Microplastics and Misinformation: What Science Really Says
November 12, 2025
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Brand Name :
Nexplanon, Implanon
Synonyms :
etonogestrel
Class :
Progestins
Brand Name :
Nexplanon, Implanon
Synonyms :
etonogestrel
Class :
Progestins
Dosage Forms & Strengths
Implant
68mg
Subdermally insert one implant
If prolonged contraceptive protection is desired, a new implant may be inserted in its place at least three years after the original implant date.
No previous usage of hormonal contraception in the previous month:
Insert between Days 1-5 of the menstruation, even if the patient is bleeding
Change from one contraceptive method to another:
OCP: Within Seven days after the last active medication
Transdermal patch: During a transdermal contraception system's seven-day patch-free time
Vaginal ring: During the 7-day etonogestrel/ethinylestradiol ring-free period
Change from progestin-only contraception:
When changing pills, you can do so on any day of the month. Avoid skipping any days between the final dose and the insertion
On the same day as the removal of the contraceptive implant
Intrauterine device or Implant: On the same day that a progestin-containing IUD is removed
Injection: When the subsequent contraceptive injection is scheduled to be given
Not suggested
Refer adult dosing
They may increase the thrombogenic effect when combined with asparaginase Products
may diminish the serum concentration of each other when combined
may diminish the serum concentration of each other when combined
may diminish the serum concentration of each other when combined
may diminish the serum concentration of each other when combined
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of CYP3A4 substrates
may diminish the serum concentration of Hormonal Contraceptives
may diminish the therapeutic effect of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of CYP3A4 substrates
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may diminish the serum concentration
may reduce the levels of serum concentration of hormonal contraceptives
aprepitant: they may diminish the serum concentration of hormonal contraceptives
asunaprevir: they may diminish the serum concentration of hormonal contraceptives
atazanavir: they may diminish the serum concentration of hormonal contraceptives
brigatinib: they may diminish the serum concentration of hormonal contraceptives
carfilzomib: they may increase the thrombogenic effect of hormonal contraceptives
cladribine: they may decrease the therapeutic effect of hormonal contraceptives
cobicistat: they may diminish the serum concentration of hormonal contraceptives
efavirenz: they may diminish the serum concentration of hormonal contraceptives
elagolix: they may diminish the therapeutic effect of hormonal contraceptives
exenatide: they may diminish the therapeutic effect of hormonal contraceptives
felbamate: they may diminish the serum concentration of hormonal contraceptives
fosaprepitant: they may diminish the serum concentration of hormonal contraceptives
griseofulvin: they may diminish the serum concentration of hormonal contraceptives
ivosidenib: they may diminish the serum concentration of hormonal contraceptives
ixazomib: they may diminish the serum concentration of hormonal contraceptives
lixisenatide: they may decrease the therapeutic effect of hormonal contraceptives
mavacamten: they may diminish the serum concentration of hormonal contraceptives
mifepristone: they may decrease the therapeutic effect of hormonal contraceptives
mycophenolate mofetil: they may diminish the serum concentration of hormonal contraceptives
nirmatrelvir and ritonavir: they may diminish the serum concentration of hormonal contraceptives
oxcarbazepine: they may diminish the serum concentration of hormonal contraceptives
pitolisant: they may diminish the serum concentration of hormonal contraceptives
protease inhibitors: they may diminish the serum concentration of hormonal contraceptives
tazemetostat: they may diminish the serum concentration of hormonal contraceptives
cannabidiol: they may diminish the serum concentration of hormonal contraceptives
may diminish the serum concentration of CYP3A4 Inducers
may diminish the serum concentration of each other when combined
may have a decreased therapeutic efficacy when combined with etonogestrel
may diminish the serum concentration of CYP3A4 substrates
may enhance the serum concentration of CYP3A4 substrates
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of Hormonal Contraceptives
may diminish the therapeutic effect of hyperglycaemia associated agents
may diminish the therapeutic effect of hyperglycaemia associated agents
may diminish the therapeutic effect of hyperglycaemia associated agents
may diminish the therapeutic effect of hyperglycaemia associated agents
may diminish the therapeutic effect of hyperglycaemia associated agents
encorafenib: they may diminish the serum concentration of hormonal contraceptives
mobocertinib: they may diminish the serum concentration of hormonal contraceptives
omaveloxolone: they may diminish the serum concentration of hormonal contraceptives
pexidartinib: they may diminish the serum cocentration of hormonal contraceptives
tranexamic acid: they may increase the thrombogenic effect of hormonal contraceptives
may increase the serum concentration of Vitamin K Antagonists
may increase the serum concentration of Vitamin K Antagonists
may increase the serum concentration of Vitamin K Antagonists
may increase the serum concentration of Vitamin K Antagonists
may increase the serum concentration of Vitamin K Antagonists
may increase the levels of serum concentration of vitamin K antagonists
may increase the levels of serum concentration of vitamin K antagonists
may increase the levels of serum concentration of vitamin K antagonists
may increase the levels of serum concentration of vitamin K antagonists
may increase the levels of serum concentration of vitamin K antagonists
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
It may diminish the effects when combined with metformin by pharmacodynamic antagonism
may diminish the serum concentration of Hormonal Contraceptives
may diminish the serum concentration of CYP3A4 substrates
may diminish the serum concentration of CYP3A4 substrates
may enhance the serum concentration of Hormonal Contraceptives
may enhance the serum concentration of Hormonal Contraceptives
may enhance the serum concentration of Hormonal Contraceptives
may enhance the serum concentration of Hormonal Contraceptives
