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Etonogestrel Brand Names- Implanon | Nexplanon
What is Etonogestrel
Etonogestrel is a synthetic progestin that is the active metabolite of the prodrug desogestrel.
The etonogestrel implant is a contraceptive device consisting of a single sterile rod for subdermal placement in the upper arm; the implant is designed to release etonogestrel over a 3-year period.
The etonogestrel implant is unique among the progestin-only contraceptives because it provides long-acting, high contraceptive efficacy (cumulative Pearl Index of 0.38 pregnancies per 100 women-years of use) that also allows a rapid return to fertility after removal.
Etonogestrel subdermal implants are available only for use by physicians who undergo specialized training for device insertion and removal. Progestin-only contraceptives can be used in female patients from menarche to over the age of 40 years and up until the time of menopause with the proper selection of products.
The choice of a routine hormonal contraceptive for any given patient is based on the individual’s contraceptive needs, underlying medical conditions or risk factors for adverse effects, and individual preferences for use.
The Centers for Disease Control’s U.S. Medical Eligibility Criteria describe considerations for risk vs. benefits, including medical conditions or attributes that contraindicate use; these criteria can help prescribing practitioners in product selection for individual patients.
Etonogestrel has been used off-label for the medical management of endometriosis and endometriosis-related pain in women who also desire contraception.
An etonogestrel implant (Implanon) was initially approved by the FDA in 2006 but was removed from the U.S. market in 2015 after Nexplanon was FDA approved to replace it in 2011.
Nexplanon, which is bioequivalent to Implanon, has a pre-loaded applicator designed to reduce the risk of insertion errors and is a radiopaque device to allow for localization via standard imaging procedures to confirm placement.
Indications
- contraception
- endometriosis
Side Effects
- abdominal pain
- acne vulgaris
- alopecia
- amenorrhea
- anaphylactoid reactions
- angioedema
- anorexia
- anxiety
- arthralgia
- asthenia
- back pain
- bleeding
- breast discharge
- breast enlargement
- bronchospasm
- constipation
- cough
- depression
- diarrhea
- dizziness
- drowsiness
- dysmenorrhea
- dyspepsia
- dysuria
- edema
- emotional lability
- erythema
- fatigue
- fever
- flatulence
- gastritis
- headache
- hematoma
- hot flashes
- hypertension
- hypertrichosis
- infection
- injection site reaction
- insomnia
- leukorrhea
- libido decrease
- mastalgia
- melasma
- menstrual irregularity
- migraine
- myalgia
- nausea
- paresthesias
- pelvic pain
- pharyngitis
- pruritus
- pulmonary embolism
- rash
- rhinitis
- seizures
- sinusitis
- stroke
- thrombosis
- urticaria
- vaginal bleeding
- vaginal discharge
- vaginal irritation
- vaginitis
- vomiting
- weight gain
- weight loss
Monitoring Parameters
- pap smear
- pelvic exam
- pregnancy testing
- weight
Contraindications
- breast cancer
- breast-feeding
- cerebrovascular disease
- cervical cancer
- children
- contact lenses
- coronary artery disease
- depression
- diabetes mellitus
- ectopic pregnancy
- edema
- gallbladder disease
- geriatric
- heart failure
- hepatic disease
- hepatocellular cancer
- human immunodeficiency virus (HIV) infection
- hyperlipidemia
- hypertension
- infants
- intramuscular administration
- jaundice
- migraine
- myocardial infarction
- neonates
- obesity
- ovarian cyst
- pregnancy
- renal disease
- renal failure
- renal impairment
- seizure disorder
- stroke
- surgery
- thromboembolic disease
- thrombophlebitis
- tobacco smoking
- vaginal bleeding
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetohexamide
- Acitretin
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-glucosidase Inhibitors
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Apalutamide
- Aprepitant, Fosaprepitant
- Armodafinil
- Artemether; Lumefantrine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atazanavir; Cobicistat
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bexarotene
- Boceprevir
- Bosentan
- Brigatinib
- Bromocriptine
- Butabarbital
- Canagliflozin; Metformin
- Carbamazepine
- Cenobamate
- Chloramphenicol
- Chlorpropamide
- Cimetidine
- Ciprofloxacin
- Clarithromycin
- Clobazam
- Cobicistat
- Cyclosporine
- Dabrafenib
- Danazol
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deferasirox
- Diltiazem
- Dronedarone
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enasidenib
- Encorafenib
- Enzalutamide
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Felbamate
- Fluconazole
- Fluvoxamine
- Fosamprenavir
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- grapefruit juice
- Griseofulvin
- Hydantoins
- Idelalisib
- Imatinib
- Incretin Mimetics
- Indinavir
- Insulins
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lamotrigine
- Lesinurad
- Lesinurad; Allopurinol
- Linagliptin
- Linagliptin; Metformin
- Lopinavir; Ritonavir
- Lorlatinib
- Lumacaftor; Ivacaftor
- Meglitinides
- Mephobarbital
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methohexital
- Mifepristone
- Modafinil
- Nelfinavir
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Nicardipine
- Nilotinib
- Octreotide
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oxcarbazepine
- Pegaspargase
- Pentobarbital
- Pexidartinib
- Phenobarbital
- Phentermine; Topiramate
- Pitolisant
- Posaconazole
- Pramlintide
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Primidone
- Quinine
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifamycins
- Rifapentine
- Ritonavir
- Rufinamide
- Saquinavir
- Saxagliptin
- Secobarbital
- Simvastatin; Sitagliptin
- Sitagliptin
- St. John’s Wort, Hypericum perforatum
- Sugammadex
- Sulfonylureas
- Tazemetostat
- Telithromycin
- Thalidomide
- Thiopental
- Tipranavir
- Tolazamide
- Tolbutamide
- Topiramate
- Trandolapril; Verapamil
- Ulipristal
- Verapamil
- Voriconazole