Ethinyl Estradiol / Etonogestrel
Ethinyl estradiol and etonogestrel is a combination estrogen/progestin hormonal contraceptive used to prevent pregnancy, available as a vaginal ring under several brand names.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 11 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾
If you smoke and are over 35 years old, do not use this ring. Smoking while using combination hormonal contraceptives significantly raises the risk of serious heart and blood vessel problems — including heart attack, stroke, and dangerous blood clots — and this risk goes up with age and the number of cigarettes smoked. These complications can be fatal. Women over 35 who smoke must use a different form of contraception.
📖 Ethinyl Estradiol / Etonogestrel: Patient Information Guide
A plain-language walkthrough of Ethinyl Estradiol / Etonogestrel — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Ethinyl estradiol and etonogestrel is used as a combination hormonal contraceptive to prevent pregnancy. All approved products containing this ingredient combination are vaginal rings indicated for females of reproductive age.
- EluRyng (vaginal ring) — indicated to prevent pregnancy
- EnilloRing (vaginal ring) — indicated to prevent pregnancy
- NuvaRing (vaginal ring, extended release insert) — indicated to prevent pregnancy
- Etonogestrel/Ethinyl Estradiol Vaginal Ring (generic, extended release insert) — indicated to prevent pregnancy
- Etonogestrel and Ethinyl Estradiol vaginal ring (generic ring and insert) — indicated to prevent pregnancy
⚙️How it works▾
Ethinyl estradiol and etonogestrel work together by suppressing the hormonal signals (gonadotropins) that tell your ovaries to release an egg — so ovulation is prevented. On top of that, the combination thickens cervical mucus (making it harder for sperm to get through) and alters the uterine lining to make implantation less likely. These three layers of protection work together to prevent pregnancy.
💊How it's taken▾
One ring is inserted into the vagina and worn continuously for three weeks. It is then taken out for a one-week break, during which a withdrawal bleed typically occurs. A new ring goes in one week after the last one was removed — on the same day of the week. The exact placement inside the vagina doesn't matter for effectiveness.
- EnilloRing can be inserted by hand or with an optional applicator included with the product
- If the ring comes out accidentally, rinse it with cool water and reinsert it as soon as possible — check your product's specific guidance for what to do if it's out for an extended time
- Always follow your prescriber's instructions and the product's full directions for use
🤒Side effects — in detail▾
The most commonly reported side effects in clinical trials were:
- Vaginitis (vaginal irritation or infection)
- Headache, including migraine
- Mood changes — depression, mood swings, or low mood
- Device-related events — discomfort, a foreign body sensation, or the ring coming out
- Nausea or vomiting
- Vaginal discharge or discomfort
- Weight gain
- Breast pain or tenderness
- Painful periods (dysmenorrhea)
- Acne
- Decreased libido (sex drive)
More serious reactions — including deep vein thrombosis (blood clot in the leg), severe allergic reactions, and gallbladder problems — have been reported and require prompt medical attention.
⚠️Warnings & precautions▾
- Blood clots, stroke, and heart attack: Using combination hormonal contraceptives raises the risk of dangerous blood clots, stroke, and heart attack — especially in women who smoke, are over 35, have high blood pressure, or have other cardiovascular risk factors. Stop using the ring and get emergency care if you have chest pain, sudden severe headache, vision changes, or leg pain and swelling.
- Smoking over age 35: Women over 35 who smoke must not use this ring. The combined risk is serious and potentially fatal.
- Liver problems: The ring is not for women with liver disease or liver tumors. Stop using it if you develop jaundice (yellowing of the skin or eyes).
- Toxic shock syndrome (TSS): Rare cases have been reported in ring users, sometimes in those also using tampons. Seek care immediately for high fever, vomiting, sunburn-like rash, or dizziness.
- High blood pressure: The ring can raise blood pressure. Women with well-controlled hypertension should be monitored; it must not be used by those with uncontrolled hypertension.
- Surgery or prolonged immobility: Stop the ring at least 4 weeks before major surgery and don't restart until 2 weeks after you're mobile again, due to increased clot risk.
- Vaginal irritation: In some cases the ring has adhered to vaginal tissue and required removal by a healthcare provider. Tell your doctor if you notice persistent discomfort or irritation.
