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<div style="text-align:center; border-width:2px; border-style:solid; border-color:#4a9888; border-bottom: 0; padding: 10px 10px 5px 10px; border-radius:15px 15px 0 0"><strong>WARNINGS TO FEMALES WHO SMOKE</strong></div>

WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT ANNOVERA<sup>®</sup>?

<div class="isi-container" style="font-size:14px; line-height:1.4; color:#363636 !important;">       <div style="text-align:left;">     <div style="text-align:left; border-width:2px; border-style:solid; border-color:#4a9888; padding:10px; border-radius:15px; margin-top:10px;">       <strong>WARNINGS TO FEMALES WHO SMOKE</strong>       <p style="color:#363636; margin-top:10px; margin-bottom:0;">         Do not use ANNOVERA if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects (heart and blood vessel problems) from birth control methods, including death by heart attack, blood clots, or stroke. This risk increases with age and the number of cigarettes you smoke.       </p>     </div>   </div>    <h5 style="font-size:18px; margin-top:20px; margin-bottom:6px;"><strong>What is ANNOVERA?</strong></h5>   <ul style="padding-left:20px;">     <li style="color:#363636;">ANNOVERA is a hormone-releasing system used by females who are able to become pregnant to prevent pregnancy. You insert ANNOVERA into your vagina and it remains in your vagina for 3 weeks at a time. ANNOVERA is in the shape of a ring that is reusable for 1 year.</li>     <li style="color:#363636;">ANNOVERA does not protect against HIV infections (AIDS) and other sexually transmitted infections (STIs).</li>     <li style="color:#363636;">It is not known if ANNOVERA is safe and effective in females with a body mass index (BMI) greater than 29 kg/m<sup>2</sup>.</li>   </ul>    <h5 style="font-size:18px; margin-top:20px; margin-bottom:6px;"><strong>Who should not use ANNOVERA? Do not use ANNOVERA if you:</strong></h5>   <ul style="padding-left:20px;">     <li style="color:#363636;">smoke and are over 35 years old.</li>     <li style="color:#363636;">have or have had a blood clot in your arms, legs, lungs, or eyes.</li>     <li style="color:#363636;">have had a stroke.</li>     <li style="color:#363636;">have reduced blood flow to your brain (cerebrovascular disease).</li>     <li style="color:#363636;">have reduced blood flow or blockage in 1 or more of the arteries that supply blood to your heart (coronary artery disease).</li>     <li style="color:#363636;">have had a heart attack.</li>     <li style="color:#363636;">have heart rhythm or heart valve problems that increase your risk of having blood clots, such as an infection of the inner lining of the heart and heart valves or a type of irregular heartbeat called atrial fibrillation.</li>     <li style="color:#363636;">have a problem with your blood that makes it clot more than normal.</li>     <li style="color:#363636;">have high blood pressure that is not controlled with medicine or have high blood pressure with blood vessel damage.</li>     <li style="color:#363636;">have diabetes and are over 35 years old; have diabetes with high blood pressure or problems with your kidneys, blood vessels, eyes, or nerves; or have had diabetes for longer than 20 years.</li>     <li style="color:#363636;">have headaches with changes in vision, numbness or weakness, have migraine headaches with aura, or are over age 35 years old and have any type of migraine headaches.</li>     <li style="color:#363636;">have liver disease or liver tumors.</li>     <li style="color:#363636;">have or have had breast cancer or any cancer that is sensitive to the female hormones estrogen or progesterone.</li>     <li style="color:#363636;">have unexplained vaginal bleeding.</li>     <li style="color:#363636;">are allergic to segesterone acetate, ethinyl estradiol, or any of the ingredients in ANNOVERA. See the end of this leaflet for a complete list of ingredients in ANNOVERA.</li>     <li style="color:#363636;">take any Hepatitis C drug combination medicine containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir. This may increase levels of the liver enzyme alanine aminotransferase (ALT) in the blood.</li>   </ul>    <h5 style="font-size:18px; margin-top:20px; margin-bottom:6px;"><strong>What should I tell my healthcare provider before using ANNOVERA?</strong></h5>   <p style="color:#363636;">Before you use ANNOVERA tell your healthcare provider if you:</p>   <ul style="padding-left:20px;">     <li style="color:#363636;">have any of the conditions listed above.</li>     <li style="color:#363636;">smoke.</li>     <li style="color:#363636;">are pregnant or think you are pregnant.</li>     <li style="color:#363636;">recently had a baby, miscarriage, or abortion.</li>     <li style="color:#363636;">have breast problems such as an abnormal mammogram or breast x-ray, breast nodules, fibrocystic breast disease, or a family history of breast cancer.</li>     <li style="color:#363636;">have any medical condition, especially migraine headaches, depression, seizures, diabetes, high blood pressure, high cholesterol or triglycerides, gallbladder disease, liver disease, heart disease, or kidney disease.</li>     <li style="color:#363636;">have a family history of blood clots or stroke.</li>     <li style="color:#363636;">have yellowing of the skin or eyes (jaundice).</li>     <li style="color:#363636;">have a condition that makes your vagina become irritated easily.</li>     <li style="color:#363636;">have a history of toxic shock syndrome.</li>     <li style="color:#363636;">had gallbladder problems when you were pregnant.</li>     <li style="color:#363636;">are scheduled for surgery. The hormones in ANNOVERA may increase your risk of blood clots after surgery. You should stop using ANNOVERA at least 4 weeks before you have surgery and not restart until at least 2 weeks after your surgery.</li>     <li style="color:#363636;">are scheduled for any laboratory tests. Certain blood tests may be affected by hormonal birth control methods.</li>     <li style="color:#363636;">are breastfeeding or plan to breastfeed. You should not use ANNOVERA if you are breastfeeding. The hormones in ANNOVERA may decrease your milk production. The hormones in ANNOVERA pass into your breast milk. Talk with your healthcare provider about the best birth control method for you while breastfeeding.</li>   </ul>    <p style="color:#363636;"><strong>     Tell your healthcare provider about all medicines you take</strong>, including prescription and over-the-counter medicines, vitamins, and herbal supplements. ANNOVERA may affect the way other medicines work, and other medicines may affect how well ANNOVERA works.   </p><br>    <p style="color:#363636;">     Do not use any vaginal products such as oil-based suppositories, oil-based creams, or oil-based gels while the vaginal system is in your vagina. <strong>Do not</strong> use any vaginal lubricants that have silicone or oil in them. Water-based lubricants are ok to use. <strong>Be sure to read the ingredients on the label carefully before you buy a vaginal lubricant.</strong>   </p>    <h5 style="font-size:18px; margin-top:20px; margin-bottom:6px;"><strong>What are the possible side effects of ANNOVERA?</strong></h5>   <p style="color:#363636;">     ANNOVERA may cause serious side effects including <strong>blood clots</strong>. Like pregnancy, hormonal contraceptives increase the risk of serious blood clots, especially in females who have other risk factors, such as smoking, obesity, or age greater than 35. This increased risk is highest when you first start taking hormonal contraceptives and when you restart the same or different hormonal contraceptive after not using it for 4 weeks or more. <strong>It is possible to die or be permanently disabled from a problem caused by a blood clot, such as a heart attack or stroke</strong>.   </p><br>    <p style="color:#363636;"><strong>Other serious side effects include:</strong></p>   <ul style="padding-left:20px;">     <li style="color:#363636;">toxic shock syndrome</li>     <li style="color:#363636;">liver problems, including liver tumors</li>     <li style="color:#363636;">high blood pressure</li>     <li style="color:#363636;">gallbladder problems</li>     <li style="color:#363636;">changes in sugar and fat (cholesterol and triglycerides) levels in your blood</li>     <li style="color:#363636;">headache</li>     <li style="color:#363636;">irregular or unusual vaginal bleeding and spotting in between your menstrual periods</li>     <li style="color:#363636;">depression</li>     <li style="color:#363636;">possible cancer in your cervix</li>     <li style="color:#363636;">swelling of your skin especially around your mouth, eyes, and in your throat (angioedema)</li>     <li style="color:#363636;">dark patches of skin on your forehead, cheeks, upper lip, and chin (chloasma)</li>   </ul>    <p style="color:#363636;"><strong>The most common side effects of ANNOVERA include:</strong></p>   <ul style="padding-left:20px;">     <li style="color:#363636;">headache, including migraine</li>     <li style="color:#363636;">nausea/vomiting</li>     <li style="color:#363636;">vaginal yeast infection (candidiasis)</li>     <li style="color:#363636;">lower/upper abdomen pain</li>     <li style="color:#363636;">painful periods</li>     <li style="color:#363636;">vaginal discharge</li>     <li style="color:#363636;">urinary tract infection</li>     <li style="color:#363636;">breast pain/tenderness</li>     <li style="color:#363636;">irregular vaginal bleeding</li>     <li style="color:#363636;">diarrhea</li>     <li style="color:#363636;">genital itching</li>   </ul>    <p style="color:#363636;"><strong>     You are encouraged to report negative side effects of prescription drugs to the FDA. Visit     <a href="https://www.fda.gov/medwatch" target="_blank" rel="noopener noreferrer" style="text-decoration: underline;">www.fda.gov/medwatch</a>     or call 1-800-FDA-1088.</strong>   </p>    <p style="margin-top:15px; color:#363636;">     <strong style="font-family:'GT America';">       Please see the Full Prescribing Information, including the Boxed Warning and Patient Information.     </strong>   </p>  </div>

