A pregnancy test should be performed prior to inserting a new ring. grazie! NuvaRing® is indicated for use by females of reproductive age to prevent pregnancy. Finisco l'ultimo anello il 16 marzo 2008 e poi faccio un mese di pausa (in realta' è perchè il 23 e il 24 avevo la testa altrove e mi sono dimenticata di inserirlo di nuovo). seizure medicine - carbamazepine, felbamate, lamotrigine, oxcarbazepine, phenobarbital, phenytoin, rufinamide, topiramate. Although the primary effect of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation). The woman may not experience a withdrawal bleed from her previous cycle. Contraception 2013; 87: 93–100. Avoid storing NuvaRing in direct sunlight or at temperatures above 30°C (86°F). Merck & Co., Inc., Whitehouse Station, NJ 08889, USA, For patent information: www.merck.com/product/patent/home.html. Small amounts of contraceptive steroids and/or metabolites, including etonogestrel and ethinyl estradiol are transferred to human milk. You should not use the NuvaRing vaginal ring if you smoke and are older than 35 years of age. Use of tampons will not make NuvaRing less effective or stop NuvaRing from working. (etonogestrel/ethinyl estradiol vaginal ring). Serious Adverse Reactions: deep vein thrombosis [see Warnings and Precautions (5.1)], anxiety, cholelithiasis, and vomiting. pregnancy. Choose a position for insertion of NuvaRing. Discontinue NuvaRing use if jaundice develops. You may switch from a minipill on any day. NuvaRing contains a combination of a progestin and estrogen, 2 kinds of female hormones. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. sudden, severe headache unlike your usual headaches, weakness or numbness in an arm or leg, or trouble speaking. Available for Android and iOS devices. Occasional missed periods may occur with the appropriate use of NuvaRing. Ansia alve ragazze,vi contatto per chiederlie delle delucidazioni,che da un p di tempo mi tengono parecchio in ansia. For this reason, CHCs, including NuvaRing, should not be used by women who are over 35 years of age and smoke. Buonasera ho 39 anni e madre di 4 figli faccio uso del nuvaring da più di un anno e mi trovo bene a differenza della pillola con cui avevo forti mal di testa.Premetto che [See Contraindications (4) and Warnings and Precautions (5.3).]. The effect of hepatic impairment on the pharmacokinetics of NuvaRing has not been studied. No adverse embryofetal effects were observed when the combination was administered to pregnant rabbits at a desogestrel/ethinyl estradiol dose that was 2/5 times the anticipated vaginal human dose. Combination hormonal contraceptives act by suppression of gonadotropins. For example, if you insert your NuvaRing on a Monday at 8:00 am, you should remove it on the Monday 3 weeks later at 8:00 am. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Advise the patient to read the FDA-approved patient labeling (Patient Information and Instructions for Use). The hydroxylated ethinyl estradiol metabolites have weak estrogenic activity. You may start using NuvaRing no sooner than 4 weeks (28 days) after having a baby if you are not breastfeeding. come si presenta il falso ciclo? If anaphylaxis and/or angioedema is suspected, NuvaRing should be discontinued and appropriate treatment administered. Etonogestrel and Ethinyl Estradiol Vaginal Insert, FDA-funded Study in Kaiser Permanente and Medicaid databases, First use of a combined hormonal contraceptive (CHC) during the study period, COCs available during the course of the study. It may harm them. Sidney, S. et. [See Contraindications (4).]. Tell your doctor if this bleeding continues or is very heavy. Se, ad esempio, lo avete inserito alle 18 del giovedì 1/09 dovrete rimuoverlo alle 18 del giovedì 22/9. When possible, advise the nursing mother to use non-estrogen-containing contraception until she has completely weaned her child. There is substantial evidence that CHCs do not increase the incidence of breast cancer. Hormonal birth control methods may not be a good choice for you if you have ever had jaundice (yellowing of the skin or eyes) caused by pregnancy or related to previous use of hormonal birth control. An optional alternative is to insert the ring using the applicator for NuvaRing [see Applicator for NuvaRing Instructions for Use]. Choose the position for inserting the ring that is most comfortable for you, like lying down, squatting, or standing with one leg up. Citapram 40 mg. Citapram 40 mg may be available in the countries listed below. secondo voi andrà meglio il mese prossimo? Prima di nuvaring usavo evra, il cerotto, ed era peggio di così!! Based on the results of a US clinical study, approximately 1 to 3 women out of 100 women may get pregnant during the first year they use NuvaRing. NuvaRing can be removed