What is Nexplanon® (etonogestrel implant) used for?
Nexplanon® is commonly used as contraception to prevent pregnancy.
Etonogestrel in Nexplanon® 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. There is no estrogen in this product.
Nexplanon® implant 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.
Nexplanon® may not work as well in overweight women.
How should I take Nexplanon® (etonogestrel implant)?
Nexplanon® is given as an implant by a healthcare professional.
How do I store Nexplanon® (etonogestrel implant)?
Nexplanon® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Nexplanon® in the bathroom or the freezer. There may be different brands of Nexplanon® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.
You should not flush Nexplanon® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.
Precautions & warnings
What should I know before using Nexplanon® (etonogestrel implant)?
Before using this drug, tell your doctor if:
- You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
- You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- You have allergy with any of active or inactive ingredients of Nexplanon® or other medications.
- You have any other illnesses, disorders, or medical conditions.
You should not use an etonogestrel implant if you have any of the following conditions: unusual vaginal bleeding, liver disease or liver cancer, or if you have ever had breast or uterine cancer, a heart attack, a stroke, or a blood clot.
Do not use if you are pregnant or if you have recently had a baby.
Do not use the implant if you are breastfeeding a baby younger than 4 weeks old.
Using an etonogestrel implant can increase your risk of blood clots, stroke, or heart attack, especially if you have certain other conditions, or if you are overweight or smoking.
The timing of when you will receive this implant depends on whether you were using birth control before, and what type it was.
Etonogestrel implant is inserted through a needle (under local anesthesia) into the skin of your upper arm, just inside and above the elbow. After the implant is inserted, your arm will be covered with 2 bandages. Remove the top bandage after 24 hours, but leave the smaller bandage on for 3 to 5 days. Keep the area clean and dry.
You should be able to feel the implant under your skin. Tell your doctor if you cannot feel the implant at any time while it is in place.
Etonogestrel implant can remain in place for up to 3 years. If the implant is placed correctly, you will not need to use back-up birth control. Follow your doctor’s instructions.
You may have irregular and unpredictable periods while using the etonogestrel implant. Tell your doctor if your periods are very heavy or long-lasting, or if you miss a period.
If you need surgery or medical tests or if you will be on bed rest, you may need to have your etonogestrel implant removed for a short time. Any doctor or surgeon who treats you should know that you have an etonogestrel implant.
The etonogestrel implant must be removed by the end of the third year after it was inserted and may be replaced at that time with a new implant. After the implant is removed, your ability to get pregnant will return quickly. If the implant is not replaced with a new one, start using another form of birth control right away if you wish to prevent pregnancy.
Is it safe during pregnancy or breastfeeding?
There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category X, 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
What side effects can occur from Nexplanon® (etonogestrel implant)?
Common side effects may include:
- Changes in your menstrual periods
- Light menstrual bleeding or spotting
- Stomach pain
- Breast tenderness
- Weight gain
- Vaginal itching or discharge
- Problems with contact lenses
Call your doctor at once if you have:
- Warmth, redness, swelling, or oozing where the implant was inserted
- Severe pain or cramping in your pelvic area (may be only on one side)
- Sudden numbness or weakness especially on one side of the body, sudden severe headache, slurred speech, problems with vision or balance
- Sudden cough, wheezing, rapid breathing, coughing up blood
- Pain, swelling, warmth, or redness in one or both legs
- Chest pain or heavy feeling, pain spreading to the jaw or shoulder, nausea, sweating, general ill feeling
- Swelling in your hands, ankles, or feet
- Yellowing of the skin or eyes
- A breast lump
- Symptoms of depression: sleep problems, weakness, tired feeling, mood changes
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
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.
What drugs may interact with Nexplanon® (etonogestrel implant)?
Nexplanon® 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.
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:
- Rifamycins: rifampin, rifabutin
- John’s wort
- Drugs used to treat seizures: barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate
- HIV drugs: such as nelfinavir, nevirapine, ritonavir
Does food or alcohol interact with Nexplanon® (etonogestrel implant)?
Nexplanon® 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 Nexplanon® (etonogestrel implant)?
Nexplanon® 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.
Health conditions that may interact with this drug are:
- Abnormal Genital Bleeding
- Hepatic Neoplasms
- Breast Malignancy
- Liver Disease
- Fluid Retention
- Retinal Thrombosis
The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this medication.
What is the dose of Nexplanon® (etonogestrel implant) for an adult?
The efficacy of Nexplanon® does not depend on daily, weekly or monthly administration.
All healthcare providers should receive instruction and training prior to performing insertion and/or removal of Nexplanon®.
What is the dose of Nexplanon® (etonogestrel implant) for a child?
The dosage has not been established in girls younger than 18 years old. 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 Nexplanon® (etonogestrel implant) available?
Nexplanon® is available in the following dosage forms and strengths:
- Implant: etonogestrel 68mg
What should I do in case of an emergency or overdose?
If the implant is correctly inserted, an overdose of etonogestrel is highly unlikely.
What should I do if I miss a dose?
Since etonogestrel is given as an implant by a healthcare professional, you will not be on a frequent dosing schedule.
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