When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to etonogestrel or ethinyl estradiol, if you are pregnant, or if you have vaginal bleeding that has not been checked by a doctor, liver disease or tumors, breast cancer, problems with blood clots, or certain heart problems.

How to Use This Medicine:
Insert

• This medicine is in a ring that is put into your vagina. Your doctor or nurse will show you how to put in the ring. The ring is left in place for 3 weeks then removed and another inserted 1 week later. During the week without the ring, you will usually have your menstrual period. Follow directions about how to use the ring, and ask your doctor if you have questions.
• The first time you start using the ring, you should also use a second form of birth control during the first 7 days to avoid pregnancy. Do not use a diaphragm, because the ring may affect how the diaphragm fits.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Missed dose:
  
  • If NuvaRing® has slipped out and it has been out for less than 3 hours, rinse it in cool or lukewarm water and reinsert it. You should still be protected from pregnancy. If NuvaRing® has been out for more than 3 hours, insert a new ring. You must use an extra method of birth control until the NuvaRing® has been in place for 7 days in a row. Do not use a diaphragm.
  • If you leave the vaginal ring in place for more than 4 weeks, you may not be protected from pregnancy. Make sure that you are not pregnant before you insert a new ring. You must use an additional form of birth control (not a diaphragm) until the new ring has been in place for 7 days in a row.
  • If you forget to insert a new ring after the ring-free week, call your doctor for instructions.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Place the used NuvaRing® in the re-sealable foil pouch and put it in the trash where children and pets cannot get to it. Do not flush the ring down the toilet.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and medicines can affect how this medicine works. Tell your doctor if you are also using St John's wort, acetaminophen, ascorbic acid, aprepitant, atorvastatin, boceprevir, bosentan, carbamazepine, clofibric acid, cyclosporine, felbamate, griseofulvin, lamotrigine, morphine, oxcarbazepine, phenobarbital, phenytoin, prednisolone, rifabutin, rifampicin, rufinamide, salicylic acid, telaprevir, temazepam, theophylline, tizanidine, or topiramate.
• Also tell your doctor if you are using medicine to treat an infection (such as fluconazole, itraconazole, ketoconazole, miconazole, voriconazole), medicine to treat HIV, or thyroid medicines.
• Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Tell your doctor if you are breastfeeding, or if you recently had a baby, miscarriage, or abortion. Tell your doctor if you have kidney disease, cervical cancer, diabetes, epilepsy, migraines, heart or blood vessel disease, high cholesterol, or high blood pressure. Also tell your doctor if you have a history of depression, chloasma gravidarum, jaundice during pregnancy, or toxic shock syndrome, or if you smoke.
• This medicine may cause the following problems:
  
  • Higher risk of heart attack, stroke, or blood clots
  • Liver problems
  • High blood pressure
  • Gallbladder disease
  • Possible increased risk of breast or cervical cancer
• Tell any doctor who treats you that you are using this medicine. You may need to stop using this medicine before and after you have surgery, because of the risk of blood clots.
• This medicine will not protect you from HIV/AIDS or other sexually transmitted infections.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will check the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain that may spread, trouble breathing, unusual sweating, fainting
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Fast, slow, or pounding heartbeat
• Numbness or weakness on one side of your body, pain in your lower leg, sudden or severe headache, problems with vision, speech, or walking
• Redness, pain, itching, or burning sensation inside your vagina
• Sudden high fever, diarrhea, dizziness, fainting, muscle aches, or a sunburn-like rash
• Unusual or unexpected vaginal bleeding or heavy bleeding
• Vision loss, double vision

If you notice these less serious side effects, talk with your doctor:

• Breast tenderness or swelling
• Depression, mood changes

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088