by hooking the index finger under the forward rim or by grasping the rim between the index and middle finger and pulling it out. Store NuvaRing at room temperature for up to 4 months after you receive it. NuvaRing can be rinsed with cool to lukewarm (not hot) water and reinserted as soon as possible, but at the latest within three hours. In the US study, the Pearl Index was 2.02 (95% CI [1.1, 3.4]) per 100 women-years of NuvaRing use. However, there is controversy about the extent to which these findings may be due to differences in sexual behavior and other factors. sono piccole perdite scure di un giorno massimo due come ho letto in giro? If NuvaRing has been left in place for up to one extra week (i.e., up to four weeks total), the woman will remain protected. If you would like more information, talk with your healthcare provider. Le perdite vaginali maleodoranti (per es. Etonogestrel: Etonogestrel is approximately 32% bound to sex hormone-binding globulin (SHBG) and approximately 66% bound to albumin in blood. Use other birth control methods until you are no longer breastfeeding. During Week 3: The woman should discard that ring. Dispose of a used vaginal ring in the foil pouch it came in and throw it away where children and pets cannot get to it. NuvaRing (NEW-vah-ring) Birth Control Pill Won't Raise Depression Risk, Most U.S. Women Under 50 Use Contraception: Report. L'ho inserito il primo giorno di mestruazioni il 20 agosto..per qualche giorno ho are scheduled for surgery. What if I miss my regular scheduled period when using NuvaRing? A partire dall’anoressia, la bulimia nervosa, varie forme di inadeguato apporto vitaminico/proteico e l’obesità sono tutte cause di debilitamento fisico che può originare fenomeni di spotting. Adverse reactions commonly reported by CHC users are: Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Studies have shown an increased risk of developing hepatocellular carcinoma in long term (>8 years) CHC users. Adverse Reactions (≥ 1%) Leading to Study Discontinuation: 13.0% of the women discontinued from the clinical trials due to an adverse reaction; the most common adverse reactions leading to discontinuation were device-related events (2.7%), mood changes (1.7%), headache (including migraine) (1.5%) and vaginal symptoms (1.2%). are scheduled for any laboratory tests. What should I know about my period when using NuvaRing? Mi piace. If NuvaRing has been left inside your vagina for more than 4 weeks (28 days), you may not be protected from pregnancy and you should see your healthcare provider to be sure you are not pregnant. il 30/01 ho avuto il ciclo regolare. transmitted diseases. This risk is highest during your first year of using the vaginal ring, or when you insert a new ring after not wearing one for 4 weeks or longer. If a woman using NuvaRing develops new headaches that are recurrent, persistent, or severe, evaluate the cause and discontinue NuvaRing if indicated. Hold NuvaRing between your thumb and index finger and press the sides of the ring together, Insert the folded NuvaRing into your vagina and gently push it further up into your vagina using your index finger, When you insert NuvaRing it may be in different positions in your vagina, but NuvaRing does not have to be in an exact position for it to work. dismenorrea.it ha informato i visitatori su argomenti come Dysmenorrhea symptoms, Dysmenorrhea Symptoms e Rimedi Sintomi Menopausa. It is removed for a one-week break, during which a withdrawal bleed usually occurs. During the first 7 days, you may need to use back-up birth control (condoms or spermicide, but not a diaphragm or female condom). Ethinyl estradiol: Ethinyl estradiol released by NuvaRing is rapidly absorbed. Spesso è il ritmo forsennato della vita quotidiana a interferire con il ciclo sino a renderlo irregolare, con mestruazioni abbondanti e ravvicinate, e precedute dalle perdite scure. Dopo 3 settimane, rimuovilo e attendi fino a quando inizi a sanguinare. You should switch from an implant or the IUS and start using NuvaRing on the day that you remove the implant or IUS. A woman who is using NuvaRing should have a yearly visit with her healthcare provider for a blood pressure check and for other indicated healthcare. The NuvaRing vaginal ring contains a combination of ethinyl estradiol and etonogestrel are female hormones that prevent ovulation (the release of an egg from an ovary). Questa è una falsa credenza smentita dalla fisiologia. Keep NuvaRing and all medicines out of the reach of children. Nuvaring, rapporto completo e ritardo nel inserimento. Some women are aware of the ring on occasion during the 21 days of use or during intercourse, and sexual partners may feel NuvaRing in the vagina. Uso nuvaring da diversi anni con regolarità. The ring is pushed out of the applicator. Gently remove the applicator. NuvaRing is not made with natural rubber latex. Consider discontinuation of NuvaRing in the case of an increased frequency or severity of migraine during CHC use (which may be prodromal of a cerebrovascular event) [see Contraindications (4)]. Although the absolute VTE rates are increased for users of CHCs compared to non-users, the rates associated with pregnancy are even greater, especially during the post-partum period (see Figure 1). Consider another non-hormonal method of birth control until you are ready to stop breastfeeding. La nutrizione gioca un ruolo determinante nell'alleviare i disturbi della Sindrome Premestruale e della Dismenorrea. Inserting a new ring will start the next three-week use period. The following adverse reactions have been identified during post-approval use of NuvaRing. Cigarette smoking increases the risk of serious cardiovascular events from combination hormonal contraceptive (CHC) use. Consider a visit with your healthcare provider for a pre-pregnancy checkup before you stop using NuvaRing. Get emergency medical help if you have signs of an allergic reaction to NuvaRing: hives; difficult breathing; swelling of your face, lips, tongue, or throat. This is less likely to occur if breastfeeding is well established, Inform patients that amenorrhea may occur. The women were followed for 24 to 48 months. Nei due ultimi intervalli liberi da anello ho riscontrato perdite scarse, che non scendono, visibili solo sull'assorbente interno, di colore scuro. Consult the labeling of all concurrently-used drugs to obtain further information about interactions with hormonal contraceptives or the potential for enzyme alterations. While using NuvaRing, you should not use certain female barrier contraceptive methods such as a vaginal diaphragm, cervical cap or female condom as your back-up method of birth control because NuvaRing may interfere with the correct placement and position of a diaphragm, cervical cap or female condom. CHCs may decrease glucose tolerance. If you leave NuvaRing in your vagina longer than 4 weeks (28 days), remove the ring and check to make sure you are not pregnant. This product is intended to prevent 10 pt? However, breakthrough spotting or bleeding may occur. Parere mio, dipendono dall'anello: quando si inizia per la prima volta un contraccettivo ormonale le mestruazioni possono bloccarsi di colpo, proseguire normali, durare a lungo (anche tutto il primo blister)... non mi parrebbe strano che potessero già cambiare colore. There may be new information. Spotting prima delle mestruazioni. NuvaRing can be rinsed with cool to lukewarm (not hot) water and reinserted as soon as possible, but at the latest within three hours. Note: Insert and remove NuvaRing on the same day of the week and at the same time: Your healthcare provider should examine you at least 1 time a year to see if you have any signs of side effects from using NuvaRing. CHCs containing ethinyl estradiol may inhibit the metabolism of other compounds (e.g., cyclosporine, prednisolone, theophylline, tizanidine, and voriconazole) and increase their plasma concentrations. In women with hereditary angioedema, exogenous estrogens may induce or exacerbate symptoms of angioedema. Place the used NuvaRing in the re-closable foil pouch and properly throw it away in your household trash out of the reach of children and pets. Would it be a problem if the Nuvaring was stored at room temperature? Open the package only when you are ready to use the applicator. NuvaRing (etonogestrel/ethinyl estradiol vaginal ring) is a non-biodegradable, flexible, transparent, colorless to almost colorless, combination contraceptive vaginal ring containing two active components, a progestin, etonogestrel (13-ethyl-17-hydroxy-11-methylene-18,19-dinor-17α-pregn-4-en-20-yn-3-one) and an estrogen, ethinyl estradiol (19-nor-17α-pregna-1,3,5(10)-trien-20-yne-3,17-diol). Grazie in anticipo. Following a second trimester abortion or miscarriage: new NuvaRing has been used for 7 days in a row, following one of the two options below: (etonogestrel/ethinyl estradiol vaginal ring), etonogestrel and ethinyl estradiol insert, extended release, We comply with the HONcode standard for trustworthy health information -, Applicator for NuvaRing Instructions for Use, "What is the most important information I should know about NuvaRing?". A new ring is inserted one week after the last ring was removed. Do not flush your used NuvaRing down the toilet. If you do not start NuvaRing within 5 days after a first trimester abortion or miscarriage, use a non-hormonal birth control method, such as male condoms and spermicide, while you wait for your period to start. Before you use NuvaRing tell your healthcare provider if you: Tell your healthcare provider about all medicines and herbal products you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. al., Cardiovascular risk associated with the use of an etonogestrel-containing vaginal ring. NuvaRing may also be started on Days 2-5 of the woman's cycle, but in this case a barrier method, such as male condoms with spermicide, should be used for the first seven days of NuvaRing use in the first cycle. Choose the best way for you: If you are changing from a birth control pill or patch to NuvaRing: If you have been using your birth control method correctly and are certain that you are not pregnant, you can change to NuvaRing any day. After dispensing to the user, NuvaRing can be stored for up to 4 months at 25°C (77°F); excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature]. This list is not complete and many other drugs can interact with ethinyl estradiol and etonogestrel. Se, ad esempio, lo avete inserito alle 18 del giovedì 1/09 dovrete rimuoverlo alle 18 del giovedì 22/9. Advise women to regularly check for the presence of NuvaRing in the vagina (for example, before and after intercourse). Changing From a Progestin-Only Method (progestin-only pill [POP], Implant, or Injection or a Progestin-Releasing Intrauterine System [IUS]): The woman may switch from the POP on any day; instruct her to start using NuvaRing on the day after she took her last POP. NuvaRing may cause serious side effects, including: The most common side effects of NuvaRing are: Some women have spotting or light bleeding during NuvaRing use. Hormonal birth control methods that contain estrogen, like NuvaRing, may decrease the amount of milk you make. If NuvaRing is lost, a new vaginal ring should be inserted … are pregnant or think you may be pregnant. Overdosage may cause withdrawal bleeding in females and nausea. The use of tampons had no effect on serum concentrations of etonogestrel and ethinyl estradiol during use of NuvaRing [see Dosage and Administration (2.5)]. A high risk of arterial or venous thrombotic diseases. Although some women may be aware of NuvaRing in the vagina, most women do not feel it when it is in place. CHCs can reduce milk production in breastfeeding mothers. Smoking can greatly increase your risk of blood clots, stroke, or heart attack. NuvaRing is contraindicated in women who currently have or have had breast cancer because breast cancer is a hormonally-sensitive tumor [see Contraindications (4)]. Some drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include: phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John's wort. NuvaRing (etonogestrel/ethinyl estradiol vaginal ring) is a non-biodegradable, flexible, transparent, colorless to almost colorless, combination contraceptive vaginal ring, with an outer diameter of 54 mm and a cross-sectional diameter of 4 mm. Any doctor or surgeon who treats you should know that you are using the NuvaRing vaginal ring. If the patient has not adhered to the prescribed dosing schedule, consider the possibility of pregnancy at the time of the first missed period and take appropriate diagnostic measures. Ingredient matches. An increased risk of thromboembolic and thrombotic disease associated with the use of CHCs is well-established. Select one or more newsletters to continue. Lo inserisco correttamente ogni volta alla stessa ora. il ciclo era preceduto da qualche giorno di macchie marroni e poi appariva leggermente rosso ma il flusso era inesistente cmq ed era marrone. The effect of renal impairment on the pharmacokinetics of NuvaRing has not been studied. A past history of CHC-related cholestasis predicts an increased risk with subsequent CHC use. Ethinyl estradiol: Ethinyl estradiol is highly but not specifically bound to serum albumin (98.5%) and induces an increase in the serum concentrations of SHBG. Mantenere l'anello in posizione per 3 settimane. Inserting NuvaRing (Figure F, Figure G) and positioning NuvaRing (Figure H, Figure I). ho inserito il primo anello il 7 gennaio alle 18 e l'ho tolto il 28 gennaio alla stessa ora. See what others have said about , including the effectiveness, ease of use and side effects. Mestruazioni a macchie: Scure Le mestruazioni a macchie scure di solito si verificano durante il periodo dell’ovulazione ossia a metà periodo tra un ciclo e l’altro. Smoking can greatly increase your risk of blood clots, stroke, or heart attack. In order to maintain contraceptive effectiveness, the new ring must be inserted exactly one week after the previous one was removed even if menstrual bleeding has not finished. Data sources include IBM Watson Micromedex (updated 7 Dec 2020), Cerner Multum™ (updated 4 Dec 2020), ASHP (updated 3 Dec 2020) and others. In some cases, the ring adhered to vaginal tissue, necessitating removal by a healthcare provider and in some instances (i.e., when the tissue had grown over the ring), removal was achieved by cutting the ring without incising the overlying vaginal tissue. Le perdite da impianto in gravidanza possono presentarsi una decina di giorni dopo l'avvenuto concepimento (quindi leggermente in anticipo rispetto alle mestruazioni), mentre le perdite premestruali fanno la loro comparsa qualche giorno prima dell'arrivo del ciclo. Data sources include IBM Watson Micromedex (updated 7 Dec 2020), Cerner Multum™ (updated 4 Dec 2020), ASHP (updated 3 Dec 2020) and others. Do not use NuvaRing in women with liver disease such as acute viral hepatitis or severe (decompensated) cirrhosis of the liver [see Contraindications (4)]. Ciao, sto usando nuvaring da quasi due settimane, l'ho messo su consiglio del ginecologo il primo giorno di mestruazioni, solo che continuo ad avere delle perdite scure di sangue, tipo quelle che vengono all'inizio o negli ultimi giorni delle mestruazioni, anche se non abbondanti. Each box on the chart contains a list of birth control methods that are similar in effectiveness. Bleeding patterns were evaluated in three large clinical studies. The used ring should be placed in the sachet (foil pouch) and discarded in a waste receptacle out of the reach of children and pets (do not flush in toilet). The frequency of VTE in women using CHCs has been estimated to be 3 to 12 cases per 10,000 women-years. Pharmacokinetic data show that the use of tampons has no effect on the systemic absorption of the hormones released by NuvaRing. Call your healthcare provider right away if you have: If you are not currently using hormonal birth control, you have 2 ways to start using NuvaRing. If the ring-free interval has been extended beyond one week, consider the possibility of pregnancy, and an additional method of contraception, such as male condoms with spermicide, MUST be used until NuvaRing has been used continuously for seven days. The hormones in NuvaRing also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus. To achieve maximum contraceptive effectiveness, NuvaRing must be used as directed [see Dosage and Administration (2.2)]. Place the used NuvaRing in the re-sealable foil pouch and put it in a trash can out of the reach of children and pets. Version: 12.02. levonorgestrel, Sprintec, norethindrone, medroxyprogesterone, Mirena, Depo-Provera. You must use another birth control method, such as male condoms with spermicide, until the new NuvaRing has been used for 7 days in a row. Use: For females of reproductive age to prevent pregnancy, NuvaRing dosage information (in more detail). Figure 2: Mean Serum Concentration-Time Profile of Etonogestrel and Ethinyl Estradiol during Three Weeks of NuvaRing Use. For women using COCs that did not contain the progestins desogestrel (DSG) or gestodene (GSD), VTE incidence was 8.9 per 10,000 WY. If the woman has retained one NuvaRing for longer than four weeks, rule out pregnancy. A causal relationship between the use of NuvaRing and TSS has not been established. Women with BMI ≥ 30 kg/m2 were excluded from these studies. Throw NuvaRing away if the expiration date on the label has passed. Advise women who are breastfeeding not to use NuvaRing but to use other forms of contraception until the child is weaned. Copyright 1996-2020 Cerner Multum, Inc. Do not start NuvaRing any later than the day you would start your next birth control pill or apply your patch. è normale che possa essere così rosso e così abbondante lo spotting? Tell your healthcare provider about any side effect that bothers you or that does not go away. Cigarette smoking increases the risk of serious cardiovascular events from combination hormonal contraceptive (CHC) use. The NuvaRing vaginal ring is used as contraception to prevent pregnancy. Last updated on May 28, 2020. if you take any hepatitis C medication containing ombitasvir/paritaprevir/ritonavir (Technivie). are breastfeeding or plan to breastfeed. Ask your doctor or pharmacist if you have any questions. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use NuvaRing only for the indication prescribed. NuvaRing can slip or accidentally come out (expelled) of your vagina, for example, during sexual intercourse, bowel movements, use of tampons, or if it breaks. The exact position of NuvaRing inside the vagina is not critical for its function. elle28. Using Nuvaring can increase your risk of blood clots, stroke, or heart attack. Avoid direct sunlight. da quando mi è finito il ciclo ho avuto spotting, all'inizio scuro e scarso ma dopo qualche giorno è diventato rosso e abbondante, come il sangue mestruale insomma. Nuvaring ha la forma di un anello, altamente elastico, ... Il prelievo dev'essere effettuato lontano da rapporti sessuali, dalle mestruazioni, dall'impiego di irrigatori vaginali, ovuli o candelette. Consider the possibility that you may be pregnant if: You may stop using NuvaRing whenever you wish. If NuvaRing is out of the vagina for more than three continuous hours: During Weeks 1 and 2: Contraceptive efficacy may be reduced. Hepatic adenomas are associated with CHC use. If NuvaRing breaks and slips out of your vagina, throw the broken ring in your household trash out of the reach of children and pets. Do not co-administer NuvaRing with HCV drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, due to potential for ALT elevations [see Warnings and Precautions (5.4)]. Infatti l’ovulazione non è prevedibile.L’unica cosa certa è che le mestruazioni verranno 14 giorni dopo l’ovulazione. Gently insert the barrel into the vagina until your fingers (on the finger grip) touch your body. Ma anche le donne che adoperano e assumono farmaci contraccettivi hanno la possibilità di constatare delle mestruazioni a macchie scure. Use of this product before menarche is not indicated. If you are not pregnant, insert a new NuvaRing (See Steps 1 through 4). What should I tell my healthcare provider before using NuvaRing? For more information, ask your healthcare provider or pharmacist. (etonogestrel/ethinyl estradiol vaginal ring) Several epidemiology studies indicate that third generation oral contraceptives, including those containing desogestrel (etonogestrel, the progestin in NuvaRing, is the biologically active metabolite of desogestrel), may be associated with a higher risk of VTE than oral contraceptives containing other progestins. Know the medicines you take. Your risk of stroke or blood clot is highest during your first year of using NuvaRing, or when you insert a new ring after not wearing one for 4 weeks or longer. Le perdite marroni sono un tipo di secrezione vaginale che può fare la sua comparsa in diversi momenti della vita per evidenziare la presenza di un possibile disturbo di salute. Using a condom is the only way to protect yourself from these diseases. user9933. Gently pull downward and forward to remove the NuvaRing and pull it out. In all of these cases, the woman should use an additional barrier method such as a male condom with spermicide, for the first seven days. Women who use hormonal birth control methods may have a slightly higher chance of getting cervical cancer. Use NuvaRing exactly as your healthcare provider tells you to use it. CHCs have been shown to decrease plasma concentrations of acetaminophen, clofibric acid, morphine, salicylic acid and temazepam. See the list of ingredients in NuvaRing at the end of this leaflet. Hypersensitivity reactions of anaphylaxis and angioedema have been reported during use of NuvaRing. certain anti-seizure medicines (such as barbiturates, carbamazepine, felbamate, oxcarbazepine, phenytoin, rufinamide and topiramate), medicine to treat fungal infections (griseofulvin), certain combinations of HIV medicines, (such as nelfinavir, ritonavir, darunavir/ritonavir, (fos)amprenavir/ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir), certain hepatitis C (HCV) medicines (such as boceprevir and telaprevir), non-nucleoside reverse transcriptase inhibitors (such as efavirenz and nevirapine), medicine to treat tuberculosis (such as rifampicin and rifabutin), medicine to treat high blood pressure in the vessels of the lung (bosentan), medicine to treat chemotherapy-induced nausea and vomiting (aprepitant), medicines that affect how your liver breaks down other medicines (such as itraconazole, ketoconazole, voriconazole, fluconazole, clarithromycin, erythromycin, and diltiazem), certain HIV medicines (atazanavir/ritonavir and indinavir), non-nucleoside reverse transcriptase inhibitors (such as etravirine), medicines to lower cholesterol such as atorvastatin and rosuvastatin. Begin NuvaRing at the time of your next menstrual period. If the expelled NuvaRing has been out of your vagina for more than 3 continuous hours: If NuvaRing was out of the vagina for an unknown amount of time, you may not be protected from pregnancy. Advise patients that cigarette smoking increases the risk of serious cardiovascular events from use of NuvaRing, and women who are over 35 years old and smoke should not use NuvaRing, Inform patients that the increased risk of VTE compared to non-users of CHCs is greatest after initially starting a CHC or restarting (following a 4-week or greater CHC-free interval) the same or a different CHC. Hormonal birth control methods help to lower the chances of becoming pregnant. This leaflet summarizes the most important information about NuvaRing. Acute or chronic disturbances of liver function may necessitate the discontinuation of CHC use until markers of liver function return to normal.
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