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While using this medication, you might experience mild side effects such as vaginal discomfort or irritation, nausea, vomiting, headache, bloating, breast tenderness, fluid retention leading to ankle or feet swelling, or changes in weight. Spotting or vaginal bleeding between periods can also occur, particularly during the initial months. If these symptoms persist or worsen, it’s important to consult your healthcare provider.

This medication can also lead to an increase in blood pressure, so regular monitoring is recommended. Notify your healthcare provider if you notice elevated readings. Serious side effects requiring immediate medical attention include lumps in the breast, mood changes like depression, severe abdominal pain, unusual vaginal bleeding, dark urine, or yellowing of the skin or eyes.

In rare instances, the medication can cause complications such as the ring being accidentally placed in the bladder, leading to symptoms like painful urination. Additionally, it may rarely cause severe issues from blood clots, such as heart attacks or strokes. Seek urgent medical help if you experience symptoms like chest pain, severe headaches, sudden dizziness, or trouble speaking.

Toxic shock syndrome, though very rare, is a serious risk associated with vaginal rings. If you experience symptoms such as a sudden high fever or a sunburn-like rash, remove the ring and seek immediate medical care. Severe allergic reactions are also rare but require urgent attention if symptoms like swelling of the face or difficulty breathing occur. Always discuss any unusual symptoms with your healthcare provider.

Certain medications can interact with this drug. These include aromatase inhibitors like anastrozole and exemestane, fezolinetant, ospemifene, tamoxifen, tizanidine, tranexamic acid, and some medications for chronic hepatitis C (such as ombitasvir/paritaprevir/ritonavir, with or without dasabuvir).

Additionally, some medicines can reduce the effectiveness of hormonal birth control by lowering the hormone levels in your body, which may lead to pregnancy. Examples include griseofulvin, modafinil, rifamycins (like rifampin and rifabutin), ritonavir, St. John's wort, and certain seizure medications (such as barbiturates, carbamazepine, felbamate, phenytoin, primidone, and topiramate), as well as some HIV medications (like nelfinavir and nevirapine).

Always inform your doctor when you start any new medication and discuss whether you should use an additional non-hormonal birth control method. If you experience any unusual spotting or bleeding, notify your doctor, as these could indicate that your birth control is not effective.

This drug may also affect certain lab tests, such as those related to blood clotting and thyroid function, potentially leading to inaccurate results. Ensure that all your healthcare providers and lab technicians are aware that you are taking this medication.