NuvaRing (Etonogestrel, Ethinyl Estradiol Vaginal Ring) Drug Overview of Drug Interactions and Missed Dose for Patients and Caregivers at RxList

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May 27, 2012

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Birth Control (Types and Options) »

Introduction to birth control types and options

If a woman is sexually active and she is fertile — physically able to become pregnant — she needs to ask herself, "Do I want to become pregnant now?" If her answer is "No," she must use some method of birth control (contraception).

If a woman does not want to get pregnant at this point in her life, does she plan to become pregnant in the future? Soon? Much later? Never? Her answers to these questions can determine the method of birth control that she and her male sexual partner use — now and in the future.

There are a number of different ways to describe birth control. Terms include contraception, pregnancy prevention, fertility control, and family planning. But no matter what the process is called, sexually active people can choose from a plethora of methods to reduce the possibility of their becoming pregnant. Nevertheless, no method of birth control av...

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DRUG INTERACTIONS: The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.

To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.

Some products that may interact with this drug include: aromatase inhibitors (e.g., anastrozole, exemestane), raloxifene, sodium tetradecyl sulfate, tamoxifen, medication for underactive thyroid (hypothyroidism), drugs that may increase blood levels of this drug such as acetaminophen, ascorbic acid (vitamin C), atorvastatin, azole antifungals such as itraconazole/ketoconazole/vaginal miconazole.

Certain drugs can decrease the effectiveness of combination-type birth control by decreasing the amount of birth control hormones in your system. This can result in pregnancy. These drugs include: many antibiotics (e.g., cephalosporins, chloramphenicol, macrolides such as erythromycin, penicillins, sulfas), aprepitant, bexarotene, bosentan, dapsone, felbamate, griseofulvin, certain HIV protease inhibitors (e.g., amprenavir, nelfinavir, ritonavir), modafinil, nevirapine, phenylbutazone, rifamycins (e.g., rifampin), many seizure medications (e.g., barbiturates, carbamazepine, oxcarbazepine, phenytoin, lamotrigine, topiramate), St. John's wort. Consult your doctor or pharmacist for details, and ask them if you should use additional reliable birth control methods while taking any of the drugs mentioned above.

This drug can speed up or slow down the removal of other drugs from your body by affecting certain liver enzymes. These affected drugs include acetaminophen, aspirin, clofibrate, cyclosporine, morphine, corticosteroids such as prednisolone, certain benzodiazepines such as lorazepam/temazepam, and theophylline, among others. If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting this medication.

This medication can affect the results of certain lab tests (e.g., blood tests for clotting factors, thyroid). Make sure laboratory personnel and all your doctors know you use this medication.

This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

OVERDOSE: This product may be harmful if swallowed. Overdose with this product is highly unlikely. Do not use more than one ring at a time. If overdose or swallowing is suspected, remove the ring if possible and contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.

NOTES: Do not share this product with others.

Keep all laboratory and medical appointments. You should have regular complete physical exams including blood pressure, breast exam, pelvic exam, and screening for cervical cancer (Pap smear). Follow your doctor's instructions for examining your own breasts, and report any lumps immediately. Consult your doctor for more details.

MISSED DOSE: If this product is out of the vagina for more than 3 hours, or if you forget to insert or remove this product at the recommended time, read the Patient Information Leaflet or consult your doctor or pharmacist to establish a new dosing schedule. If the hormone ring has been removed for longer than 3 hours, using a back-up method of birth control for 7 days is recommended. See the How to Use section. Consult your doctor or pharmacist for more information.

If you have trouble remembering to remove and reinsert the ring as directed, or if it falls out repeatedly, contact your doctor to discuss switching to another form of birth control.

STORAGE: Pharmacist: Prior to dispensing, store in the refrigerator between 36-46 degrees F (2-8 degrees C). Do not freeze.

Patient: Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture for up to 4 months. Brief storage up to 59-86 degrees F (15-30 degrees C) is permitted. Do not use after the expiration date. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed (See How to Use section).