etonogestrel (Intradermal route)
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Contraceptive, Progestin
Pharmacologic Class: Progestin
Uses For etonogestrel
Etonogestrel implant is a medicine that is used in women to prevent pregnancy. It is a form of birth control. etonogestrel contains a hormone in a flexible plastic rod about the size of a matchstick. It is effective for three years when inserted just beneath the skin of your upper arm.
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.
etonogestrel is available only with your doctor's prescription.
Before Using etonogestrel
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 etonogestrel, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to etonogestrel 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. etonogestrel 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. etonogestrel should not be used 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.
Interactions with Medicines
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 etonogestrel, 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 etonogestrel 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.
- Tranexamic Acid
Using etonogestrel 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 etonogestrel 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
Interactions with Food/Tobacco/Alcohol
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 etonogestrel 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 etonogestrel, or give you special instructions about the use of food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of etonogestrel. Make sure you tell your doctor if you have any other medical problems, especially:
- Abnormal or unusual vaginal bleeding (non-menstrual) or
- Breast cancer, now or in the past or if suspected or
- Cancer (progestin-sensitive), now or in the past or
- Liver disease, active or
- Liver tumors, benign or malignant—Should not be used in patients with these conditions.
- Blood clots, now or in the past—Should not be used in patients with blood clots in the brain, legs, lungs, eyes, or heart.
- Depression, or history of or
- Diabetes or
- Fluid retention (body swelling) or
- Gallbladder disease or
- Heart disease or
- Hypertension (high blood pressure) or
- Hyperlipidemia (high cholesterol or fats in the blood)—Use with caution. May make these conditions worse.
- Obesity—This condition may cause the medicine to not work as well.
Proper Use of etonogestrel
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 etonogestrel. Tests will be done to make sure you are not pregnant before etonogestrel is inserted.
etonogestrel 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 etonogestrel. The Consent Form tells you about some possible risks when using etonogestrel, 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 to answer them.
After etonogestrel is inserted, you should check that it is in place. Gently press your fingertips over the skin in your arm where etonogestrel was inserted. You should be able to feel the small rod.
You may have to use another form of birth control (e.g., condoms, diaphragms, or spermicides) until the implant has been in place for 7 days. Talk with your doctor about this.
Your doctor must remove etonogestrel after 3 years. If you would like to stop using etonogestrel, your doctor can remove it at any time.
If you still want to prevent pregnancy after etonogestrel is removed, you should start using another form of birth control (e.g., condoms, diaphragms, or spermicides) right away. If you still want to continue using etonogestrel, your doctor can insert a new implant under your skin after taking the old one out.
Precautions While Using etonogestrel
If you will be using the etonogestrel implant for a long time, it is very important that your doctor check you at regular visits for any problems or unwanted effects that may be caused by etonogestrel.
If you become pregnant while using etonogestrel, you have a slightly higher chance of having an ectopic pregnancy (occurs outside the womb). Ectopic pregnancies can cause serious internal bleeding. Contact your doctor immediately to have the implant removed.
Tell your doctor if you are breastfeeding or planning to breastfeed. You may start using etonogestrel if you had a baby more than 4 weeks ago.
Etonogestrel implant will not protect you against HIV/AIDS or other sexually transmitted diseases. The use of latex (rubber) condoms or abstinence (not having sex) is recommended for protection from these diseases.
Tell your doctor if you have 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.
etonogestrel 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.
Using etonogestrel 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 a surgery or will need to be on bed rest. Your risk of these serious medical problems is greater during surgery or bed rest, or if you smoke cigarettes.
etonogestrel may also increase your risk of having irregular monthly periods, ovarian cysts, high blood pressure, gallbladder problems, or liver tumors.
Call your doctor right away if you have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.
If you wear contact lenses and you have blurred vision, difficulty in reading, or any other change in vision while using etonogestrel, check with your doctor right away. Your doctor may want you to get your eyes checked by an eye doctor (ophthalmologist).
etonogestrel 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.
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 etonogestrel.
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.
etonogestrel Side Effects
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
- general feeling of discomfort or illness
- joint pain
- loss of appetite
- muscle aches and pain
- runny nose
- sore throat
- trouble sleeping
- unusual tiredness or weakness
- 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 injection site
- blurred vision or other changes in vision
- breast discharge
- breast enlargement
- burning while urinating
- difficult or painful urination
- difficulty with breathing
- difficulty with swallowing
- fast heartbeat
- headache, severe and throbbing
- lumps in the breasts
- 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
- skin rash
- slow or fast heartbeat
- stomach or pelvic discomfort, aching, or heaviness
- swelling of the hands, ankles, feet, or lower legs
- tightness in the chest
- Collection of blood under the skin at the injection site
- deep, dark purple bruise at the injection 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
- ear congestion
- feeling sad or empty
- increased clear or white vaginal discharge
- increased weight
- irregular bleeding cycle
- itching of the vagina or genital area
- light vaginal bleeding between regular menstrual periods
- loss of interest or pleasure
- loss of voice
- mental depression
- nasal congestion
- pain, cramps, or heavy menstrual bleeding
- pain during sexual intercourse
- pain or tenderness around the eyes and cheekbones
- 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
- Abdominal or stomach bloating and cramping
- abnormal ejaculation
- abnormal or decreased touch sensation
- acid or sour stomach
- bone pain
- burning feeling in the chest or stomach
- decreased interest in sexual intercourse
- difficulty having a bowel movement (stool)
- difficulty with moving
- dull ache or feeling of pressure or heaviness in the legs
- earache, redness, or swelling in the ear
- 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
- 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
- sleepiness or unusual drowsiness
- stomach upset or pain
- stuffy nose
- swollen joints
- tenderness in the stomach area
- unable to sleep
- vaginal burning or pain
- weight loss
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.
See also: Side effects (in more detail)
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More about etonogestrel
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- Support Group
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- Drug class: contraceptives