I do not like to use condoms (NOT CONVENIENT), so I have always used oral contraceptives. I tried many tablets - Yarina, Lindinet 20, Klaira. After another hormonal failure, the doctor advised me to switch to Nova Ring.
Nova Ring is a ring-shaped contraceptive for intervaginal use.
Ring dimensions: thickness 4mm, diameter 54mm.
The ring is stored in a special package:
I'll warn you right away. This method of contraception is not cheap. A ring for 1 cycle costs 900-1050 rubles. (each pharmacy is different). It is more profitable to buy a package for 3 cycles.
For me, this is the most convenient method of contraception:
1. There is the smallest amount of hormones in the ring. After using Nova Ring, hormonal disruptions in my body stopped.
2. No need to be afraid that you will miss a pill. I inserted the ring at the beginning of the cycle and you can forget about everything for a month!
3. Reduced monthly. For a place of 7 days, they became 3-4 days.
4. When applied, no acne, no weight gain.
Like many girls, there were many fears before using:
1. How to paste? The first time I was afraid to insert the ring myself, so I turned to the doctor for help. But in fact, inserting the ring is as easy as shelling pears! Nothing complicated: the ring must be inserted on the first day of the menstrual cycle. The procedure is not complicated and painless - you need to squeeze the ring with two fingers, take a comfortable position and insert it deep into the vagina. The ring is injected 1 time in 4 weeks.
2. How to pull out? After insertion, the ring should be in the vagina for exactly 3 weeks, and then removed strictly on the same day of the week on which it was inserted.
The ring is easy to take out, there is nothing complicated about it - I picked it up with my finger and that's it! The main thing is to remember the day of the week when it was entered, because it must be extracted strictly on the same day of the week when it was entered.
3. Fear - what will happen during sex. The husband does not experience any discomfort . I sometimes have discomfort, but this happens rarely. In such cases, I simply take out the ring and enter it again. For hygiene reasons, I always take the ring out after sex, rinse it, and reinsert it.
Of the side effects that I noticed, these are mood swings, increased irritability before critical days, and a decrease in libido. But I had all these kidneys when using birth control pills - Yarina, Lindinet 20 and Klaira. Therefore, I take these side effects calmly. And if you compare the ring with pills, I can say with confidence that the ring is much more convenient to use. Nuvaring is the most convenient method of contraception!!!
P.S. Many girls complain about the inconvenience of storage and inconvenience during transportation. I want to note that the ring really needs to be stored in the refrigerator at a temperature of -2 to -8. But if you accidentally left the ring at room temperature down to -25, nothing bad will happen to the ring. I had the ring in the chest of drawers for a week, the effect of contraception was preserved. It is written on our Russian packaging that storage at temperatures from -2 to -8. In fact, Nuvaring can be stored for up to 3 months at room temperature, as the manufacturer claims. But if you leave it in the cold or in extreme heat, then it’s not worth the risk and the ring should be thrown away!
Or frequently asked questions about the NovaRing hormonal ring, which the doctor hears at every appointment.
What is NuvaRing?
is an elastic ring that is inserted deep into the vagina. The system is installed in the first days of the menstrual cycle and remains in the genital tract for 21 days. The contraceptive ring contains the female sex hormones estrogen and progesterone. These substances are gradually released and enter the bloodstream, blocking ovulation and making pregnancy impossible. Hormones also make cervical mucus viscous so that nimble sperm do not penetrate and do not fulfill their intended purpose.
To date, the NuvaRing vaginal ring is considered one of the most effective contraceptives with a minimum amount of hormones. This fact makes the system popular with both young women and older ladies. What should you know about NovaRing and how to use this contraceptive correctly?
Who is NuvaRing suitable for?
The contraceptive ring is a good choice for different categories of women:
- Young and nulliparous, having one sexual partner.
- After childbirth and completion of breastfeeding.
- In the premenopausal period (in the absence of a chronic pathology that can become a contraindication).
