Nuvaring

Nuvaring Vaginal Ring 1 pc (Refrigerator)

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Ethinylestradiol, Etonogestrel vaginal delivery system


What Ethinylestradiol, Etonogestrel is and what it is used for:

This medicine is a contraceptive vaginal ring used to prevent pregnancy. Each ring contains a small amount of two female sex hormones – etonogestrel and ethinylestradiol.
The ring slowly releases these hormones into the blood circulation. Because of the low amount of hormones that is released, Ethinylestradiol, Etonogestrel ring is considered a low-dose hormonal contraceptive. Since Ethinylestradiol, Etonogestrel ring releases two different types of hormones it is a so-called combined hormonal contraceptive.
Ethinylestradiol, Etonogestrel ring works just like a combined contraceptive pill (the Pill) but instead of taking a pill every day, the ring is used for 3 weeks in a row. Ethinylestradiol, Etonogestrel ring releases two female sex hormones that prevent the release of an egg cell from the ovaries. If no egg cell is released you cannot become pregnant.
What you need to know before you use Ethinylestradiol, Etonogestrel


Do not use Ethinylestradiol, Etonogestrel:
Tell your doctor:
if you have (or have ever had) a blood clot in a blood vessel of your legs (deep vein thrombosis, DVT), your lungs (pulmonary embolus, PE) or other organs;
if you know you have a disorder affecting your blood clotting - for instance, protein C deficiency, protein S deficiency, antithrombin – III deficiency, Factor V Leiden or antiphospholipid antibodies;
if you need an operation or if you are off your feet for a long time
if you have ever had a heart attack, or a stroke;
if you have (or have ever had) angina pectoris (a condition that causes severe chest pain and may be a first sign of a heart attack) or transient ischaemic attack (TIA – temporary stroke symptoms);
if you have any of the following diseases that may increase your risk of a clot in the arteries:
o severe diabetes with blood vessel damage
o very high blood pressure
o a very high level of fat in the blood (cholesterol or triglycerides)
o a condition known as hyperhomocysteinaemia
if you have (or have ever had) a type of migraine called ‘migraine with aura’;
if you have (had) inflammation of the pancreas (pancreatitis) associated with high levels of fat in your blood;
if you have (had) severe liver disease and your liver is not yet working normally;
if you have (had) a benign or malignant tumour in the liver;
if you have (had), or if you may have, cancer of the breast or the genital organs;
if you have any unexplained vaginal bleeding;
if you are allergic to ethinylestradiol or etonogestrel, or any of the other ingredients of this medicine
Warnings and precautions:

You should let your doctor know:

if a close relative has or has ever had breast cancer;
if you have epilepsy
if you have liver disease (for instance jaundice) or gallbladder disease (for instance gallstones);
if you have Crohn’s disease or ulcerative colitis (chronic inflammatory bowel disease);
if you have systemic lupus erythematosus (SLE - a disease affecting your natural defence system);
if you have haemolytic uraemic syndrome (HUS - a disorder of blood clotting causing failure of the kidneys);
if you have sickle cell anaemia (an inherited disease of the red blood cells);
if you have elevated levels of fat in the blood (hypertriglyceridaemia) or a positive family history for this condition. Hypertriglyceridaemia has been associated with an increased risk of developing pancreatitis (inflammation of the pancreas);
if you need an operation, or you are off your feet for a long time;
if you have just given birth you are at an increased risk of blood clots. You should ask your doctor how soon after delivery you can start using Ethinylestradiol, Etonogestrel ring:

if you have an inflammation in the veins under the skin (superficial thrombophlebitis);
if you have varicose veins;
if you have a condition that occurred for the first time or worsened during pregnancy or previous use of sex hormones (e.g. hearing loss, porphyria [a disease of the blood], herpes gestationis [skin rash with vesicles during pregnancy], Sydenham’s chorea [a disease of the nerves in which sudden movements of the body occur], hereditary angioedema [you should see your doctor immediately if you experience symptoms of angioedema such as swollen face, tongue and/or throat and/or difficulty swallowing or hives together with difficulty breathing];
if you have (or have ever had) chloasma (yellowish-brown pigment patches, so called ‘pregnancy patches’, particularly on the face). If so, avoid too much exposure to the sun or ultraviolet light;
if you have a medical condition that makes it difficult to use Ethinylestradiol, Etonogestrel ring – for example, if you are constipated, have a prolapse of the uterine cervix or have pain during intercourse;
if you have an urgent, frequent, burning, and/or painful urination, and cannot locate the ring in the vagina. These symptoms may indicate accidental placement of Ethinylestradiol, Etonogestrel ring into the urinary bladder.


