Etonogestrel Implant: Contraception Guidance

Therapeutic action

Hormonal contraceptive, progestogen.

Indications

Long-acting contraception.

Forms and strengths, route of administration

• Flexible rod containing 68 mg of etonogestrel, in a sterile disposable applicator.
• To be inserted subdermally into the inner side of the non-dominant arm, 6 to 8 cm above the elbow crease, under local anaesthesia and aseptic conditions.

Dose

The implant may be inserted at any moment of the cycle if it is reasonably certain the woman is not pregnant, including when switching from another form of contraception.

Use condoms for 7 days after insertion if it is inserted more than 7 days after the start of menstruation, more than 28 days postpartum if not breastfeeding, or more than 7 days after an abortion.

Duration

As long as this method of contraception is desired and well tolerated, for a maximum of 3 years, after which it no longer provides contraception and must be changed.

Contra-indications, adverse effects, precautions

• Do not administer to patients with breast cancer, severe or recent liver disease, unexplained vaginal bleeding, or active thromboembolic disorders.
• May cause menstrual irregularities, amenorrhoea, menometrorrhagia, breast tenderness, headache, weight gain, itching, acne, mood changes, abdominal pain, gastrointestinal disturbances, and allergic reactions.
• Enzyme-inducing drugs such as rifampicin, rifabutin, efavirenz, nevirapine, lopinavir, ritonavir, phenobarbital, phenytoin, carbamazepine, and griseofulvin reduce contraceptive effectiveness.
• Pregnancy: contraindicated.
• Breast-feeding: no contra-indication.