Why is NuvaRing better than birth control pills?
The vaginal ring has three clear advantages over similarly formulated COCs:
- The estrogen dosage is lower than in any hormonal pills.
- The drug does not pass through the gastrointestinal tract and does not affect digestion.
- You do not need to remember to take pills every day - just enter the ring once and forget about it for 21 days.
Can NuvaRing be used for breastfeeding mothers?
Instructions for use of the contraceptive ring do not recommend the use of NuvaRing during lactation. You should wait until the end of breastfeeding and only then put the ring. Nursing mothers can use mini-pills (pure progestin preparations) as contraception. Don't forget about condoms.
Can a woman put a contraceptive ring herself or should she go to the doctor?
NuvaRing is simple, convenient and affordable. Any woman can easily insert the ring on her own. To do this, you need to take a comfortable position - squatting, standing or lying down - and insert the ring as deep as possible. If you have any difficulties, you can make an appointment to see a doctor. The doctor will introduce the ring, after which he will tell the patient in detail how to do this at home.
Can a man feel the ring during sex?
No, NuvaRing is not felt at all during intercourse.
Can a woman feel the vaginal ring?
No, if the NuvaRing is placed correctly, it will not be felt in the vagina.
Why doesn't the ring fall out?
NuvaRing, inserted deeply, is securely fixed in the vagina by the muscles. In addition, the ring lies horizontally in the genital tract, as if on a shelf, and the probability of its falling out is extremely low.
Can the ring fall out?
Rarely, but it does happen. In this case, you need to wash the ring with warm or cool water and gently insert it back into the vagina. The contraceptive effect does not suffer if less than 3 hours have passed since the ring fell out.
The ring fell out, but I did not have time to quickly return it to its place. What to do?
If more than 3 hours have passed after the ring fell out or was removed, you need to act according to the scheme:
- If such a problem happened on the 1st or 2nd week of using the NovaRing ring, you need to return it to its place as soon as possible. The contraceptive effect of the drug is reduced, and for some time the woman will not be protected from unwanted pregnancy. It is recommended to additionally use a condom for the next 7 days.
- If the ring falls out in the 3rd week of use, it must be discarded and a new one inserted immediately. In this case, there will be no menstrual-like bleeding, but scanty spotting may be noted. This is normal, no need to panic. The ring is removed after the prescribed 21 days, then a break is made for 7 days and a new drug is introduced.
- If a woman does not want to immediately put a new ring, she can wait for withdrawal bleeding and enter NuvaRing after 7 days. This option is possible only when the ring has never fallen out during the first two weeks. If the problem has occurred before, see point 2.
Is it possible to remove the ring from the vagina during sex?
Yes, but it makes no sense, because NuvaRing is not felt by either a woman or a man. If the ring was nevertheless removed, it must be returned within 2-3 hours and no later.
Can the NuvaRing fall too deep?
No, the birth control ring is securely attached to the vagina. It will not fall into the uterus, since the entrance to the reproductive organ is blocked by a closed pharynx. The ring has nowhere to go from the woman's genital tract, and even during sex, it will not penetrate too deeply.
Can NuvaRing be left in the vagina for 4 weeks?
This is acceptable because the contraceptive effect of the system lasts up to 28 days. After 4 weeks, the ring must be removed: the level of hormones drops, and the woman loses her protection against unwanted pregnancy.
Can NuvaRing be frozen?
The birth control ring can be stored in the refrigerator for up to 12 hours. It is not recommended to freeze the system in the freezer. If you need to take a contraceptive with you (for example, when traveling to another city), use a special cooler bag.
Can menses be cancelled?
Yes, you can insert a new ring without a week break. Menstruation will not come, but spotting bleeding in the middle of the cycle is possible. A new ring can be left in the vagina for 21 days (according to the usual scheme).
How to postpone the date of menstruation when using the NovaRing ring?
