ethinyl estradiol/etonogestrel
Brand names: NuvaRing
NuvaRing is a vaginal ring that contains hormones to prevent pregnancy. It releases hormones over three weeks to stop you from getting pregnant.
What it does
NuvaRing is used by women of reproductive age to prevent pregnancy.
Common side effects
Vaginal infection, Headache (including migraine), Mood changes (like depression or mood swings)
Key warnings
Cigarette smoking increases your risk of serious heart problems if you use hormonal birth control like NuvaRing.
How It Works
NuvaRing contains two hormones: etonogestrel and ethinyl estradiol. These hormones are released slowly into your body. They prevent pregnancy mainly by stopping your ovaries from releasing an egg.
How to Take It
Insert one NuvaRing into your vagina. Keep it in place for three weeks, then remove it for one week. After the ring-free week, insert a new ring. You can insert the ring in a position that is comfortable for you.
Pregnancy & Breastfeeding
Do not use NuvaRing if you are pregnant. NuvaRing can pass into breast milk and may reduce milk production. Talk to your doctor about other birth control options if you are breastfeeding.
Missed Dose
If the ring is out of your vagina for more than 3 hours, it may not prevent pregnancy. Refer to the full prescribing information for detailed instructions.
Storage
Before you get NuvaRing, it should be stored in the refrigerator. After you get it, you can store it at room temperature for up to 4 months, but keep it out of direct sunlight and away from high heat.
Serious Warnings
Cigarette smoking increases your risk of serious heart problems if you use hormonal birth control like NuvaRing. This risk is higher if you are over 35 and smoke more cigarettes. If you are over 35 and smoke, you should not use NuvaRing.
Known 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) ] .
Mechanism: Taking these medications at the same time can cause a rise in liver enzymes. This is often a sign that the liver is under stress or being irritated.
What to do: Talk to your doctor about the risks to your liver before starting these drugs together. They may need to monitor your liver health with blood tests.
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%.
Mechanism: Atorvastatin can raise the levels of birth control hormones in your blood.
What to do: Your doctor should be aware of this combination, as it may increase the risk of side effects from your birth control.
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.
Mechanism: Amoxicillin does not change the levels of birth control hormones in your blood.
What to do: You can take these together without needing to change your dose or use extra protection.
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. The effects of other antibiotics on etonogestrel or ethinyl estradiol concentrations have not been evaluated. 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%.
Mechanism: This combination can increase the amount of estrogen that stays in your blood.
What to do: Your doctor may need to monitor you for side effects or adjust your hormone levels.
A significant decrease in the plasma concentrations of lamotrigine has been shown, likely due to induction of lamotrigine glucuronidation. This may reduce seizure control; therefore, dosage adjustments of lamotrigine may be necessary.
Mechanism: The birth control ring causes your body to process and remove the seizure medicine more quickly.
What to do: Your doctor may need to increase your dose of lamotrigine to make sure it still prevents seizures.
Common Questions
How do I insert NuvaRing?
How do I remove NuvaRing?
What do I do with the used ring?
When should I start using NuvaRing?
What if I'm switching from the pill?
What if the ring comes out?
Can I have sex with NuvaRing in?
What if I have heavy bleeding?
Can other medicines affect NuvaRing?
What if I want to stop using NuvaRing?
What are the common side effects of ethinyl estradiol/etonogestrel?
Does ethinyl estradiol/etonogestrel interact with other medications?
What drug class is ethinyl estradiol/etonogestrel?
Is ethinyl estradiol/etonogestrel safe during pregnancy?
Related Medications in Vaginal Contraceptive Ring
Other drugs grouped near ethinyl estradiol/etonogestrel — same-class peers and common alternatives.
abiraterone
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anastrozole
Arimidex
Anastrozole is a medicine used to treat breast cancer in women after menopause.
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bazedoxifene/conjugated estrogens
Duavee
Duavee is a combination medicine containing estrogen and a drug that blocks estrogen in some parts of the body.
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cabergoline
Dostinex
Cabergoline is a medicine that helps lower the amount of prolactin in your body.
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clomiphene
Clomid, Serophene
Clomiphene citrate is a medicine that helps women ovulate.
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Compare ethinyl estradiol/etonogestrel vs abiraterone side-by-side →
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What the FDA Data Shows for ethinyl estradiol/etonogestrel
The FDA label for ethinyl estradiol/etonogestrel (sold under brand names such as NuvaRing) classifies it as a prescription-only medication in the Vaginal Contraceptive Ring class. NuvaRing is used by women of reproductive age to prevent pregnancy. Official labeling lists 13 commonly reported side effects, including Vaginal infection, Headache (including migraine), Mood changes (like depression or mood swings).
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. Voluntary reports accumulate over the lifetime of a drug and reflect wide-ranging clinical use. The database also lists 28 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. Acquisition-cost data is surveyed weekly by CMS and updated as manufacturers report changes.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: March 21, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages