Generic Name: Etonogestrel Brand Name(s): Etonogestrel.

Uses

What is Etonogestrel used for?

This product is a small, thin plastic rod that is inserted under the skin to prevent pregnancy. The rod slowly releases etonogestrel into the body over a 3-year period. Etonogestrel is similar to a natural hormone made in your body. It works mainly by preventing the release of an egg (ovulation) during your menstrual cycle. It also makes vaginal fluid thicker to help prevent sperm from reaching an egg (fertilization) and changes the lining of the uterus (womb) to prevent attachment of a fertilized egg. This product does not contain any estrogen.

This medication may not work as well in women who are very overweight or those taking certain drugs. (See also Drug Interactions section.) Discuss your birth control options with your doctor.

Using this medication does not protect you or your partner against sexually transmitted diseases (such as HIV, gonorrhea, chlamydia).

How should I take Etonogestrel?

Ask your doctor about the best time to schedule your appointment to have the rod placed. Your doctor may want you to have a pregnancy test first. The medication usually starts working right away when the rod is inserted during the first 5 days of your period. If your appointment is at another time in your menstrual cycle, you may need to use a non-hormonal form of birth control (such as condoms, diaphragm, spermicide) for the first 7 days after the rod is placed. Ask your doctor about whether you need back-up birth control.

The rod will be inserted under the skin in your upper arm by a health care professional. Usually it will be placed in the arm that you do not write with. Be sure you can feel the rod underneath your skin after it has been placed. If at any time you cannot feel the rod underneath the skin or feel that the rod has been bent or broken, tell your doctor right away.

There will be 2 bandages covering the area where the rod is placed. Leave the top bandage on for 24 hours. Keep the smaller bandage on as directed by your doctor, usually for 3 to 5 days. Keep the bandage clean and dry.

The rod must be removed after 3 years and can be replaced if continued birth control is desired. The rod can be removed at any time by a trained health care professional if birth control is no longer desired or if there are side effects.

How do I store Etonogestrel?

Store at 25°C (77°F); excursions are permitted between 15°C and 30˚C (59˚F and 86˚F).

Precautions & warnings

What should I know before using Etonogestrel?

Before using etonogestrel, tell your doctor or pharmacist if you are allergic to it; or to other progestins (such as norethindrone, desogestrel); or to any anesthetics or antiseptics that might be used in the procedure; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood clots (for example in the legs, eyes, lungs), blood clotting disorders (such as protein C or protein S deficiency), high blood pressure, abnormal breast exam, personal or family history of cancer (especially breast or cervical cancer), high cholesterol or triglyceride (blood fat) levels, depression, diabetes, gall bladder problems, severe headaches/migraine, heart problems (such as heart valve disease, irregular heartbeat, previous heart attack), history of yellowing eyes/skin (jaundice) during pregnancy or while using hormonal birth control (such as pills, patch), kidney disease, liver disease (including tumors), stroke, swelling (edema), unexplained vaginal bleeding.

Do not use this medication if you smoke cigarettes/use tobacco and are over 35 years old. Smoking raises your risk of stroke, heart attack, blood clots, and high blood pressure from hormonal birth control (such as the pill, implant, patch, ring). The risk of these serious problems increases with age and with the number of cigarettes you smoke. Do not smoke or use tobacco.

Tell your doctor at least 4 weeks beforehand if you will be having surgery or will be confined to a chair or bed for a long time (such as on a long plane flight). You may need to have this medication removed for a time or take special precautions.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication may cause blotchy, dark areas on your face and skin (melasma). Sunlight may worsen this effect. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors.

If you are nearsighted or wear contact lenses, you may develop vision problems or trouble wearing your contact lenses. Contact your eye doctor if these problems occur.

This product must not be used during pregnancy. If you become pregnant or think you may be pregnant, tell your doctor right away. A certain serious pregnancy problem (ectopic pregnancy) may be more likely if you become pregnant while using this product.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Etonogestrel during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Etonogestrel. Etonogestrel is pregnancy risk category N according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Etonogestrel?