Very simple: you just need to introduce a new ring not after 7 days, but, for example, 5 or 6 after the removal of the previous one. It is important to know: the shorter the break, the higher the likelihood of spotting in the middle of the cycle.
Can a contraceptive ring be used by girls under the age of 18?
The safety of NuvaRing in adolescents has not been studied. Internal consultation of the doctor is necessary.
Should I use the ring if there is a uterine prolapse?
With this pathology, NuvaRing may fall out. It is recommended to use other means of contraception.
Why can't you drink antibiotics if there is a ring?
This is not entirely true. If the doctor has prescribed antibiotics, they should be taken. The problem is that when using some antibiotics (in particular ampicillin and tetracycline), there is a decrease in the contraceptive effect. While a woman is taking antibiotics, she should additionally use condoms - for the entire period of treatment and for 7 days after completion of the course of therapy.
Can the NuvaRing break?
Yes, this is possible. The risk of ring rupture increases with the simultaneous use of vaginal suppositories against a fungal infection (thrush). During treatment, you need to additionally use condoms and monitor the condition of NovaRing.
Can the birth control ring be used with tampons?
Yes, the use of tampons does not affect the functionality of NovaRing. In rare cases, the ring may fall out after the tampon is removed.
Does NovaRing lead to cervical cancer?
It is believed that the main cause of cervical cancer is the human papillomavirus (HPV), but not the use of hormonal contraceptives. Statistics show that women who use NovaRing are more likely to develop cervical cancer, but gynecologists attribute this to regular check-ups with a doctor and annual testing (a smear for oncocytology). It is worth noting that in this situation, the disease is usually detected in the early stages, when it is much easier to cure it.
How fast can I get pregnant after removing the NuvaRing?
Restoration of fertility occurs within 1-3 months after discontinuation of the drug. This means that a woman can become pregnant already in the first cycle after removing the ring. In some cases, the conception of a child occurs after 3-12 months.
How does the menstrual cycle change after the insertion of the vaginal ring?
After the introduction of NovaRing, a gradual release of hormones begins. The menstrual cycle becomes monotonous. The level of own hormones remains stable. Menstruation, as a rule, becomes less abundant, their duration decreases. Menstrual-like bleeding on the background of NovaRing comes every 28 days strictly according to the schedule.
How much does NuvaRing cost?
The average price for a contraceptive ring is about 1000 rubles.
The vaginal ring is an outsider in the world of contraceptives. Talk about contraception often centers around pills or intrauterine contraceptives. But a vaginal ring (produced under the name Nuvaring) may be the perfect option for you. Here
Novaring is a flexible plastic loop that enters the vagina and releases hormones to prevent unintended pregnancy. Nuvaring uses estrogen and progestin. Many people are afraid of such devices, although they are not much different from taking combined hormonal birth control pills. The only significant difference is, perhaps, the form.
Estrogen suppresses ovulation so your ovaries don't release eggs for sperm to fertilize, while progestin thickens cervical mucus to make it harder for sperm to travel, Mayo Clinic explains. (Mayo Clinic is a non-profit organization, one of the largest private medical and research centers in the world). Progestin also thins the uterine lining so that if the egg does get fertilized, it won't be able to get the nutrients it needs to grow.
Studies have shown that when used correctly, NuvaRing has a 0.3 percent failure rate. This means that less than one woman in 100 will become pregnant in the first year of using the ring if they follow the device's instructions. If used incorrectly (for example, if you forget to insert and remove the vaginal ring when you should), this number rises to nine out of 100 women who become pregnant in the first year of using the device. According to studies, have the same failure rates.
One more thing to keep in mind: Nuvaring does not protect against sexually transmitted infections, therefore, if you are at such risk, you must use barrier methods of contraception such as condoms and so-called rubber dams (oral condoms).
1. The vaginal ring will help with heavy and painful periods.
Thank progestin for such properties of the ring. Since progestin reduces the volume of the uterine lining, prostaglandins, which are hormone-like chemicals that cause hellish period cramps, are also made from the uterine lining. Therefore, thinning it can translate into a decrease in the production of pain-provoking prostaglandins, so it really is a win-win.