Other medicines and Ethinylestradiol, Etonogestrel:

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
These include medicines used for the treatment of:
epilepsy (e.g. primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine, topiramate, felbamate);
tuberculosis (e.g. rifampicin);
HIV infection (e.g. ritonavir, nelfinavir, nevirapine, efavirenz);
Hepatitis C virus infection (e.g. boceprevir, telaprevir);
other infectious diseases (e.g. griseofulvin);
high blood pressure in the blood vessels of the lungs (bosentan);
depressive moods (the herbal remedy St. John’s wort).
Ethinylestradiol, Etonogestrel ring may influence the effect of other medicines, e.g.
medicines containing ciclosporin
the anti-epileptic lamotrigine (this could lead to an increased frequency of seizures)


How to use Ethinylestradiol, Etonogestrel:

You can insert and remove Ethinylestradiol, Etonogestrel ring yourself. Your doctor will tell you when to start using Ethinylestradiol, Etonogestrel ring for the first time.
The vaginal ring must be put in on the correct day in your monthly cycle and left in place for 3 weeks in a row.
Regularly check that Ethinylestradiol, Etonogestrel ring is in your vagina (for example, before and after intercourse) to ensure that you are protected from pregnancy.
After the third week, you take Ethinylestradiol, Etonogestrel ring out and have a one week break. You will usually have your monthly period during this ring-free interval.
While using Ethinylestradiol, Etonogestrel ring , you should not use certain female barrier contraceptive methods, such as a vaginal diaphragm, cervical cap, or female condom. These contraceptive barrier methods should not be used as your back-up method of birth control because Ethinylestradiol, Etonogestrel ring may interfere with the correct placement and position of a diaphragm, cervical cap, or female condom. You can however use a male condom as an extra barrier contraceptive method.
Three weeks in, one week out
Starting with the day you put it in, the vaginal ring must be left in place without interruption for 3 weeks.
After 3 weeks you remove the ring on the same day of the week and at approximately the same time as it was put in. For example, if you put Ethinylestradiol, Etonogestrel ring in on a Wednesday at about 22.00 h, you should remove the ring 3 weeks later, on Wednesday, at about 22.00 h.
After you have removed the ring, you do not use a ring for 1 week. During this week a vaginal bleed should occur. Usually this starts 2–3 days after removal of Ethinylestradiol, Etonogestrel ring .
Start a new ring exactly after the 1 week interval (again on the same day of the week and approximately the same time), even if you have not stopped bleeding.
If the new ring is inserted more than 3 hours too late, the protection from pregnancy may be reduced.

Possible side effects:

Stop using the product and seek immediate medical attention if you have noticed:
Signs of deep vein thrombosis: swelling of one leg or along a vein in the leg or foot especially when accompanied by pain or tenderness in the leg which may be felt only when standing or walking; increased warmth in the affected leg; change in colour of the skin on the leg e.g. turning pale, red or blue.
Signs of a pulmonary embolism: sudden unexplained breathlessness or rapid breathing; sudden cough without an obvious cause, which may bring up blood; sharp chest pain which may increase with deep breathing; severe light headedness or dizziness; rapid or irregular heartbeat; severe pain in your stomach.
Signs of retinal vein thrombosis (blood clot in the eye): symptoms most commonly occur in one eye: immediate loss of vision or painless blurring of vision which can progress to loss of vision.
Signs of heart attack: chest pain, discomfort, pressure, heaviness; sensation of squeezing or fullness in the chest, arm or below the breastbone;
Signs of a stroke: sudden weakness or numbness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; sudden, severe or prolonged headache with no known cause; loss of consciousness or fainting with or without seizure.
Signs of blood clots blocking other blood vessels: swelling and slight blue discolouration of an extremity; severe pain in your stomach (acute abdomen).
Signs of a severe allergic reaction: swelling of the face, lips, mouth, tongue or throat.
Signs of breast cancer: dimpling of the skin; changes in the nipple; any lumps you can see or feel.
Signs of cancer of the cervix: vaginal discharge that smells and contains blood; unusual vaginal bleeding; pelvic pain; painful sex.
Signs of severe liver problems: severe pain in your upper abdomen; yellow skin or eyes (jaundice).

How to store Ethinylestradiol, Etonogestrel:

Keep Ethinylestradiol, Etonogestrel ring out of the sight and reach of children.
If you discover that a child has been exposed to the hormones from Ethinylestradiol, Etonogestrel ring , ask your doctor for advice.
Store below 30°C. Store in the original package in order to protect from light and moisture.
Do not use a Ethinylestradiol, Etonogestrel ring if it was dispensed to you more than 4 months ago. The dispensing date is stated on the carton and sachet.
Do not use Ethinylestradiol, Etonogestrel ring after the expiry date which is stated on the carton and sachet.
Do not use Ethinylestradiol, Etonogestrel ring if you notice a colour change in the ring or any visible signs of deterioration.
Dispose of the used ring with the normal household waste, preferably inside the reclosable sachet. Do not flush Ethinylestradiol, Etonogestrel ring down the toilet. As with other medicines, do not throw away unused or outdated rings via wastewater or household waste. Ask your pharmacist how to throw away any unused rings no longer required. These measures will help protect the environment.


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  • Manufacturer: Nuvaring
  • Product form: Intrauterine Device
  • Ingredients: Etonogestrel - Ethinylestradiol