Class Name(s):

• 68:12 Contraceptives

Pronunciation:

• e toe" noe jes' trel

Brand Name(s):

• Nexplanon^®

WHY is this medicine prescribed?

Etonogestrel is used to prevent pregnancy. Etonogestrel is in a class of medications called progestins. It works by preventing ovulation (the release of eggs from the ovaries).

HOW should this medicine be used?

Etonogestrel comes as an implant (a small, thin, flexible tube containing medication) to be placed into the inside of your upper arm by a healthcare provider. You may need to have a pregnancy test before you receive your implant to make sure you are not pregnant. Your healthcare provider will determine the best time for you to receive the implant.

Etonogestrel implant may be replaced after 3 years if you want to continue to use it to prevent pregnancy. Etonogestrel implant may be removed at any time if you no longer want to use this medication to prevent pregnancy.

Etonogestrel is an effective method of birth control, but it does not prevent the spread of human immunodeficiency virus (HIV, the virus that causes acquired immunodeficiency syndrome [AIDS]) and other sexually transmitted diseases.

If you cannot feel the implant at any time after insertion or feel that it may be broken or bent, call your healthcare provider. Use another non-hormonal method of birth control (e.g., condoms) until they can check it.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Are there OTHER USES for this medication?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before receiving etonogestrel,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using etonogestrel. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• you should know that the following nonprescription or herbal product may interact with etonogestrel: St. John's wort. Be sure to let your doctor and pharmacist know that you are taking these medications before you receive an etonogestrel implant. Do not start any of these medications while using etonogestrel without discussing with your healthcare provider.
• tell your doctor if you are pregnant or think that you are pregnant; or if you have or have ever had blood clots in your legs, lungs, or eyes; conditions in which the blood clots easily; a stroke or mini-stroke; breast cancer; liver cancer, liver tumors, or other types of liver disease; or unexplained vaginal bleeding. Your doctor will probably tell you that you should not receive etonogestrel implant.
• tell your doctor if you have or have ever had gallbladder disease, diabetes or prediabetes, high blood cholesterol or fats, or depression.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using etonogestrel implant, call your doctor immediately.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using etonogestrel implant.
• tell your doctor and pharmacist if you wear contact lenses. If you notice changes in vision or ability to wear your lenses while using etonogestrel, see an eye doctor.

What SPECIAL DIETARY instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medication.

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Etonogestrel may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• changes in menstrual bleeding patterns
• headache
• acne
• breast tenderness or pain
• swelling, redness, irritation, burning, or itching of the vagina
• weight gain
• difficulty in sleeping, weakness, lack of energy, fatigue, or change in mood

Some side effects can be serious. If you experience any of these symptoms call your doctor immediately or get emergency medical treatment:

• implant becomes lost, broken, or bent
• shortness of breath, leg pain, sudden chest pain, sudden severe headache, sudden changes in vision, weakness or numbness in an arm or leg, trouble speaking
• lower abdominal pain or swelling
• a lump in your breast
• yellowing of the skin or eyes
• unusual bleeding, including menstrual bleeding that is unusually heavy or that lasts for longer than 7 days in a row

Etonogestrel may increase the chance that you will develop liver tumors or breast cancer. Talk to your doctor about the risks of using etonogestrel implant.

Etonogestrel may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. You should have a complete physical examination every year, including blood pressure measurements, breast and pelvic exams, and a Pap test. Follow your doctor's directions for examining your breasts; report any lumps immediately.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are using etonogestrel implant.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™ Copyright, 2025. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: June 15, 2025.