NUVARING
Combination product
Pronunciation: ETH-i-nil es-tra-DYE-oel and e-toe-noe-JES-trel (NOO-va-ring)
Combination of Ethinyl estradiol and Etonogestrel.
Each component keeps its own pharmacology page; the combination itself adds no new mechanism.
Components (2)
FDA label
Read the full label on DailyMed ↗
BOXED WARNING Cigarette smoking increases the risk of serious cardiovascular events from combination hormonal contraceptive use; do not use in women over 35 years of age who smoke.
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Prevention of pregnancy | Females of reproductive age | Insert 1 ring intravaginally; retain continuously 3 weeks | Remove for 1 ring-free week (withdrawal bleed), then insert a new ring |
Renal Undefined
Hepatic Undefined
Ring out of the vagina >3 continuous hours may reduce contraceptive efficacy; ring-free interval must not exceed 1 week.
Instructions
- Insert one ring vaginally; keep in place continuously for 3 weeks, remove for 1 week, then insert new ring on same weekday
- If expelled/removed, rinse and reinsert within 3 hours; if out >3 hours use back-up method for 7 days
- Do not use with certain vaginal barrier methods (diaphragm/cervical cap/female condom)
Available strengths
- insert 0.015/0.12 mg/d
- ring 0.015/0.12 mg/24 hr
Contraindications
- A high risk of arterial or venous thrombotic diseases (including smoking if over age 35; current/past DVT or PE; cerebrovascular disease; coronary artery disease; thrombogenic valvular or thrombogenic rhythm diseases; inherited or acquired hypercoagulopathies)
- Uncontrolled hypertension
- Diabetes mellitus with vascular disease
- Headaches with focal neurological symptoms or migraine headaches with aura; women over age 35 with any migraine headaches
- Liver tumors, benign or malignant, or liver disease
- Undiagnosed abnormal uterine bleeding
- Pregnancy
- Current diagnosis of, or history of, breast cancer
- Use of Hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
Cautions
- Thromboembolic and other vascular events — stop if a thrombotic event occurs; stop ≥4 weeks before and 2 weeks after major surgery
- Toxic shock syndrome
- Liver disease — discontinue if jaundice develops
- High blood pressure; carbohydrate and lipid metabolic effects
- Headache; bleeding irregularities and amenorrhea; depression
- Breast and cervical cancer
- Hereditary angioedema; chloasma
Adverse reactions
- Vaginitis, vaginal discharge/discomfort
- Headache (including migraine); mood changes
- Device-related events (expulsion/discomfort/foreign body sensation)
- Nausea/vomiting, abdominal pain
- Breast pain/tenderness, weight increase, dysmenorrhea, acne, decreased libido
Pregnancy Contraindicated in pregnancy; discontinue if pregnancy is confirmed.
Lactation Not recommended; combination hormonal contraceptives can reduce milk production; small amounts of hormones transferred to milk.
Cost
NUVARING
What pharmacies pay · NADAC 9/30/26
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 0.015/0.12 mg/d | insert | per unit | $46.35/ea | offered |
Part D rank #189.