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NuvaRing
NuvaRing is a vaginal contraceptive ring that contains the hormones etonogestrel and ethinyl estradiol, which are used to prevent pregnancy. NuvaRing is classified as a combined hormonal contraceptive (CHC) and works by releasing a continuous, low dose of hormones that prevent ovulation. It also thickens the cervical mucus and thins the uterine lining, further preventing fertilization and implantation. NuvaRing is inserted into the vagina and remains in place for three weeks, providing effective birth control without the need for daily attention, like traditional birth control pills.
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Frequently Asked Questions
How effective is NuvaRing?
NuvaRing is over 99% effective when used correctly and consistently. However, its typical use effectiveness rate is around 91%, accounting for potential errors like forgetting to replace the ring on time.
Can I use tampons while wearing NuvaRing?
Yes, tampons can be used while wearing NuvaRing. Just make sure not to pull out the ring when removing the tampon.
What should I do if NuvaRing comes out accidentally?
If NuvaRing slips out of the vagina, rinse it with lukewarm water and reinsert it within 3 hours. If it has been out for more than 3 hours, use backup contraception for the next 7 days.
Can NuvaRing affect my weight?
Some women may experience weight gain while using NuvaRing, but this side effect is not common for everyone. If you notice significant changes in weight, speak to your healthcare provider.
Can I skip my period while using NuvaRing?
Yes, it is possible to skip your period by inserting a new ring immediately after the 3-week period without taking a ring-free week. Consult your healthcare provider for guidance on how to do this safely.
Comprehensive Drug Guide
How Does NuvaRing Work?
- Inhibiting ovulation by suppressing the release of eggs from the ovaries.
- Thickening cervical mucus, making it more difficult for sperm to reach an egg.
- Thinning the lining of the uterus, making it less likely for a fertilized egg to implant.
These combined actions provide effective contraception when the NuvaRing is used correctly.
Common Dosages
- Vaginal ring: Delivers 0.120 mg of etonogestrel and 0.015 mg of ethinyl estradiol daily.
Typical Dosing
- For contraception: NuvaRing is inserted into the vagina and left in place for 3 weeks. After 3 weeks, the ring is removed for a 1-week ring-free interval, during which a menstrual period usually occurs. After the ring-free week, a new ring is inserted to start the next cycle. The ring must be replaced on the same day of the week to maintain effectiveness.
Typical Dosing
FDA Approved Indications
- Contraception: Prevention of pregnancy in women of reproductive age.
Who Shouldn't Take NuvaRing?
- A history of blood clots (deep vein thrombosis or pulmonary embolism)
- Stroke or heart attack
- Liver disease
- Breast cancer or other hormone-sensitive cancers
- Uncontrolled high blood pressure
- Smoking and over the age of 35
Advice From The Pharmacist
- Insert NuvaRing properly: Pinch the ring and gently insert it into the vagina, pushing it in until it feels comfortable. It does not need to be in an exact position to be effective.
- If NuvaRing slips out, rinse it with cool or lukewarm water and reinsert it within 3 hours to maintain effectiveness. If it has been out for more than 3 hours, use backup contraception for 7 days.
- Avoid smoking while using NuvaRing, especially if you are over 35 years old, as smoking increases the risk of serious cardiovascular side effects.
- Store NuvaRing in the refrigerator until use or at room temperature for up to 4 months.
Side Effects of NuvaRing
Common Side Effects
- Vaginal irritation or discharge
- Headaches
- Nausea
- Breast tenderness
- Weight gain
Uncommon/Severe Side Effects
- Blood clots (deep vein thrombosis, pulmonary embolism)
- Stroke or heart attack
- High blood pressure
- Liver problems
Risks and Warnings of NuvaRing
- Blood Clot Risk: NuvaRing increases the risk of blood clots, which can lead to serious conditions like deep vein thrombosis or pulmonary embolism. Women who smoke or have a history of clotting disorders are at higher risk.
- Cardiovascular Risk: Women over 35 who smoke should avoid using NuvaRing, as it can increase the risk of heart attack, stroke, and high blood pressure.
- Liver Health: Rare cases of liver tumors have been associated with hormonal contraceptive use. Discontinue use if you experience severe abdominal pain or jaundice.
Interactions with NuvaRing
Common Drug Interactions
- Antibiotics: Some antibiotics, such as rifampin, may reduce the effectiveness of NuvaRing.
- Anticonvulsants: Medications like carbamazepine and phenytoin may decrease the contraceptive efficacy of NuvaRing.
- HIV medications: Certain drugs used to treat HIV, such as ritonavir, can interfere with the effectiveness of NuvaRing.
Alternatives to NuvaRing
- Birth control pills: A daily oral contraceptive that contains a combination of estrogen and progestin, similar to NuvaRing.
- Depo-Provera (medroxyprogesterone): A long-acting contraceptive injection given every three months.
- Nexplanon: A hormonal contraceptive implant placed under the skin that lasts for up to 3 years.
- Intrauterine devices (IUDs): Hormonal and non-hormonal options are available for long-term contraception.
