Questions and Answers About NEXPLANON® (etonogestrel implant) 68mg

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Questions and Answers

Here are some frequently asked questions and answers about NEXPLANON.

Questions about NEXPLANON

What is NEXPLANON?

NEXPLANON is a small, thin and flexible birth control implant that provides up to 3 years of continuous pregnancy prevention. It’s placed discreetly under the skin of your inner, upper arm by your health care provider.

Is NEXPLANON an IUD?

No, it's not an intrauterine device (IUD) because it’s placed in your arm, not in your uterus. But like an IUD, it’s a long-acting birth control option because it lasts for up to 3 years.

No, it's not an intrauterine device (IUD) because it’s placed in your arm, not your uterus. But like an IUD, it’s a long-acting birth control option because it lasts for up to 3 years.

How big is NEXPLANON?

NEXPLANON is small. It’s 1.6 inches (4cm) in length.

How does NEXPLANON work?

NEXPLANON puts a steady, low dose of hormone into your bloodstream. NEXPLANON works for up to 3 years to prevent pregnancy. NEXPLANON prevents pregnancy in several ways. The most important way is by stopping the release of an egg from your ovary. NEXPLANON also thickens the mucus in your cervix and this change may keep sperm from reaching the egg. NEXPLANON also changes the lining of your uterus.

Does NEXPLANON contain estrogen?

No. NEXPLANON does not contain estrogen.

Does NEXPLANON work as well as the pill?

NEXPLANON is over 99% effective (less than 1 pregnancy per 100 women who used NEXPLANON for 1 year) at preventing pregnancy and you don’t have to remember to take it every day. NEXPLANON is one of the most effective forms of birth controls available.

What if I want NEXPLANON for more than 3 years?

The NEXPLANON implant must be removed after 3 years. Your health care provider can insert a new implant under your skin after taking out the old one if you choose to continue using NEXPLANON for birth control.

What if I change my mind and want to stop using NEXPLANON before 3 years?

Your health care provider can remove the implant at any time. You may become pregnant as early as the first week after removal of the implant. If you do not want to get pregnant after your health care provider removes the NEXPLANON implant, you should start another birth control method right away.

Will NEXPLANON affect my period?

The most common side effect of NEXPLANON is a change in your normal menstrual bleeding pattern. In studies, one out of ten women stopped using the implant because of an unfavorable change in their bleeding pattern. Your period may be longer or shorter, or you may have no bleeding at all. The time between periods may vary, and you may also have spotting in between periods.

Questions about insertion and removal

How do I get NEXPLANON?

In order to get NEXPLANON inserted, you can make an appointment with a health care provider who has been trained to insert and remove NEXPLANON. Call your health care provider to see if they have been trained. Only you and your health care provider can decide if NEXPLANON is the right birth control option for you.

When should I have NEXPLANON inserted in my arm?

Your health care provider will help you determine when to have NEXPLANON inserted. The timing will depend upon whether you are currently using birth control and which method you are using. You should not use NEXPLANON if you are pregnant or think you may be pregnant.

Your health care provider may:

Perform a pregnancy test before inserting NEXPLANON
Schedule the insertion at a specific time of your menstrual cycle (for example, within the first days of your regular menstrual bleeding)

How is NEXPLANON inserted in the arm?

NEXPLANON is inserted discreetly under the skin of your inner, upper arm by a trained health care provider. This minor surgical procedure is done in their office, and in a clinical study, the average time to actually insert NEXPLANON was under a minute. Find out more about insertion and removal.

What do I need to do after the insertion?

Immediately after the NEXPLANON implant has been placed, you and your health care provider should check that the implant is in your arm by feeling for it. If you cannot feel the implant immediately after insertion, the implant may not have been inserted, or it may have been inserted deeply. A deep insertion may cause problems with locating and removing the implant. Once the health care professional has located the implant, removal may be recommended. If at any time you cannot feel the NEXPLANON implant, contact your health care provider immediately and use a non-hormonal birth control method (such as condoms) until your health care provider confirms that the implant is in place. You may need special tests to check that the implant is in place or to help find the implant when it is time to take it out. If the implant cannot be found in the arm after a thorough search, your health care professional may use x-rays or other imaging methods on your chest. Depending on the exact position of the implant, removal may be difficult and may require surgery.

