Generic Name: etonogestrel (implant) (e toe noe JES trel)Brand Names: Implanon
Etonogestrel implant contains 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 other purposes not listed in this medication guide.
Before receiving the etonogestrel implant, tell your doctor if you have an ovarian cyst, heart disease, high cholesterol, diabetes, gallbladder disease, a seizure disorder, or if you are overweight.
Etonogestrel implant is inserted through a needle into the skin of your upper arm. The medicine is released slowly into the body from the implant. The implant can remain in place to provide continuous contraception for up to 3 years.You will most likely 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 to have any type of medical tests or surgery, or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are using etonogestrel implant.
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. If you choose not to replace the implant, your ability to get pregnant will return quickly. Start using another form of birth control right away if you wish to avoid an unintended pregnancy.What should I discuss with my healthcare provider before receiving the etonogestrel implant?Do not use an etonogestrel implant 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. Do not receive the implant if you are allergic to etonogestrel, or if you have:
a history of stroke or blood clot;
a history of breast cancer;
abnormal vaginal bleeding; or
liver disease or liver cancer.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely use an etonogestrel implant:
an ovarian cyst;
high blood pressure;
heart disease or congestive heart failure;
high cholesterol or if you are overweight;
a history of depression;
seizures or epilepsy.
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.
Etonogestrel implant is inserted through a needle into the skin of your upper arm, just inside and above the elbow. The implant will be placed in your arm under local anesthetic in your doctor's office or other clinic setting.Before receiving this implant, you may need a pregnancy test to make sure you are not pregnant.
The timing of when you will receive this implant depends on whether or not you were using birth control before, and what type it was. Follow your doctor's instructions.
This implant must be inserted only by a physician or other healthcare provider who has been specially trained in the insertion of the etonogestrel implant. Incorrect placement of the rod too deeply can make it difficult or impossible to remove later on. If the rod is incorrectly inserted and falls out, you will not be protected from unintended pregnancy.
Once the implant is inserted, you should be able to feel it under your skin. Tell your doctor if you cannot feel the implant under the skin at any time while it is in place.
Etonogestrel is released slowly into the body from the implant. The implant can remain in place to provide continuous contraception 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.After the implant is inserted, your doctor will cover your arm with two bandages. You may remove the top bandage after 24 hours, but leave the smaller bandage on your arm for 3 to 5 days. Keep the area clean and dry while wearing the bandage. You will most likely 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).
Your doctor will need to see you on a regular basis while you are using this medication. You may also need to have routine mammograms. Do not miss any appointments.If you need to have any type of medical tests or surgery, or if you will be on bed rest, you may need to have the implant removed for a short time. Any doctor or surgeon who treats you should know that you are using an etonogestrel implant.
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. If you choose not to replace the implant, your ability to get pregnant will return quickly. Some women have become pregnant within the first week after removal of an etonogestrel implant. Start using another form of birth control right away if you wish to avoid an unintended pregnancy.Do not use etonogestrel implants for longer than recommended by your doctor.
Since the etonogestrel implant is inserted under the skin and remains in place for up to 3 years, you will not be on a dosing schedule. Be sure to see your doctor for removal of the implant by the end of the third year.
If the implant is correctly inserted, an overdose of etonogestrel is highly unlikely. Overdose symptoms may include nausea, vomiting, and vaginal bleeding.
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.
warmth, redness, swelling, or oozing where the implant was inserted;
sudden numbness or weakness, especially on one side of the body;
severe pain or cramping in your pelvic area (may be only on one side);
sudden headache, confusion, pain behind the eyes, problems with vision, speech, or balance;
chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
swelling in your hands, ankles, or feet;
jaundice (yellowing of the skin or eyes); or
symptoms of depression (sleep problems, weakness, mood changes).
Less serious side effects may include:
pain, numbness, or tingling where the implant was inserted;
minor bleeding or scarring where the implant was inserted;
acne, freckles or darkening of facial skin;
menstrual cramps, changes in menstrual bleeding pattern;
increased hair growth, loss of scalp hair;
nausea, mild stomach pain;
vaginal itching or discharge;
headache, back pain, nervousness, dizziness;
runny or stuffy nose, sore throat, cough; 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.
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.
Before receiving etonogestrel implant, tell your doctor if you are using any of the following drugs:
phenylbutazone (Azolid, Butazolidin);
St. John's wort;
antibiotic medicines such as griseofulvin (Grisactin, Grifulvin V, Fulvicin PG), itraconazole (Sporanox), ketoconazole (Nizoral), amoxicillin (Augmentin), ampicillin (Omnipen), doxycycline (Doryx, Vibramycin), minocycline (Minocin), penicillin (Veetids, Pen Vee K, Bicillin), rifampin (Rifadin), rifabutin (Mycobutin), tetracycline (Sumycin, Achromycin, Robitet), and others;
seizure medicines such as phenytoin (Dilantin), carbamazepine (Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), or topiramate (Topamax);
a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton); or
HIV medicines such as amprenavir (Agenerase), atazanavir (Reyataz), tipranavir (Aptivus), indinavir (Crixivan), saquinavir (Invirase), lopinavir/ritonavir (Kaletra), fosamprenavir (Lexiva), ritonavir (Norvir), or nelfinavir (Viracept).
This list is not complete and there may be other drugs that can interact with etonogestrel implant. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.