Commonly Used Brand Name(s)Implanon, Nexplanon
Therapeutic ClassificationsContraceptive, Progestin
Etonogestrel implant is used in women to prevent pregnancy. It is a form of birth control that contains a hormone in a flexible plastic rod about the size of a matchstick. It is effective for 3 years when inserted just beneath the skin of your upper arm.
This medicine stops the release of an egg from your ovary. The mucus in your cervix thickens and may prevent sperm from reaching the egg.
Etonogestrel implant will not protect a woman from sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). The use of latex (rubber) condoms or abstinence (not having sex) is recommended for protection from these diseases.
This medicine is to be given only by or under the direct supervision of a trained healthcare professional.
It is very important that you tell your doctor if you think you might be pregnant or if you missed a period before you receive this medicine. A pregnancy test will be done to make sure you are not pregnant before this medicine is inserted.
This medicine comes with patient instructions. After reading the instructions, you will be asked to sign a USER CARD and a Patient Consent Form before you receive this medicine. The Consent Form tells you about some possible risks when using this medicine, and when it must be removed. Make sure you understand what is in the patient instructions and the Consent Form before you sign it. Keep the USER CARD in a safe place at home with your health records. If you have any questions, ask your doctor.
The implants are usually inserted by your doctor between the first and fifth day of your menstrual period, even if you are still bleeding.
After this medicine is inserted, your doctor should feel your arm to check that the implants are in the right place. You can also check it by gently pressing your fingertips over the insertion site. You should be able to feel the small rod. If you cannot feel the implants in your arm, you will need to use a non-hormonal birth control (such as condoms, spermicide) until your doctor confirms that the implants are in place.
Your doctor will cover the insertion site with 2 bandages. You may remove the top bandage after 24 hours. The smaller bandage may be removed after 3 to 5 days.
Your doctor must remove this medicine after 3 years. If you would like to stop using this medicine, your doctor can remove it at any time. Do not try to remove the implants by yourself.
If you still want to prevent pregnancy after this medicine is removed, you should start using another form of birth control (eg, condoms, diaphragms, or spermicides) right away. If you still want to continue using this medicine, your doctor can insert a new implant under your skin after taking the old one out.
Do not eat grapefruit or drink grapefruit juice while you are using this medicine.
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies on the relationship of age to the effects of etonogestrel implant have not been performed in the pediatric population. However, pediatric-specific problems that would limit the usefulness of this medication in teenagers are not expected. This medicine may be used for birth control in teenage females but should not be used before the start of menstruation.
Appropriate studies on the relationship of age to the effects of etonogestrel implant have not been performed in the geriatric population. This medicine is not indicated for use in elderly women.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- St John's Wort
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Mycophenolate Mofetil
- Mycophenolic Acid
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.
Other Medical ProblemsTOP
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Abnormal or unusual vaginal bleeding (non-menstrual) or
- Blood clots (eg, deep vein thrombosis, pulmonary embolism), or history of or
- Heart attack, or history of or
- Stroke, or history of or
- Breast cancer, known or suspected, or progestin-sensitive, or history of or
- Liver disease (active), including tumors—Should not be used in patients with these conditions.
- Depression, or history of or
- Diabetes or
- Fluid retention (body swelling) or
- Gallbladder disease or
- Heart disease or
- Hyperlipidemia (high cholesterol or fats in the blood) or
- Hypertension (high blood pressure) or
- Kidney disease—Use with caution. May make these conditions worse.
- Obesity—This condition may cause the medicine to not work as well.
It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and does not cause unwanted effects.
Tell your doctor if you have recently given birth. You may start using this medicine 4 weeks after giving birth.
Etonogestrel implant will not protect you against HIV/AIDS, herpes, or other sexually transmitted diseases. Tell your doctor if you or your partner begins to have sexual intercourse with other people, or you or your partner tests positive for a sexually transmitted disease. Talk with your doctor if you have any concerns.
Tell your doctor if you had an allergic reaction to numbing medicines (anesthetics) or skin cleansers (antiseptics). These medicines will be used when etonogestrel implant is inserted into your arm.
This medicine may cause several problems related to insertion and removal, such as pain, irritation, swelling, bruising, scarring, or other complications. Talk to your doctor about these possible risks.
You could have less bleeding or may even stop having periods while using this medicine. Call your doctor if you have a change from your regular bleeding pattern after you have had your implants for awhile, such as more bleeding or if you miss a period (and if you were having periods even with your implants).
Call your doctor right away if you think you have become pregnant while you are using this medicine. You may have a higher risk of an ectopic pregnancy (occurs outside the womb) if you get pregnant while your implants are in place. This can be a serious and life-threatening condition. It can also cause problems that may make it harder for you to become pregnant in the future.
Using this medicine may increase your risk of blood clots in the legs (deep vein thrombosis), lungs (pulmonary embolism), brain (stroke), heart (heart attack), or eyes (blindness). Make sure your doctor knows at least 4 weeks before if you are going to have surgery or will need to be on bed rest. There is a higher risk of having these serious medical problems during surgery or bed rest or if you smoke regularly.
This medicine may also increase your risk of having ovarian cysts, breast cancer, gallbladder problems, or liver tumors. Talk to your doctor if you have any concerns.
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.
This medicine may increase your weight. Your doctor may need to check your weight on a regular basis while you are using this medicine. Talk to your doctor about ways to prevent weight gain.
Your blood pressure might get too high while you are using this medicine. This may cause headaches, dizziness, or blurred vision. You might need to measure your blood pressure at home. If you think your blood pressure is too high, call your doctor right away.
This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.
This medicine may also increase the amount of cholesterol and fats in your blood. If this condition occurs, your doctor may give you some medicines that can lower the amount of cholesterol and fats in the blood.
If you wear contact lenses and you have blurred vision, difficulty in reading, or any other change in vision while using this medicine, check with your doctor right away. Your doctor may want your eyes be checked by an eye doctor (ophthalmologist).
Before you have any medical tests, tell the medical doctor in charge that you are using etonogestrel implant. The results of some tests may be affected by this medicine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (St. John's wort) or vitamin supplements.