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Etonogestrel-Ethinyl Estradiol

Pronounced

"et-oh-no-GES-trel / ETH-in-il ess-tra-DYE-ole"

Common brand names:

Nuvaring

Uses

This product is a vaginal ring containing combination hormone medication and is used to prevent pregnancy. It contains 2 hormones: a progestin (etonogestrel) and an estrogen (ethinyl estradiol).

Using this product does not protect you or your partner against sexually transmitted diseases (such as HIV, gonorrhea, chlamydia).

How to Use This Medication

Read the Patient Information Leaflet provided by your pharmacist before you start using this product and each time you get a refill. The leaflet contains very important information on how to properly use and dispose of the vaginal ring. If you have any questions, ask your doctor or pharmacist.

This product is for vaginal use only. Before use, wash and dry your hands. Remove the ring from the reclosable foil pouch, keeping the pouch for later disposal of the used ring. Fold the ring in half and gently push it into your vagina as directed, until it feels comfortable. Although some women may be aware of the ring in the vagina, most women do not feel it once it is in place; it will not interfere with sexual intercourse (though your partner may be able to feel the ring). Unlike a diaphragm, the ring's exact position in the vagina does not affect how well it works. Once inserted, keep the ring in place for 3 weeks in a row.

If this is the first time you are using the ring, use a backup form of non-hormonal birth control (such as condoms, spermicide) for the first 7 days to prevent pregnancy until the ring has enough time to work. Do not use a diaphragm, female condom, or cervical cap for backup birth control since the ring may interfere with proper placement. If you start using the ring on the first day of your period, you do not need to use backup birth control the first week.

After using the ring for 3 weeks, remove it on the same day of the week and about the same time that you placed it. Place the used ring back into the foil pouch and discard in the trash. Do not flush the used ring down a toilet. If you have pain/bleeding when trying to remove the ring, or if you cannot remove it, tell your doctor right away.

Next, do not wear a ring for 1 week (7 days). You should have your period within 2 to 3 days after the ring is removed. After 1 ring-free week, insert a new ring on the same day of the week that you removed the old ring, whether or not you have your period. If you do not get your period, consult your doctor. Do not go longer than 7 days without a ring. Doing so will increase your risk of pregnancy.

Regularly check that the ring is in your vagina, such as before and after sexual intercourse. The ring may accidentally fall out during sexual intercourse, during a bowel movement, or while removing a tampon. If this happens and the ring has been out of your vagina for less than 3 hours, rinse it with cool to lukewarm (not hot) water and re-insert the ring as soon as possible. If the ring has been out longer than 3 hours, you could become pregnant. Re-insert it or insert a new ring as directed and use a backup form of non-hormonal birth control (such as condoms, spermicide) for the next 7 days to prevent pregnancy. If you are not sure how long the ring has been out of your vagina, you may not be protected from pregnancy. Contact your doctor for a pregnancy test before inserting a new ring and use a backup form of non-hormonal birth control (such as condoms, spermicide) for 7 days.

If you have left the ring in place longer than directed, up to an extra week (4 weeks total), you will still be protected from pregnancy. Remove the ring and insert a new ring after 1 ring-free week. However, if you have left the ring in place longer than 4 weeks, you may not be protected from pregnancy. Remove the ring and contact your doctor for a pregnancy test before inserting a new ring and use a backup form of non-hormonal birth control (such as condoms, spermicide) for 7 days.

Rarely, the vaginal ring has broken at the weld joint after placement. This increases the chance of it slipping out of the vagina. If this happens, throw it away and use a new ring.

Ask your doctor or pharmacist about how to switch from other forms of hormonal birth control (such as birth control pills) to this product. If any information is unclear, consult the Patient Information Leaflet or your doctor or pharmacist.

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Drug information is selected from data included with permission and copyrighted by First DataBank, Inc. This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional. Always seek the advice of your healthcare professional if you have any questions about this product or your medical condition. This information is not intended as individual medical advice and does not substitute for the knowledge and judgment of your healthcare professional. This information does not contain any assurances that this product is safe, effective or appropriate for you.

This information is intended only for residents of the United States. Products sold under the same brand names in other countries may contain different ingredients.

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Information expires December 2025.