Nexplanon
Nexplanon (etonogestrel) is an implant placed in your arm to prevent pregnancy. It's a long-acting medication that continues to prevent pregnancy for up to 3 years after insertion. It's one of the most effective forms of birth control available. Unlike other birth control options that contain two hormones (estrogen and progesterone), Nexplanon (etonogestrel) only contains a progesterone called etonogestrel. The most common side effects include irregular vaginal bleeding (e.g., longer periods, spotting) and headaches.
What is Nexplanon (etonogestrel)?
What is Nexplanon (etonogestrel) used for?
- To prevent pregnancy
How Nexplanon (etonogestrel) works
The Nexplanon (etonogestrel) implant slowly releases etonogestrel, which is a progestin (a manmade form of progesterone). It works to prevent pregnancy by stopping your ovaries from releasing an egg, by making it difficult for sperm to enter the uterus (womb), and by preventing a fertilized egg from implanting in your uterus.
Drug facts
Side effects of Nexplanon (etonogestrel)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (25%)
- Absence of period (20%)
- More frequent or longer vaginal bleeding (20%)
- Vaginal pain or itching (15%)
- Weight gain (14%)
- Acne (14%)
- Breast pain (13%)
- Stomach pain (11%)
- Sore throat (11%)
- Vaginal discharge (10%)
Less Common Side Effects
- Flu-like symptoms
- Dizziness
- Menstrual cramps
- Back pain
- Body pain
- Pain at insertion site
- Nausea
- Mood swings
- Nervousness
- Depression
Nexplanon (etonogestrel) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Ectopic pregnancy: severe, unexplainable pelvic pain, unusual vaginal bleeding
- Heart attack: chest pain or tightness, pain that radiates up to your shoulder, arm, neck, or jaw
- Stroke: sudden trouble talking, trouble walking, numbness on one side of your body or face, sudden, severe headaches
- Blood clot in the lungs: trouble breathing, chest pain
- Breast lumps or pain
More on Nexplanon (etonogestrel) side effects
The following Nexplanon (etonogestrel) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Breast pain
chills
general feeling of discomfort or illness
headache
joint pain
loss of appetite
muscle aches and pain
shivering
sweating
trouble sleeping
unusual tiredness or weakness
vomiting
Less common
Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the insertion site
blurred vision or other changes in vision
breast discharge
breast enlargement
burning feeling while urinating
difficult or painful urination
difficulty with breathing
difficulty with swallowing
dizziness
headache, severe and throbbing
lumps in the breasts
nervousness
noisy breathing
painful or tender cysts in the breasts
pounding in the ears
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
shortness of breath
slow or fast heartbeat
stomach or pelvic discomfort, aching, or heaviness
swelling of the hands, ankles, feet, or lower legs
tightness in the chest
Rare
Collection of blood under the skin at the insertion site
deep, dark purple bruise at the insertion site
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Back pain
blemishes on the skin, pimples
body aches or pain
crying
depersonalization
discouragement
dysphoria
ear congestion
euphoria
feeling sad or empty
hoarseness
increased clear or white vaginal discharge
increased weight
irregular bleeding cycle
irritability
itching of the vagina or genital area
light vaginal bleeding between regular menstrual periods
loss of interest or pleasure
loss of voice
mental depression
pain, cramps, or heavy menstrual bleeding
pain during sexual intercourse
pain or tenderness around the eyes and cheekbones
paranoia
quick to react or overreact emotionally
rapidly changing moods
stomach pain
tender, swollen glands in the neck
thick, white vaginal discharge with no odor or with a mild odor
trouble concentrating
voice changes
Less common
Abnormal ejaculation
abnormal or decreased touch sensation
belching
bone pain
burning feeling in the chest or stomach
decreased interest in sexual intercourse
difficulty having a bowel movement
difficulty with moving
dull ache or feeling of pressure or heaviness in the legs
excess air or gas in the stomach or intestines
feeling of vaginal pressure
feeling of warmth
hair loss or thinning of the hair
inability to have or keep an erection
increased appetite
increased hair growth on the forehead, back, arms, and legs
indigestion
itching skin near damaged veins
lack or loss of strength
loss in sexual ability, desire, drive, or performance
muscle cramping or stiffness
passing gas
pelvic pain
redness of the face, neck, arms, and occasionally upper chest
redness, swelling in the ear, or earache
sleepiness or unusual drowsiness
stomach bloating and cramping
swollen joints
tenderness in the stomach area
vaginal burning or pain
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Nexplanon (etonogestrel)
Pros
- Works better than oral birth control pills to prevent pregnancy
- Can be inserted in your provider's office within a few minutes and without any kind of sedation (medication to put you asleep)
- Continues working for 3 years and doesn't require you to remember to take the medication every day
- Can be used while breastfeeding as long as it's been 4 weeks since you gave birth
- A possible lower-cost birth control option for people without insurance
Cons
- Can raise your risk of an ectopic pregnancy if you do get pregnant
- Breakthrough bleeding and irregular cycles are common side effects.
