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mylan pharmaceuticals inc. - drospirenone (unii: n295j34a25) (drospirenone - unii:n295j34a25), ethinyl estradiol (unii: 423d2t571u) (ethinyl estradiol - unii:423d2t571u) - drospirenone and ethinyl estradiol tablets are indicated for use by females of reproductive potential to prevent pregnancy. drospirenone and ethinyl estradiol tablets are also indicated for the treatment of symptoms of premenstrual dysphoric disorder (pmdd) in females of reproductive potential who choose to use an oral contraceptive as their method of contraception. the effectiveness of drospirenone and ethinyl estradiol tablets for pmdd when used for more than three menstrual cycles has not been evaluated. the essential features of pmdd according to the diagnostic and statistical manual-4th edition (dsm-iv) include markedly depressed mood, anxiety or tension, affective lability, and persistent anger or irritability. other features include decreased interest in usual activities, difficulty concentrating, lack of energy, change in appetite or sleep, and feeling out of control. physical symptoms associated with pmdd include breast tenderness, headache, joint and muscle pain, bloating and weight gain. in this di

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jubilant cadista pharmaceuticals inc - drospirenone (unii: n295j34a25) (drospirenone - unii:n295j34a25), ethinyl estradiol (unii: 423d2t571u) (ethinyl estradiol - unii:423d2t571u) - drospirenone and ethinyl estradiol tablets are indicated for use by women to prevent pregnancy.  drospirenone and ethinyl estradiol tablets are also indicated for the treatment of symptoms of premenstrual dysphoric disorder (pmdd) in women who choose to use an oral contraceptive as their method of contraception. the effectiveness of drospirenone and ethinyl estradiol tablets for pmdd when used for more than three menstrual cycles has not been evaluated. the essential features of pmdd according to the diagnostic and statistical manual-4th edition (dsm-iv) include markedly depressed mood, anxiety or tension, affective lability, and persistent anger or irritability. other features include decreased interest in usual activities, difficulty concentrating, lack of energy, change in appetite or sleep, and feeling out of control. physical symptoms associated with pmdd include breast tenderness, headache, joint and muscle pain, bloating and weight gain. in this disorder, these symptoms occur regularly during the lute

United States - English - NLM (National Library of Medicine)

afaxys pharma, llc - drospirenone (unii: n295j34a25) (drospirenone - unii:n295j34a25), ethinyl estradiol (unii: 423d2t571u) (ethinyl estradiol - unii:423d2t571u) - jasmiel® is indicated for use by females of reproductive potential to prevent pregnancy. jasmiel is also indicated for the treatment of symptoms of premenstrual dysphoric disorder (pmdd) in females of reproductive potential who choose to use an oral contraceptive as their method of contraception. the effectiveness of jasmiel for pmdd when used for more than three menstrual cycles has not been evaluated. the essential features of pmdd according to the diagnostic and statistical manual-4th edition (dsm-iv) include markedly depressed mood, anxiety or tension, affective lability, and persistent anger or irritability. other features include decreased interest in usual activities, difficulty concentrating, lack of energy, change in appetite or sleep, and feeling out of control. physical symptoms associated with pmdd include breast tenderness, headache, joint and muscle pain, bloating and weight gain. in this disorder, these symptoms occur regularly during the luteal phase and remit within a few days following onset of menses; the disturbance markedly interferes with work or school, or with usual social activities and relationships with others. diagnosis is made by healthcare providers according to dsm-iv criteria, with symptomatology assessed prospectively over at least two menstrual cycles. in making the diagnosis, care should be taken to rule out other cyclical mood disorders. jasmiel has not been evaluated for the treatment of premenstrual syndrome (pms). jasmiel is indicated for the treatment of moderate acne vulgaris in women at least 14 years of age, who have no known contraindications to oral contraceptive therapy and have achieved menarche. jasmiel should be used for the treatment of acne only if the patient desires an oral contraceptive for birth control. jasmiel is contraindicated in females who are known to have or develop the following conditions: - renal impairment - adrenal insufficiency - a high risk of arterial or venous thrombotic diseases. examples include women who are known to: smoke, if over age 35 [see  boxed warning   and  warnings and precautions (5.1) ] have deep vein thrombosis or pulmonary embolism, now or in the past [see warnings and precautions (5.1) ] have cerebrovascular disease [see warnings and precautions (5.1) ] have coronary artery disease [see warnings and precautions (5.1) ] have thrombogenic valvular or thrombogenic rhythm diseases of the heart (for example, subacute bacterial endocarditis with valvular disease, or atrial fibrillation) [see warnings and precautions (5.1) ] have inherited or acquired hypercoagulopathies [see warnings and precautions (5.1) ] have uncontrolled hypertension [see warnings and precautions (5.6) ] have diabetes mellitus with vascular disease [see warnings and precautions (5.8) ] have headaches with focal neurological symptoms or have migraine headaches with or without aura if over age 35 [see warnings and precautions (5.9) ] - smoke, if over age 35 [see  boxed warning   and  warnings and precautions (5.1) ] - have deep vein thrombosis or pulmonary embolism, now or in the past [see warnings and precautions (5.1) ] - have cerebrovascular disease [see warnings and precautions (5.1) ] - have coronary artery disease [see warnings and precautions (5.1) ] - have thrombogenic valvular or thrombogenic rhythm diseases of the heart (for example, subacute bacterial endocarditis with valvular disease, or atrial fibrillation) [see warnings and precautions (5.1) ] - have inherited or acquired hypercoagulopathies [see warnings and precautions (5.1) ] - have uncontrolled hypertension [see warnings and precautions (5.6) ] - have diabetes mellitus with vascular disease [see warnings and precautions (5.8) ] - have headaches with focal neurological symptoms or have migraine headaches with or without aura if over age 35 [see warnings and precautions (5.9) ] - undiagnosed abnormal uterine bleeding [see warnings and precautions (5.10) ] - current diagnosis of, or history of, breast cancer, which may be hormone-sensitive [see warnings and precautions (5.3) ] - liver tumors, benign or malignant, or liver disease [see warnings and precautions (5.4)   and  use in specific populations (8.7) ] - use of hepatitis c drug combinations containing ombitasvir, paritaprevir/ritonavir, with or without dasabuvir due to the potential for alt elevations [see warnings and precautions (5.5) and drug interactions (7.3) ]. risk summary there is no use for contraception in pregnancy; therefore, jasmiel should be discontinued during pregnancy. epidemiologic studies and meta-analyses have not found an increased risk of genital or non-genital birth defects (including cardiac anomalies and limb-reduction defects) following exposure to chcs before conception or during early pregnancy. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4 percent and 15 to 20 percent, respectively. data human data a retrospective database study of women in norway, that included 44,734 pregnancies of which 368 were women who inadvertently took drsp/ee during the first trimester of a pregnancy, found there were no adverse effects on pre-term birth, small for gestational age, or birth weight z-scores. post-marketing adverse event data on the use of jasmiel in pregnant women suggest that frequencies of miscarriage and congenital anomalies were not higher than the estimated background risk in the general population. risk summary drsp is present in human milk. after a single oral administration of 3 mg drsp/0.03 mg ee tablets, drsp concentration in breast milk over the 24-h period ranged from 1.4 to 7 ng/ml, with a mean ± standard deviation value of 3.7 ± 1.9 ng/ml. the estimated mean infant dose was 0.003 mg/day, which is about 0.1% of maternal dose (see data). there is limited information on the effects of jasmiel on the breast-fed infant. chcs can reduce milk production in breast-­feeding females. this reduction can occur at any time but is less likely to occur once breast-feeding is well-established. when possible, advise the nursing female to use other methods of contraception until she discontinues breast-feeding [see also dosage and administration (2.2)]. the developmental and health benefits of breast-feeding should be considered along with the mother’s clinical need for jasmiel and any potential adverse effects on the breast-fed child from jasmiel or from the underlying maternal condition. data human data an open-label study evaluated the degree of drsp transfer into milk within 72 hours following a single oral administration of 3 mg drsp/0.03 mg ee tablets to 6 healthy lactating women who were 1 week to 3 months post­-partum. drsp was present in breast milk with a mean cmax of 13.5 ng/ml, while the mean cmax in serum of lactating women was 30.8 ng/ml. the drsp concentration in breast milk over the 24-hour period following dosing ranged from 1.4 to 7 ng/ml, with a mean ± standard deviation value of 3.7 ± 1.9 ng/ml. based on single dose data, the maximal daily infant dose of drsp was calculated to be 0.003 mg/day, which represented a mean of 0.1% of the maternal dose. safety and efficacy of jasmiel has been established in women of reproductive age. efficacy is expected to be the same for postpubertal adolescents under the age of 18 and for users 18 years and older. use of this product before menarche is not indicated. jasmiel has not been studied in postmenopausal women and is not indicated in this population. jasmiel is contraindicated in patients with renal impairment [see contraindications (4)  and  warnings and precautions (5.2)] . in subjects with creatinine clearance (clcr) of 50 to 79 ml/min, serum drsp levels were comparable to those in a control group with clcr ≥ 80 ml/min. in subjects with clcr of 30 to 49 ml/min, serum drsp concentrations were on average 37% higher than those in the control group. in addition, there is a potential to develop hyperkalemia in subjects with renal impairment whose serum potassium is in the upper reference range, and who are concomitantly using potassium sparing drugs [see clinical pharmacology (12.3)] . jasmiel is contraindicated in patients with hepatic disease [see contraindications (4) and warnings and precautions (5.4)] . the mean exposure to drsp in women with moderate liver impairment is approximately three times higher than the exposure in women with normal liver function. jasmiel has not been studied in women with severe hepatic impairment. no clinically significant difference was observed between the pharmacokinetics of drsp or ee in japanese versus caucasian women [see clinical pharmacology (12.3)] .