<span style="color:#363636">WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT ANNOVERA<sup>®</sup>?</span>

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<p>ANNOVERA is the only annual, procedure-free ring.</p>
<p><span style="padding-top: 10px; display: inline-block; font-size: 12px;">*ANNOVERA should be inserted for 21 days, then removed for 7 days, washed, and reinserted—repeat for one year (13 cycles).</span></p>


One and done*

<p>ANNOVERA is soft, comfortable, and no wider than a tampon during insertion.</p>


The comfort you want

<p>ANNOVERA did not have a significant impact on weight.</p>


No meaningful change in weight

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<p>With this ring, you get confidence in your birth control without sacrificing your comfort and convenience.<br><br> Speak to an UpScript physician today to determine if ANNOVERA may be right for you. Eligible patients may pay as little as $0.*</p>

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Say “I do” to confidence and control with ANNOVERA

<p style="margin-bottom:10px;">Please see Important Safety Information, including BOXED WARNING. This website and the services offered here are owned and operated by UpScript Investments Holdings LLC. Any services provided and information shared through this website are subject to UpScript's legal terms and privacy policies. </p>  <p style="font-size:85%; margin-top:0; padding-left:12px; text-indent:-7px; margin-left:-12px">*This is not health insurance. Subject to change. Savings card offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. Please see Eligibility Criteria, Terms, Conditions, Restrictions, and Exclusions    <a href="https://www.annovera.com/wp-content/uploads/MAYNE_Annovera_Copay_Card.pdf" target="_blank" rel="noopener noreferrer" style="color:blue;">here</a>. </p>

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<div style="text-align:left; border-width:2px; border-style:solid; border-color:#4a9888; border-bottom: 0; padding: 10px 10px 5px 10px; border-radius:15px 15px 0 0"><strong>WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS</strong><br>See full prescribing information for complete boxed warning.<ul style="margin:5px 0 0"><li>Females over 35 years old who smoke should not use ANNOVERA.</li><li>Cigarette smoking increases the risk of serious cardiovascular events from combination hormonal contraceptive use.</li></div>

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<div class="isi-container" style="font-size:14px; line-height:1.6; color:#000;">

  
  <div style="text-align:left;">
    <div style="text-align:left; border-width:2px; border-style:solid; border-color:black; padding:5px;">
      <strong>
        WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS
        <br><br>
        <i>See full prescribing information for complete boxed warning.</i>
      </strong>
      <ul class="list-d" style="padding-left:20px; margin-top:10px;">
        <li class="fw-b padL25">Females over 35 years old who smoke should not use ANNOVERA.</li>
        <li class="fw-b padL25">Cigarette smoking increases the risk of serious cardiovascular events from combination hormonal contraceptive use.</li>
      </ul>
    </div>
  </div>