may enhance the serum concentration of Hormonal Contraceptives
etonogestrel leads to a reduction in the rate of excretion of nitric oxide, which leads to an increased level of serum
When etonogestrel is used together with clomocycline, this leads to reduction in concentration serum of clomocycline
protease inhibitors may reduce the level of serum concentration of hormonal contraceptives
protease inhibitors may reduce the level of serum concentration of hormonal contraceptives
protease inhibitors may reduce the level of serum concentration of hormonal contraceptives
protease inhibitors may reduce the level of serum concentration of hormonal contraceptives
protease inhibitors may reduce the level of serum concentration of hormonal contraceptives
CYP3A4 Inducers may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may increase the levels of serum concentration of hormonal contraceptives
may increase the levels of serum concentration of hormonal contraceptives
may increase the levels of serum concentration of hormonal contraceptives
may increase the levels of serum concentration of hormonal contraceptives
may increase the levels of serum concentration of hormonal contraceptives
may increase the levels of serum concentration of hormonal contraceptives
may increase the levels of serum concentration of hormonal contraceptives
may increase the levels of serum concentration of hormonal contraceptives
may increase the levels of serum concentration of hormonal contraceptives
may increase the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may decrease the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
etravirine: they may diminish the serum concentration of hormonal contraceptive
flibanserin: they may enhance the serum concentration of hormonal contraceptives
thalidomide: they may increase the thrombogenic effect of hormonal contraceptives
voriconazole: they may enhance the serum concentration of hormonal contraceptives
it may reduce the therapeutic effect of the drug
CYP3A4 inducers decrease the concentration of hormonal contraceptives in the serum
CYP3A4 inducers decrease the concentration of hormonal contraceptives in the serum
CYP3A4 inducers decrease the concentration of hormonal contraceptives in the serum
CYP3A4 inducers decrease the concentration of hormonal contraceptives in the serum
CYP3A4 inducers decrease the concentration of hormonal contraceptives in the serum
topiramate decreases the concentration of hormonal contraceptives in the serum
perampanel decreases the concentration of hormonal contraceptives in the serum
Actions and Spectrum:
Mechanism of Action:
Spectrum of Activity:
etonogestrel is a highly effective form of contraception and provides long-term protection. The spectrum of activity includes:
Convenience and Compliance: Once the implant is inserted under the skin, it does not require daily attention, which can be advantageous for people who may have difficulties with daily pill usage or other short-acting contraceptive methods.
Frequency defined
>10%
Headache (25%)
Amenorrhea (22%)
Weight gain (14%)
Breast pain (13%)
Oligomenorrhea (34%)
Vaginitis (24.5%)
Menorrhagia (18%)
Acne (13.5%)
Pharyngitis (11%)
Upper resp tract infection (13%)
Leucorrhea (10.5%)
1-10%
Depression (6%)
Dysmenorrhea (7%)
Flu-like symptoms (8%)
Nausea (6%)
Pain (6%)
Back pain (7%)
Dizziness (7%)
Emotional lability (7%)
Insertion-site pain (9%)
Nervousness (6%)
Post-marketing reports
Fatigue
Pyrexia
Migraine
Anxiety
Libido decreased
Edema
Implant site reaction
Convulsions
Somnolence
Insomnia
Dysuria
Black box warning:
None
Contraindications/caution:
Contraindications:
Caution:
Allergic Reactions: Some individuals may experience allergic reactions to etonogestrel or the components of the contraceptive implant.
Pregnancy consideration:
etonogestrel should not be used if a person is already pregnant. It is meant for preventing pregnancy and not terminating an existing one.
Lactation: Excretion of the drug in human breast milk is known in small amounts
Pregnancy category:
Category A:Â well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D:Â adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category
Pharmacology:
etonogestrel primarily works by inhibiting ovulation (the release of an egg from the ovary) during the menstrual cycle. It also thickens the cervical mucus, making it more difficult for sperm to reach the egg, and alters the uterine lining, making it less receptive to a fertilized egg.
Pharmacodynamics:
The pharmacodynamics of etonogestrel involves:
Pharmacokinetics:
Absorption
etonogestrel has 100% bioavailability; the entire dose is absorbed and available for its intended actions. After implantation, the release rate of etonogestrel gradually decreases over time.
During weeks 5 to 6, the release rate is approximately 60-70 mcg/day.
After one year, the release rate decreases to about 35 to 45 mcg/day.
After two years, the release rate decreases to approximately 30 to 40 mcg/day.
After three years, the release rate is about 25 to 30 mcg/day.
Distribution
It is highly protein-bound, with approximately 98% bound to proteins in the blood. Among the proteins binding etonogestrel, 32% is bound to sex hormone-binding globulin (SHBG), and 66% is bound to albumin. The volume of distribution of etonogestrel is 201 liters.
Metabolism
etonogestrel undergoes hepatic metabolism primarily via the CYP3A4 enzyme in the liver. During this process, etonogestrel is metabolized into various metabolites.
Elimination and Excretion
The half-life of etonogestrel is approximately 25 hours, primarily eliminated from the body through urine (primarily) and feces.
Administration:
Subdermal Implantation
Patient information leaflet
Generic Name: etonogestrel
Why do we use etonogestrel?
etonogestrel is used primarily as a form of hormonal contraception. It is a synthetic progestin hormone that mimics the effects of natural progesterone in the body. The most common use of etonogestrel is in contraceptive implants, such as Nexplanon. However, it may also be combined with other hormones in certain contraceptive pills or as a component of intrauterine devices (IUDs) to provide contraception.
Endometrial protection: etonogestrel is sometimes used with estrogen in hormone replacement therapy (HRT) for menopausal women who have undergone a hysterectomy. The progestin component helps protect the endometrial lining from abnormal growth with unopposed estrogen therapy.
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