2. Vaginal ring size fits all
The ring itself is flexible so it can bend and stretch to fit any vagina. Of course, if not so much time has passed after natural childbirth, it may not be suitable, but in general, Nuvaring fits most vagina sizes. Doctors say that in practice it is extremely rare for women who are not suitable for this method of contraception.
3. The vaginal ring is inserted and removed at the same time of day. For many, it is more convenient than pills.
During the week off the ring, you will begin your period, which is really just bleeding caused by a lack of additional hormones. After the end of this week, you must insert a new ring on the same day and time as before, even if your period has not ended.
The fact that Nuvaring offers many of the same benefits as the pill but without the daily commitment makes it an attractive option for many women. Gynecologists say that often women who are excellent candidates for taking birth control pills refuse them, as it is difficult for them to keep track of time and strictly adhere to indications. The ring is a terrific alternative.
4. Insertion and removal of the ring without pain or discomfort
The process is quite easy and fast if the woman feels comfortable and does everything according to the instructions. Here is how the NuvaRing developers recommend inserting the device:
- Wash and dry your hands.
- Choose a position that is comfortable for you, such as lying down, squatting, or standing with one leg up.
- Take your Nuvaring out of the case, hold it between your thumb and forefinger, and then squeeze on both sides.
- Paste ring in the vagina and push it with your index finger. If you feel like you haven't pushed it in deep enough, or if its location makes you uncomfortable, you may need to push the vaginal ring even deeper.
The whole process usually takes no more than a couple of minutes. You can also ask your doctor to give you a special tampon-like applicator that can make it easier for you to insert Nuvaring.
The removal process is also quite simple:
- Wash and dry your hands.
- Take a comfortable position.
- Insert your index finger into the vagina and hook the ring with it.
- Pull gently down and forward to pull it out.
As a last resort, if something goes wrong, your doctor will always help you through this process.
5. Nuvaring is not stored in the refrigerator
You do not need to keep your Nuvaring in the refrigerator, unlike the pharmacist, who just has to follow such instructions. Store Nuvaring at room temperature (20-25°C) for up to four months or until the expiration date, whichever comes first. This prescribing information also advises pharmacists to keep Novaring refrigerated at 2-7 degrees Celsius before selling the device to patients. Pharmacists can store Nuvaring for more than four months, and keeping the rings in the refrigerator helps extend their shelf life.
Don't think you can keep your vaginal ring until it expires, or longer than four months if you've ever taken it out of the fridge. In the end, we do not recommend joking with this, because contraception is serious.
6. The vaginal ring cannot be "lost inside"
Such fears are justified, because you put a foreign object in the vagina, but there is no need to worry. Experts explain that the cervix (the narrow lower end of the uterus) blocks the movement of the ring inside the body. The only place it can travel is your vagina.
However, something still worth considering: the creators of Nuvaring note that some women accidentally insert the ring into the bladder (through the urethra) instead of their vagina. So if you experience pain after inserting the ring and can't find it in your vagina, call your doctor as soon as possible.
7. After consultation with your doctor, you can use the vaginal ring and manage your menstrual cycle
They weren't made to manipulate your periods, so it's important to talk to your doctor before using them for that purpose.
It often happens that a week of rest from the ring may fall at a time that is completely inconvenient for you, for example, on the beach weekend that you have been dreaming of for so long. Thus, you may want to change the timing of your period, or cancel it entirely.
Remember that when the ring is inside you, it releases a combination of progestin and estrogen to prevent unintended pregnancy. But when you remove it, the circulation of hormones in the body stops, and in response to this, bleeding begins. But do not worry, if after seven days you insert a new ring, you will still be protected from pregnancy. So, if you want your period to start earlier than usual (for example, the week before your vacation, not during it), you can take your ring out for that week and then put in a new one (on the same day of the week and time, on that you have inserted and removed in the past).
