ETONOGESTREL; ETHINYL ESTRADIOL (et oh noe JES trel; ETH in il es tra DYE ole) prevents ovulation and pregnancy. It belongs to a group of medications called contraceptives. It is a combination of the hormones estrogen and progestin.
What should I tell my care team before I take this medication?
They need to know if you have any of these conditions:
Abnormal vaginal bleeding
Blood clots
Blood vessel disease
Breast, cervical, endometrial, ovarian, liver, or uterine cancer
Diabetes
Gallbladder disease
Having surgery
Heart disease or recent heart attack
High blood pressure
High cholesterol or triglycerides
History of irregular heartbeat or heart valve problems
Kidney disease
Liver disease
Lupus
Migraine headaches
Protein C or S deficiency
Recently had a baby, miscarriage, or abortion
Stroke
Tobacco use
An unusual or allergic reaction to estrogens, progestins, other medications, foods, dyes, or preservatives
Pregnant or trying to get pregnant
Breastfeeding
How should I use this medication?
Insert the ring into your vagina as directed. Follow the directions on the prescription label. The ring will remain place for 3 weeks and is then removed for a 1-week break. A new ring is inserted 1 week after the last ring was removed, on the same day of the week. Check often to make sure the ring is still in place. If the ring was out of the vagina for an unknown amount of time, you may not be protected from pregnancy. Perform a pregnancy test and call your care team. Do not use more often than directed.
A patient package insert for the product will be given with each prescription and refill. Read this sheet carefully each time. The sheet may change frequently.
Contact your care team regarding the use of this medication in children. Special care may be needed.
What if I miss a dose?
You will need to use the ring exactly as directed. It is very important to follow the schedule every cycle. If you do not use the ring as directed, you may not be protected from pregnancy. If the ring should slip out, is lost, or if you leave it in longer or shorter than you should, contact your care team for advice.
What may interact with this medication?
Do not take this medication with the following:
Dasabuvir; ombitasvir; paritaprevir; ritonavir
Ombitasvir; paritaprevir; ritonavir
Vaginal lubricants or other vaginal products that are oil-based or silicone-based
This medication may also interact with the following:
Acetaminophen
Antibiotics or medications for infections, especially rifampin, rifabutin, rifapentine, griseofulvin, penicillins, or tetracyclines
Aprepitant or fosaprepitant
Armodafinil
Ascorbic acid (vitamin C)
Barbiturate medications, such as phenobarbital or primidone
Bosentan
Certain antivirals for HIV or hepatitis
Certain medications for cancer treatment
Certain medications for cholesterol
Certain medications for seizures, such as carbamazepine, clobazam, felbamate, lamotrigine, oxcarbazepine, phenytoin, rufinamide, or topiramate
Cyclosporine
Dantrolene
Elagolix
Flibanserin
Grapefruit juice
Lesinurad
Medications for diabetes
Medications to treat fungal infections, such as griseofulvin, miconazole, fluconazole, ketoconazole, itraconazole, posaconazole, or voriconazole
Mifepristone
Mitotane
Modafinil
Morphine
Mycophenolate
St. John's wort
Tamoxifen
Temazepam
Theophylline or aminophylline
Thyroid hormones
Tizanidine
Tranexamic acid
Ulipristal
Warfarin
What side effects may I notice from receiving this medication?
Side effects that you should report to your care team as soon as possible:
Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
Gallbladder problems—severe stomach pain, nausea, vomiting, fever
Increase in blood pressure
Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
New or worsening migraines or headaches
Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
Toxic shock syndrome—fever, headache, general discomfort and fatigue, vomiting, diarrhea, rash or peeling of the skin over hands or feet
Unusual vaginal discharge, itching, or odor
Vaginal pain, irritation, or sores
Worsening mood, feelings of depression
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Breast pain or tenderness
Dark patches of skin on the face or other sun-exposed areas
Irregular menstrual cycles or spotting
Nausea
Weight gain
What should I watch for while using this medication?
Visit your care team for regular checks on your progress. You will need a regular breast and pelvic exam and Pap smear while on this medication.
Check with your care team to see if you need an additional method of contraception during the first cycle that you use this ring. Male condoms (made with natural rubber latex, polyisoprene, and polyurethane) and spermicides may be used. Do not use a diaphragm, cervical cap, or a female condom, as the ring can interfere with these birth control methods and their proper placement.
If you have any reason to think you are pregnant, stop using this medication right away and contact your care team.
If you are using this medication for hormone related problems, it may take several cycles of use to see improvement in your condition.
Smoking tobacco increases the risk of getting a blood clot or having a stroke while you are taking this medication, especially if you are older than 35 years.
You may get dark patches on your face (chloasma) while taking this medication. If you noticed dark patches on your face during a pregnancy, your risk of getting it is higher. Keep out of the sun. If you cannot avoid the sun, wear protective clothing and use sunscreen. Do not use sun lamps, tanning beds, or tanning booths.
This medication can make your body retain fluid, making your fingers, hands, or ankles swell. Your blood pressure can go up. Contact your care team if you feel you are retaining fluid.
If you are going to have elective surgery, you may need to stop using this medication before the surgery. Consult your care team for advice.
Using this medication does not protect you or your partner against HIV or other sexually transmitted infections (STIs).
Where should I keep my medication?
Keep out of the reach of children and pets.
Store unopened medication for up to 4 months at room temperature at 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Do not store above 30 degrees C (86 degrees F). Throw away any unused medication 4 months after the dispense date or the expiration date, whichever comes first. A ring may only be used for 1 cycle (1 month). After the 3-week cycle, a used ring is removed and should be placed in the re-closable foil pouch and discarded in the trash out of reach of children and pets. Do NOT flush down the toilet.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
This information is educational only and should not be construed as specific instructions for individual patients nor as a substitute for medical advice, diagnosis or treatment. Talk to your health care provider or pharmacist about the information and instructions. K Health assumes no liability for any use or reliance on this information.
