NuvaRing

Overview

About NuvaRing

In Depth >

Why should NuvaRing not be prescribed?

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Do not use NuvaRing if you have any of the following conditions:

A clotting disorder (past or present)
A tendency for strokes or mini-strokes (past or present)
Heart disease (past or present)
A heart valve disorder
Severe high blood pressure
Diabetes with impaired circulation
Certain types of headaches
Breast cancer (past or present)
Endometrial cancer or any other estrogen-dependent cancer
Unexplained vaginal bleeding
Liver disease or liver tumors
Jaundice during pregnancy or from prior hormonal contraceptive use
Pregnancy
Smoking 15 or more cigarettes per day past age 35
Planned surgery that will keep you immobilized
Allergy to any component of NuvaRing

Special warnings about NuvaRing

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Hormonal contraceptives pose a slightly increased risk of blood clots and related disorders such as phlebitis, heart disease, heart attack, vision loss, and stroke. Smoking and advancing age increase this risk.

The estrogen in hormonal contraceptives also appears to cause a slight increase in the risk of breast cancer while the contraceptives are in use. This increase subsides after the contraceptives are stopped.

The risk of developing dangerous liver tumors also goes up very slightly. If you develop signs of liver problems, such as yellowing of the skin or whites of the eyes, you should stop using NuvaRing. Hormonal contraceptives can also hasten the development of gallbladder disease in susceptible women.

If you have diabetes, hormonal contraceptives may worsen the problem. In a few women, they cause an increase in triglyceride (blood fat) levels as well.

Especially in older women, hormonal contraceptives may foster an increase in blood pressure. If you already suffer from high blood pressure or kidney disease, it's best to avoid these drugs. If you do decide to use them and sustain an increase in blood pressure, you'll have to discontinue their use.

Similarly, if NuvaRing triggers migraine headaches or makes them worse, you'll need to stop using this product.

Hormonal contraceptives sometimes leave the user depressed. If you've suffered from depression in the past, use NuvaRing with caution. If you become depressed, alert your doctor immediately; you may need to discontinue use of NuvaRing.

Remember that NuvaRing, like other forms of hormonal contraception, does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Possible food and drug interactions when taking NuvaRing

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If NuvaRing is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining NuvaRing with the following:

Acetaminophen
Antibiotics such as ampicillin and tetracycline
Anticonvulsants such as felbarnate, carbamazepine, oxcarbazepine, phenytoin, phenobarbital, and topiramate,
Antifungals such as griseofluvin, itraconazole, and ketoconazole
Atorvastatin
Clofibrate
Cyclosporine
HIV drugs classified as protease inhibitors
Morphine
Phenylbutazone
Prednisolone
Rifadin
St. John's wort
Temazepam
Theophylline
Vitamin C

Special information if you are pregnant or breastfeeding

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NuvaRing should not be used during pregnancy or while nursing.

Recommended dosage for NuvaRing

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ADULTS

NuvaRing is inserted in the vagina once a month. It stays in the vagina continuously for three weeks. It must be removed exactly 21 days after insertion. A new ring is inserted precisely 7 days later.

The time to start use of NuvaRing depends on your previous contraceptive program:

If you did not use a hormonal contraceptive in the past month

Count the first day of your menstrual period as day 1. Insert the first ring between day 1 and day 5 of the cycle, even if you are still bleeding on day 5. During the first cycle, use an extra method of birth control such as male condoms or spermicide for the first 7 days of ring use.

If you are switching from a combination birth control pill

Insert NuvaRing any time during the first 7 days after the last tablet and no later than the day you would have started a new pill cycle. No extra birth control method is needed.

If you are switching from a progestin-only contraceptive

When you are switching from a progestin-only contraceptive, use an extra method of birth control, such as male condoms or spermicide, for the first 7 days after inserting NuvaRing.

If you are switching from the "mini-pill," you can start using NuvaRing on any day of the month. Do not skip days between your last pill and first day of NuvaRing use.
If you are switching from a progestin implant, start using NuvaRing on the same day you have your implant removed.
If you are switching from an injectable contraceptive, start using NuvaRing on the day when your next injection is due.
If you are switching from a progestin-containing IUD, start using NuvaRing on the same day you have your IUD removed.

Following a first trimester abortion or miscarriage

If you start using NuvaRing within 5 days after a complete first trimester abortion or miscarriage, you do not need to use an extra method of contraception. If more than 5 days have passed, proceed as you would if you had not used a hormonal contraceptive for the past month.

Overdosage

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Given the design of NuvaRing, it is unlikely that overdosage will occur. Symptoms of overdose with other hormonal contraceptives include nausea, vomiting, vaginal bleeding, and other menstrual irregularities.