🔀What it interacts with▾
Several drugs and products can interact with this ring — either making it less effective or raising hormone levels:
- Enzyme-inducing medications (phenytoin, carbamazepine, rifampin, topiramate, and others) — lower hormone levels and can make the ring fail to prevent pregnancy; use a backup non-hormonal method
- St. John's Wort (herbal supplement) — can reduce the ring's effectiveness; avoid or use backup contraception
- Vaginal miconazole (antifungal) — can raise hormone levels from the ring by up to 40%
- Hepatitis C drugs containing ombitasvir/paritaprevir/ritonavir — must NOT be used at the same time as the ring; can cause dangerous liver enzyme spikes
- HIV antivirals and HCV protease inhibitors — can significantly raise or lower hormone levels; discuss with your provider
- Atorvastatin — can raise ethinyl estradiol levels moderately
- Lamotrigine (seizure medication) — the ring can lower lamotrigine levels, potentially reducing seizure control; dose adjustments may be needed
- Thyroid hormone replacement — the ring can increase thyroid-binding globulin; some women may need higher thyroid doses
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Women over 35 who smoke must not use this ring — the cardiovascular risk is too high
- Do not use if you have a history of blood clots, stroke, heart attack, or coronary artery disease
- Do not use if you have uncontrolled high blood pressure or diabetes with vascular complications
- Do not use if you have liver disease, benign or malignant liver tumors
- Do not use if you have unexplained abnormal uterine bleeding
- Do not use if you have or have had breast cancer
- Do not use if you are pregnant
- Do not use with hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir
- Breastfeeding mothers: the ring is not recommended as it may reduce milk production; a non-estrogen option is preferred until weaning is complete
- Adolescents after their first period (menarche): efficacy is expected to be the same as in adults; the ring is not for use before menarche
- Women with migraines with aura, or any migraines if over 35, should not use the ring
- If you have liver or kidney problems, discuss with your doctor — the ring has not been formally studied in these populations
- Tell your doctor if you have gallbladder disease, as combination hormonal contraceptives may worsen it
🚑If you take too much▾
If a ring breaks, it does not release a higher dose of hormones. There are no reports of serious harm from overdose with combination hormonal contraceptives. Too much exposure may cause nausea or withdrawal bleeding. If you suspect an overdose, remove all rings and contact a healthcare provider for guidance.
📡Pharmacodynamics — effects in the body▾
Ethinyl estradiol and etonogestrel suppress gonadotropins — the hormones that trigger ovulation — so eggs are not released. The combination also thickens cervical mucus to block sperm and changes the uterine lining to reduce the chance of implantation. Together, these effects provide multiple mechanisms of pregnancy prevention.
🔬Pharmacokinetics — how your body processes it▾
Both hormones are absorbed rapidly through the vaginal wall. Etonogestrel reaches nearly complete (approximately 100%) bioavailability by this route, while ethinyl estradiol reaches about 56% — similar to oral dosing. Both are processed (metabolized) in the liver by an enzyme called CYP3A4 and are cleared from the body mainly through urine, bile, and feces. Etonogestrel has an elimination half-life of about 29 hours; ethinyl estradiol's is about 45 hours, meaning both stay active in the body for one to two days after removal.
📦How to store it▾
Prior to dispensing to the user, store refrigerated 2°C to 8°C (36°F to 46°F). stored for up to 4 months at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F) .
📄 Written from Ethinyl Estradiol / Etonogestrel’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Ethinyl Estradiol / Etonogestrel — the kind of thing our pharmacy team would talk through with you at the counter.
How exactly do I use this ring — do I need to place it in a specific spot? ▾
What should I do if the ring slips out? ▾
What side effects should I expect, and which ones mean I need to call a doctor? ▾
I take other medications — will they affect how well the ring works? ▾
Can I use this ring if I'm breastfeeding? ▾
I'm a smoker. Is this ring safe for me? ▾
Is Ethinyl Estradiol / Etonogestrel available over the counter? ▾
When was Ethinyl Estradiol / Etonogestrel first available? ▾
Who makes Ethinyl Estradiol / Etonogestrel? ▾
💬 Answers drafted from Ethinyl Estradiol / Etonogestrel’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Ethinyl Estradiol / Etonogestrel comes
Ethinyl Estradiol / Etonogestrel is available in 2 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Vaginal insert
How this form is used
- EluRyng is used vaginally to prevent pregnancy in females of reproductive age
- EnilloRing is used vaginally to prevent pregnancy in females of reproductive age
- Etonogestrel/Ethinyl Estradiol Vaginal Ring (generic) is used vaginally to prevent pregnancy in females of reproductive age
- Etonogestrel and Ethinyl Estradiol vaginal ring (generic) is used vaginally to prevent pregnancy in females of reproductive age
- Insert one ring into the vagina and leave it in place continuously for three weeks, then remove it for a one-week ring-free break
- EnilloRing may be inserted by hand or with its optional applicator — follow the Instructions for Use provided with the product
- EluRyng: after removal, place the used ring in its foil pouch and discard in a waste receptacle — do not flush
- Insert the new ring on the same day of the week as the previous ring was removed, approximately one week later
Insert or device
📊 Ethinyl Estradiol / Etonogestrel across the U.S. market
How Ethinyl Estradiol / Etonogestrel appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
📈 How widely Ethinyl Estradiol / Etonogestrel is used
A general measure of how commonly Ethinyl Estradiol / Etonogestrel is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Ethinyl Estradiol / Etonogestrel is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Ethinyl Estradiol / Etonogestrel prescribed? Of the 1,596 medications we measure, Ethinyl Estradiol / Etonogestrel ranks #325 by Medicaid prescriptions — more than 80% of them.
