Nexplanon, the brand name for the prescription birth control implant etonogestrel, is a single-hormone contraceptive that steadily releases the hormone progestin, providing women with long-term contraception for up to three years. The implant requires a healthcare professional to insert and remove it. The most common side effect of Nexplanon is a change in the menstrual bleeding pattern. Other common side effects include mood swings, weight gain, headache, acne, and depressed mood. Women should not use Nexplanon who may be pregnant, have a history of blood clots, have liver disease, have unexplained vaginal bleeding, or have a history of breast cancer.
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Nexplanon overview
BRAND NAMES:
Nexplanon
Generic Names:
Etonogestrel implant
Uses:
Nexplanon is a birth control implant made up of a slow-releasing hormone that is used to prevent pregnancy. It prevents pregnancy from occurring in three ways: it stops the release of an egg from the ovary, it thickens mucus in the cervix making it harder for the sperm to reach the egg, and it thins the lining of the uterus making implantation of the egg more difficult. Nexplanon is available as a small plastic rod that is implanted under the skin of the upper arm by a healthcare professional. It may remain there for up to three years before being removed by a healthcare professional.
Therapeutic Classes:
Contraceptive
Progestin
Forms:
Implant
How it’s taken:
Subdermal (just under the skin) implant
What is Nexplanon used for?
A prescription birth control method for the prevention of pregnancy
Expert tips for using Nexplanon
A healthcare professional will place the Nexplanon implant using a minor surgical procedure performed under a local anesthetic. The implant is placed just under the skin on the upper arm and may be removed at any time.
If you cannot feel the Nexplanon implant just under the skin, contact your healthcare professional immediately. Use a different, non-hormonal birth control method until it is confirmed that the implant is in place.
Nexplanon may cause changes to your normal menstrual patterns such as longer or shorter bleeding during your periods, spotting between periods, no bleeding at all, or the time between periods may change.
Tell your healthcare professional about all medicines you take, including over-the-counter (OTC) drugs, vitamins, and herbal supplements. Some medicines may cause Nexplanon to be less effective.
What form(s) does Nexplanon come in
Implant
68 mg
What are common Nexplanon doses?
Single 68 mg implant for up to three years
Common Nexplanon prescriptions
Nexplanon
68mg implant
How to take Nexplanon
Read and follow the patient instructions that come with Nexplanon. Talk to your healthcare provider or pharmacist if you have any questions.
This medicine is an implant. It will be surgically placed under the skin of your upper, inner arm by a nurse or other trained healthcare professional.
The implant must be removed after three years. You may have a new one inserted after three years if you still want to use it as a form of birth control. However, it can be removed at any time if you want to stop using it.
You might have to use another form of birth control for seven days after the implant is inserted.
Gently press your fingertips over the skin where the implant was inserted. You should be able to feel the implant.
If at any time you cannot feel the Nexplanon implant, contact your healthcare professional immediately and use a non-hormonal birth control method until your healthcare professional confirms that the implant is in place.
What to do if you miss a dose of Nexplanon
Not applicable
Nexplanon contraindications
Nexplanon is not right for everyone. You should not use Nexplanon if you:
Are pregnant or think you may be pregnant
Have, or have had, blood clots in your legs (deep vein thrombosis), lungs (pulmonary embolism), eyes (total or partial blindness), heart (heart attack), or brain (stroke)
Have, or have had, liver disease or a liver tumor
Have unexplained vaginal bleeding
Have, or have had, breast cancer or any other cancer that is sensitive to progestin
An allergy to the active drug or any inactive ingredients in the Nexplanon implant
Nexplanon warnings
Your healthcare provider will check your progress and the effects of this medicine at regular visits. Keep all appointments.
Tell any doctor or dentist who treats you that you are using Nexplanon. This medicine may affect certain medical test results.
You might need to have the implant removed if you will be inactive for a period of time (e.g., after major surgery) because of the risk of blood clots.
This medicine will not protect you from HIV/AIDS or other sexually transmitted diseases.
This medicine may change your usual menstrual cycle. You might have irregular bleeding, or your periods may be lighter, shorter, heavier, or longer. You might not have a period in some cycles.
This medicine may cause the following problems:
Ectopic (tubal) pregnancy
Increased risk of heart attack, stroke, or blood clots
Cysts in the ovaries
Increased risk of breast cancer
Liver cancers or tumors
High blood pressure
Tell your healthcare provider if you are breastfeeding, or if you have recently given birth, or if you have kidney disease, cancer, blood circulation problems, high blood pressure, diabetes or prediabetes, high cholesterol, a history of depression, or if you smoke.
Tell your healthcare provider immediately if you think you have become pregnant. The implant will need to be removed.
Nexplanon interactions
Tell any healthcare provider or dentist who treats you that you are using Nexplanon. This medicine may affect certain medical test results.
Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
Do not eat grapefruit or drink grapefruit juice while you are using this medicine. This may increase the amount of etonogestrel in your body, which could raise your risk of side effects.
Some foods and medicines can affect how Nexplanon works. Tell your healthcare professional if you are using any of the following:
Aprepitant
Bosentan
Carbamazepine
Cyclosporine
Felbamate
Fluconazole
Griseofulvin
Itraconazole
Ketoconazole
Lamotrigine
Oxcarbazepine
Phenobarbital
Phenytoin
Rifabutin
Rifampicin
Rifampin
Rufinamide
St John's wort
Topiramate
Voriconazole
Any medicine for HIV/AIDS
Nexplanon side effects
The most common potential side effects of Nexplanon include:
Mild headache
Weight gain
Mild pain, tingling, bleeding, bruising, redness, itching, or swelling where the implant is placed
Mood changes
Acne or pimples
Potential serious side effects of Nexplanon include:
Severe or ongoing pain, tingling, bleeding, bruising, redness, itching, or swelling where the implant is placed
Chest pain, trouble breathing, or coughing up blood
Allergic reaction: itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, or trouble breathing
Double vision or trouble seeing
Dark urine or pale stools
Nausea, vomiting, loss of appetite, or stomach pain
Yellow skin or eyes
Numbness or weakness on one side of your body
Sudden or severe headache
Problems with vision, speech, or walking
Unusual or severe pain in your abdomen
Unusual or unexpected vaginal bleeding or heavy bleeding
Pain in your lower leg (calf)
You should contact your healthcare provider if you experience any of the following symptoms:
Pain in your lower leg that does not go away
Severe chest pain or heaviness in the chest
Sudden shortness of breath, sharp chest pain, or coughing blood
Symptoms of a severe allergic reaction, such as swollen face, tongue or throat; trouble breathing or swallowing
Sudden severe headache unlike your usual headaches
Weakness or numbness in your arm, leg, or trouble speaking
Sudden partial or complete blindness
Yellowing of your skin or whites of your eyes, especially with fever, tiredness, loss of appetite, dark colored urine, or light-colored bowel movements
Severe pain, swelling, or tenderness in the lower stomach (abdomen)
Lump in your breast
Problems sleeping, lack of energy, tiredness, or you feel very sad
Heavy menstrual bleeding
Sources:
Nexplanon (etonogestrel implant), FDA label
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