert; ring.
On the market
- Earliest approval on file
- October 3, 2001 Nuvaring, Organon Usa Organon; Drugs@FDA’s file, where older or withdrawn approvals can be missing
- Generic approvals
- 5 first December 11, 2019; 4 with a marketed status in Drugs@FDA
- Labelers listed (NDC)
- 9 of which 5 under generic applications, 3 under brand applications, repackagers included
Supply and safety
- Pharmacy cost (NADAC)
- $46.35 per ring Etonogestrel-ee vaginal ring
- Shortage (FDA)
- No current entry
- Recalls by its makers (FDA)
- No recall recorded
- FAERS reports
- 22,084 through July 30, 2026
What is ethinyl estradiol and etonogestrel used for?
From the label: indications and usageFOR VAGINAL USE ONLY NuvaRing ® is indicated for use by females of reproductive age to prevent pregnancy. NuvaRing is an estrogen/progestin combination hormonal contraceptive (CHC) indicated for use by women to prevent pregnancy.
Conditions named in the indications of ethinyl estradiol and etonogestrel's FDA labels, with every medicine labeled for each:
Source: FDA drug label (NuvaRing), Organon LLC, effective November 14, 2025 (SPL set 55eb60e3-6f4d-40a3-8ee6-e7fd2d0c7d97), via openFDA; the full label on DailyMed
What does the patient leaflet for ethinyl estradiol and etonogestrel say first?
The FDA-approved Medication Guide or Patient Information that comes with the medicine, in its own words.
From the patient leaflet: What is the most important information I should know about NuvaRing?Do not use NuvaRing if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects (heart and blood vessel problems) from combination hormonal contraceptives (CHCs), including death from heart attack, blood clots or stroke. This risk increases with age and the number of cigarettes you smoke. Hormonal birth control methods help to lower the chances of becoming pregnant. They do not protect against HIV infection (AIDS) and other sexually transmitted infections.
From the patient leaflet: How should I store NuvaRing and throw away used NuvaRings?Store NuvaRing at room temperature between 68°F to 77°F (20°C to 25°C). Store NuvaRing at room temperature for up to 4 months after you receive it. Throw NuvaRing away if the expiration date on the label has passed. Do not store NuvaRing above 86°F (30°C). Avoid direct sunlight. Place the used NuvaRing in the re-closable foil pouch and properly throw it away in your household trash out of the reach of children and pets. Do not flush your used NuvaRing down the toilet. Keep NuvaRing and all medicines out of the reach of children.
Source: FDA drug label (NuvaRing), Organon LLC, effective November 14, 2025 (SPL set 55eb60e3-6f4d-40a3-8ee6-e7fd2d0c7d97), via openFDA; the full label on DailyMed
Is there a generic for ethinyl estradiol and etonogestrel (Nuvaring)?
The FDA approved the first generic ethinyl estradiol and etonogestrel on December 11, 2019. 5 generic applications are approved; 4 of them carry a current (not discontinued) marketing status in Drugs@FDA; that status is not evidence that the generic is on sale.
FDA's NDC Directory lists ethinyl estradiol and etonogestrel from 5 labelers under a generic (ANDA) application and from 3 brand labelers. A listing means the company has registered the product for sale; it does not show that every pharmacy stocks it.
- 2001 earliest approval on file
- 2019 first generic approved
Source: Drugs@FDA, FDA NDC Directory and the Orange Book (openFDA bulk files, October 8, 2026)
What do pharmacies pay for ethinyl estradiol and etonogestrel (Nuvaring)?
In CMS's NADAC survey of October 7, 2026, pharmacies paid $46.35 per ring (Etonogestrel-ee vaginal ring), down 6% from $49.37 on October 8, 2025. The chart's scale runs from the lowest to the highest price shown, not from zero. NADAC is what retail pharmacies paid their wholesalers, per unit, in CMS's monthly survey; what a patient pays depends on insurance and the pharmacy.
- Etonogestrel-ee vaginal ring (generic)
- Nuvaring vaginal ring (brand)
| Strength and form | Brand or generic | Pharmacy cost | 30 tablets, or one pen or vial | 12-month change |
|---|---|---|---|---|
| Eluryng vaginal ring | Generic | $46.35 per ring | n/a | -6% |
| Enilloring vaginal ring | Generic | $46.35 per ring | n/a | -6% |
| Etonogestrel-ee vaginal ring | Generic | $46.35 per ring | n/a | -6% |
| Nuvaring vaginal ring | Brand | $155.70 per ring | n/a | -0.1% |
Source: CMS National Average Drug Acquisition Cost (NADAC) survey, October 7, 2026: what retail pharmacies paid per unit; not a counter price
What does the ethinyl estradiol and etonogestrel label say about other medicines?
