NUVARING VAG RING [F] 1 EA

Name	Manufacturer	Price	Unit Price	Stock	Buy Now
NUVARING VAG RING [F] 1 EA		$45.59		product.inStock

NUVARING VAG RING (1 EA)

Generic Name: etonogestrel - ethinyl estradiol slow release vaginal ring
Brand Name: Nuvaring
Drug class: Contraceptives

WHAT IS THE DOSAGE OF THIS MEDICATION?

Nuvaring vaginal ring is available as one ring device that delivers etonogestrel 0.120 mg/ethinyl estradiol 0.015 mg per day.

WHAT IS THIS MEDICATION USED FOR?

This combination product contains two active medications: etonogestrel and estradiol. Etonogestrel belongs to a class of medications called progestins. It is a man-made hormone similar to the hormone progesterone, produced by the ovaries. Estradiol belongs to the class of medications called estrogen. It is also a hormone produced by the ovaries. Together, etonogestrel (progestin) and ethinyl estradiol (estrogen) belong to the class of medications called combination hormonal contraceptives.

Etonogestrel - ethinyl estradiol is used to prevent pregnancy by preventing ovulation (the release of an egg by the ovaries), changing the mucus produced by the cervix, making it difficult for sperm to enter the uterus and changing the lining of the uterus, and making it difficult for a fertilized egg to anchor and grow.

A ring is inserted into the vagina for 3 weeks at a time, then removed for a 1-week break, during which time a menstrual period usually occurs. A new ring is inserted 1 week after the last ring is removed.

Inserting the ring

Choose the position that is most comfortable for you (standing with one leg up, squatting, or lying down), as agreed upon by you and your doctor.

Wash and dry your hands thoroughly.
Remove the ring from its foil pouch. (Keep the foil pouch for proper disposal of the ring after use.)
Hold the ring between your thumb and index finger and press the opposite sides of the ring together.
Gently push the folded ring into your vagina.

The exact position of the ring is not important for it to work. When the ring is in place, most women do not feel it. If you feel uncomfortable, use your finger to gently push the ring further into your vagina. There is no danger of the ring being pushed too far up in the vagina or getting lost. The ring can only be inserted as far as the end of the vagina, where the cervix will block the ring from going any further.

Removing the ring

Remove the vaginal ring 3 weeks after insertion on the same day of the week as it was inserted and at about the same time. To remove the vaginal ring:

Wash and dry your hands thoroughly.
Hook your index finger under the forward rim or by holding the rim between the index and middle finger and pull it out.
Place the used ring in the foil pouch and properly dispose of it in a waste container that is kept out of the reach of children and pets.

Do not flush the ring down the toilet.

Your menstrual period will usually start 2 to 3 days after you remove the ring, and may not end before the new ring is inserted. For continuous protection against pregnancy, you must insert a new ring one week after one was removed, even if your menstrual period has not stopped.

If the ring slips out of the vagina and is replaced within 3 hours, you should still be protected from pregnancy. Rinse the ring with cool or lukewarm water and re-insert it as soon as possible.

If the ring has been out of the vagina for more than 3 hours in the first or second week, protection from pregnancy may no longer be adequate and there is a possibility that you could become pregnant. Reinsert the ring as soon as you remember and use a second method of birth control, such as condoms, until the ring has been in place for 7 days in a row. Use it on the same schedule as you would have used the one that you were originally using.

If the ring has been out of the vagina for more than 3 hours in the third week, protection from pregnancy may be reduced. Throw the ring away and either:

Insert a new ring immediately, starting the next 3-week period of use - you may not experience a menstrual period, or you may experience spotting or breakthrough bleeding; or
Have your period and insert a new ring no more than 7 days after the previous ring was removed or expelled - use this option only if the ring was in place continuously for the previous 7 days.

If the ring has been left in your vagina for an extra week or less (up to 4 weeks total), remove it, take a 1-week break, and re-insert a new ring. If the ring has been left in place for more than 4 weeks total, there is a possibility that you may become pregnant. To prevent pregnancy, you must use an extra method of birth control, such as condoms until a new ring has been in place for 7 days in a row.

While using this medication, you should be examined by your doctor at least once a year.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor.

