Ethinyl Estradiol Etonogestrel

Ethinyl Estradiol Etonogestrel Brand Names

EluRyng | NuvaRing

What is Ethinyl Estradiol Etonogestrel

Ethinyl estradiol and etonogestrel and used together in a combination hormonal contraceptive vaginal ring; the vaginal ring is left in place for 3 weeks, followed by a 1 week hiatus.

Ethinyl estradiol is a potent, synthetic estrogen. Etonogestrel, also known as 3-keto-desogestrel, is the biologically active metabolite of desogestrel.

Etonogestrel is a third-generation progestin with lowered androgenic effects and relatively no estrogenic action compared to older progestins.

Thus etonogestrel may have positive influences on acne, fluid retention, and lipid profiles.

There are no epidemiologic data available to determine vaginal combination hormonal contraceptive safety profiles are different than combined oral contraceptives (COCs), and the standard risks and benefits of the combined hormonal contraceptives apply.

Combined hormonal contraceptives can be used in female patients from menarche to over the age of 40 years up until the time of menopause with proper selection of products.

The choice of a routine hormonal contraceptive for any given patient is based on the individual’s contraceptive needs, underlying medical conditions or risk factors for adverse effects, and individual preferences for use.

All combined hormonal contraceptives have risks related to venous and arterial thromboembolism, particularly in women who smoke and contain a boxed warning about tobacco smoking.

The Centers for Disease Control’s U.S. Medical Eligibility Criteria describe considerations for risk vs. benefits, including medical conditions or attributes that contraindicate use; these criteria can help prescribing practitioners in product selection for individual patients.

Patients with a sensitivity for vaginal irritation, or those with conditions (e.g., vaginal stenosis, cervical prolapse, rectoceles, and cystoceles) that may make expulsion of the ring more likely to occur may not be the best candidates for this vaginal ring contraceptive.

Indications

1. acne vulgaris
2. amenorrhea
3. contraception
4. dysfunctional uterine bleeding
5. endometriosis
6. hirsutism
7. polycystic ovary syndrome

For routine contraception under the following conditions

Side Effects

1. abdominal pain
2. acne vulgaris
3. alopecia
4. amenorrhea
5. anaphylactoid reactions
6. angioedema
7. anorexia
8. anxiety
9. appetite stimulation
10. azotemia
11. bowel ischemia
12. breakthrough bleeding
13. breast enlargement
14. candidiasis
15. cataracts
16. cervical dysplasia
17. chills
18. cholecystitis
19. cholelithiasis
20. cholestasis
21. colitis
22. confusion
23. cystitis
24. depression
25. diplopia
26. dizziness
27. edema
28. elevated hepatic enzymes
29. emotional lability
30. erythema multiforme
31. erythema nodosum
32. fever
33. fluid retention
34. galactorrhea
35. gingivitis
36. headache
37. hepatitis
38. hepatoma
39. hirsutism
40. hyperlipidemia
41. hypertension
42. hypotension
43. infertility
44. intracranial bleeding
45. jaundice
46. lactation suppression
47. leukorrhea
48. libido decrease
49. maculopapular rash
50. mastalgia
51. melasma
52. menstrual irregularity
53. migraine
54. myalgia
55. myocardial infarction
56. nausea
57. new primary malignancy
58. oligomenorrhea
59. optic neuritis
60. pancreatitis
61. papilledema
62. peliosis hepatis
63. photosensitivity
64. porphyria
65. pulmonary embolism
66. retinal thrombosis
67. sinusitis
68. stroke
69. thromboembolism
70. thrombosis
71. toxic-shock syndrome
72. urticaria
73. vaginal pain
74. vaginitis
75. visual impairment
76. vomiting
77. weight gain
78. weight loss

Monitoring Parameters

• pap smear
• pelvic exam

Contraindications

• acquired immunodeficiency syndrome (AIDS)
• atrial fibrillation
• breast cancer
• breast-feeding
• cerebrovascular disease
• cervical cancer
• children
• chloasma
• cholestasis
• contact lenses
• contraceptive devices
• coronary artery disease
• coronary thrombosis
• depression
• diabetes mellitus
• endocarditis
• endometrial cancer
• gallbladder disease
• geriatric
• glaucoma
• headache
• hepatic disease
• hepatitis
• hepatocellular cancer
• hereditary angioedema
• history of angioedema
• human immunodeficiency virus (HIV) infection
• hypercalcemia
• hypercholesterolemia
• hyperlipidemia
• hypertension
• hypertriglyceridemia
• hypothyroidism
• jaundice
• migraine
• myocardial infarction
• obesity
• obstetric delivery
• ovarian cancer
• porphyria
• pregnancy
• protein C deficiency
• protein S deficiency
• renal disease
• stroke
• surgery
• systemic lupus erythematosus (SLE)
• thromboembolic disease
• thromboembolism
• thrombophlebitis
• thyroid disease
• tobacco smoking
• uterine cancer
• vaginal bleeding
• vaginal cancer
• valvular heart disease
• visual disturbance

