Drug: NuvaRing

etonogestrel and ethinyl estradiol vaginal ring (pronounced eh-toh-noh-GES-trel and ETH-in-il es-trah-DIGH-al)

Common Side Effects: headache, inflamed sinuses, nausea, vaginal itch or discharge, upper respiratory tract infection.

Less Common Side Effects: emotional instability, difficulties having sex, feeling the ring inside you, ring falling out of the vagina, vaginal discomfort, weight gain, liver dysfunction (yellowing of eyes and skin, fever, chills, abdominal pain).

Missed Dose: If the ring slips out of your vagina (for example, while removing a tampon, moving your bowels, or straining to lift something) and you can reinsert it in less than 3 hours, you're probably still protected from pregnancy. Rinse the ring with cool to lukewarm (not hot) water and replace it in your vagina immediately. If the ring stays out for longer than 3 hours, you may not be protected from pregnancy. Wash the ring as described above, reinsert it immediately, and use an additional form of birth control (such as a male condom or spermicide) until the ring has been in place for 7 consecutive days. A prolapsed (or dropped) uterus may increase the risk of the ring falling out of the vagina. If the ring falls out often, consult your health care provider.

If you accidentally leave the ring in your vagina for longer than 3 weeks but less than 4 weeks, remove it and take a 1-week break before inserting another ring. No additional birth control is required. However, if you leave the ring in place for longer than 4 weeks, you may not be protected from pregnancy. You should check to make sure you aren't pregnant. After a one-week break, if you aren't pregnant, insert a new ring and use an additional form of birth control until the ring has been in place for 7 days.

Drug Interactions: Combining certain medications may alter their actions or produce unwanted effects. Tell your health care provider about other prescription medications, nonprescription medications, herbs, and supplements you're taking, especially:

acetaminophen (Tylenol)
antibiotics
antifungals (such as griseofulvin and itraconazole)
antiseizure medications (such as barbiturates, carbamazepine, felbamate, oxcarbazepine, phenytoin, and topiramate)
atorvastatin (Lipitor)
clofibric acid
cyclosporine (Neoral, Sandimmune)
HIV protease inhibitors
morphine
prednisolone
rifampin
salicylic acid
St. John's wort
temazepam (Restoril)
theophylline
vitamin C.

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