If you want to stop your periods altogether, you can simply wear your ring for four weeks instead of three (you'll still be protected from pregnancy for that period) and then put in a new ring instead of taking a break. However, we emphasize that, again, you should talk to your doctor before trying to do it yourself. Also, you may experience breakthrough bleeding if you try this way.
8. The ring is less likely than the pill to cause breakthrough bleeding.
Such an advantage is not so much due to the ring itself, but to its correct use. Technically, the ring contains the same hormones as the pill, so the risk of breakthrough bleeding is the same in this regard. However, some women may forget to take their birth control pills on time (sometimes, this lasts for a lifetime) - and this increases the chances of unforeseen bleeding. Because you don't have to change your NuvaRing as often as you would with a pill, the chances of misusing it causing breakthrough bleeding are greatly reduced.
9. The vaginal ring practically does not cause irritation in the vagina
According to NuvaRing.com, The most common side effects of the ring include irritation inside your vagina or cervix, and vaginal discharge. This can happen because there is a foreign object in the vagina, although doctors say that such cases are extremely rare. Despite this, we recommend discussing possible side effects with your doctor.
10. The ring should not fall out, but if it does, you have three hours to try again
According to NuvaRing.com, there is a chance that the ring can slip out when you take out a tampon, have sex, or strain during a bowel movement. That's why you should check your ring regularly, including after the points we just mentioned to make sure it's still in place. If the ring came out of your vagina less than three hours ago, rinse it with cool or warm water and reinsert it, as the company says.
If it's been no more than three hours since the ring fell out, simply rinsing it out and putting it back in is enough, but you should also use a back-up birth control method when your ring hasn't been in place for seven consecutive days, the company said. If shedding occurs in the third week, discard the ring and insert a new one (but note that you may not have a period for 21 days or may experience breakthrough bleeding), or insert a new ring no later than seven days after you noticed that the ring fell out (you will probably have your period during this period).
If you are worried about what happened, be sure to ask your doctor about the specific steps to take in your case.
11. The vaginal ring can be taken out before sex
It all depends on personal preference. You definitely don't need to take the ring off during sex, but some partners can sometimes feel it during sex. If you like, you can take your NuvaRing out for up to three hours and then re-insert it, according to the Mayo Clinic. The protection will continue to work because the hormones are still circulating in your bloodstream.
12. Nuvaring is not for everyone.
Some of the main contraindications include:
- The presence of blood clots (thrombi) in the arms, legs, eyes, or lungs. Like other combined ones, the ring increases the risk of blood clots because the hormones it contains affect the blood clotting process. While the overall risk of blood clots is very low, even with combined hormonal birth control, factors such as personal medical history increase the chances that this can happen to you.
- Stroke. The risk of stroke increases substantially when you use birth control methods that contain ethinyl estradiol, which is in the ring. Again, this is not something most women using a vaginal ring need to worry about, but factors such as a history of stroke increase your risk.
- High blood pressure that cannot be controlled with medication. The ring can further increase your blood pressure, says the American College of Obstetricians and Gynecologists (ACOG), so it is not recommended for women who suffer from hypertension that does not respond to medication.
- Smoking and age over 35. Smoking increases the risk of serious problems with the heart and blood vessels in general, so women who smoke are more likely to experience serious contraceptive-related side effects such as blood clots, heart attack, and stroke. According to the Mayo Clinic, this risk is especially high in smokers over the age of 35.
When discussing contraceptive options with your doctor, be sure to share these or any other details of your medical history that may affect your choice of contraceptive method that is ideal for you.
13. Fertility returns to normal after a few cycles after using the ring
The vaginal ring works to release a constant stream of hormones, but when you take it out, your body returns to normal. Usually the ovaries "wake up" fairly quickly, but for some women it can take several months for a normal menstrual cycle to return.