United States - English - NLM (National Library of Medicine)

jubilant cadista pharmaceuticals inc - drospirenone (unii: n295j34a25) (drospirenone - unii:n295j34a25), ethinyl estradiol (unii: 423d2t571u) (ethinyl estradiol - unii:423d2t571u) - drospirenone and ethinyl estradiol tablets are indicated for use by women to prevent pregnancy. do not prescribe drospirenone and ethinyl estradiol tablets to women who are known to have the following: - renal impairment - adrenal insufficiency - a high risk of arterial or venous thrombotic diseases. examples include women who are known to: smoke, if over age 35 [see boxed warning and warnings and precautions (5.1)] have deep vein thrombosis or pulmonary embolism, now or in the past [see warnings and precautions (5.1)] have cerebrovascular disease [see warnings and precautions (5.1)] have coronary artery disease [see warnings and precautions (5.1)] have thrombogenic valvular or thrombogenic rhythm diseases of the heart (for example, subacute bacterial endocarditis with valvular disease, or atrial fibrillation) [see warnings and precautions (5.1)] have inherited or acquired hypercoagulopathies [see warnings and precautions (5.1)] have uncontrolled hypertension [see warnings and precautions (5.5)]

United States - English - NLM (National Library of Medicine)

camber pharmaceuticals, inc. - drospirenone (unii: n295j34a25) (drospirenone - unii:n295j34a25), ethinyl estradiol (unii: 423d2t571u) (ethinyl estradiol - unii:423d2t571u) - drospirenone and ethinyl estradiol tablets are indicated for use by females of reproductive potential to prevent pregnancy. drospirenone and ethinyl estradiol tablets are also indicated for the treatment of symptoms of premenstrual dysphoric disorder (pmdd) in females of reproductive potential who choose to use an oral contraceptive as their method of contraception. the effectiveness of drospirenone and ethinyl estradiol tablets for pmdd when used for more than three menstrual cycles has not been evaluated. the essential features of pmdd according to the diagnostic and statistical manual-4th edition (dsm-iv) include markedly depressed mood, anxiety or tension, affective lability, and persistent anger or irritability. other features include decreased interest in usual activities, difficulty concentrating, lack of energy, change in appetite or sleep, and feeling out of control. physical symptoms associated with pmdd include breast tenderness, headache, joint and muscle pain, bloating and weight gain.  in

United States - English - NLM (National Library of Medicine)

