etonogestrel/ethinyl estradiol ring - vaginal, Nuvaring (cont.)

USES: This medication is a combination of 2 hormones (an estrogen and a progestin) and is used to prevent pregnancy. It works mainly by preventing the release of an egg (ovulation) during your menstrual cycle. It also can work by making vaginal fluid thicker to help prevent sperm from reaching an egg (fertilization) and by changing the lining of the uterus (womb) to prevent attachment of a fertilized egg. If a fertilized egg does not attach to the uterus, it passes out of the body.Using this hormone ring does not protect you or your partner against HIV or other sexually transmitted diseases (STDs).

HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start using this product and each time you get a refill. Make sure you understand how to insert a new ring and how to dispose of the used product. If you have any questions, consult your doctor or pharmacist.This product is for vaginal use only. Insert 1 ring and leave in for 3 continuous weeks (21 days), then remove it and discard properly. Do not use a ring for a 1-week period. After the ring-free week, insert a new ring at about the same time of the same day that you removed the previous ring the week before. It may be helpful to mark a calendar to remind you when to remove it and insert a new ring. If any of the information is unclear, consult your doctor or pharmacist.Wash and dry your hands. Open the reclosable foil pouch. Remove the ring, saving the pouch to dispose of the ring after it is used. Fold the ring in half gently and insert into your vagina. When the ring is placed properly, you should not feel it, and it will not interfere with sexual intercourse (though your partner may feel the ring). Unlike a diaphragm, the ring's exact position in the vagina does not matter as long as it stays securely inside. It is very important that you follow the directions carefully for when to insert and remove the ring to prevent pregnancy.If this is the first time you are using this ring, insert it on the first day of your period. For the first cycle of use only, if you insert the ring on days 2-5 instead of the first day, use an additional form of non-hormonal birth control (e.g., male condom or spermicide) for the first 7 days to prevent pregnancy until the medication has enough time to work. A diaphragm is not recommended as a back-up method of birth control with this ring because it may interfere with the correct placement of the diaphragm. If you start on the first day of your period, you do not need to use back-up birth control the first week.Remove the ring after the 3rd week on the same day of the week and about the same time as you placed it. Put the used ring in the foil pouch and discard in the trash. Do not flush the used ring down a toilet. If you have pain/bleeding when trying to remove the ring, or if you cannot remove it, tell your doctor immediately. Rarely, the ring can become attached to the vagina. If this occurs, your doctor will need to remove the ring.Do not wear a ring for 1 week (7 days). You should get your period within 2 to 3 days after the ring is removed. If your period does not begin during the ring-free week, consult your doctor. Do not go longer than 7 days without a ring. Doing so may increase your risk of pregnancy.After 1 ring-free week, insert a new ring on the same day of the week and about the same time as during the last cycle. You must insert the new ring one week after the last one was removed, even if your period has not stopped. If you need to insert a new ring during your period, you may use tampons at the same time as the ring without affecting how well the ring works. Do not go longer than 7 days without a ring. Doing so may make this product less effective.The vaginal ring may accidentally fall out during intercourse, during a bowel movement, or while removing a tampon. If the ring falls out of the vagina, rinse it with cool to lukewarm (not hot) water and re-insert as soon as possible, within 3 hours maximum.If the ring has been out more than 3 hours, or if you are not sure how long it has been out, you may not be protected from pregnancy. In this case, rinse the ring, re-insert as soon as possible, and use a back-up method of birth control (e.g., male condoms, spermicide) until the ring has been in place for 7 continuous days.If you have left the ring in place for longer than 3 weeks, but less than 4 weeks, remove it, wait 1 week, then insert a new ring.If you have left the ring in place for longer than 4 weeks, your body may not have enough hormones to protect you from pregnancy. Remove the ring and contact your doctor for a pregnancy test. If not pregnant, insert a new ring and use a back-up method of birth control (e.g., condoms, spermicide) until the new ring has been in place for 7 continuous days.If the ring breaks, discard it and replace with a new ring.If you experience urgent/frequent/burning/painful urination and you cannot find the ring in your vagina, tell your doctor immediately. You may have accidentally inserted the ring into your bladder.Ask your doctor or pharmacist or consult the Patient Information Leaflet for information about switching from other forms of birth control to the vaginal ring. If any of this information is unclear, ask your doctor or pharmacist.

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