Nuvaring and/or Equivalent Etonogestrel/Ethinyl Estradiol Prescription Information
NuvaRing is a reversible, third generation Contraceptive Device for women. Containing a combination of female hormones ethinyl estradiol and etonogestrel which prevent the normal ovulation process, NuvaRing is a comfortable and flexible ring of about 2 inches in diameter. It is made up of copolymer ethylene-vinyl acetate that releases a low dose of active ingredients over a period of three weeks. NuvaRing, currently manufactured by Merck pharmaceuticals, is available by prescription. It is presently used by approximately 1.5 million women globally.
NuvaRing is approved as a reversible contraception technique to Prevent Unwanted Pregnancies. More convenient than oral contraceptives, NuvaRing eliminates the need to remember to take a pill every day. NuvaRing is easy to insert and remains in the vaginal muscular area without any hindrance during sexual intercourse or exercise. If NuvaRing is accidentally ejected, the manufacturer recommends rinsing the ring with cool water prior to reinsertion. NuvaRing's contraceptive efficacy will be reduced if it remains ejected for more than three hours.
Dose, Administration and Dosage forms:
NuvaRing contains 11.7 mg of etonogestrel and 2.7 mg of ethinyl estradiol in each device and continuously delivers 120 g of etonogestrel and 15 g of ethinyl estradiol per day for a three week period. One NuvaRing is inserted in the vagina for a duration of three weeks and should be removed for one week to allow for the menstrual period. A new ring should be inserted at the end of the fourth week to begin a new four week cycle. To insert NuvaRing, press the sides together between the thumb and forefinger and insert while squatting, lying down or standing with one leg raised. Remove NuvaRing by hooking it with the forefinger or by grasping it between the index and middle fingers. If NuvaRing is accidentally ejected, the manufacturer recommends using a backup method of contraception until this ring has been reinserted for a subsequent week.
Mechanism of action:
NuvaRing acts as contraceptive by preventing ovulation and by causing the cervix to excrete excessive mucous, thus making it difficult or impossible for sperm to reach the uterus. As a third line of defense, the excess mucous deters a fertilized egg from adhering to the wall of the uterus. Theoretically, NuvaRing also affects the endometrium and implantation; however, there is no scientific evidence.
Side-effects and safety profile:
During two large clinical trials, about 15% of participants discontinued NuvaRing because of its adverse events. Most of these adverse events were related to device usage like object sensation, emotional lability, vaginal discomfort, and sexual discomfort. 2.5% of participants discontinued use of NuvaRing due to expulsion of the device.
The most common side-effects reported in clinical trials by 5-14% of participants were: headaches, nausea, vaginitis, vaginal infections and irritation, upper respiratory tract infection, sinusitis, leukorrhea, and weight gain or loss.
Other side effects related with NuvaRing usage include: migraine headache, vomiting, abdominal pains and cramping, bloating, rashes, mood alteration, depression, breast tenderness and pains, breast enlargement, lactation issues, spotting, breakthrough bleedings, altered menstrual flow, amenorrhea, temporary infertility, persistent melasma/chloasma, porphyria, altered cervical ectropion, cholestatic jaundice, corneal steepening, exacerbation of systemic lupus erythematosus (SLE) and chorea, urticaria, angioedema and anaphylactic reactions. Women who experience any of these more serious side-effects should immediately consult with a physician.
NuvaRing is contraindicated in women with a history of blood clots, stroke, heart attack, chest pain, high cholesterol or triglycerides, breast or uterine cancer, liver cancer or other liver issues, severe high blood pressure, heart valve disorder, abnormal vaginal bleeding or irregular menstrual cycles, kidney disorders, depression, gallbladder disorders, diabetes, seizures, or migraine headaches.
NuvaRing is contraindicated in pregnant women as it can harm an unborn baby or cause birth defects.
NuvaRing is contraindicated for those who are allergic to ethinyl estradiol or etonogestrel.
NuvaRing is contraindicated in nursing mothers as its active ingredients excrete via breast milk and can harm the baby.
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