What Is The Safety Problem With NuvaRing And Why Are Lawsuits Being Filed

Organon Fails to Warn Sufficiently About High Dose of Dangerous Progestin Etonogestrel, Which Causes Blood Clots

NuvaRing is a contraceptive vaginal ring that releases 15 micrograms of ethinyl estradiol and 120 micrograms of etonogestrel per day. Each ring is used for one cycle, comprising 3 weeks continuous use of the ring followed by a 1-week ring-free period. It is manufactured by by Organon USA, Inc. and was approved in October 2001 by the FDA for sale in the U.S.

As a result of case reports made by women and their doctors, NuvaRing use is associated with serious side effects resulting from blood clots, such pulmonary embolism (PE) and deep vein thrombosis (DVT) as well as strokes and heart attacks, with some events resulting in death.

The likely reason that NuvaRing causes these blood clots is because this vaginal ring has a relatively high dose of etonogestrel, which is a metabolite of the dangerous progestin desogestrel. As background, desogestrel is classified as a "third generation" progestin.

In February 2007 the consumer advocacy group Public Citizen sent to the FDA a letter entitled "Petition to the FDA to Ban Third Generation Oral Contraceptives Containing Desogestrel due to Increased Risk of Venous Thrombosis" which included this information:

Based on the epidemiologic evidence from these studies, including two meta-analyses, Public Citizen has concluded that third generation oral contraceptives essentially double the risk of venous thrombosis when compared to second generation oral contraceptives. The FDA acknowledged this in a statement in November 1995 stating “new studies indicate about a two-fold increase in the risk of venous blood clots associated with products containing desogestrel.” The risk essentially translates to about 1.5 additional incidents of thromboembolic disease per 10,000 women-years.

The current version of the NuvaRing Physician's Insert, or label, contains some warnings about the risk of blood clots, or venous thrombosis, but none of the warning is bolded nor does the NuvaRing label have a so-called "black box" warning. A similar non-bolded warning currently appears on Organon's third generation combination oral contraceptive pill Desogen, known elsewhere around the world as Marvelon, both of which combine 150 micrograms of the progestin desogestrel with 30 micrograms of the estrogen ethinylestradiol.

Given that serious blood clot-related conditions like pulmonary embolism (PE) and deep vein thrombosis (DVT) -- not to mention strokes and heart attacks -- can lead to significant functional disability and possibly death, this level of warning on the current NuvaRing label seems insufficient. Moreover, one may allege that the current label constitutes a so-called "failure to warn" by Organon in light of the existing evidence about a biological mechanism underlying the association between etonogestrel, as a desogestrel metabolite, and the increased risk of developing blood clots.

For this reason, in July 2007 alone more than 30 lawsuits were filed in New Jersey against the pharmaceutical company Organon asserting that NuvaRing caused a stroke-induced death, cases of pulmonary embolism, and other serious blood clot related injuries in women using this contraceptive vaginal ring.