If you're having problems with your cycle a few months after you stop using the ring, talk to your doctor. Perhaps the ring masked the symptoms of an underlying condition that is affecting your periods or fertility, or your fertility has changed naturally over time. In any case, your doctor may order an examination for you to find out the reason for such changes.
NovaRing
Active substance:
Etonogestrel* (Etonogestrel*) + Ethinylestradiol* (Etonogestrel* + Ethinylestradiol*)
Composition and form of release:
Vaginal rings 1 ring etonogestrel 11.7 mg ethinyl estradiol 2.7 mg other ingredients: ethylene vinyl acetate copolymer (28% - vinyl acetate); ethylene vinyl acetate copolymer (9% - vinyl acetate); magnesium stearate; purified water
the ring is packed in an aluminum foil bag; 1 or 3 bags in a cardboard box.
Dosage and administration:
How to use the NovaRing® vaginal ring
A woman can independently place NovaRing® into the vagina. The doctor should inform the woman how to insert and remove the ring.
To introduce the ring, a woman should choose the most comfortable position for her, for example, standing, raising one leg, squatting or lying down. The ring must be squeezed and inserted into the vagina to a comfortable position. The exact position in the vagina is not decisive for the contraceptive effect of the ring.
After the introduction of the ring should be in the vagina constantly for 3 weeks. If it is accidentally removed (for example, when removing a tampon), the ring must be rinsed with warm water and immediately placed in the vagina. The ring is removed after 3 weeks on the same day of the week on which it was placed in the vagina. After a week break, a new ring is introduced. To remove the ring, you can pick it up with your index finger or, squeezing it between your index and middle fingers, pull it out of the vagina.
Bleeding associated with discontinuation of the drug usually begins 2-3 days after the removal of the ring and may not completely stop until the time when you need to start using the next one.
How to start using NovaRing®
Hormonal contraceptives were not used in the previous cycle
NovaRing® must be administered between days 1 and 5 of the menstrual cycle, but no later than day 5, even if the woman has not completed her menstrual bleeding. During the first 7 days of use, additional use of barrier methods of contraception, such as a condom, is recommended.
Switching from combined oral contraceptives
A woman should enter NovaRing® no later than the day following the interval in taking the drug. If the combined oral contraceptive also contains inactive tablets (placebo), the ring should be inserted no later than the day following the last placebo tablet.
Switching from progestogen contraception (mini-pill, implant, or injectable contraception) or progestogen-releasing intrauterine device (IUD)
A woman taking a "mini-drink" can switch to using NuvaRing® any day. She should switch from the implant or IUD from the day they are removed, and from the injectable on the day the next injection is needed. In all these cases, the woman must use the additional barrier method for the first 7 days.
After an abortion in the first trimester
A woman can start using the ring immediately after an abortion. In this case, she does not need additional contraceptives. If the use of NovaRing® immediately after an abortion is undesirable, the woman should follow the recommendations above.
After childbirth or abortion in the second trimester
A woman should start using the NovaRing® vaginal ring within 4 weeks after childbirth or an abortion in the second trimester. If the use of the vaginal ring is started at a later date, additional barrier methods of contraception should be used in the first 7 days of use. However, if sexual intercourse has already taken place during this period, it is necessary to first exclude pregnancy or wait for the first menstruation before using the vaginal ring.
The drug is contraindicated during lactation.
The contraceptive effect and cycle control may be impaired if a woman violates the recommended regimen. To avoid losing the contraceptive effect in case of deviation from the regimen, the following recommendations should be followed.
In the event of an extended break in the use of the ring
A woman should place a new ring in her vagina as soon as possible. Additionally, for the next 7 days, you must use a barrier method of contraception, such as a condom. If during the break in the use of the ring there were sexual contacts, the possibility of pregnancy should be considered. The longer the break, the higher the risk of pregnancy.
In the case when the ring was temporarily outside the vagina
The ring should be in the vagina constantly for 3 weeks. If it was accidentally removed and left outside the vagina for less than 3 hours, the contraceptive effect will not decrease. The woman should re-insert the ring into her vagina as soon as possible.
