Learn more about usage, cautions, and possible side effects .
Chemical Name: ETONOGESTREL (et-oh-noe-JES-trel) and ETHINYL ESTRADIOL (ETH-in-il ess-tra-DYE-ole)
This contraceptive ring contains a progestin and estrogen combination used to prevent pregnancy. It contains hormones similar to those in birth control pills. The hormones release from the ring slowly over time.
WARNING: Smoking cigarettes while using this medicine increases your chance of having heart problems. Do not smoke while using this medicine. The risk of heart problems increases with age (in women greater than 35 years of age) and with frequent smoking (15 cigarettes per day or greater). Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. AN ADDITIONAL FORM OF BIRTH CONTROL may be needed if you are taking antifungals (such as ketoconazole or itraconazole), aprepitant, bosentan, barbiturates (such as phenobarbital or butalbital), carbamazepine, felbamate, griseofulvin, HIV protease inhibitors (such as ritonavir or lopinavir), hydantoins (such as phenytoin), modafinil, nevirapine, oxcarbazepine, penicillin antibiotics (such as ampicillin), phenylbutazone, rifampin, tetracycline antibiotics (such as doxycycline), topiramate, troglitazone, or troleandomycin. These medicines may decrease the effectiveness of the birth control pills. Ask your doctor or pharmacist for more information about additional forms of birth control. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking atorvastatin, acetaminophen, cyclosporine, corticosteroids (such as prednisolone), theophylline, temazepam, salicylates, morphine, clofibric acid, beta-blockers (such as metoprolol), or lamotrigine. Inform your doctor of any other medical conditions including high cholesterol or triglyceride (fat) levels, recent pregnancy, depression, high blood pressure, gallbladder problems, kidney problems, thyroid problems, severe constipation, obesity, vaginal conditions (such as vaginal stenosis or cervical prolapse), any allergies (especially to hormones used in birth control pills, such as estrogen, or progestins), or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have a history of blood clots (such as in the legs, groin, or lungs), heart disease or stroke, heart valve disease, severe high blood pressure, diabetes (especially if you have circulation problems), severe headaches, recent major surgery, long periods of sitting or lying down, liver problems, jaundice during pregnancy or while using birth control pills, cancer (especially endometrial or breast), undiagnosed abnormal vaginal bleeding, currently pregnant, or heavy tobacco use (if 35 years old or greater). Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.
Follow the directions for using this medicine provided by your doctor. THIS MEDICINE COMES with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have before using this medicine. Follow all instructions on how to use this hormone ring and also the best time (during your menstrual cycle) to start using it. Wear each ring for 3 continuous weeks, and then remove it for a 1 week period. A new ring is inserted one week after the last ring is removed and a new cycle begins again. If any of the information is unclear, consult your doctor or pharmacist. Wash and dry your hands. Open the foil pouch container. Remove the ring and save the pouch to discard the ring after it is used. Insert the ring into your vagina. Rarely, some women have inserted the ring into the bladder by mistake. Do not insert the ring into your bladder. When correctly placed, you should not feel the ring and it will not interfere with sexual intercourse. Remove the ring on the fourth week on the same day of the week and about the same time as you placed it. This will be the start of a one week (7 days) ring-free break. Put the used ring in the original foil pouch and throw away in a trash container. DO NOT FLUSH the used ring down the toilet. Your menstrual period should usually start within 2 to 3 days after the ring is removed. If your period does not begin during the ring-free week, consult your doctor. At the end of the fourth week, insert a new ring on the same day of the week and about the same time as during the last cycle. You must insert the new ring one week after the last one was removed, even if your menstrual bleeding has not stopped. DO NOT GO LONGER THAN 7 DAYS without a ring. Doing so may make this product less effective. If the ring falls out of the vagina, rinse it with cool to lukewarm (not hot) water and re-insert as soon as possible. Do not go more than 3 hours without the ring in place. If the ring is out for more than 3 hours, you may not be protected from pregnancy. In this case, rinse the ring, re-insert as soon as possible, and use a back-up method of birth control (e.g., condoms, spermicide) until the ring has been in place for 7 straight days. If you have left the ring in place for longer than than recommended, refer to the Patient Information Leaflet for instructions on what you should do. Prior to dispensing, pharmacists will STORE THIS MEDICINE in the refrigerator between 36 and 46 degrees F (2 and 8 degrees C). Do not freeze. Patients should STORE THIS MEDICINE at room temperature between 59 and 86 degrees F (15 and 30 degrees C), away from heat and light. DO NOT USE AFTER the expiration date. IF YOU MISS INSERTING THE NEW RING ON THE SCHEDULED DAY, insert it as soon as you remember. You must use a backup method of birth control until the new ring has been in place for 7 days. If you are not sure what to do if you miss inserting the new ring on the scheduled day, use an extra form of birth control (eg, condoms) and talk with your doctor.