Store this medication at room temperature, protect it from sunlight, and keep it out of the reach of children. This medication should be used within 4 months of receiving from the pharmacy.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

WHO SHOULD NOT TAKE THIS MEDICATION

Do not use etonogestrel - ethinyl estradiol slow release vaginal ring if you:

are allergic to etonogestrel, ethinyl estradiol, or any ingredients of the medication
are pregnant or suspect you may be pregnant
are a smoker and over the age of 35 years
experience migraines with vision problems (aura)
have recently had or are planning to have surgery that will limit your ability to move around
have very high blood pressure
have existing or have had blood vessel or blood clotting disorders (including deep vein thrombosis, pulmonary embolism, thrombophlebitis, cerebrovascular disease such as stroke, heart attack, and coronary artery disease)
have any eye problems caused by blood vessel disease in the eye (such as partial or complete loss of vision or other vision changes)
have heart disease involving the valves of the heart
have a blood condition that makes you more likely to develop clots
have risk factors for blood clotting disorders
have active liver disease
have severe cholesterol problems
have diabetes with blood vessel changes
have a history of pancreatitis with high levels of triglycerides
have or have had a heart attack, chest pain (angina pectoris), or other circulatory disorders
have or have had cancers that are caused by or enhanced by estrogen (e.g., breast cancer, endometrial cancer)
have or have had liver tumours
have or have had unusual vaginal bleeding that has not been evaluated by a doctor
are taking the following medications for Hepatitis C treatment: ombitasvir, paritaprevir, ritonavir with or without dasabuvir, or glecaprevir and pibrentasvir

POTENTIAL INTERACTION WITH OTHER MEDICATION

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Inform your doctor about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

The following medications could potentially interact with etonogestrel - ethinyl estradiol slow release vaginal ring:

acetaminophen
acetylsalicylic acid (ASA)
acitretin
ampicillin
anastrozole
antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
apixaban
aprepitant
'azole' antifungal medications (e.g., itraconazole, ketoconazole, voriconazole)
barbiturates (e.g., phenobarbital, butalbital)
benzodiazepines (e.g., diazepam, lorazepam, oxazepam)
beta-blockers (e.g., propranolol, metoprolol, atenolol)
betaxolol
bosentan
bromocriptine
calcium channel blockers (e.g., diltiazem, verapamil)
carbamazepine
celecoxib
ceritinib
cholestyramine
clobazam
clofibrate
cobicistat
colestipol
oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
cyclosporine
dabigatran
dabrafenib
deferasirox
dehydroepiandrosterone
diabetes medications (e.g., acarbose, canagliflozin. glyburide, insulin, lixisenatide, linagliptin, metformin, rosiglitazone)
echinacea
elagolix
erlotinib
estrogens (estradiol, conjugated/equine, esterified, estropipate)
fludrocortisone
folic acid
gingko biloba
heparin
HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine, rilpivirine)
HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
hyaluronidase
idelalasib
lamotrigine
lenalidomide
lomitapide
low molecular weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
macrolide antibiotics (e.g., clarithromycin, erythromycin)
melatonin
mifepristone
modafinil
mycophenolate
nitrofurantoin
octreotide
ospemifene
oxcarbazepine
penicillin
perampanel
phenytoin
pomalidomide
primidone
rifabutin
rifampin
rivaroxaban
roflumilast
ropinirole
rufinamide
St. John's wort
sarilumab
selegiline
siltuximab
sulfamethoxazole
tacrolimus
tetracycline
thalidomide
theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
thyroid replacements (e.g., dessicated thyroid, levothyroxine)
tizanidine
tobacco (smoked)
tocilizumab
topiramate
tranexamic acid
Vitamin C
voriconazole
warfarin

WHAT ARE THE SIDE EFFECTS OF THIS MEDICATION?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

This is not a complete list of possible side effects. If you notice other effects not listed, please contact your doctor or pharmacist.

Possible side effects include:

acne
back pain
breast tenderness
can feel the device in place
changes in usual menstrual period (flow, menstrual cramps)
decreased interest in sexual activity
diarrhea
dizziness
expulsion of device
fatigue
headache
intolerance to contact lenses
mood changes
nausea
rash
vomiting
weight gain
abdominal pain or swelling
anxiety
breast lumps
discharge from the breasts
severe headache or worsening headache or migraine
signs of a blood clot in the arm or leg (tenderness, pain, swelling, warmth, or redness in the arm or leg) or lungs (difficulty breathing, sharp chest pain that is worst when breathing in, coughing, coughing up blood, sweating, or passing out)
signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
swelling hands, legs or feet
symptoms of a urinary tract infection (e.g., pain when urinating, urinating more often than usual, low back or flank pain)
unusual or unexpected vaginal bleeding or spotting
vaginal injury associated with broken rings
vaginal itching or infections

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