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etonogestrel

Generic Name: etonogestrel (implant) (e toe noe JES trel)
Brand Name: Implanon, Nexplanon

What is etonogestrel implant?

Etonogestrel is a hormone that prevents ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.

Etonogestrel implant is used as contraception to prevent pregnancy. The medicine is contained in a small plastic rod that is implanted into the skin of your upper arm. The medicine is released slowly into the body. The rod can remain in place and provide continuous contraception for up to 3 years.

Etonogestrel implant may also be used for purposes not listed in this medication guide.

What is the most important information I should know about etonogestrel?

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.

Slideshow: Emergency Contraception Laid Bare - The 10 Biggest Myths Revealed

Do not use if you are pregnant or if you have recently had a baby.

Smoking can increase your risk of blood clot, stroke, or heart attack while using this medicine.

What should I discuss with my healthcare provider before receiving the etonogestrel implant?

Do not use if you are pregnant. If you have recently had a baby, wait at least 3 weeks (4 weeks if breast-feeding) before receiving an etonogestrel implant.

You may need to have a negative pregnancy test before receiving the implant.

You should not use this implant if you are allergic to etonogestrel, or if you have:

  • a history of heart attack, stroke, or blood clot;

  • a history of hormone-related cancer such as breast or uterine cancer;

  • unusual vaginal bleeding that has not been checked by a doctor; or

  • liver disease or liver cancer.

To make sure etonogestrel implant is safe for you, tell your doctor if you have:

  • diabetes;

  • high cholesterol or triglycerides, or if you are overweight;

  • high blood pressure;

  • headaches;

  • gallbladder disease;

  • a history of depression; or

  • if you are allergic to numbing medicines.

The etonogestrel implant should not be used in girls younger than 18 years old.

Do not use the implant if you are breast-feeding a baby younger than 4 weeks old.

How is the etonogestrel implant used?

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.

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.

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 (you may be pregnant).

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.

Have regular physical exams and mammograms, and self-examine your breasts for lumps on a monthly basis while using this medicine.

What happens 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. Be sure to see your doctor for removal of the implant by the end of the third year.

What happens if I overdose?

If the implant is correctly inserted, an overdose of etonogestrel is highly unlikely.

What should I avoid while taking etonogestrel implant?

Do not smoke while using etonogestrel implant, especially if you are older than 35. Smoking can increase your risk of blood clots, stroke, or heart attack caused by etonogestrel implant.

Etonogestrel implant will not protect you from sexually transmitted diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.

Etonogestrel implant side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

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;

  • jaundice (yellowing of the skin or eyes);

  • a breast lump; or

  • symptoms of depression (sleep problems, weakness, tired feeling, mood changes).

Common side effects may include:

  • changes in your menstrual periods;

  • light menstrual bleeding or spotting;

  • stomach pain;

  • breast tenderness;

  • acne;

  • weight gain;

  • vaginal itching or discharge; or

  • problems with contact lenses.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Etonogestrel dosing information

Usual Adult Dose for Contraception:

One 68 mg implant inserted subdermally. The implant should not be left in place more than three years.

The timing of insertion must be done according to the patient's recent history, as follows:

If no preceding hormonal contraceptive use in the past month, the implant must be inserted between Days 1 through 5, (counting the first day of menstruation as "Day 1"), even if the woman is still bleeding.

If switching from a combination hormonal contraceptive, the implant may be inserted anytime within seven days after the last active (estrogen plus progestin) oral contraceptive tablet, anytime during the seven-day ring-free period of NuvaRing (etonogestrel/ethinyl estradiol vaginal ring), or anytime during the seven-day patch-free period of a transdermal contraceptive system.

If switching from a progestin-only method, the implant must inserted as follows: if switching from a progestin-only pill, any day of the month (do not skip any days between the last pill and insertion); if switching from a progestin-only implant, insert the implant on the same day as contraceptive implant removal; if switching from a progestin-containing IUD, insert the implant on the same day as contraceptive implant removal; if switching from a contraceptive injection, insert the implant on the day when the next injection would be due.

Following first trimester abortion or miscarriage: the implant may be inserted immediately following a complete first trimester abortion. If it is not inserted within five days following a first trimester abortion, follow the instructions under no preceding hormonal contraceptive use in the past month.

Following delivery or a second trimester abortion: the implant may be inserted between 21 to 28 days postpartum if not exclusively breast feeding or between 21 to 28 days following second trimester abortion. If more than four weeks have elapsed, pregnancy should be excluded and the patient should use a non-hormonal method of birth control during the first seven days after the insertion. If the patient is exclusively breast-feeding, insert the implant after the fourth postpartum week.

What other drugs will affect etonogestrel implant?

Tell your doctor about all medicines you use, and those you start or stop using during your while your etonogestrel implant is in place, especially:

  • bosentan;

  • griseofulvin;

  • rifampin;

  • St. John's wort;

  • topiramate;

  • medicine to treat HIV or AIDS;

  • a barbiturate--butabarbital, secobarbital, phenobarbital (Solfoton); or

  • seizure medicine--carbamazepine, felbamate, oxcarbazepine, phenytoin.

This list is not complete. Other drugs may interact with etonogestrel, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about etonogestrel implant.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.04. Revision Date: 2015-01-14, 5:03:41 PM.

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