Interactions

• Acarbose
• Acetaminophen
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetohexamide
• Acitretin
• Albiglutide
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-glucosidase Inhibitors
• Alprazolam
• Amikacin
• Aminoglycosides
• Amiodarone
• Amitriptyline; Chlordiazepoxide
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amobarbital
• Amoxicillin
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amoxicillin; Clavulanic Acid
• Ampicillin
• Ampicillin; Sulbactam
• Amprenavir
• Anastrozole
• Apalutamide
• Aprepitant, Fosaprepitant
• Armodafinil
• Artemether; Lumefantrine
• Ascorbic Acid, Vitamin C
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Atazanavir
• Atazanavir; Cobicistat
• Atorvastatin
• Atorvastatin; Ezetimibe
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azelastine; Fluticasone
• Azithromycin
• Aztreonam
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• Bendamustine
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• Deferasirox
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• Demeclocycline
• Dexamethasone
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• Diltiazem
• Dipeptidyl Peptidase-4 Inhibitors
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• Doripenem
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• Duloxetine
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• Elagolix
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• Elvitegravir
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• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enalapril; Felodipine
• Enasidenib
• Encorafenib
• Enzalutamide
• Eravacycline
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• Ertugliflozin; Sitagliptin
• Erythromycin
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• Felbamate
• Felodipine
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• Fluticasone; Vilanterol
• Fluvoxamine
• food
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• Gemifloxacin
• Gentamicin
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• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Glycylcyclines
• grapefruit juice
• Green Tea
• Griseofulvin
• Hemin
• Hyaluronidase
• Hyaluronidase, Recombinant; Immune Globulin
• Hydantoins
• Hydralazine
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydralazine; Isosorbide Dinitrate, ISDN
• Hydrocortisone
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• Insulins
• Isavuconazonium
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isotretinoin
• Isradipine
• Itraconazole
• Ivosidenib
• Ixabepilone
• Kanamycin
• Ketoconazole
• Lamotrigine
• Lefamulin
• Leflunomide
• Lenalidomide
• Lesinurad
• Lesinurad; Allopurinol
• Letrozole
• Levofloxacin
• Levothyroxine
• Levothyroxine; Liothyronine (Porcine)
• Levothyroxine; Liothyronine (Synthetic)
• Linagliptin
• Linagliptin; Metformin
• Lincomycin
• Lincosamides
• Linezolid
• Liothyronine
• Liraglutide
• Lixisenatide
• Lomitapide
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Lorazepam
• Lorlatinib
• Lumacaftor; Ivacaftor
• Mecamylamine
• Meglitinides
• Melatonin
• Mephobarbital
• Meropenem
• Meropenem; Vaborbactam
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methohexital
• Methylprednisolone
• Metreleptin
• Metronidazole
• Metyrapone
• Miconazole
• Miconazole; Petrolatum; Zinc Oxide
• Midazolam
• Mifepristone
• Miglitol
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• Mineral Oil
• Minocycline
• Minoxidil
• Mitotane
• Mivacurium
• Modafinil
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• Morphine
• Morphine; Naltrexone
• Moxifloxacin
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• Nafcillin
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• Nefazodone
• Nelfinavir
• Neomycin
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• Nevirapine
• Nicardipine
• Nifedipine
• Nilotinib
• Nimodipine
• Nisoldipine
• Nitrofurantoin
• Nitroprusside
• Norfloxacin
• Octreotide
• Ofloxacin
• Omadacycline
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Amoxicillin; Rifabutin
• Oritavancin
• Ospemifene
• Oxacillin
• Oxazepam
• Oxcarbazepine
• Paromomycin
• Pazopanib
• Pegaspargase
• Penicillin G
• Penicillin G Benzathine
• Penicillin G Benzathine; Penicillin G Procaine
• Penicillin G Procaine
• Penicillin V
• Pentobarbital
• Perindopril; Amlodipine
• Pexidartinib
• Phenobarbital
• Phenothiazines
• Phenoxybenzamine
• Phentermine; Topiramate
• Piperacillin
• Piperacillin; Tazobactam
• Pitolisant
• Plazomicin
• Polymyxin B
• Polymyxins
• Posaconazole
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Prazosin
• Prednisolone
• Prednisone
• Primidone
• Propafenone
• Propoxyphene
• Pyrimethamine; Sulfadoxine
• Quazepam
• Quinine
• Raloxifene
• Ramelteon
• Ranolazine
• Rasagiline
• Reserpine
• Ribociclib
• Ribociclib; Letrozole
• Rifabutin
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• Riluzole
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• Rituximab; Hyaluronidase
• Rivaroxaban
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• Secobarbital
• Selegiline
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• SGLT2 Inhibitors
• Siltuximab
• Simvastatin; Sitagliptin
• Sincalide
• Sitagliptin
• Sofosbuvir; Velpatasvir
• Sofosbuvir; Velpatasvir; Voxilaprevir
• Somatropin, rh-GH
• St. John’s Wort, Hypericum perforatum
• Streptogramins
• Streptomycin
• Succinylcholine
• Sugammadex
• Sulfadiazine
• Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
• Sulfasalazine
• Sulfisoxazole
• Sulfonamides
• Sulfonylureas
• Tacrine
• Tacrolimus
• Tamsulosin
• Tazemetostat
• Tedizolid
• Telaprevir
• Telavancin
• Telithromycin
• Telotristat Ethyl
• Temazepam
• Temsirolimus
• Terazosin
• Terbinafine
• Teriflunomide
• Testolactone
• Tetracycline
• Thalidomide
• Theophylline, Aminophylline
• Thiazolidinediones
• Thiopental
• Thyroid hormones
• Ticarcillin
• Ticarcillin; Clavulanic Acid
• Tigecycline
• Tinidazole
• Tipranavir
• Tizanidine
• tobacco
• Tobramycin
• Tocilizumab
• Tolazamide
• Tolbutamide
• Tolvaptan
• Topiramate
• Toremifene
• Trandolapril; Verapamil
• Tranexamic Acid
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• Triamcinolone
• Triazolam
• Tricyclic antidepressants
• Trimethoprim
• Tucatinib
• Ulipristal
• Ursodeoxycholic Acid, Ursodiol
• Valdecoxib
• Valproic Acid, Divalproex Sodium
• Vancomycin
• Verapamil
• Vincristine
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• Vorapaxar
• Voriconazole
• Warfarin
• Zolmitriptan
• Zonisamide