Frequently Asked Questions

• Smoke and are over 35 years old
• Have or have had blood clots in your arms, legs, eyes, or lungs
• Have an inherited problem with your blood that makes it clot more than normal
• Have had a stroke
• Have had a heart attack
• Have certain heart valve problems or heart rhythm problems that can cause blood clots to form in the heart
• Have high blood pressure that medicine can't control
• Have diabetes with kidney, eye, nerve, or blood vessel damage
• Have certain kinds of severe migraine headaches with aura, numbness, weakness, or changes in vision, or have any migraine headaches if you are over age 35
• Take any Hepatitis C drug combination containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir. This may increase levels of the liver enzyme “alanine aminotransferase” (ALT) in the blood
• Have unexplained vaginal bleeding
• Are pregnant or think you may be pregnant. NuvaRing is not for pregnant women
• Have or have had breast cancer or any cancer that is sensitive to female hormones

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 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 anti-seizure medicines (such as barbiturates, carbamazepine, felbamate, oxcarbazepine, phenytoin, rufinamide and 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 (HCV) medicines (such as boceprevir and telaprevir)
• Non-nucleoside reverse transcriptase inhibitors (such as efavirenz and 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 barrier contraceptive method (such as a male condom with spermicide) when you take medicines that may make NuvaRing less effective. Since the effect of another medicine on NuvaRing may last up to 28 days after stopping the medicine, it is necessary to use the additional barrier contraceptive method for that long to help prevent you from becoming pregnant. While using NuvaRing, you should not use certain female barrier contraceptive methods such as a vaginal diaphragm, cervical cap or female condom as your back-up method of birth control because NuvaRing may interfere with the correct placement and position of a diaphragm, cervical cap or female condom.

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 and 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.

Use NuvaRing as prescribed by your healthcare provider.

• NuvaRing is used in a 4-week cycle.

• NuvaRing should not be used in conjunction with certain female barrier contraceptive methods such as vaginal diaphragm, cervical cap, or female condom because NuvaRing may interfere with the correct placement and position of these methods.
• Use of spermicides or vaginal yeast products will not make NuvaRing less effective at preventing pregnancy.
• Use of tampons will not make NuvaRing less effective or stop NuvaRing from working.
• If NuvaRing has been left inside your vagina for more than 4 weeks (28 days), you may not be protected from pregnancy and you should see your health care provider to be sure you are not pregnant. Until you know the results of your pregnancy test, you should use an extra method of birth control, such as male condoms with spermicide, until the new NuvaRing has been in place for 7 days in a row.
• Do not use more than 1 NuvaRing at a time. Too much hormonal birth control medicine in your body may cause nausea, vomiting, or vaginal bleeding.

Dispose of NuvaRing by placing the used ring in the resealable foil pouch and properly dispose of it in a waste receptacle out of the reach of children and pets. Do not throw it in the toilet.

Note: You should only choose to do option 2 if you used NuvaRing for 7 days in a row, prior to the day that your previous NuvaRing was accidentally removed or expelled.

• If NuvaRing was out of the vagina for an unknown amount of time, you may not be protected from pregnancy. Perform a pregnancy test prior to inserting a new ring and consult your health care provider.