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Overview: Nexplanon is a birth control implant that is inserted under the skin in the inner arm to prevent pregnancy for up to three years. It works by slowly releasing a progestin hormone, called etonogestrel, into your body. Common side effects include changes in menstrual bleeding, headache, vaginal inflammation, and acne. Serious side effects are rare, but can include blood clots or ovarian cysts.

Uses

What is Nexplanon used for?

Nexplanon (etonogestrel) is a birth control implant that is placed under the skin in the inner arm and is commonly used to prevent pregnancy for up to three years.

Nexplanon may also be used for other conditions as determined by your healthcare provider.

How does Nexplanon work (mechanism of action)?

Nexplanon is an implant that is inserted under the skin in the inner arm. It works by slowly releasing a progestin hormone, called etonogestrel, into the body. It prevents pregnancy by stopping the release of an egg from the ovaries (ovulation). It also works by thickening the mucus in your cervix to block sperm from reaching the uterus, and by changing the lining of your uterus to make it less likely for a pregnancy to happen.

How is Nexplanon supplied (dosage forms)?

Brands and other names

  • Implanon
  • Nexplanon

Dosage forms and strengths

  • 68 mg implant

How should I store Nexplanon?

Nexplanon is usually inserted by a healthcare provider during an in-office visit. You will not store it at home.

Side Effects

What are the most common side effects of Nexplanon?

The most common side effects of Nexplanon are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Changes in menstrual bleeding (see below)
  • Headache, nausea, or dizziness
  • Vaginal inflammation (vaginitis)
  • Weight gain
  • Acne
  • Breast, stomach, or back pain 
  • Painful periods 
  • Sore throat or flu-like symptoms
  • Mood swings, nervousness, or depressed mood
  • Pain where the implant is inserted

There may be other side effects of Nexplanon that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Nexplanon?

While less common, the most serious side effects of Nexplanon are described below, along with what to do if they happen.

Severe Allergic Reactions. Nexplanon may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Placement Problems. Some people may feel faint or dizzy a few minutes right after Nexplanon is inserted. Pain, irritation, numbness, tingling, swelling, or bruising can also occur at the insertion site. If Nexplanon is inserted too deep, it may cause nerve or blood vessel damage, or lead to the implant moving to a different part of your body. Tell your healthcare provider right away if you cannot feel the implant after it has been inserted. Also tell your healthcare provider if you have any side effects at the injection site that are severe or that bother you.

Blood Clots. Nexplanon may cause a blood clot in your arteries or veins and could cause a stroke, heart attack, or venous thromboembolism (VTE), including a blood clot in the lung (pulmonary embolism), in the back of your eye (retinal vein occlusion), or in your leg or arm (deep venous thrombosis). Get emergency help if you have any of the following signs of a blood clot.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech
  • Pain, swelling, or tenderness in your arm or leg
  • Vision loss
  • Bulging eyes
  • Double vision

Changes in Menstrual Bleeding. Nexplanon can cause your period to become irregular, longer, and heavier. It can also cause spotting or light bleeding between periods. For some people, periods become shorter or stop. Call your healthcare provider right away if bleeding is heavier or lasts longer than usual, or if it increases after it has been light or absent for a while.

Ectopic Pregnancy. If you become pregnant while using Nexplanon, you may be at higher risk of that pregnancy being outside the uterus (ectopic pregnancy). As the fertilized egg grows, it can burst (rupture) and cause life-threatening bleeding and death. Call your healthcare provider right away if you think you might be pregnant or have any of the following symptoms. 

  • Pain in your lower stomach or vomiting
  • Sharp belly cramps 
  • Unusual vaginal bleeding or discharge
  • Pain on one side of your body
  • Dizziness or weakness
  • Pain in your shoulder, neck, or rectum
  • Fever, chills, or flu-like symptoms

Ovarian Cysts. Nexplanon may cause cysts to form on your ovaries. Some ovarian cysts are harmless and go away on their own, while others may grow and cause bloating, swelling, or pain in your lower belly. Get emergency help right away if you have any of the following symptoms that an ovarian cyst has burst.

  • Sharp, sudden pain in your lower belly or back
  • Abnormal spotting or bleeding
  • Pain with fever and throwing up
  • Dizziness, weakness, or feeling faint
  • Fast breathing (hyperventilation)

Warnings & Precautions

Who should not use Nexplanon?

Allergies to Ingredients. People who are allergic to any of the following should not use Nexplanon.

  • Nexplanon
  • Etonogestrel
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Nexplanon.

Pregnancy. Do not use Nexplanon if you are or think you might be pregnant. If you become pregnant, contact your healthcare provider right away. See the Pregnancy section for more details.

Blood Clots. Nexplanon should not be used if you have or have had blood clots, including a blood clot in the lungs (pulmonary embolism) or in the leg or arm deep venous thrombosis (DVT). The medicine may increase the risk of developing a blood clot that could be dangerous or even deadly.