If the ring has been outside the vagina for more than 3 hours, the contraceptive effect may be reduced. The woman should place the ring in the vagina as soon as possible, after which it should be permanently in the vagina for at least 7 days, while additionally using a barrier method of contraception during these 7 days.
If the ring was outside the vagina for more than 3 hours during the third week of its use, then it should be extended beyond the prescribed 3 weeks (until the end of 7 days after the reinsertion of the ring). After that, the ring should be removed and a new one placed after a week break.
If the removal of the ring from the vagina for more than 3 hours occurs during the first week of using the ring, the possibility of pregnancy should be considered.
In case of prolonged use of the ring
If NovaRing® has been used for no longer than a maximum period of 4 weeks, the contraceptive effect is still sufficient. A woman can take a week off from using the ring and then place a new ring. If the ring has been in the vagina for more than 4 weeks, the contraceptive effect may decrease, and pregnancy must be excluded before using a new ring.
If a woman does not adhere to the recommended regimen and then does not bleed during a week off the ring due to removal of the ring, pregnancy must be ruled out before using a new vaginal ring.
How to change the time of your period
To delay the onset of menstruation, a woman can start using a new ring without a week's break. The next ring should also be used within 3 weeks. This may cause bleeding or spotting. Further, after the accepted weekly break, the woman returns to regular use.
In order to move the onset of menstruation to another day of the week from the day that falls on the current scheme of using the ring, it can be advised to shorten the upcoming break in the use of the ring by as many days as necessary. The shorter the break in the use of the ring, the higher the likelihood of the absence of bleeding that occurs after the removal of the ring, and the occurrence of untimely bleeding or spotting during the period of use of the next ring.
There is no such data.
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Possible interaction with drugs that induce microsomal liver enzymes, which can lead to an increase in the clearance of sex hormones. Interactions with the following drugs have been established: phenytoin, barbiturates, primidone, carbamazepine, rifampicin, and possibly oxcarbazepine, topiramate, felbamate, ritonavir, griseofulvin and preparations containing St. John's wort.
When treating any of the listed drugs, you should temporarily use a barrier method of contraception (condom) in combination with NuvaRing or choose another method of contraception. During the concomitant use of drugs that cause the induction of microsomal liver enzymes, and within 28 days after their withdrawal, barrier methods of contraception should be used.
If concomitant therapy is to be continued after 3 weeks of ring use, then the next ring must be administered immediately without the usual interval.
A decrease in the effectiveness of oral contraceptives containing ethinyl estradiol has been observed with concomitant taking antibiotics, especially such as ampicillin and tetracyclines. The mechanism of this effect has not been studied. In a pharmacokinetic interaction study, ingestion of amoxicillin (875 mg 2 times / day) or doxycycline (200 mg / day, and then 100 mg / day) for 10 days during the use of the drug NovaRing slightly affected the pharmacokinetics of etonogestrel and ethinyl estradiol. When using antibiotics (excluding amoxicillin and doxycycline), you should use a barrier method of contraception (condom) during treatment and for 7 days after stopping antibiotics. If concomitant therapy is to be continued after 3 weeks of ring use, then the next ring must be administered immediately without the usual interval.
Pharmacokinetic studies have not revealed the effect of the simultaneous use of antifungal agents and spermicides on the contraceptive efficacy and safety of NovaRing. With the combined use of suppositories with antifungal drugs, the risk of ring rupture slightly increases.
Hormonal contraceptives can cause a violation of the metabolism of other drugs. Accordingly, their plasma and tissue concentrations may increase (eg, cyclosporine) or decrease (eg, lamotrigine).
To exclude a possible interaction, it is necessary to study the instructions for use of other drugs.
Pharmacokinetic data show that the use of tampons does not affect the absorption of hormones released from the NovaRing vaginal ring. In rare cases, the ring may be accidentally removed when the tampon is removed.