- Can raise your blood pressure
- Might lead to mood changes or depression
- Risk of Nexplanon (etonogestrel) implant moving and not working well
Pharmacist tips for Nexplanon (etonogestrel)
- Nexplanon (etonogestrel) will be inserted by a healthcare provider in their office and keeps working for 3 years after it's placed. It can be removed before then if you want to try to get pregnant.
- If you get Nexplanon (etonogestrel) removed, you should start another form of birth control right away if you don't wish to become pregnant. In medical studies, some people were able to get pregnant as early as 1-2 weeks after Nexplanon (etonogestrel) was removed.
- After your provider places Nexplanon (etonogestrel), they'll cover it with two bandages. Don't remove the larger, top bandage for at least 24 hours. Keep the smaller, bottom bandage clean, dry, and in place for 3 to 5 days after.
- Make sure you can always feel your implant. If there's ever a time you can't feel Nexplanon (etonogestrel), call your provider right away. This could be a sign that the implant has moved, meaning you could get pregnant. Use a barrier method of protection (e.g., condoms, diaphragms) to prevent pregnancy until your provider confirms the implant is in the right place.
- When you go in for your yearly health checkup, ask your provider to feel whether Nexplanon (etonogestrel) is still in place.
- If you experience an injury at or around the area of the Nexplanon (etonogestrel) implant, let your provider know right away. Though rare, injuries can cause the implant to break. This can affect how well Nexplanon (etonogestrel) works.
- Nexplanon (etonogestrel) can be used while breastfeeding as long as it's been at least 4 weeks since you gave birth. The medication from the implant will not hurt your baby, but you might notice a slight drop in your milk supply.
- Nexplanon (etonogestrel) doesn't protect you from HIV or other sexually transmitted infections (STIs). Only abstinence and condoms can help protect you from STIs. Talk to your provider right away if this is a concern for you.
- Nexplanon (etonogestrel) can affect your menstrual cycle and menstrual bleeding. It's possible you might even have no period while using the implant. Call your provider if this is concerning to you or if your bleeding becomes very heavy.
- Nexplanon (etonogestrel) can cause mood changes. If you've been depressed in the past or are currently experiencing depression, ask your family or loved ones to tell if they notice any changes in your mood. If Nexplanon (etonogestrel) is affecting your mood too much, you might want to talk with your provider about other options for birth control.
- There are several medications that can make birth controls, including Nexplanon (etonogestrel), not work as well. Discuss all medications you take with your provider before having the implant placed. Before starting any new medications, ask your pharmacist or provider if they'll interact with Nexplanon (etonogestrel).
More on Nexplanon (etonogestrel) tips
Common questions about Nexplanon (etonogestrel)
Nexplanon (etonogestrel) is long-acting and can prevent pregnancy for up to 3 years. If you choose to continue using Nexplanon (etonogestrel), you'll need to get it removed after 3 years and have a new one placed by your healthcare provider.
If Nexplanon (etonogestrel) is placed within 5 days of starting your period, it will work right away to prevent pregnancy. This means you won't need to use a back-up birth control method, such as condoms. If it's placed after the fifth day of your period starting, you'll need to use a back-up method for the first 7 days after insertion. If you're switching from another birth control method, talk to your provider about when you can expect Nexplanon (etonogestrel) to start working and if you need to use a back-up method at first.
Nexplanon (etonogestrel) is one of the most effective methods of birth control available. It is over 99% effective, meaning that fewer than one person out of every 100 gets pregnant while using this medication for 1 year. Pregnancy is more likely to happen if your implant isn't in the correct position. Call your provider if you aren't able to feel your implant on the inside of your upper arm.
Your healthcare provider will place Nexplanon (etonogestrel) under the skin of the inner side of your upper arm using a needle. The procedure should take a few minutes.
