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NuvaRing

(NOO-vuh-ring)

A hormonal contraceptive to prevent pregnancy

Disclaimer

The content on this page is not medical advice and should be used for informational purposes only. Always consult your health care provider or pharmacist to determine what medication and dosage are right for you.

Last updatedJuly 27, 2021

NuvaRing

NuvaRing is a hormonal contraceptive, containing progestin and estrogen. It is a small, flexible piece of plastic that is inserted into the vagina to provide birth control.

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Generic name

Etonogestrel and ethinyl estradiol
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Rx or OTC

Available by prescription only

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Black box warning

Cigarette smoking increases the risk of serious cardiovascular side effects from combination oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use combination hormonal contraceptives, including NuvaRing, should be strongly advised not to smoke.

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When & How

  • Insert the NuvaRing into the vagina, using a position that is most comfortable for you (follow the insert instructions).
  • The exact placement of NuvaRing inside the vagina is not critical for it to work.
  • Leave it in for 3 weeks, and then remove.
  • After 1 week, insert a new NuvaRing.
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Do’s

  • Leave the ring in during sex or any other physical activity.
  • Use additional barrier protection against sexually transmitted infections (STIs).
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Don’ts

  • Do not use a vaginal diaphragm, cervical cap, or female condom because NuvaRing may interfere with the correct placement and position of these products.
  • Do not flush the ring down the toilet—hormones left in the ring might contaminate the water system. Dispose of it in the foil pouch it came in.
  • Do not use a lubricant containing oil or silicone. Use water-based lubricants only.
  • Do not store above 86°F or in direct sunlight (store at room temperature).
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Discuss with your doctor

  • If you smoke
  • If you’re older than 35 years of age
  • If you have a history of blood clots in your legs or lungs, or had a stroke
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What is NuvaRing?

NuvaRing is a hormonal contraceptive, containing progestin and estrogen, similar to the hormones in the birth control pill. It is a small, flexible piece of plastic that is inserted into the vagina.

The ring slowly releases the hormones during a 3-week period to prevent pregnancy. After 3 weeks, it is removed, allowing a normal period, before a new ring is inserted.

It is available by prescription only

NuvaRing dosages
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Vaginal ring

0.120 mg/0.015 mg per day

Similar drugs to NuvaRing

  • EluRyng

Side effects

Disclaimer

Medications may affect individuals differently. Usage of any medication may include side effects and other interactions. Here is a list of known common side effects and interactions. This list is not exhaustive -- there may be other side effects or interactions for this medication that are not listed here. In some cases, the likelihood of side effects or interactions may increase depending on dosage. It’s important to keep in mind that in extreme cases, other serious side effects, even death, may occur. Always consult your health care provider or pharmacist to determine what medication and dosage is right for you.

Vaginitis (pain and itching with discharge)

14% of people experience vaginitis (pain and itching with discharge)

Headache or migraine

11% of people experience headache or migraine

Full list of side effects

  • Vaginitis
  • Headache or migraine
  • Mood changes (such as depression)
  • Discomfort
  • Sensation of a foreign body
  • Nausea/vomiting
  • Vaginal discharge
  • Weight gain
  • Breast pain, discomfort, and tenderness
  • Painful cramps
  • Acne
  • Decreased sexual drive
  • Hives
  • Mask of pregnancy (melasma) or hyperpigmentation
  • Gastrointestinal symptoms (abdominal cramps and bloating)
  • Decrease in lactation when used immediately postpartum
  • Jaundice
  • Spotting
  • Change in menstrual flow
  • Temporary infertility after stopping treatment
  • Change in corneal curvature (steepening)
  • Intolerance to contact lenses

Long-term complications

  • Pulmonary embolism or blood clot in the lungs
  • Blood clot in the deep veins of the body and legs
  • High blood pressure
  • Gallbladder problems
  • Liver problems or tumors

Safety notes

  • NuvaRing does not protect against HIV infection and other sexually transmitted infections like chlamydia, gonorrhea, or syphilis.
  • In very rare cases, toxic shock syndrome (a bacterial infection) has occurred with the use of NuvaRing, though in some of the cases, tampon usage was involved.
  • Mood changes, such as depression, are a common side effect of hormonal contraception. If you have a severe history of depression, talk to your doctor.
  • Using NuvaRing is associated with increased risks of several serious conditions: myocardial infarction, thromboembolism, stroke, hepatic neoplasia, and gallbladder disease.
  • The risk of cardiovascular events is greater if underlying factors such as hypertension, hyperlipidemia, obesity, and diabetes are present.

What else you should know

  • Your menstrual period will usually start 2 to 3 days after the ring is removed and you still may have your period before the next ring is inserted.
  • NuvaRing can accidentally come out while removing a tampon, during intercourse, or if straining during a bowel movement. Call your health care professional to discuss when and how to re-insert the ring.
  • It’s safe to use tampons, menstrual cups, and pads with the NuvaRing.
  • Bleeding or spotting may occur after inserting a new ring.
  • Some women choose to skip a period while using the NuvaRing. To do this, just take it out between 3 and 4 weeks, and replace it with a new one right away. By not waiting a week to replace it, you won’t get your period.

NuvaRing interactions

Disclaimer

Medications may affect individuals differently. Usage of any medication may include side effects and other interactions. Here is a list of known common side effects and interactions. This list is not exhaustive -- there may be other side effects or interactions for this medication that are not listed here. In some cases, the likelihood of side effects or interactions may increase depending on dosage. It’s important to keep in mind that in extreme cases, other serious side effects, even death, may occur. Always consult your health care provider or pharmacist to determine what medication and dosage is right for you.

Tell your doctor if you are taking any of these medications or supplements

These anticonvulsants decrease the levels of hormones from the NuvaRing (an alternative birth control is recommended):

  • Phenytoin
  • Phenobarbital
  • Oxcarbazepine
  • Carbamazepine

These HIV drugs decrease the effectiveness of NuvaRing (an alternative birth control is recommended):

  • Elvitegravir
  • Fosamprenavir
  • Indinavir
  • Lopinavir
  • Nelfinavir
  • Nevirapine
  • Ritonavir
  • Saquinavir
  • Atazanavir

Antifungals to avoid while using NuvaRing:

  • Griseofulvin
  • Ketoconazole
  • Posaconazole

.

Herbals:

  • St John’s wort will decrease the effectiveness of the ring.

Do not use NuvaRing with these anticoagulants—it will make them ineffective.

  • Warfarin
  • Enoxaparin
  • Heparin

Tell your doctor if you have any of these pre-existing conditions

  • Abnormal blood clots in the legs, eyes, and lungs or a history of clotting disorders
  • Current or past history of strokes, aneurysms, vertebral stenosis, vascular malformations, carotid stenosis, intracranial stenosis, clot formation, embolism, or blood vessel rupture
  • Heart valve disease with blood clot complications
  • Severe high blood pressure
  • Diabetes complications like blindness, kidney failure
  • Headaches with involuntary movements, tremor, weakness, loss of muscle control, increased muscle tone, loss of muscle tone, paralysis symptoms
  • Major surgery with prolonged bed rest
  • Known or suspected breast cancer or previous breast cancer
  • Cancer of the lining of the uterus or other known or suspected estrogen-dependent cancer
  • Undiagnosed abnormal genital bleeding
  • Liver-related jaundice of pregnancy or jaundice with prior hormonal contraceptive use
  • Liver tumors (benign or malignant) or active liver disease
  • Known or suspected pregnancy
  • Heavy smoking (≥15 cigarettes per day) and over age 35
  • Hypersensitivity to any of the components of NuvaRing

NuvaRing pricing

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