RING VAGINAL NOVARING 15MKG + 120MKG/DAY SACHET

Vaginal ring

Composition

1 ring contains 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

Packing

3 pcs.

Mechanism of action

Novoring is a hormonal contraceptive for intravaginal administration, containing estrogen - ethinyl estradiol and gestagen - etonogestrel, which releases ethinyl estradiol - 15 mcg / day and etonogestred 120 mcg / day. Etonogestrel, a derivative of 19-nortestosterone, binds to Progesterone receptors in target organs.
The main mechanism of contraceptive action of the drug Novairing is the inhibition of ovulation. In addition to the contraceptive effect of the drug has a positive effect on the menstrual cycle. Against the background of its use, the cycle becomes more regular, menstruation is less painful, with less intensity of bleeding, which in turn can help reduce the frequency of iron deficiency states. In addition, there is evidence of a reduction in the risk of endometrial cancer and ovarian cancer.

Indications and usage

Intravaginal contraception.

Contraindications

Hypersensitivity to the drug;
venous or arterial thrombosis / thromboembolism (including in the anamnesis);
risk factors for thrombosis (including in history);
migraine with focal neurological symptoms;
diabetic angiopathy;
pancreatitis (including history) in combination with a high degree of hypertriglyceridemia (LDL concentration more than 500 mg / dL);
severe liver disease (until normalization of function indicators);
liver tumors (benign or malignant, including a history);
hormone-dependent malignant tumors (established or suspected, for example, tumors of the genitals or mammary glands);
vaginal bleeding of unknown etiology;
pregnancy or suspicion of it;
lactation period.

with caution the drug should be prescribed for diabetes, obesity (body mass index over 30 kg / m2), hypertension, atrial fibrillation, valvular heart disease, dyslipoproteinemia, liver or gall bladder disease, Crohn's disease or ulcerative colitis, sickle cell anemia, SLE, hemolytic uremic syndrome, epilepsy, smoking in combination with the age of more than 35 years, with prolonged immobilization, serious surgical interventions, fibrocystic mastopathy, uterine fibroids, congenital hyperbilir Binh (Gilbert syndrome, Dubin-Johnson and Rotor)chloasma (avoid exposure to ultraviolet rays), as well as conditions that impede the use of the vaginal ring (cervical prolapse, bladder hernia, rectal hernia, severe chronic constipation).

Dosage and administration

Novaring is inserted into the vagina 1 time in 4 weeks. The ring is placed in the vagina for 3 weeks and then removed on the same day of the week in which it was placed in the vagina. After a week break, a new ring is introduced. Bleeding associated with the termination of the drug, usually begins 2-3 days after the removal of NovaRing and may not completely stop until the moment when it is necessary to start using the next ring.

If hormonal contraceptives were not used in the previous menstrual cycle, Novairing should be administered between days 1 and 5 of the menstrual cycle, but no later than the 5th day of the cycle, even if the woman has not completed menstrual bleeding. During the first 7 days of the first cycle of Novaring, additional use of barrier methods of contraception is recommended.

When switching from taking combined oral contraceptives, Novara should be administered no later than the day following the interval in which the drug is taken. If the combined oral contraceptive also contains an inactive pill (placebo), then NewRing should be administered no later than the day following the last placebo pill.

When switching from progestin contraception (mini-pilli, implant or injection contraception) or progestogen-releasing intrauterine devices (IUD), administration of NovRing should be done on any day (if the patient was taking mini-pili), the next day after removing the implant or IUD, and with injectable contraception - on the day when the next injection is needed. In all these cases, an additional barrier method of contraception should be used during the first 7 days of using Novaring.

Adverse reactions

From the side of the central nervous system: headache, migraine, depression, emotional lability, dizziness, anxiety, fatigue.
Gastrointestinal:nausea, abdominal pain, diarrhea, vomiting.
On the part of the endocrine system:decrease in libido, soreness, tension and an increase in the mammary glands, dysmenorrhea, an increase or decrease in body weight.
From the reproductive system: vaginal discharge ("whites"), vaginitis, cervicitis.
Urogenital: urinary tract infections (including cystitis).
Local reactions: loss of ring, discomfort during sexual intercourse in women and men, foreign body sensation in the vagina.
Other: increase or decrease in body weight.

Special notes

Before you assign Novairing, you should collect a detailed history of the patient, as well as conduct a medical examination, taking into account contraindications and warnings. During the period of NovoraRing, the survey should be repeated at least once a year.The frequency and list of studies should be selected individually for each patient, but in any case, special attention should be paid to control of blood pressure, examination of the mammary glands, abdominal organs and small pelvis, including cervical cytology and appropriate laboratory tests.
The effectiveness of Novairing can be reduced in case of non-compliance with the regimen of use or the concomitant use of other drugs.
If it is necessary to use drugs that may affect the contraceptive effect of the ring while using Novaring, you should use a barrier method of contraception in addition to using Novaring or choose another method of contraception. When taking inductors of liver microsomal enzymes against the use of Novaring, a barrier method of contraception should be used during the course of taking concomitant drugs and for 28 days after stopping their use. If antibiotics are taken at the same time (excluding rifampicin and griseofulvin), a barrier method should be used for at least 7 days after discontinuing the course of antibiotic therapy. If the course of therapy with concomitant drugs continues for more than 3 weeks of applying the ring, the next ring is placed immediately, without a week break.
The use of contraceptive steroids can affect the results of certain laboratory tests.including biochemical indicators of liver, thyroid, adrenal and kidney function, plasma levels of transport proteins (for example, corticosteroid-binding globulin and sex hormone-binding globulin), lipid / lipoprotein fractions, carbohydrate metabolism and coagulation and fibrinolysis. Indicators, as a rule, vary within normal values.
On the background of pregnancy or taking oral hormonal contraceptives, the occurrence of such conditions as pregnant herpes, hearing loss, minor chorea, and porphyria may occur.
The patient should be informed that Novairing does not protect against HIV infection (AIDS) and other sexually transmitted diseases.
During the use of NovingRing, irregular bleeding may occur (slight discharge or sudden bleeding).
In some women, there is no bleeding caused by the removal of the ring during the break in use of the ring. If Novairing was used as recommended, it is unlikely that the woman is pregnant. If there is a deviation from the recommended regimen and there is no bleeding from discontinuation of the drug, or in the absence of bleeding 2 times in a row, pregnancy should be excluded.
The extent of exposure and the possible pharmacological effects of ethinyl estradiol and etonogestrel on sexual partners through absorption through the skin of the penis have not been studied.

The interaction between hormonal contraceptives and other drugs can lead to bleeding "breakthrough" and / or loss of contraceptive effect.
With simultaneous use of NuvaRing with drugs that induce hepatic microsomal enzymes (phenytoin, phenobarbital, primidone, Carbamazepine , rifampicin, oxcarbazepine, topiramate , felbamate, ritonavir, Griseofulvin , Hypericum preparations) enhanced the metabolism of sex hormones and decreases NuvaRing contraceptive effect.
The effectiveness of Novairing may also decrease while taking some antibiotics, such as penicillins and tetracyclines. These drugs reduce the enterohepatic circulation of estrogen, which leads to a decrease in the concentration of ethinyl estradiol.
The effect on the contraceptive effect and preservation of Novirring antifungal drugs and spermicidal agents administered intravaginally is not known. No direct interactions of etonogestrel with co-administered ethinyl estradiol were found.

Keep out of reach of children at a temperature of 2 ° to 8 ° C

Vaginal ring