lupin pharmaceuticals, inc. - ethinyl estradiol (unii: 423d2t571u) (ethinyl estradiol - unii:423d2t571u), drospirenone (unii: n295j34a25) (drospirenone - unii:n295j34a25) - nikki™ (drospirenone and ethinyl estradiol tablets usp), 3 mg/0.02 mg is indicated for use by females of reproductive potential  to prevent pregnancy. nikki (drospirenone and ethinyl estradiol tablets usp), 3 mg/0.02 mg is also indicated for the treatment of symptoms of premenstrual dysphoric disorder (pmdd) in females of reproductive potential who choose to use an oral contraceptive as their method of contraception. the effectiveness of nikki (drospirenone and ethinyl estradiol tablets usp), 3 mg/0.02 mg for pmdd when used for more than three menstrual cycles has not been evaluated. the essential features of pmdd according to the diagnostic and statistical manual-4th edition (dsm-iv) include markedly depressed mood, anxiety or tension, affective lability, and persistent anger or irritability. other features include decreased interest in usual activities, difficulty concentrating, lack of energy, change in appetite or sleep, and feeling out of control. physical symptoms associated with pmdd include breast tenderness, headache, joint and muscle pain, bloating and weight gain. in this disorder, these symptoms occur regularly during the luteal phase and remit within a few days following onset of menses; the disturbance markedly interferes with work or school, or with usual social activities and relationships with others. diagnosis is made by healthcare providers according to dsm-iv criteria, with symptomatology assessed prospectively over at least two menstrual cycles. in making the diagnosis, care should be taken to rule out other cyclical mood disorders. nikki (drospirenone and ethinyl estradiol tablets usp), 3 mg/0.02 mg has not been evaluated for the treatment of premenstrual syndrome (pms). nikki (drospirenone and ethinyl estradiol tablets usp), 3 mg/0.02 mg is indicated for the treatment of moderate acne vulgaris in women at least 14 years of age, who have no known contraindications to oral contraceptive therapy and have achieved menarche. nikki (drospirenone and ethinyl estradiol tablets usp), 3 mg/0.02 mg should be used for the treatment of acne only if the patient desires an oral contraceptive for birth control. nikki is contraindicated in females who are known to have or develop the following conditions: - renal impairment - adrenal insufficiency - a high risk of arterial or venous thrombotic diseases. examples include women who are known to:           о smoke, if over age 35 [see boxed warning and warnings and precautions (5.1)]           о have deep vein thrombosis or pulmonary embolism, now or in the past [see warnings and precautions (5.1)]           о have cerebrovascular disease [see warnings and precautions (5.1)]           о have coronary artery disease [see warnings and precautions (5.1)]           о have thrombogenic valvular or thrombogenic rhythm diseases of the heart (for example, subacute bacterial endocarditis with valvular disease, or atrial fibrillation) [see warnings and precautions (5.1)]           о have inherited or acquired hypercoagulopathies [see warnings and precautions (5.1)]           о have uncontrolled hypertension [see warnings and precautions (5.6)]           о have diabetes mellitus with vascular disease [see warnings and precautions (5.8)]           о have headaches with focal neurological symptoms or have migraine headaches with or without aura if over age 35 [see warnings and precautions (5.9)] - undiagnosed abnormal uterine bleeding [see warnings and precautions (5.10)] - current diagnosis of, or history of, breast cancer, which maybe hormone sensitive [see warnings and precautions (5.3)] - liver tumors, benign or malignant, or liver disease [see warnings and precautions (5.4) and use in specific populations (8.7)] - use of hepatitis c drug combinations containing ombitasvir, paritaprevir/ritonavir, with or without dasabuvir due to the potential for alt elevations [see warnings and precautions (5.5) and drug interactions (7.3)]. risk summary there is no use for contraception in pregnancy; therefore, nikki should be discontinued during pregnancy. epidemiologic studies and meta-analyses have not found an increased risk of genital or non-genital birth defects (including cardiac anomalies and limb-reduction defects) following exposure to chcs before conception or during early pregnancy. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4 percent and 15 to 20 percent, respectively. data human data a retrospective database study of women in norway, that included 44,734 pregnancies of which 368 were women who inadvertently took drsp/ee during the first trimester of a pregnancy, found there were no adverse effects on pre-term birth, small for gestational age, or birth weight z-scores. post-marketing adverse event data on the use of nikki in pregnant women suggest that frequencies of miscarriage and congenital anomalies were not higher than the estimated background risk in the general population. risk summary drsp is present in human milk. after a single oral administration of 3 mg drsp/0.03 mg ee tablets, drsp concentration in breast milk over the 24-h period ranged from 1.4 to 7.0 ng/ml, with a mean ± standard deviation value of 3.7 ± 1.9 ng/ml. the estimated mean infant dose was 0.003 mg/day, which is about 0.1% of maternal dose (see data). there is limited information on the effects of nikki on the breast-fed infant. chcs can reduce milk production in breast-feeding females. this reduction can occur at any time but is less likely to occur once breast-feeding is well-established. when possible, advise the nursing female to use other methods of contraception until she discontinues breast-feeding [see also dosage and administration (2.2)]. the developmental and health benefits of breast-feeding should be considered along with the mother's clinical need for nikki and any potential adverse effects on the breast-fed child from nikki or from the underlying maternal condition. data human  data an open-label study evaluated the degree of drsp transfer into milk within 72 hours following a single oral administration of 3 mg drsp/0.03 mg ee tablets to 6 healthy lactating women who were 1 week to 3 months post-partum. drsp was present in breast milk with a mean cmax of 13.5 ng/ml, while the mean cmax in serum of lactating women was 30.8 ng/ml. the drsp concentration in breast milk over the 24-hour period following dosing ranged from 1.4 to 7.0 ng/ml, with a mean ± standard deviation value of 3.7 ± 1.9 ng/ml. based on single dose data, the maximal daily infant dose of drsp was calculated to be 0.003 mg/day, which represented a mean of 0.1% of the maternal dose. safety and efficacy of nikki have been established in women of reproductive age. efficacy is expected to be the same for postpubertal adolescents under the age of 18 and for users 18 years and older. use of this product before menarche is not indicated. nikki has not been studied in postmenopausal women and is not indicated in this population. nikki is contraindicated in patients with renal impairment [see contraindications (4) and warning and precautions (5.2)]. in subjects with creatinine clearance (clcr) of 50 to 79 ml/min, serum drsp levels were comparable to those in a control group with clcr ≥80 ml/min. in subjects with clcr of 30 to 49 ml/min, serum drsp concentrations were on average 37% higher than those in the control group. in addition, there is a potential to develop hyperkalemia in subjects with renal impairment whose serum potassium is in the upper reference range, and who are concomitantly using potassium sparing drugs [see clinical pharmacology (12.3)]. nikki is contraindicated in patients with hepatic disease [see contraindications (4) and warning and precautions (5.4)]. the mean exposure to drsp in women with moderate liver impairment is approximately three times higher than the exposure in women with normal liver function. nikki has not been studied in women with severe hepatic impairment. no clinically significant difference was observed between the pharmacokinetics of drsp or ee in japanese versus caucasian women [see clinical pharmacology (12.3)].