How do I get NEXPLANON removed?

NEXPLANON can be removed at any time by your health care provider during the 3-year period, but must be removed by the end of the third year.

Removal of NEXPLANON involves a minor surgical procedure in which your health care provider makes a small incision in your arm where NEXPLANON is located.

What are the possible risks of the insertion and removal procedure?

The implant may not be placed in your arm at all due to a failed insertion. If this happens, you may become pregnant. Immediately after the insertion, you and your health care provider will feel for it to ensure that NEXPLANON has been placed correctly. If you can’t feel it, contact your health care provider immediately and use a non-hormonal birth control method (such as condoms) until your health care provider confirms the implant is in place. Location and removal of the implant may be difficult or impossible because the implant is not where it should be. Special procedures, including surgery in the hospital, may be needed to remove the implant. If the implant is not removed, then the effects of NEXPLANON will continue for a longer period of time.

Implants have been found in the pulmonary artery (a blood vessel in the lung). If the implant cannot be found in the arm, your health care professional may use x-rays or other imaging methods on the chest. If the implant is located in the chest, surgery may be needed.

Other problems related to insertion and removal are:

Pain, irritation, swelling, or bruising at the insertion site
Scarring, including a thick scar called a keloid around the insertion site
Infection
Scar tissue may form around the implant making it difficult to remove
The implant may come out by itself. You may become pregnant if the implant comes out by itself. Use a back-up birth control method and call your health care provider right away if the implant comes out
The need for surgery in the hospital to remove the implant
Injury to nerves or blood vessels in your arm
The implant breaks making removal difficult

Questions about using it

When should I call my health care provider?

Call your health care provider right away if you have:

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 pharynx; trouble swallowing; or hives and trouble breathing
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
Felt that the implant may have broken or bent while in your arm

What medicines can interact with NEXPLANON (etonogestrel implant)?

Tell your health care provider about all the medicines you take, including prescription and nonprescription medicines, vitamins and herbal supplements. Certain medicines may make NEXPLANON less effective, including:

Aprepitant
Barbiturates
Bosentan
Carbamazepine
Felbamate
Griseofulvin
Oxcarbazepine
Phenytoin
Rifampin
St. John's wort
Topiramate
HIV medicines
Hepatitis C Virus medicines

Ask your health care provider if you’re not sure if your medicine is listed above.

If you are taking medicines or herbal products that might make NEXPLANON less effective, you and your doctor may decide to leave NEXPLANON in place; in that case, an additional non-hormonal contraceptive should be used. Because the effect of another medicine on NEXPLANON may last up to 28 days after stopping the medicine, it is necessary to use the additional non-hormonal contraceptive for that long.

When you’re using NEXPLANON, tell all of your health care providers that you have NEXPLANON in place in your arm.

Who should not use NEXPLANON?

Do not use NEXPLANON if you:

Are pregnant or think you may be pregnant
Have, or have had serious blood clots, such as blood clots in your legs (deep venous thrombosis), lungs (pulmonary embolism), eyes (total or partial blindness), heart (heart attack), or brain (stroke)
Have liver disease or a liver tumor
Have unexplained vaginal bleeding
Have breast cancer or any other cancer that is sensitive to progestin (a female hormone), now or in the past
Are allergic to anything in NEXPLANON

Tell your health care provider if you have or have had any of the conditions listed above. Your health care provider can suggest a different method of birth control.

In addition, talk to your health care provider about using NEXPLANON if you have:

Diabetes
High cholesterol or triglycerides
Headaches
Gallbladder or kidney problems
A history of depressed mood
High blood pressure
An allergy to numbing medicines (anesthetics) or medicines used to clean your skin (antiseptics). These medicines will be used when the implant is placed into or removed from your arm.

What if I become pregnant while using NEXPLANON?

You should see your health care provider right away if you think that you might be pregnant. It’s important to remove NEXPLANON and make sure that the pregnancy is not ectopic (occurring outside the womb). Based on experience with other hormonal contraceptives, NEXPLANON is not likely to cause birth defects.

Can I use NEXPLANON when I am breastfeeding?