SMOKING CIGARETTES while using this medicine may increase your risk of stroke, heart attack, blood clots, high blood pressure, or other diseases of the heart and blood vessels. DURING YOUR FIRST RING CYCLE, additional method of birth control may be necessary for the first 7 days of use. CHECK WITH YOUR DOCTOR or pharmacist to see if you need the additional birth control method. DO NOT LEAVE THE RING IN PLACE for longer than 4 weeks. If this happens, your body may not have enough hormones to protect you from pregnancy. Remove the ring and check to make sure you are not pregnant. If pregnant, contact your physician immediately. If not pregnant, insert a new ring and use a back-up method of birth control (such as condoms or spermicide) until the new ring has been in place for 7 straight days. SOME MEDICINES may decrease the effectiveness of birth control pills. If you are prescribed certain medicines such as anticonvulsants, antibiotics, antifungals, or certain medicines for HIV, you may need to use an additional form of birth control. If you have any questions about which medicines will decrease the effectiveness of the birth control pill, contact your doctor, nurse, or pharmacist. To prevent pregnancy, use an additional form of birth control until your next period. Ask your doctor, nurse, or pharmacist for more information about additional forms of birth control. IF YOU WEAR CONTACT LENSES and you develop problems with them, contact your doctor. SOME WOMEN HAVE RARELY PLACED THIS MEDICINE into the bladder by mistake. Contact your doctor right away if you develop persistent bladder problems (such as difficult or painful urination) and you can not locate the ring in your vagina. THIS MEDICINE MAY CAUSE dark skin patches on your face. Exposure to the sun may make these patches darker. If patches develop, use a sunscreen or protective clothing when exposed to the sun, sunlamps, or tanning booths. USE OF THIS MEDICINE WILL NOT PREVENT the spread of sexually transmitted diseases (STDs). THIS BIRTH CONTROL DEVICE MAY INTERFERE with the correct placement of a diaphragm. The use of a diaphragm as a back-up method of birth control is not recommended. DO NOT USE THIS MEDICINE if you are pregnant. IF YOU SUSPECT THAT YOU COULD BE PREGNANT, contact your doctor immediately. THE MEDICINES IN THIS RING ARE EXCRETED IN BREAST MILK. IF YOU ARE OR WILL BE BREAST-FEEDING while you are using this medicine, check with your doctor or pharmacist to discuss the risks to your baby.
SIDE EFFECTS that may occur while you are taking this medicine include breast tenderness or enlargement; changes in appetite or weight; dizziness; headache; mild hair loss; nausea; nervousness; spotting or breakthrough bleeding; or stomach cramps or bloating. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience change in the amount of urine produced; difficulty wearing contact lenses; persistent or recurrent vaginal bleeding; persistent or recurring headache or dizziness; swelling of fingers, hands, legs, or ankles; vaginal discomfort or irritation; or unusual vaginal discharge. CONTACT YOUR DOCTOR IMMEDIATELY if you experience a missed menstrual period; breast lump or discharge; calf/leg pain or swelling; chest pain; confusion; coughing up blood; dark urine; fainting; heavy vaginal bleeding; mental or mood changes (such as depression); migraines; numbness of an arm or leg; one-sided weakness; pale stools; severe stomach pain; severe dizziness; slurred speech; sudden severe headache or vomiting; sudden shortness of breath; symptoms of toxic shock syndrome (such as sudden fever, vomiting, diarrhea, dizziness, or sunburn-like rash on the face or body); unusual tiredness or weakness; vision changes (such as loss of vision); or yellowing of the skin or eyes (with or without fever). AN ALLERGIC REACTION to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your healthcare provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other. Check drug interactions
Overdose with this product is highly unlikely. Do not use more than one ring at a time. If overdose is suspected, remove the ring and contact your local poison control center or emergency room immediately. This product may be harmful if swallowed. Symptoms of overdose may include severe nausea and vomiting, unusual vaginal bleeding or irregular menstrual periods.
DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. DO NOT USE AFTER the expiration date. KEEP THIS MEDICINE out of the reach of children and pets. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.
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