Learn How NuvaRing® (etonogestrel/ethinyl estradiol vaginal ring) Works With Your Cycle Learn How NuvaRing® (etonogestrel/ethinyl estradiol vaginal ring) Works With Your Cycle

What Should I Tell My Health Care Provider Before Using NuvaRing?

Before you use NuvaRing tell your health care provider if you:
  • Have any medical conditions
  • Smoke
  • Are pregnant or think you are pregnant
  • Recently had a baby
  • Recently had a miscarriage or abortion
  • Have a family history of breast cancer
  • Have or have had breast nodules, fibrocystic disease, an abnormal breast x-ray, or abnormal mammogram
  • Use tampons and have a history of toxic shock syndrome
  • Have been diagnosed with depression
  • Have had liver problems including jaundice during pregnancy
  • Have or have had elevated cholesterol or triglycerides
  • Have or have had gallbladder, liver, heart, or kidney disease
  • Have diabetes
  • Have a history of jaundice (yellowing of the skin or eyes) caused by pregnancy (also called cholestasis of pregnancy)
  • Have a history of scanty or irregular menstrual periods
  • Have any condition that makes the vagina become irritated easily
  • Have or have had high blood pressure
  • Have or have had migraines or other headaches or seizures
  • Are scheduled for surgery. NuvaRing® (etonogestrel/ethinyl estradiol vaginal ring) may increase your risk of blood clots after surgery. You should stop using NuvaRing at least 4 weeks before you have surgery and not restart it until at least 2 weeks after your surgery
  • Are scheduled for any laboratory tests. Certain blood tests may be affected by hormonal birth control methods
  • Are breastfeeding or plan to breastfeed. Hormonal birth control methods that contain estrogen, like NuvaRing, may decrease the amount of milk you make. A small amount of hormones from NuvaRing may pass into your breast milk. Consider another non-hormonal method of birth control until you are ready to stop breastfeeding
  • Have (or have ever had) an allergic reaction while using NuvaRing, including hives, swelling of the face, lips, tongue, and/or throat causing difficulty in breathing or swallowing (anaphylaxis and/or angioedema)

Tell your health care provider about all medicines and herbal products you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.

Some medicines and herbal products may make hormonal birth control less effective, including, but not limited to:

  • Certain antiseizure medicines (such as barbiturates, carbamazepine, felbamate, oxcarbazepine, phenytoin, rufinamide, topiramate)
  • Medicine to treat fungal infections (griseofulvin)
  • Certain combinations of HIV medicines (such as nelfinavir, ritonavir darunavir/ritonavir, (fos)amprenavir/ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir)
  • Certain hepatitis C medicines (such as boceprevir, telaprevir)
  • Non-nucleoside reverse transcriptase inhibitors (such as nevirapine)
  • Medicine to treat tuberculosis (such as rifampicin and rifabutin)
  • Medicine to treat high blood pressure in the vessels of the lung (bosentan)
  • Medicine to treat chemotherapy-induced nausea and vomiting (aprepitant)
  • St John’s wort

Use an additional birth control method (such as a male condom with spermicide) when you take medicines that may make NuvaRing® (etonogestrel/ethinyl estradiol vaginal ring) less effective. Continue back-up birth control for 28 days after stopping the medicine to help prevent you from becoming pregnant.

Some medicines and grapefruit juice may increase the level of ethinyl estradiol in your blood if used together, including:

  • The pain reliever acetaminophen
  • Ascorbic acid (vitamin C)
  • Medicines that affect how your liver breaks down other medicines (such as itraconazole, ketoconazole, voriconazole, fluconazole, clarithromycin, erythromycin, and diltiazem)
  • Certain HIV medicines (atazanavir/ritonavir, indinavir)
  • Non-nucleoside reverse transcriptase inhibitors (such as etravirine)
  • Medicines to lower cholesterol such as atorvastatin and rosuvastatin

Hormonal birth control methods may interact with lamotrigine, a medicine used for seizures. This may increase the risk of seizures, so your health care provider may need to adjust your dose of lamotrigine.

Women on thyroid replacement therapy may need increased doses of thyroid hormone.

Ask your health care provider if you are not sure if you take any of the medicines listed above. Know the medicines you take. Keep a list of them to show your health care provider and pharmacist when you get a new medicine.

Important Safety Information
  • Do not use NuvaRing if you smoke cigarettes and are over age 35. Smoking increases your risk of serious heart and blood vessel problems from combination hormonal contraceptives (CHCs) including heart attack, blood clots, or stroke which can be fatal. This risk increases with age and the number of cigarettes smoked.
  • The use of a CHC, like NuvaRing, is associated with increased risks of several serious side effects, including blood clots, stroke, or heart attack. NuvaRing is not for women with a history of these conditions or any condition that makes your blood more likely to clot. The risk of getting blood clots may be greater with the type of progestin in NuvaRing than with some other progestins in certain low-dose birth control pills. The risk of blood clots is highest when you first start using CHCs and when you restart the same or different CHC after not using it for a month or more.  
  • NuvaRing is also not for women with high blood pressure that medicine can’t control; diabetes with kidney, eye, nerve, or blood vessel damage; certain kinds of severe migraine headaches; liver disease or liver tumors; take any Hepatitis C drug combination containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, as this may increase levels of the liver enzyme “alanine aminotransferase” (ALT) in the blood; unexplained vaginal bleeding; breast cancer or any cancer that is sensitive to female hormones; or if you are or may be pregnant.
  • NuvaRing does not protect against HIV infection (AIDS) and other sexually transmitted infections.
  • The most common side effects reported by users of NuvaRing are irritation inside your vagina or on your cervix; headache (including migraine); mood changes (including depression); the ring slipping out or causing discomfort; nausea and vomiting; vaginal discharge; weight gain; vaginal discomfort; breast pain, discomfort, or tenderness; painful menstrual periods; abdominal pain; acne; and less sexual desire.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

Please read the Patient Information for NuvaRing® (etonogestrel/ethinyl estradiol vaginal ring), including the information about the increased risk of serious cardiovascular side effects, especially in women who smoke, and discuss it with your health care provider. The physician Prescribing Information also is available.