Nausea, stomach cramping/bloating, dizziness, headache, breast tenderness, acne, hair loss, weight gain, and vaginal irritation/discharge may occur. Pain, bruising, numbness, infection, and scarring may occur at the site where the rod is placed. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Your periods may be early or late, shorter or longer, heavier or lighter than normal. You may also have some spotting between periods, especially during the first several months of use. If bleeding is prolonged (more than 8 days) or unusually heavy, contact your doctor. If you miss 2 periods in a row, contact your doctor for a pregnancy test.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

The rod must be removed after 3 years. This is usually a simple procedure done in your doctor’s office. Rarely (for example, if the rod has been placed too deeply or can’t be felt), the rod may require surgery to remove.

Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as new/worsening depression), lump in the breast, unwanted facial/body hair, severe stomach/abdominal/pelvic pain, unusual tiredness, dark urine, yellowing eyes/skin.

This medication may rarely cause serious (sometimes fatal) problems from blood clots (such as deep vein thrombosis, heart attack, pulmonary embolism, stroke). Get medical help right away if you have: shortness of breath/rapid breathing, chest/jaw/left arm pain, unusual sweating, confusion, sudden dizziness/fainting, pain/swelling/warmth in the groin/calf, sudden/severe headaches, trouble speaking, weakness on one side of body, sudden vision changes.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Etonogestrel?

Some drugs may cause hormonal birth control to work less well by decreasing the amount of birth control hormones in your body. This effect can result in pregnancy. Examples include griseofulvin, modafinil, rifamycins (such as rifampin, rifabutin), St. John’s wort, drugs used to treat seizures (such as barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate), HIV drugs (such as nelfinavir, nevirapine, ritonavir), among others.

Tell your doctor when you start any new drug, and discuss if you should use additional reliable birth control. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well.

This medication may interfere with certain laboratory tests (such as sex-hormone-binding globulin, thyroid), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this medication.

Etonogestrel may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Etonogestrel?

Etonogestrel may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Etonogestrel?

Etonogestrel may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Etonogestrel.

What is the dose of Etonogestrel for an adult?

Usual Adult Dose for Contraception

One 68 mg implant subdermally just under the skin at the inner side of the non-dominant upper arm

-Remove no later than the end of the third year

Comments:

-Implant may be replaced by a new implant at the time of removal.

-If no preceding hormonal contraceptive in the last month: insert between days 1 and 5 of the menstrual cycle, even if still bleeding.

-Switching from combined hormonal contraceptive: insert the day after the last active tablet of the oral contraceptive, or the day of removal of the vaginal ring or patch.

-Switching from progestin-only injectable contraceptive: implant the day the next injection is due.

-Switching from progestin-only minipill: switch any day of the month, within 24 hours after the last tablet.

-Switching from progestin-only implant or intrauterine device: insert the same day the previous contraception is removed.

-Following first trimester abortion or miscarriage: insert within 5 days of abortion/miscarriage.

-Following second trimester abortion or miscarriage: insert between 21 and 28 days of abortion/miscarriage.

-Postpartum, not breastfeeding: insert between 21 and 28 days postpartum.

-Postpartum, breastfeeding: insert after the fourth week postpartum, advise use of a barrier contraceptive method until 7 days after implantation.

-If inserted as recommended above, back up contraception is not necessary. If deviating from the above recommendations, a barrier contraceptive is recommended until 7 days after insertion.

Liver Dose Adjustments

Contraindicated

Other Comments

Administration advice:

-An implant should always be removed before inserting a new one.

-The manufacturer product information should be consulted.

Patient advice:

-Advise patients that this product does not protect against HIV infection or other sexually transmitted diseases

What is the dose of Etonogestrel for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Etonogestrel available?

Etonogestrel is available in the following dosage forms and strengths:

  • Subcutaneous implant

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Etonogestrel, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 29, 2018 | Last Modified: January 29, 2018

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