The ethinyl estradiol and etonogestrel label names 41 other medicines in its interaction, contraindication or warning sections. The sentences are the labels' own; a label lists what its studies and reports found, not every interaction.
| Medicine named | Section | What the label says |
|---|---|---|
| Acetaminophen | drug interactions | Ascorbic acid and acetaminophen may increase plasma ethinyl estradiol concentrations, possibly by inhibition of conjugation. |
| Amoxicillin | drug interactions | The serum concentrations of etonogestrel and ethinyl estradiol were not affected by concomitant administration of oral amoxicillin or doxycycline in standard dosages during 10 days of antibiotic treatment. |
| Aprepitant | drug interactions | Some drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include: phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John's wort. |
| Ascorbic acid | drug interactions | Ascorbic acid and acetaminophen may increase plasma ethinyl estradiol concentrations, possibly by inhibition of conjugation. |
| Atazanavir | drug interactions | … (fos)amprenavir/ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir] or increase [e.g., indinavir and atazanavir/ritonavir]) /HCV protease inhibitors (decrease [e.g., boceprevir and telaprevir]) or with non-nucleoside reverse transcriptase inhibitors (decrease [e.g., efavirenz, nevirapine] or increase [e.g. … |
| Atorvastatin | drug interactions | Substances increasing the plasma concentrations of CHCs Co-administration of atorvastatin and certain CHCs containing ethinyl estradiol increase AUC values for ethinyl estradiol by approximately 20-25%. |
| Bosentan | drug interactions | Some drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include: phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John's wort. |
| Carbamazepine | drug interactions | Some drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include: phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John's wort. |
| Cyclosporine | drug interactions | Effects of CHCs on Other Drugs CHCs containing ethinyl estradiol may inhibit the metabolism of other compounds (e.g., cyclosporine, prednisolone, theophylline, tizanidine, and voriconazole) and increase their plasma concentrations. |
| Darunavir | drug interactions | … noted in some cases of co-administration with HIV protease inhibitors (decrease [e.g., nelfinavir, ritonavir, darunavir/ritonavir, (fos)amprenavir/ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir] or increase [e.g., indinavir and atazanavir/ritonavir]) /HCV protease inhibitors (decrease [e.g., boceprevir and … |
| Doxycycline | drug interactions | The serum concentrations of etonogestrel and ethinyl estradiol were not affected by concomitant administration of oral amoxicillin or doxycycline in standard dosages during 10 days of antibiotic treatment. |
| Drospirenone | warnings and precautions | … COCs containing the following progestins: chlormadinone acetate, cyproterone acetate, desogestrel, dienogest, drospirenone, ethynodiol diacetate, gestodene, levonorgestrel, norethindrone, norgestimate, or norgestrel COCs available excluding DSG- or GSD -containing OCs; … |
| Efavirenz | drug interactions | … [e.g., boceprevir and telaprevir]) or with non-nucleoside reverse transcriptase inhibitors (decrease [e.g., efavirenz, nevirapine] or increase [e.g., etravirine]). |
| Etravirine | drug interactions | … non-nucleoside reverse transcriptase inhibitors (decrease [e.g., efavirenz, nevirapine] or increase [e.g., etravirine]). |
Every other medicine the ethinyl estradiol and etonogestrel label names
| Medicine named | Section | What the label says |
|---|---|---|
| Felbamate | drug interactions | … contraceptives include: phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing … |
| Fluconazole | drug interactions | Concomitant administration of strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma estrogen and/or progestin … |
| Glecaprevir and pibrentasvir | drug interactions | Concomitant use with some other HCV antiviral medicinal products, such as those containing glecaprevir/pibrentasvir, may increase the risk of ALT elevations [see Warnings and Precautions (5.4) ]. |
| Griseofulvin | drug interactions | … include: phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John's wort. |
| Itraconazole | drug interactions | Concomitant administration of strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma estrogen and/or progestin … |
| Ketoconazole | drug interactions | Concomitant administration of strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma estrogen and/or progestin … |
| Lamotrigine | drug interactions | A significant decrease in the plasma concentrations of lamotrigine has been shown, likely due to induction of lamotrigine glucuronidation. |
| Levonorgestrel | warnings and precautions | … desogestrel, dienogest, drospirenone, ethynodiol diacetate, gestodene, levonorgestrel, norethindrone, norgestimate, or norgestrel COCs available excluding DSG- or GSD -containing OCs; … |
| Lopinavir and ritonavir | drug interactions | Human immunodeficiency virus (HIV) / Hepatitis C Virus (HCV) protease inhibitors and non-nucleoside reverse transcriptase inhibitors Significant changes in the plasma concentrations of the estrogen … |