Your healthcare provider can remove Nexplanon (etonogestrel) any time within 3 years after it was placed. This is usually done in their office. Your provider will first put some numbing medication around the area where Nexplanon (etonogestrel) was inserted. Then, they'll make a small cut in your arm and gently remove the implant with forceps. After it has been removed, they'll close your wound and place a bandage. While you can remove the top bandage after 24 hours, you'll need to keep the wound closure adhesive on for 3 to 5 days.
People who took Nexplanon (etonogestrel) in clinical studies did report weight gain as a side effect. People typically gain an average of 3 to 4 pounds after having Nexplanon (etonogestrel) in place for 1 to 2 years. A small group of people stopped using Nexplanon (etonogestrel) because of weight gain. But it's unclear whether the weight gain was caused by the implant, or other reasons. If you do gain weight, it could be because your body is holding onto water and you might feel bloated. If you notice that you have gained a lot of weight since starting on Nexplanon (etonogestrel), let your provider know.
Acne is one of the most common side effects of Nexplanon (etonogestrel), so there's a good chance this might happen to you. Most acne caused by this medication is mild and can be treated with over-the-counter products. If your acne becomes severe or is too bothersome for you, let your provider know so you can discuss alternatives.
While the answer to this question is unique for everyone, it's possible to conceive as early as one week after having Nexplanon (etonogestrel) removed. If you're not sure whether you want to get pregnant after Nexplanon (etonogestrel) removal, make sure to use a condom.
How to save using GoodRx
Risks and warnings for Nexplanon (etonogestrel)
Nexplanon (etonogestrel) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Problems during insertion and removal
Nexplanon (etonogestrel) will be implanted just below the skin, so you can feel it through the skin at all times. If Nexplanon (etonogestrel) is inserted too deeply, it can damage the muscles, tissues, and blood vessels around it. It can also lead to unwanted pregnancies. Very rarely, implants that have been inserted too deeply can move to another part of the body and cause infections. If Nexplanon (etonogestrel) has been placed incorrectly, your provider will need to be removed and placed again. If there's ever a time you can't feel the implant, contact your provider right away and use a barrier method of protection (e.g., condoms, diaphragms) to prevent pregnancy until your provider confirms the implant is in the right place.
Irregular periods
Nexplanon (etonogestrel) can commonly cause a change from your normal menstrual bleeding pattern, such as an absent period, spotting, or longer periods. If you're concerned with your menstrual cycle changes, talk with your provider. Most of the time, the kind of menstrual period you experience within the first 3 months after Nexplanon (etonogestrel) is placed is likely what will you'll continue to experience as long as the implant is in place.
Ectopic pregnancy or ovarian cyst
If you happen to get pregnant while taking Nexplanon (etonogestrel), there's a small chance that the pregnancy may be ectopic (outside of the womb). Additionally, Nexplanon (etonogestrel) can raise the risk of ovarian cysts (small sacs of fluid in the ovary). Although they rarely cause problems and tend to go away without any treatment, contact your provider if you ever have serious pain in your stomach area so they can check you for an ovarian cyst or ectopic pregnancy.
Blood clots
- Risk factors: History of blood clots | Having Nexplanon (etonogestrel) placed less than 21 days after giving birth | Medical problems or surgical procedures causing you to be bed-bound for a long time
There have been reports of blood clots in people using birth controls containing both estrogen and progestin. Blood clots can be very dangerous and lead to a heart attack, a stroke, or a pulmonary embolism (life-threatening blood clot in the lungs). Nexplanon (etonogestrel) only contains progestin, so it's unclear whether or not it carries the same risk for blood clots as combination birth controls. If you've ever had blood clots in the past, ask your provider whether Nexplanon (etonogestrel) is a good option for you.
In addition, you shouldn't get Nexplanon (etonogestrel) implanted if it has been less than 3 weeks since you delivered a baby because you're at a higher risk for getting blood clots during this time. Be sure to discuss all your past and present medical conditions with your provider before starting Nexplanon (etonogestrel). If you need to have surgery that will make it difficult for you to move much, ask your surgeon if you should have the implant removed before your procedure is done. Call 911 or get medical attention right away if you have pain in your legs or arms, chest pain, sudden severe headaches, trouble breathing, or sudden changes in your speech or vision.
Possible risk of cancer
- Risk factors: Personal or family history of breast cancer
Experts aren't sure if there's a higher risk of developing breast cancer from using combination birth control. But there are some cancer types that are sensitive to hormones in the birth controls. Because of this, people who have ever had breast cancer or have a strong family history of breast cancer should talk to their provider before using Nexplanon (etonogestrel) to see if this birth control is a good option for them. Remember to perform monthly breast self-exams and tell your provider about any changes you notice.
