NEXPLANON®

NEXPLANON® is a radiopaque, progestin-only subdermal contraceptive implant that contains 68 mg of etonogestrel, a synthetic hormone that prevents pregnancy. It is a long-acting reversible contraceptive (LARC) that provides effective birth control for up to 3 years. The implant is 4 cm long and 2 mm in diameter, made of ethylene vinyl acetate, and is inserted under the skin of the non-dominant upper arm using a pre-loaded sterile applicator.

The device works by suppressing ovulation, increasing cervical mucus viscosity, and altering the endometrial lining, thus reducing the likelihood of fertilization and implantation. Its radiopaque marker (barium sulfate) allows for easy detection via X-ray, improving clinical safety during localization and removal.

NEXPLANON® must be inserted subdermally by a trained healthcare professional under sterile conditions.

Key features:

• Provides up to 3 years of contraceptive protection
  
• Inserted in non-dominant arm, subdermally, 8–10 cm from the medial epicondyle
  

Administration details:

• Insert between days 1–5 of the menstrual cycle if no hormonal contraception used
  
• Insert on the same day when switching from another implant or IUD
  
• For postpartum non-breastfeeding: insert between days 21–28
  
• Breastfeeding: insert after 4th postpartum week
  
• Use local anesthesia, verify implant placement by palpation
  
• Confirm placement using X-ray, ultrasound, or MRI if not palpable
  

Indications:

• Prevention of pregnancy in women for up to 3 years
  

Contraindications:

• Known or suspected pregnancy
  
• History of thrombosis or thromboembolic disorders
  
• Liver tumors or active liver disease
  
• Unexplained vaginal bleeding
  
• Known or suspected breast cancer
  
• Allergy to etonogestrel or any implant components

Side effects may include:

• Menstrual irregularities (most common)
  
• Weight gain, headache, acne
  
• Insertion site pain, swelling, or infection
  
• Rare: vascular complications, implant migration, ectopic pregnancy
  

Each implant contains:

• 68 mg etonogestrel – active ingredient
  
• 15 mg barium sulfate – for radiopacity
  
• 0.1 mg magnesium stearate
  
• Implant core made from ethylene vinyl acetate (EVA) copolymer
  

No latex. Drug release rate decreases over time:

• ~60–70 mcg/day at week 6
  
• ~25–30 mcg/day by end of year 3
  

Each NEXPLANON® package includes:

• 1 sterile implant (preloaded in disposable applicator)
  
• Implant: radiopaque, 4 cm x 2 mm rod
  
• Sterile blister pack and prescribing information
  

Yes, some women may experience adverse effects, most of which are mild and temporary.

Common side effects (≥10%):

• Irregular bleeding patterns
  
• Headache, vaginitis
  
• Weight increase, acne
  
• Breast tenderness, abdominal pain
  

Less common or serious side effects:

• Ectopic pregnancy
  
• Depressed mood
  
• Ovarian cysts
  
• Vascular complications (e.g., thrombosis, pulmonary embolism)
  
• Insertion complications (e.g., migration, nerve injury)
  

Storage instructions:

• Store at 15–30°C (59–86°F) – controlled room temperature
  
• Do not expose to temperatures above 30°C
  
• Keep in original sterile packaging until use
  
• Dispose of applicator as hazardous waste