United States - English - NLM (National Library of Medicine)

amneal pharmaceuticals llc - etonogestrel (unii: 304gth6rnh) (etonogestrel - unii:304gth6rnh), ethinyl estradiol (unii: 423d2t571u) (ethinyl estradiol - unii:423d2t571u) - for vaginal use only eluryng™ is indicated for use by females of reproductive age to prevent pregnancy. eluryng is contraindicated in females who are known to have or develop the following conditions: - a high risk of arterial or venous thrombotic diseases. examples include women who are known to: - smoke, if over age 35 [see boxed warning  and warnings and precautions (5.1) ] - have deep vein thrombosis or pulmonary embolism, now or in the past [see warnings and precautions (5.1)] - have cerebrovascular disease [see warnings and precautions (5.1)] - have coronary artery disease [see warnings and precautions (5.1)] - have thrombogenic valvular or thrombogenic rhythm diseases of the heart (for example, subacute bacterial endocarditis with valvular disease, or atrial fibrillation) [see warnings and precautions (5.1)] - have inherited or acquired hypercoagulopathies [see warnings and precautions (5.1)] - have uncontrolled hypertension [see warnings and precautions (5.5)] - have diabetes mellitus with vascular disease [see warnings and precautions (5.9)] - have headaches with focal neurological symptoms or migraine headaches with aura [see warnings and precautions (5.10)] women over age 35 with any migraine headaches [see warnings and precautions (5.10)] - women over age 35 with any migraine headaches [see warnings and precautions (5.10)] - liver tumors, benign or malignant or liver disease [see warnings and precautions (5.3)  and use in specific populations (8.6) ] - undiagnosed abnormal uterine bleeding [see warnings and precautions (5.11)] - pregnancy, because there is no reason to use chcs during pregnancy [see use in specific populations (8.1) ] - current diagnosis of, or history of, breast cancer, which may be hormone-sensitive [see warnings and precautions (5.14)] - hypersensitivity reactions, including anaphylaxis and angioedema, to any of the components of eluryng [see warnings and precautions (5.6)  and adverse reactions (6)] -   use of hepatitis c drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, due to potential for alt elevations [see warnings and precautions (5.4)] . risk summary eluryng is contraindicated during pregnancy because there is no need for pregnancy prevention in a woman who is already pregnant. epidemiologic studies and meta-analyses have not shown an increased risk of genital or non-genital birth defects (including cardiac anomalies and limb-reduction defects) following maternal exposure to low dose chcs prior to conception or during early pregnancy. no adverse developmental outcomes were observed in pregnant rats and rabbits with the administration of etonogestrel during organogenesis at doses approximately 300 times the anticipated daily vaginal human dose (~0.002 mg/kg/day). no adverse developmental outcomes were observed in pregnant rats and rabbits with the co-administration of the combination desogestrel/ethinyl estradiol during organogenesis at desogestrel/ethinyl estradiol doses at least 2/5 times, respectively, the anticipated daily vaginal human dose (~0.002 desogestrel/0.00025 ethinyl estradiol mg/kg/day). discontinue eluryng use if pregnancy is confirmed. data animal data in rats and rabbits at dosages up to 300 times the anticipated dose, etonogestrel is neither embryotoxic nor teratogenic. co-administration of a maternally toxic dose of desogestrel/ethinyl estradiol to pregnant rats was associated with embryolethality and wavy ribs at a desogestrel/ethinyl estradiol dose that was 40/130 times, respectively, the anticipated vaginal human dose (0.002 desogestrel/0.00025 ethinyl estradiol mg/kg/day). no adverse embryofetal effects were observed when the combination was administered to pregnant rats at a desogestrel/ethinyl estradiol dose that was 4/13 times, respectively, the anticipated vaginal human dose. when desogestrel/ethinyl estradiol was given to pregnant rabbits, pre-implantation loss was observed at a desogestrel/ethinyl estradiol dose that was 3/10 times, respectively, the anticipated vaginal human dose. no adverse embryofetal effects were observed when the combination was administered to pregnant rabbits at a desogestrel/ethinyl estradiol dose that was 2/5 times the anticipated vaginal human dose. risk summary small amounts of contraceptive steroids and/or metabolites, including etonogestrel and ethinyl estradiol are transferred to human milk. harmful effects have not been observed in breastfed infants exposed to chcs through breast milk. chcs can reduce milk production in breastfeeding mothers. this is less likely to occur once breastfeeding is well-established; however, it can occur at any time in some women. when possible, advise the nursing mother to use non-estrogen-containing contraception until she has completely weaned her child. the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for eluryng and any potential adverse effects on the breastfed child from eluryng or from the underlying maternal condition. safety and efficacy of eluryng have been established in women of reproductive age. efficacy is expected to be the same for postpubertal adolescents under the age of 18 and for users 18 years and older. use of this product before menarche is not indicated. eluryng has not been studied in postmenopausal women and is not indicated in this population. the effect of hepatic