Etonogestrel-Ethinyl Estradiol

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 23, 2024

Directions

How To Use Etonogestrel - Ethinyl Estradiol (NuvaRing)

To achieve maximum contraceptive effectiveness, use etonogestrel - ethinyl estradiol as directed. Leave the vaginal ring in place for 3 consecutive weeks and then remove it for 1 week. Replace it with a new ring after a 1-week break to maintain contraceptive effectiveness.

You can insert the vaginal ring in whatever position you find comfortable (standing with one leg up, squatting, or lying down). The exact positioning of the ring inside the vagina is not important for contraceptive efficacy. To remove the ring, hook your index finger around the front rim of the ring and pull it out. You should experience a withdrawal bleed 2-3 days after removing the ring. Place a new ring in your vagina exactly one week later, on the same day of the week that you removed the old ring, even if your menstrual bleeding has not stopped. Discard the used ring in its foil pouch.

Read the prescription label and patient information leaflet carefully and use etonogestrel - ethinyl estradiol exactly as prescribed. Do not change the schedule for inserting and removing the vaginal ring without your doctor’s approval.

When you first start using an etonogestrel - ethinyl estradiol vaginal ring, you may need to use a backup birth control method, such as a male condom or spermicide, for 7 days to protect against an unwanted pregnancy.

Do not use a female condom, cervical cap, or diaphragm when you have a contraceptive ring in place. Never insert more than one contraceptive ring at any given time.

Your vaginal ring will stay in place until you remove it. However, it may occasionally fall out during sexual intercourse or a bowel movement. If this happens, rinse it with cool or lukewarm water (do not wash it with hot water). Replace it within 3 hours. If more than 3 hours have passed since it fell out, replace it with a new ring. Remove the replacement ring on your originally scheduled day and go back to your regular schedule. If you cannot replace your contraceptive ring within 3 hours, you will need to use a backup method of birth control (a non-hormonal method such as male condoms with spermicide) until you replace the ring and have had it in place for 7 days.

Different brands of hormonal contraceptive vaginal rings may contain different hormones and doses. Do not switch to another brand without checking with your doctor. If you want to change to a different birth control method, your doctor will tell you how and when in your menstrual cycle to make the switch.

Etonogestrel - ethinyl estradiol contraceptive ring will work only as long as you use it regularly. Do not stop using it without talking to your doctor.

Missed dose: If you do not insert the vaginal ring on schedule, you will need a backup method of birth control to prevent pregnancy. If you leave the vaginal ring in place for one extra week (a total of four weeks), remove it, leave it out for one week, and then insert a new contraceptive ring. If you have left the vaginal ring in place for more than 4 weeks, you should do a pregnancy test and use an additional method of non-hormonal contraception (male condoms or spermicide) until you have placed a new contraceptive ring and it has been in place for at least 7 days.

Storage: Store etonogestrel - ethinyl estradiol contraceptive ring at room temperature (between 15-30° C or 59-86° F) away from moisture, heat, and direct light in its original container, tightly closed. Do not store medications in the bathroom where they can be exposed to moisture and heat. Keep all medications safely out of reach of children and pets.

Unused medicine: Unused or expired etonogestrel - ethinyl estradiol vaginal rings should be disposed of in a way that children, other people, and pets cannot get to them. Do not throw etonogestrel - ethinyl estradiol in the trash or flush it down the toilet. The best way to dispose of expired or unneeded etonogestrel - ethinyl estradiol is through your local waste disposal company or a drug take-back program. Learn more about proper medication disposal.

NOTE: This medication guide is a summary and may not contain all possible drug information on etonogestrel - ethinyl estradiol. The information contained here may not be up-to-date. This sheet is for information purposes only. If you have questions about the etonogestrel - ethinyl estradiol vaginal ring, talk to your healthcare professionals for medical advice.