Utilization by Ethinyl Estradiol / Etonogestrel product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
21 DAY ethinyl estradiol 0.000625 MG/HR / etonogestrel 0.005 MG/HR Vaginal System
Summed across the 6 of 19 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1367436
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Ethinyl Estradiol / Etonogestrel, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 6 of 19 listed Ethinyl Estradiol / Etonogestrel NDCs with Medicaid activity.
🔍 Compare Ethinyl Estradiol / Etonogestrel products
A representative set of FDA-listed product records for Ethinyl Estradiol / Etonogestrel — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Insert or device | ||||
| ETONOGESTREL 11.7 mg/1; ETHINYL ESTRADIOL 2.7 mg | — | N.V. Organon | DRUG FOR FURTHER PROCESSING | View NDC → |
| 💊Vaginal insert | ||||
| ETONOGESTREL 0.12 mg/d; ETHINYL ESTRADIOL 0.015 mg/d | Vaginal | A-S Medication Solutions × 2 listings | NDA | View NDC → |
| ETONOGESTREL 0.12 mg/d; ETHINYL ESTRADIOL 0.015 mg/d | Vaginal | A-S Medication Solutions | NDA AUTHORIZED GENERIC | View NDC → |
| 0.015; 0.12 mg/d; mg/d | Vaginal | A-S Medication Solutions × 3 listings | NDA | View NDC → |
| 0.015; 0.12 mg/d; mg/d | Vaginal | A-S Medication Solutions | NDA AUTHORIZED GENERIC | View NDC → |
| ETONOGESTREL 0.12 mg/d; ETHINYL ESTRADIOL 0.015 mg/d | Vaginal | Advanz Pharma (US) Corp. | NDA | View NDC → |
| ETONOGESTREL 0.12 mg/d; ETHINYL ESTRADIOL 0.015 mg/d | Vaginal | Amneal Pharmaceuticals LLC | ANDA | View NDC → |
| 0.015; 0.12 mg/d; mg/d | Vaginal | Amneal Pharmaceuticals LLC × 2 listings | ANDA | View NDC → |
| ETHINYL ESTRADIOL 0.015 mg/d; ETONOGESTREL 0.12 mg/d | Vaginal | AvKARE × 2 listings | ANDA | View NDC → |
| 0.015; 0.12 mg/d; mg/d | Vaginal | AvKARE | ANDA | View NDC → |
| ETHINYL ESTRADIOL 0.015 mg/d; ETONOGESTREL 0.12 mg/d | Vaginal | Northstar Rx LLC | ANDA | View NDC → |
| 0.015; 0.12 mg/d; mg/d | Vaginal | Northstar Rx LLC | ANDA | View NDC → |
| ETONOGESTREL 0.12 mg/d; ETHINYL ESTRADIOL 0.015 mg/d | Vaginal | Organon LLC | NDA | View NDC → |
| 0.015; 0.12 mg/d; mg/d | Vaginal | Organon LLC × 2 listings | NDA | View NDC → |
| ETONOGESTREL 0.12 mg/d; ETHINYL ESTRADIOL 0.015 mg/d | Vaginal | Prasco Laboratories | NDA AUTHORIZED GENERIC | View NDC → |
| 0.015; 0.12 mg/d; mg/d | Vaginal | Prasco Laboratories × 2 listings | NDA AUTHORIZED GENERIC | View NDC → |
| ETONOGESTREL 0.12 mg/d; ETHINYL ESTRADIOL 0.015 mg/d | Vaginal | Teva Pharmaceuticals USA, Inc. | ANDA | View NDC → |
| 0.015; 0.12 mg/d; mg/d | Vaginal | Teva Pharmaceuticals USA, Inc. | ANDA | View NDC → |
| ETHINYL ESTRADIOL 0.015 mg/d; ETONOGESTREL 0.12 mg/d | Vaginal | Xiromed, LLC | ANDA | View NDC → |
| 0.015; 0.12 mg/d; mg/d | Vaginal | Xiromed, LLC | ANDA | View NDC → |
Showing 27 of 27 products — FDA National Drug Code Directory. See every product, package size and price: browse all 27 Ethinyl Estradiol / Etonogestrel NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Ethinyl Estradiol / Etonogestrel — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Ethinyl Estradiol / Etonogestrel in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Ethinyl Estradiol / Etonogestrel went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one exact multiple-ingredient concept (MIN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). A product with a different ingredient combination belongs on a different page.
RxCUI 352376 1 dose form · 1 strength
-
Dose form (SCDF) Vaginal System RxCUI 2201658In current FDA listingsClinical drug / strength (SCD) 21 DAY ethinyl estradiol 0.000625 MG/HR / etonogestrel 0.005 MG/HRRxCUI 1367436
Look up RxCUI 352376 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Ethinyl Estradiol / Etonogestrel is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Ethinyl Estradiol / Etonogestrel belongs to the Progestin class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 11 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Prasco Laboratories is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.