impairment on the pharmacokinetics of eluryng has not been studied. steroid hormones may be poorly metabolized in patients with impaired liver function. acute or chronic disturbances of liver function may necessitate the discontinuation of chc use until markers of liver function return to normal [see contraindications (4)  and warnings and precautions (5.3) ]. the effect of renal impairment on the pharmacokinetics of eluryng has not been studied. eluryng ™ (el’ue ring) (etonogestrel and ethinyl estradiol vaginal ring) read these instructions for use before you start using eluryng and each time you get a refill. there may be new information. this information does not take the place of talking to your healthcare provider about your treatment. how should i start using eluryng? if you are not currently using hormonal birth control, you have 2 ways to start using eluryng. choose the best way for you: - first day start: insert eluryng on the first day of your menstrual period. you will not need to use another birth control method since you are using eluryng on the first day of your menstrual period. - day 2 to day 5 cycle start: you may choose to start eluryng on days 2 to 5 of your menstrual period. make sure you also use an extra method of birth control (barrier method), such as male condoms with spermicide for the first 7 days of eluryng use in the first cycle. if you are changing from a birth control pill or patch to eluryng: if you have been using your birth control method correctly and are certain that you are not pregnant, you can change to eluryng any day. do not start eluryng any later than the day you would start your next birth control pill or apply your patch. if you are changing from a progestin-only birth control method, such as a minipill, implant or injection or from an intrauterine system (ius): - you may switch from a minipill on any day. start using eluryng on the day that you would have taken your next minipill. - you should switch from an implant or the ius and start using eluryng on the day that you remove the implant or ius. - you should switch from an injectable and start using eluryng on the day when your next injection would be due. if you are changing from a minipill, implant or injection or from an intrauterine system (ius), you should use an extra method of birth control, such as a male condom with spermicide during the first 7 days of using eluryng. if you start using eluryng after an abortion or miscarriage: - following a first trimester abortion or miscarriage: you may start eluryng within 5 days following a first trimester abortion or miscarriage (the first 12 weeks of pregnancy). you do not need to use an additional birth control method . - if you do not start eluryng within 5 days after a first trimester abortion or miscarriage, use a non-hormonal birth control method, such as male condoms and spermicide, while you wait for your period to start. begin eluryng at the time of your next menstrual period. count the first day of your menstrual period as “day 1” and start eluryng one of the following 2 ways below. - first day start: insert eluryng on the first day of your menstrual period. you will not need to use another birth control method since you are using eluryng on the first day of your menstrual period. - day 2 to day 5 cycle start: you may choose to start eluryng on days 2 to 5 of your menstrual period. make sure you also use an extra method of birth control (barrier method), such as male condoms with spermicide for the first 7 days of eluryng use in the first cycle. - following a second trimester abortion or miscarriage: you may start using eluryng no sooner than 4 weeks (28 days) after a second trimester abortion (after the first 12 weeks of pregnancy). if you are starting eluryng after childbirth: - you may start using eluryng no sooner than 4 weeks (28 days) after having a baby if you are not breastfeeding. - if you have not gotten your menstrual period after childbirth, you should talk to your healthcare provider. you may need a pregnancy test to make sure you are not pregnant before you start using eluryng. - use another birth control method such as male condoms with spermicide for the first 7 days in addition to eluryng. if you are breastfeeding you should not use  eluryng. use other birth control methods until you are no longer breastfeeding. step 1. choose a position for insertion of eluryng. - choose the position that is comfortable for you. for example, lying down, squatting, or standing with 1 leg up (see figures a, b, and c) . positions for eluryng insertion                                                    figure a                                                 figure b                                         figure c step 2. open the pouch to remove your eluryng. - each eluryng comes in a re-sealable foil pouch. - wash and dry your hands before removing eluryng from the foil pouch. - open the foil pouch at either notch near the top. - keep the foil pouch so you can place your used eluryng in it before you throw it away in your household trash. step 3. prepare eluryng for insertion. - hold eluryng between your thumb and index finger and press the sides of the ring together (see figures d and e) .                                                    