| Miconazole | drug interactions | Co-administration of vaginal miconazole nitrate and NuvaRing increases the serum concentrations of etonogestrel and ethinyl estradiol by up to 40% [see Clinical Pharmacology (12.3) ]. |
| Morphine | drug interactions | CHCs have been shown to decrease plasma concentrations of acetaminophen, clofibric acid, morphine, salicylic acid and temazepam. |
| Nelfinavir | drug interactions | … of co-administration with HIV protease inhibitors (decrease [e.g., nelfinavir, ritonavir, darunavir/ritonavir, (fos)amprenavir/ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir] or increase … |
| Nevirapine | drug interactions | … non-nucleoside reverse transcriptase inhibitors (decrease [e.g., efavirenz, nevirapine] or increase [e.g., etravirine]). |
| Norethindrone | warnings and precautions | … dienogest, drospirenone, ethynodiol diacetate, gestodene, levonorgestrel, norethindrone, norgestimate, or norgestrel COCs available excluding DSG- or GSD -containing OCs; … |
| Norgestrel | warnings and precautions | … desogestrel, dienogest, drospirenone, ethynodiol diacetate, gestodene, levonorgestrel, norethindrone, norgestimate, or norgestrel COCs available excluding DSG- or GSD -containing OCs; … |
| Oxcarbazepine | drug interactions | … phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John's wort. |
| Phenytoin | drug interactions | Some drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include: phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine … |
| Prednisolone | drug interactions | Effects of CHCs on Other Drugs CHCs containing ethinyl estradiol may inhibit the metabolism of other compounds (e.g., cyclosporine, prednisolone, theophylline, tizanidine, and voriconazole) and … |
| Rifabutin | drug interactions | … bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John's wort. |
| Ritonavir | contraindications | … of Hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, due to potential for ALT elevations [see Warnings and Precautions (5.4) and Drug Interactions … |
| Rufinamide | drug interactions | … felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John's wort. |
| Salicylic acid | drug interactions | CHCs have been shown to decrease plasma concentrations of acetaminophen, clofibric acid, morphine, salicylic acid and temazepam. |
| Temazepam | drug interactions | CHCs have been shown to decrease plasma concentrations of acetaminophen, clofibric acid, morphine, salicylic acid and temazepam. |
| Theophylline | drug interactions | Effects of CHCs on Other Drugs CHCs containing ethinyl estradiol may inhibit the metabolism of other compounds (e.g., cyclosporine, prednisolone, theophylline, tizanidine, and voriconazole) and … |
| Tizanidine | drug interactions | … of other compounds (e.g., cyclosporine, prednisolone, theophylline, tizanidine, and voriconazole) and increase their plasma concentrations. |
| Topiramate | drug interactions | … carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John's wort. |
| Voriconazole | drug interactions | Concomitant administration of strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma estrogen and/or progestin … |
Check ethinyl estradiol and etonogestrel against other medicines
Source: FDA drug label (NuvaRing), Organon LLC, effective November 14, 2025 (SPL set 55eb60e3-6f4d-40a3-8ee6-e7fd2d0c7d97), via openFDA; the full label on DailyMed
What do FAERS reports show for ethinyl estradiol and etonogestrel?
The FDA Adverse Event Reporting System holds 22,084 reports that list ethinyl estradiol and etonogestrel among the medicines taken, through July 30, 2026, each a report of something that happened, not proof the medicine caused it; 280 are coded as a death and 6,026 as a hospital stay. Counts follow how widely a medicine is used and watched, and they are not a measure of how risky it is. Reports rose sharply in 2016 (1,659, against a median of 505 a year): FAERS counts follow reporting, which news, litigation and label changes can drive, not how often a reaction happens.
Reports received each year
The most reported reactions
Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026
What else is labeled for the same conditions as ethinyl estradiol and etonogestrel?
1 other medicine is given the same way (vaginal) and in the same FDA class as ethinyl estradiol and etonogestrel or labeled mainly for the same use (birth control), the same class first. Birth control lists all 24 medicines labeled for it, by any route. They are listed as records, not as substitutes: whether one can replace another is a prescriber's decision.
| Medicine | Shared indication | Generic labelers (vaginal) | Pharmacy cost | Shortage |
|---|---|---|---|---|
| Citric acid and lactic acid l- and potassium bitartrate | Birth control | none listed | $6.05 per gram 1.8-1-0.4% vaginal gel | No current entry |
Source: FDA drug labels (indications), NDC Directory, NADAC of October 7, 2026, FDA shortages (October 8, 2026)
What next?
- Other estrogens
- the pharmacologic class, with prices and generics
- Ethinyl estradiol and etonogestrel side effects
- the label's list beside FAERS reports
- Check an interaction
- what two or more labels say about each other