What is Eluryng: Uses, Warnings & Interactions

How to take Eluryng

• A healthcare provider will demonstrate how to put in the ring. 

• Please read the Patient Information sheet and Instructions for Use included with the ring.

• Each EluRyng box contains three vaginal rings, enough for three months. These rings can be stored at room temperature (68-77°F) for up to four months.

  • Do not store it in temperatures exceeding 86˚F.

  • Avoid direct sunlight.

• If backup barrier birth control is necessary, do not use female barrier methods such as a diaphragm, cervical cap, or female condom.

How to start:

• When first starting EluRyng, you can insert the ring:

  • On day one of the menstrual cycle, barrier birth control is not necessary.

  • On days two to five of the menstrual cycle, use barrier birth control for seven days.

• Women on birth control pills can start EluRyng and quit taking pills at any time.

  • If the pills run out, EluRyng must be inserted the day after the last pill is taken.

• Ask the prescriber when to start EluRyng if you:

  • Are using a progestin-only mini-pill, implant, IUD, or injectable contraceptive

  • Have had a recent abortion or miscarriage

  • Have given birth

• Use backup barrier birth control for seven days after switching from progestin-only birth control.

• Twenty-one days after insertion, remove the ring on the same day at the same time it was inserted. 

• The next ring must be inserted on the same day of the week, exactly seven days after removal.

Insertion:

• Wash and dry your hands.

• Choose a comfortable position (sitting, standing, or lying down)

• Remove the ring from the pouch.

• Squeeze the sides of the ring together. 

• Insert the ring into the vagina.

• Use your index finger to push the ring deeper into the vagina.

• There is no correct position for the ring. It works anywhere inside the vagina.

• Once the ring is in place, most women don’t feel it. 

  • If the ring is uncomfortable, it may not be inserted far enough. With your index finger, gently push the ring farther into your vagina. 

  • If it’s painful, the ring may have been accidentally inserted into the bladder. Check to see if the ring is in the vagina. If not, call a healthcare provider immediately.

• Regularly check to make sure the ring is still in the vagina. 

Removal:

• Wash and dry your hands.

• Insert a finger into the vagina and hook it through the EluRyng. 

• Gently pull it from the vagina.

• Put the used ring back in its resealable pouch and dispose of it in a trash can.

What to do if you miss a dose of Eluryng

• A missed dose is considered:

  • Forgetting to insert a new ring at the beginning of the cycle

  • Forgetting to remove the old ring

  • When the ring comes out

If you forget to insert a new ring:

• Check for pregnancy.

• If you are not pregnant, insert the new ring and use backup barrier birth control for seven days.

If you forget to remove an old ring:

• If it’s less than four weeks (28 days) after the ring was first inserted, remove it, allow seven days to pass, and insert a new one.

• If it’s more than four weeks, check for pregnancy. If you are not pregnant, insert a new ring and use backup barrier birth control for seven days.

If a ring slips out of the vagina:

• If it’s broken:

  • Throw it away and insert a new ring.

• If it’s not broken and has been out of the vagina for less than three hours:

  • Rinse the ring with cool or lukewarm water and reinsert it.

• If it’s been out of the vagina for more than three hours:

  • In weeks one and two, reinsert the ring. Use backup barrier birth control for seven days.

  • In week three, throw out the ring. Either insert a new ring and restart the 21-day cycle or wait seven days and insert a new ring to restart the 21-day cycle. Either way, use backup barrier birth control for seven days after the new ring is inserted.

Eluryng contraindications

• This medicine is not safe for every woman to use. 

• Do not use EluRyng if you are:

  • Pregnant

  • Older than 35 and smoke

  • Older than 35 and have migraines

• Do not use EluRyng if you have blood clots, a history of blood clot problems, or risk factors for blood clots, including:

  • Coronary artery disease

  • Blood vessel problems in the brain

  • High blood pressure that is not controlled by medications

  • Diabetes with kidney, nerve, eye, or blood vessel damage

  • Heart valve problems or irregular heartbeats that can cause blood clots

  • Conditions that cause you to form blood clots more easily

• Other contraindications include:

  • Unusual vaginal bleeding that has not been examined by a healthcare provider

  • Liver disease or liver tumors

  • Current or past breast cancer that is hormone-sensitive 

  • Migraine headaches with aura or headaches with focal neurological symptoms

  • Known allergies to any of the ingredients in the ring

Eluryng warnings

• Tell all other healthcare providers treating you that you are using EluRyng. 

• EluRyng should be removed at least four weeks before major surgery and not reinserted for at least two weeks after major surgery.

• EluRyng can affect certain blood tests. 

• Keep all appointments with the prescriber.

• Immediately tell the prescriber if you become pregnant or think you’re pregnant.

• Before starting EluRyng, tell the prescriber if you smoke, are breastfeeding, have recently had a baby or miscarriage, or have:

  • Any medical condition

  • A history of toxic shock syndrome when using tampons

  • A family history of breast cancer

  • An abnormal mammogram or breast X-ray

  • Breast nodules

  • Fibrocystic disease of the breasts

  • Heart or blood vessel problems

  • High blood pressure

  • High cholesterol or triglycerides

  • Diabetes

  • Migraines

  • Kidney problems

  • Liver problems

  • Gallbladder problems

  • Depression

  • A family history of facial swelling (angioedema)

  • A history of liver problems or jaundice while pregnant

  • A history of light or irregular periods

  • Any medical condition that causes vaginal irritation

• EluRyng can cause serious side effects, including: 

  • Toxic shock syndrome

  • Increased risk of blood clots, heart attack, and stroke

  • Increased risk of breast or cervical cancer

  • High blood pressure

  • High cholesterol

  • Liver problems

  • Gallbladder problems

• You might have spotting or irregular bleeding when you first start using this medicine. 

• This medicine may cause blotchy skin discoloration, particularly on the face. 

• EluRyng will not protect you from HIV/AIDS or other sexually transmitted diseases.

Eluryng interactions

• Do not use this medicine together with the hepatitis C drug ombitasvir/paritaprevir/ritonavir, with or without dasabuvir.

• Tell the prescriber about all prescription drugs, over-the-counter medications, and supplements regularly used.

• Some drugs significantly reduce the effectiveness of hormonal birth control, increasing the risk of pregnancy. You may need to use backup barrier birth control when taking these drugs. These include:

  • Drugs that treat seizures (including barbiturates)

  • Drugs that treat tuberculosis

  • Antiviral medications that treat HIV/AIDS or hepatitis C

  • St. John’s wort

  • Aprepitant, bosentan, griseofulvin, Paxlovid

• Other drugs that may cause problems include:

  • Drugs that treat internal fungal infections

  • Thyroid hormones

  • Acetaminophen, ascorbic acid, atorvastatin, cyclosporine, prednisolone, theophylline, tizanidine

• Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

• Ask the prescriber before you use other products or drugs in the vagina. You may need to remove the ring first.

• Tell all other healthcare professionals prescribing new medications that you are using EluRyng.