figure d                                                         figure e step 4. insert eluryng into your vagina. - insert the folded eluryng into your vagina and gently push it further up into your vagina using your index finger (see figures f and g). - when you insert eluryng it may be in different positions in your vagina, but eluryng does not have to be in an exact position for it to work (see figures h and i). - eluryng may move around slightly within your vagina. this is normal. although some women may be aware of eluryng in the vagina, most women do not feel it when it is in place.   figure f                                     figure g                                             figure h                                 figure i inserting eluryng (figure f, figure g) and positioning eluryng (figure h, figure i) note: - if the eluryng feels uncomfortable, you may not have pushed the ring into your vagina far enough. use your finger to gently push the eluryng as far as you can into your vagina. there is no danger of eluryng being pushed too far up in the vagina or getting lost (see figure g) . - some women have accidentally inserted eluryng into their bladder. if you have pain during or after insertion and you cannot find eluryng in your vagina, call your healthcare provider right away. - regularly check that eluryng is in your vagina (for example, before and after intercourse) to ensure you are protected from pregnancy. step 5. how do i remove eluryng? - wash and dry your hands. - choose the position that is most comfortable for you (see figures a, b, and c) . - put your index finger into your vagina and hook it through the eluryng. gently pull downward and forward to remove the eluryng and pull it out (see figure j) .                        figure j step 6. throw away the used eluryng. - place the used eluryng in the re-sealable foil pouch and put it in a trash can out of the reach of children and pets. - do not throw eluryng in the toilet. what else should i know about using eluryng? what if i leave eluryng in too long? - if you leave eluryng in your vagina for up to 4 weeks (28 days) you will still be getting pregnancy protection. remove your old eluryng for 1 week (7 days) and insert a new eluryng 1 week (7 days) later (see steps 1 through 4) . - if you leave eluryng in your vagina longer than 4 weeks (28 days), remove the ring and check to make sure you are not pregnant. if you are not pregnant, insert a new eluryng (see steps 1 through 4). you must use another birth control method, such as male condoms with spermicide, until the new eluryng has been used for 7 days in a row. what should i do if my eluryng comes out of my vagina? eluryng can slip or accidentally come out (expelled) of your vagina, for example, during sexual intercourse, bowel movements, use of tampons, or if it breaks. - eluryng may break causing the ring to lose its shape. if the ring stays in your vagina this should not lower eluryng’s effectiveness at preventing pregnancy. - if eluryng breaks and slips out of your vagina, throw the broken ring in your household trash out of the reach of children and pets. - insert a new eluryng (see steps 1 through 4) . - you should pay attention when removing a tampon to be sure that your eluryng is not accidentally pulled out. be sure to insert eluryng before inserting a tampon. if you accidentally pull out your eluryng while using tampons, rinse your eluryng in cool to lukewarm (not hot) water and insert it again right away. - be sure to insert eluryng before inserting a tampon. - if you accidentally pull out your eluryng while using tampons, rinse your eluryng in cool to lukewarm (not hot) water and insert it again right away. - eluryng can be pushed out of (expelled from) your vagina, for example, during sexual intercourse or during a bowel movement. if the expelled ring has been out of your vagina for less than 3 hours, rinse the expelled eluryng in cool to lukewarm (not hot) water and insert it again right away. if the expelled eluryng has been out of your vagina for more than 3 continuous hours: - if the expelled ring has been out of your vagina for less than 3 hours, rinse the expelled eluryng in cool to lukewarm (not hot) water and insert it again right away. - if the expelled eluryng has been out of your vagina for more than 3 continuous hours: - during weeks 1 and 2, you may not be protected from pregnancy. reinsert the ring as soon as you remember (see steps 1 through 4) . use another birth control method, such as male condoms with spermicide, until the ring has been in place for 7 days in a row. - during week 3, do not reinsert the eluryng that has been out of your vagina; but throw it away in your household trash away from children and pets. use another birth control method, such as male condoms with spermicide, until the new eluryng  has been used for 7 days in a row, following one of the two options below: -           option 1. insert a new ring right away to start your next 21 day eluryng use cycle. you may not have your regular period, but you may have spotting or vaginal bleeding. -           option 2. insert a new ring no later than 7 days from the time the previous ring was removed or expelled. during this time, you may have your period. note: you should only choose to do option 2 if you used eluryng for 7 days in a row, prior to the day that your previous eluryng was accidentally removed or expelled. - if eluryng was out of the vagina for an unknown amount of time, you may not be protected from pregnancy. perform a pregnancy test prior to inserting a new ring and consult your healthcare provider. this patient information and instructions for use have been approved by the u.s. food and drug administration. distributed by: amneal pharmaceuticals llc bridgewater, nj  08807 rev. 05-2022-03