Future fertility
Nexplanon (etonogestrel) wears off quickly after it has been removed. Most people will begin to ovulate again within 2 weeks of removal, meaning you can become pregnant during your first menstrual cycle off Nexplanon (etonogestrel). Be sure to switch to a different form of birth control or use a backup method of protection (e.g., condoms, diaphragms) as soon as you have Nexplanon (etonogestrel) removed to prevent unwanted pregnancies.
Liver problems
If you experience symptoms of liver problems like yellowing of the skin or eyes, pain in the right upper stomach, or dark urine, stop using Nexplanon (etonogestrel) and contact your provider right away. It's unclear whether Nexplanon (etonogestrel) can raise your risk for tumor in the liver. But people with liver problems and liver cancer shouldn't use Nexplanon (etonogestrel).
High blood pressure
If you've blood pressure that isn’t under control or within blood pressure goals, don’t use Nexplanon (etonogestrel). If you're taking medications to control your blood pressure, your provider might ask you to monitor your blood pressure regularly to make sure it doesn’t get unusually high. Most times, there aren't any obvious symptoms of high blood pressure. But if you notice changes in your vision, headache, a racing heart, or flushing, call your provider immediately.
High blood sugar and cholesterol levels
Nexplanon (etonogestrel) can raise your sugar and cholesterol levels in the blood. If you have a history of having high blood sugar, your provider might need to check your blood sugar levels more often to make sure they don’t get unusually high.
Weight gain
Nexplanon (etonogestrel) can cause you to gain weight. You can keep track of your weight after you've started this medication. If you're gaining weight too much too fast, talk with your provider and they can discuss with you about other options for birth control.
Gallbladder problems
- Risk factors: History of gallbladder condition
Though rare, Nexplanon (etonogestrel) might cause new or worsening gallbladder problems. Tell your provider if you’ve had gallbladder problems in the past so they can monitor you more closely. Get medical help if you experience any of the following symptoms so your provider can check your gallbladder: yellowing of the skin or eyes, fever, chills, nausea or vomiting with severe pain in the right upper stomach, dark urine, or light-colored stools.
Vision changes
- Risk factors: Wearing contact lens Let your provider know if you experience any vision changes after starting Nexplanon (etonogestrel). If so, you might need to have your vision checked by a specialist.
Nexplanon (etonogestrel) dosage
Typical dosage for Nexplanon (etonogestrel)
Nexplanon (etonogestrel) is placed under your skin in your upper arm by your healthcare provider at their office. Once placed, it can prevent pregnancy for up to 3 years.
Interactions between Nexplanon (etonogestrel) and other drugs
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.
- Amobarbital
- Apalutamide
- Aprepitant
- Aprobarbital
- Armodafinil
- Artemether
- Bexarotene
- Bosentan
- Brigatinib
- Butabarbital
- Butalbital
- Carbamazepine
- Cenobamate
- Clobazam
- Dabrafenib
- Darunavir
- Dexamethasone
- Elagolix
- Elvitegravir
- Encorafenib
- Enzalutamide
- Eslicarbazepine Acetate
- Eterobarb
- Etravirine
- Fosaprepitant
- Fosphenytoin
- Griseofulvin
- Heptabarbital
- Hexobarbital
- Isotretinoin
- Ivosidenib
- Lesinurad
- Lixisenatide
- Lorlatinib
- Lumacaftor
- Mephobarbital
- Methohexital
- Mitotane
- Modafinil
- Mycophenolic Acid
- Nafcillin
- Nevirapine
- Oxcarbazepine
- Pentobarbital
- Phenobarbital
- Phenylbutazone
- Phenytoin
- Pitolisant
- Prednisone
- Primidone
- Red Clover
- Rifabutin
- Rifampin
- Rifapentine
- Ritonavir
- Rufinamide
- Secobarbital
- St John's Wort
- Sugammadex
- Tazemetostat
- Telaprevir
- Theophylline
- Thiopental
- Topiramate
- Ulipristal
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.
Nexplanon (etonogestrel) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Nexplanon (etonogestrel) will not be safe for you to take.
- Pregnancy
- History of breast cancer or other progestin-sensitive cancer
- Have bleeding between your periods of which the cause hasn't yet been diagnosed by your provider
- History of blood clots or clotting disorders
- Have liver tumor, either benign or cancerous
- Acute (sudden) liver disease
What are alternatives to Nexplanon (etonogestrel)?
News about Nexplanon (etonogestrel)
Nexplanon (etonogestrel) images