  <h5 style="font-size:18px; margin-top:20px;"><strong>CONTRAINDICATIONS</strong></h5>
  <p>
    ANNOVERA (segesterone acetate and ethinyl estradiol vaginal system) is contraindicated and should not be used in women with a high risk of arterial or venous thrombotic diseases; current or history of breast cancer or other estrogen- or progestin-sensitive cancer; liver tumors, acute hepatitis, or severe (decompensated) cirrhosis; undiagnosed abnormal uterine bleeding; hypersensitivity to any of the components of ANNOVERA; and use of Hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir.
  </p>

  <h5 style="font-size:18px; margin-top:20px;"><strong>WARNINGS AND PRECAUTIONS</strong></h5>
  <ul style="padding-left:20px;">
    <li>
      Stop ANNOVERA if a thrombotic or thromboembolic event occurs, and at least 4 weeks before and through 2 weeks after major surgery. Start ANNOVERA no earlier than 4 weeks after delivery, in females who are not breastfeeding. Consider cardiovascular risk factors before initiating in all females, particularly those over 35 years.
    </li>
    <li>Discontinue if jaundice occurs.</li>
    <li>
      Stop ANNOVERA prior to starting therapy with the combination drug regimen ombitasvir/paritaprevir/ritonavir. ANNOVERA can be restarted 2 weeks following completion of this regimen.
    </li>
    <li>
      Do not prescribe ANNOVERA for females with uncontrolled hypertension or hypertension with vascular disease. Monitor blood pressure and stop use if blood pressure rises significantly in females with well-controlled hypertension.
    </li>
    <li>
      Monitor glucose in pre-diabetic or diabetic females taking ANNOVERA. Consider an alternate contraceptive method for females with uncontrolled dyslipidemias.
    </li>
    <li>
      Patients using ANNOVERA who have a significant change in headaches or irregular bleeding or amenorrhea should be evaluated. ANNOVERA should be discontinued if indicated.
    </li>
    <li>
      Other warnings include: gallbladder disease; depression; cervical cancer; increased serum concentrations of binding globulins; hereditary angioedema; chloasma (females who tend to develop chloasma should avoid exposure to the sun or UV radiation while using ANNOVERA); toxic shock syndrome (TSS) (if a patient exhibits symptoms of TSS, remove ANNOVERA, and initiate appropriate medical treatment); vaginal use (ANNOVERA may not be suitable for females with conditions that make the vagina more susceptible to vaginal irritation or ulceration).
    </li>
  </ul>

  <h5 style="font-size:18px; margin-top:20px;"><strong>ADVERSE REACTIONS</strong></h5>
  <p>
    The most common adverse reactions reported in at least 5% of women who received ANNOVERA were: headache/migraine, nausea/vomiting, vulvovaginal mycotic infection/candidiasis, lower/upper abdominal pain, dysmenorrhea, vaginal discharge, urinary tract infection, breast pain/tenderness/discomfort, bleeding irregularities including metrorrhagia, diarrhea, and genital pruritus.
  </p>

  <h5 style="font-size:18px; margin-top:20px;"><strong>DRUG INTERACTIONS</strong></h5>
  <p>
    Drugs or herbal products that induce certain enzymes, including CYP3A4, may decrease the effectiveness of ANNOVERA or increase breakthrough bleeding. Counsel patients to use a back-up or alternative method of contraception when enzyme inducers are used with ANNOVERA.
  </p>

  <h5 style="font-size:18px; margin-top:20px;"><strong>INDICATION</strong></h5>
  <p>
    ANNOVERA (segesterone acetate and ethinyl estradiol vaginal system) is a progestin/estrogen combination hormonal contraceptive indicated for use by females of reproductive potential to prevent pregnancy.
  </p><br>

  <p>
    <strong>Limitations of Use:</strong> ANNOVERA has not been adequately studied in females with a body mass index &gt;29 kg/m<sup>2</sup>.
  </p>

  
  <p style="margin-top:15px;">
    <strong>
      PLEASE NOTE THAT THIS INFORMATION IS NOT COMPREHENSIVE.
      <a href="https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=eb18194f-2021-41fa-8bdf-31e0c0eb646b&type=display"
         target="_blank"
         style="text-decoration: underline;">
        PLEASE CLICK HERE
      </a>
      FOR THE FULL PRESCRIBING INFORMATION, INCLUDING BOXED WARNING.
    </strong>
  </p>

</div>

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