United States - English - NLM (National Library of Medicine)

prasco laboratories - etonogestrel (unii: 304gth6rnh) (etonogestrel - unii:304gth6rnh), ethinyl estradiol (unii: 423d2t571u) (ethinyl estradiol - unii:423d2t571u) - for vaginal use only etonogestrel/ethinyl estradiol vaginal ring is indicated for use by females of reproductive age to prevent pregnancy. etonogestrel/ethinyl estradiol vaginal ring is contraindicated in females who are known to have or develop the following conditions: - a high risk of arterial or venous thrombotic diseases. examples include women who are known to: smoke, if over age 35 [see boxed warning and warnings and precautions (5.1)] have deep vein thrombosis or pulmonary embolism, now or in the past [see warnings and precautions (5.1)] have cerebrovascular disease [see warnings and precautions (5.1)] have coronary artery disease [see warnings and precautions (5.1)] have thrombogenic valvular or thrombogenic rhythm diseases of the heart (for example, subacute bacterial endocarditis with valvular disease, or atrial fibrillation) [see warnings and precautions (5.1)] have inherited or acquired hypercoagulopathies [see warnings and precautions (5.1)] have uncontrolled hypertension [see warnin

Israel - English - Ministry of Health

bayer israel ltd - drospirenone; ethinylestradiol as betadex clathrate; levomefolate calcium; levomefolate calcium - film coated tablets - levomefolate calcium 0.451 mg; ethinylestradiol as betadex clathrate 0.02 mg; drospirenone 3 mg; levomefolate calcium 0.451 mg - estradiol, combinations - - oral contraception. - treatment of symptoms of premenstrual dysphoric disorder (pmdd ) in women who choose to use an oral contraceptive as their method of birth control.- treatment of moderate acne vulgaris in women at least 14 years of age, who have no known contraindications to oral contraceptive therapy and have achieved menarche. - in women who choose to use an oral contraceptive as their method of contraception, to raise folate levels for the purpose of reducing the risk of a neural tube defect in a pregnancy conceived while taking the product or shortly after discontinuing the product.

Israel - English - Ministry of Health

bayer israel ltd - drospirenone; ethinylestradiol as betadex clathrate; levomefolate calcium; levomefolate calcium - film coated tablets - levomefolate calcium 0.451 mg; ethinylestradiol as betadex clathrate 0.03 mg; drospirenone 3 mg; levomefolate calcium 0.451 mg - estradiol, combinations - oral contraceptive. in women who choose to use an oral contraceptive as their method of contraception, to raise folate levels for the purpose of reducing the risk of a neural tube defect in a pregnancy conceived while taking the product or shortly after discontinuing the product.