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ethinyl estradiol/etonogestrel

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Brand names: NuvaRing

Vaginal Contraceptive Ring Rx

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.

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Common Questions

How do I insert NuvaRing?
Compress the ring and insert it into your vagina. The exact position isn't important.
How do I remove NuvaRing?
Hook your finger under the rim or grasp the rim and pull it out.
What do I do with the used ring?
Place the used ring in its foil pouch and throw it in the trash, away from children and pets. Do not flush it down the toilet.
When should I start using NuvaRing?
You can start on the first day of your period. You can also start on days 2-5, but use a barrier method like condoms for the first 7 days.
What if I'm switching from the pill?
You can switch any day, but no later than the day after your hormone-free pill interval.
What if the ring comes out?
If the ring is out for less than 3 hours, rinse it with cool to lukewarm water and reinsert it.
Can I have sex with NuvaRing in?
Yes, most women and their partners do not feel the ring during sex.
What if I have heavy bleeding?
Irregular bleeding is a common side effect. If it's heavy or concerning, talk to your doctor.
Can other medicines affect NuvaRing?
Yes, some medicines can make NuvaRing less effective. Tell your doctor about all medicines you take.
What if I want to stop using NuvaRing?
Simply remove the ring during a scheduled removal. Talk to your doctor about other birth control options.
What are the common side effects of ethinyl estradiol/etonogestrel?
The most commonly reported side effects of ethinyl estradiol/etonogestrel include Vaginal infection, Headache (including migraine), Mood changes (like depression or mood swings), Problems related to the ring (like it falling out or causing discomfort), Nausea or vomiting. Always consult your healthcare provider about potential side effects.
Does ethinyl estradiol/etonogestrel interact with other medications?
Yes, ethinyl estradiol/etonogestrel has 28 known drug interactions. Notable interactions include glecaprevir/pibrentasvir, atorvastatin, amoxicillin. Always inform your doctor about all medications you are taking.
What drug class is ethinyl estradiol/etonogestrel?
ethinyl estradiol/etonogestrel belongs to the Vaginal Contraceptive Ring drug class. It requires a prescription (Rx). NuvaRing is used by women of reproductive age to prevent pregnancy.
Is ethinyl estradiol/etonogestrel safe during pregnancy?
Do not use NuvaRing if you are pregnant. NuvaRing can pass into breast milk and may reduce milk production. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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Medication Guides

Related Health & Safety Data

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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

All federal data sources used on this page