What is etonogestrel (implant)?
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.
What should I discuss with my healthcare provider before taking 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:
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.
How should I take etonogestrel (implant)?
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.
What happens if I miss a dose of etonogestrel (implant)?
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.
Where can I get more information about etonogestrel (implant)?
Your pharmacist has information about etonogestrel (implant) written for health professionals that you may read.
What are the possible side effects of etonogestrel (implant)?
Get emergency medical help if you have any of these
signs of an allergic
reaction:
hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:
-
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;
-
breast pain;
-
acne, freckles or darkening of facial skin;
-
menstrual cramps, changes in menstrual bleeding pattern;
-
increased hair growth, loss of scalp hair;
-
weight gain;
-
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.
What is the most important information I should know about 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 use this medication if you have any of the following conditions: a history of stroke
or blood clot, a history of breast cancer, abnormal vaginal bleeding, liver disease, or liver cancer.
Using hormones can increase your risk of blood clots, stroke, or heart attack, especially if you smoke
and are older than 35.
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 avoid while taking etonogestrel (implant)?
Do not smoke while using etonogestrel implant, especially if you are older than 35.
Smoking can increase your risk of blood clots, stroke, or heart attack caused by etonogestrel implant.
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.
What other drugs will affect etonogestrel (implant)?
Before receiving etonogestrel implant, tell your doctor if you are using any of the following
drugs:
-
phenylbutazone (Azolid, Butazolidin);
-
modafinil (Provigil);
-
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.
What happens if I have an overdose of etonogestrel (implant)?