If you’re breastfeeding your child, you may use NEXPLANON if 4 weeks have passed since you had your baby. A small amount of the hormone contained in NEXPLANON passes into your breast milk. The health of breastfed children whose mothers were using the implant has been studied up to 3 years of age in a small number of children. No effects on the growth and development of the children were seen. If you’re breastfeeding and want to use NEXPLANON, talk with your health care provider for more information.

Will NEXPLANON be covered by insurance?

Check with your insurance plan for cost and coverage information. You may need to pay a co-pay, deductible, or other charges.

Support Program

NEXPLANON is a prescription medication for the prevention of pregnancy in women.

IMPORTANT SAFETY INFORMATION

You should not use NEXPLANON if you are pregnant or think you may be pregnant; have or have had blood clots; have liver disease or a liver tumor; have unexplained vaginal bleeding; have breast cancer or any other cancer that is sensitive to progestin (a female hormone), now or in the past; or are allergic to anything in NEXPLANON.
Talk to your health care provider about using NEXPLANON if you have diabetes, high cholesterol or triglycerides, headaches, gallbladder or kidney problems, history of depressed mood, high blood pressure, allergy to numbing medicines (anesthetics) or medicines used to clean your skin (antiseptics). These medicines will be used when the implant is placed into or removed from your arm.
Immediately after the NEXPLANON implant has been placed, you and your health care provider should check that the implant is in your arm by feeling for it. If you cannot feel the NEXPLANON implant, contact your health care provider immediately and use a non-hormonal birth control method (such as condoms) until your health care provider confirms that the implant is in place. You may need special tests to check that the implant is in place or to help find the implant when it is time to take it out.
The implant may not be placed in your arm at all due to failed insertion. If this happens, you may become pregnant. Removal of the implant may be very difficult or impossible if the implant is not where it should be. Special procedures, including surgery in the hospital, may be needed to remove the implant. If the implant is not removed, then the effects of NEXPLANON will continue for a longer period of time. Other problems related to insertion and removal include pain, irritation, swelling, bruising, scarring, infection, injury to the nerves or blood vessels, and breaking of the implant. Additionally, the implant may come out by itself. You may become pregnant if the implant comes out by itself. Use a back up birth control method and call your health care provider right away if the implant comes out.
The most common side effect of NEXPLANON is a change in your normal menstrual bleeding pattern. In studies, one out of ten women stopped using the implant because of an unfavorable change in their bleeding pattern. You may experience longer or shorter bleeding during your periods or have no bleeding at all. The time between periods may vary, and in between periods you may also have spotting.
If you become pregnant while using NEXPLANON, you have a slightly higher chance that the pregnancy will be ectopic (occurring outside the womb) than do women who do not use birth control. Ectopic pregnancies can cause serious internal bleeding, infertility, and even death. Call your health care provider right away if you think you are pregnant or have unexplained lower stomach (abdominal) pain.
The use of NEXPLANON may also increase your chance of serious blood clots, especially if you have other risk factors, such as smoking. If you smoke and want to use NEXPLANON, you should quit. Some examples of blood clots are deep vein thrombosis (legs), pulmonary embolism (lungs), retinal thrombosis (eyes), stroke (brain), and heart attack (heart). It is possible to die from a problem caused by a blood clot, such as a heart attack or stroke. Tell your doctor at least 4 weeks before if you are going to have surgery or will need to be on bed rest, because you have an increased chance of getting blood clots during surgery or bed rest.
Cysts may develop on the ovaries and usually go away without treatment, but sometimes surgery is needed to remove them.
Besides changes in menstrual bleeding patterns, other common side effects reported in women using NEXPLANON include: headaches; vaginitis (inflammation of the vagina); weight gain; acne; breast pain; viral infection such as sore throats or flu-like symptoms; stomach pain; painful periods; mood swings, nervousness, or depressed mood; back pain; nausea; dizziness; pain and pain at the site of insertion. Implants have been reported to be found in a blood vessel, including a blood vessel in the lung.
Call your health care provider right away if you have 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 headaches 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; or if you feel that the implant may have broken or bent while in your arm.
NEXPLANON does not protect against HIV or other STDs.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please read the accompanying Patient Information for NEXPLANON and discuss it with your health care provider. The physician Prescribing Information also is available.