Heart Attack or Stroke. Nexplanon should not be used if you have had a stroke or heart attack. Nexplanon can increase the risk of having a heart attack or stroke that could be dangerous or even deadly.

Liver Problems. Nexplanon should not be used if you have liver disease or a liver tumor. If there is a concern about the health of your liver, your healthcare provider may do tests to determine if it is working well enough to use this medicine.  

Unusual Vaginal Bleeding. Nexplanon should not be used if you have bleeding from the uterus or vagina that is not part of your menstrual cycle or is abnormal for you. 

Cancer. Nexplanon should not be used if you have, think you have, or have had breast cancer. It also should not be used if you have or have had a cancer that is sensitive to progestin (a type of hormone). These conditions could get worse if you use Nexplanon.

What should I know about Nexplanon before using it?

Nexplanon is an implant and will be inserted by your healthcare provider at a medical facility. It will be removed or replaced after three years, but can be removed at any time.

Nexplanon does not protect you from HIV, AIDS, or other sexually transmitted diseases (STDs). 

Expect your appointment to have Nexplanon inserted to be at a specific time of your menstrual cycle. Talk to your healthcare provider about whether and for how long you may need to use backup birth control options (such as condoms) after Nexplanon is placed in your arm. 

Follow your healthcare provider’s instructions for how to take care of the area where Nexplanon is implanted to prevent infection or other problems. 

It is possible for Nexplanon to break or bend while it is in your arm if the implant is accidentally hit or manipulated. Contact your healthcare provider right away if you feel the implant is broken, bent, or out of place. Use backup birth control until Nexplanon can be replaced. 

Tell your healthcare provider right away if you cannot feel the implant after it has been inserted.

You may need special X-rays or other imaging to check whether Nexplanon is in place, or to help find the implant when it is time to take it out. Depending on the exact position of the implant and scar tissue, removal may be difficult and may require surgery. Talk to your healthcare provider if you have questions.

What should I tell my healthcare provider before using Nexplanon?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Nexplanon is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Diabetes
  • High cholesterol or triglycerides
  • Headaches
  • Gallbladder, kidney, or liver problems
  • Depression 
  • High blood pressure (hypertension)
  • Allergy to any medicine known as an anesthetic or antiseptic
  • History of cancer

Upcoming Surgery or Bed Rest. You may be at higher risk for blood clots if you do not move around normally for an extended period of time. Tell your healthcare provider if you have any upcoming surgeries or need to be on bed rest. Your healthcare provider can tell you if or when you need to stop using Nexplanon.

Smoking. Smoking can increase your risk of having a serious blood clot, including a heart attack or stroke. Before starting Nexplanon, tell your healthcare provider if you smoke. 

Other Medicines and Supplements. Nexplanon may interact with other medicines and supplements. Before using Nexplanon, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Nexplanon should not be used if you are pregnant. Tell your healthcare provider if you are, think you are, or plan to become pregnant. If you become pregnant while using Nexplanon, contact your healthcare provider right away to have the implant removed. 

Breastfeeding. Nexplanon passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use Nexplanon while breastfeeding.

How can I get more information about Nexplanon?

For more information about Nexplanon, you can visit the manufacturer’s website at www.nexplanon.com or call them at 844-674-3200.

Interactions

Does Nexplanon interact with foods or drinks?

Eating grapefruit or drinking grapefruit juice while using Nexplanon can increase levels of the medicine in your body and increase the risk for side effects. Talk to your healthcare provider if you eat grapefruit or drink grapefruit juice. 

It is unknown if drinking alcohol will affect Nexplanon.

Does Nexplanon interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Nexplanon.

  • Aprepitant, which is a medicine used to prevent nausea and vomiting caused by chemotherapy 
  • A barbiturate, such as phenobarbital, butalbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
  • Bosentan, which is a medicine used to treat a condition called pulmonary arterial hypertension (PAH)
  • Any medicine that may be used to treat seizures, such as carbamazepine (Carbatrol, Tegretol, and others), phenytoin (Dilantin, Phenytek, and others), felbamate, oxcarbazepine (Trileptal, Oxtellar XR), lamotrigine, or topiramate (Topamax, Trokendi XR, Qudexy XR)
  • Griseofulvin, ketoconazole, itraconazole (Sporanox, Tolsura), fluconazole (Diflucan), or voriconazole (Vfend), which is a medicine used for fungal infections
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Rifabutin (Mycobutin), which is a medicine used to prevent Mycobacterium avium complex infection
  • St. John’s wort, which is a supplement that may be used for depression
  • A medicine for HIV, AIDS, or hepatitis C
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system

Some other medicines may alter the blood levels of Nexplanon, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Nexplanon. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Nexplanon?

If you or someone else has used too much Nexplanon, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Nexplanon?

Nexplanon is implanted by a healthcare provider and left in place for up to three years. If it has been in place for more than three years or if it is out of place, bent, or dislodged, avoid sexual intercourse or use a backup birth control (such as condoms) and contact your healthcare provider right away.

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