Etonogestrel Subcutaneous Implant 68 mg

What is this medication for?

Etonogestrel Subcutaneous Implant 68 mg (also known as Implanon NXT®) is a long-acting contraceptive implant. It slowly releases the hormone, etonogestrel, which is a type of progestogen, into the body. This prevents the release of an egg cell from the ovaries and causes changes to the cervix, making it difficult for sperm to enter the uterus (womb), thus preventing pregnancy.

How should I take or use this medication?

• Implanon NXT® comes in the form of a small, thin rod-like device, which is inserted under the skin in your upper arm by a trained healthcare professional. 

• Your healthcare professional will discuss with you on the most suitable time to insert the implant. The need for back up contraception (e.g. condoms) for the first 7 days will depend on the timing of insertion or whether you are switching from another type of hormonal contraception. 

• Implanon NXT® offers protection for up to 3 years, but can be removed earlier, if required. 

  • Your healthcare professional may advise you to replace the implant earlier if you are overweight. 

What precautions should I take when taking or using this medication?

Inform your healthcare provider if: 

• You are allergic to this medication or any of the other ingredients of this medication.

• You are pregnant or planning to become pregnant.

• You have a history of ectopic pregnancy (pregnancy outside the uterus).

• You have a history of or current medical conditions such as breast cancer, unexplained vaginal bleeding, liver problems, stroke, clotting disorders, hypertension, heart diseases, epilepsy (fits), diabetes or tuberculosis.

• You are taking any other medications, including supplements, traditional medications and herbal remedies.

What are some common side effects of this medication? ​

• During the insertion or removal of the implant, redness, bruising, pain, swelling, or itching may occur.

• Changes in menstrual bleeding patterns e.g. bleeding may become absent, irregular, infrequent, frequent, prolonged, or occasionally heavy. 

  • The bleeding pattern that you experience during the first three months generally indicates your future bleeding pattern.

  • Inform your doctor if you are having heavy and continuous bleeding as it may lead to a condition known as anaemia (decrease in the number of red blood cells).

• Nausea, vomiting, bloating, and stomach cramps.

  • Take smaller but more frequent meals. Avoid spicy, fatty foods.

• Breast tenderness

• Headache

  • You may take painkillers such as Paracetamol to manage headaches.

• Acne

• Mood changes (mood swings or low mood)

  • Inform your healthcare provider if you experience any unexplained mood changes. 

• Weight changes

• Decreased sexual drive

• Vaginal irritation or discomfort 

  • If you suspect that you may have a vaginal infection such as pain, thick white discharge, itch or burning of the vagina, please see your healthcare professional. 

Inform your healthcare professional if the side effects above become severe and bothersome.

What are some rare but serious side-effects that I need to seek medical advice immediately? 

The symptoms of a drug allergy include one or more of the following: 

• Swollen face/eyes/lips/tongue

• Difficulty in breathing

• Itchy skin rashes over your entire body

If you experience any of these side effects or symptoms, you should see your healthcare provider immediately.

Very rarely, this implant may cause:

• Increased risk of blood clot formation, though the risk is lower for implants (progestogen-only contraceptive) compared to combined oral contraceptives:

  • Any unusual sudden cough, breathlessness or difficulty in breathing 

  • Severe pain in the chest which may spread to the left arm

  • Severe pain or swelling in either of your legs

  • Change in your speech, including slurring of words

  • Change in your senses of hearing, smell or taste

  • Vision changes such as loss of vision or blurred vision

  • Changes in your senses of hearing, smell or taste

  • Unusual, severe or long-lasting headache or worsening of migraine

• Severe abdominal pain

• Dark urine or light-coloured stools, nausea, vomiting, loss of appetite, stomach pain, yellowing of your eyes or skin

• A lump in the breast, breast pain or soreness, or nipple discharge

  • It is important to regularly check your breasts. If you feel any lump in your breasts, you should contact your healthcare provider.

What food or medication should I avoid when I take or use this medication?

• Some medications might interact with this implant. Check with your healthcare provider if you want to take any other medicines, supplements or herbal products.
• If you see any other healthcare provider, inform him/her that you are using this implant before he/she prescribes any other medicines.
   

What else should I know about this medication? 

There have been occasional reports of the implant moving from the original insertion site in the arm, if incorrectly inserted or due to external forces (e.g.  manipulation of the implant or contact sports).

• If you cannot feel the implant or if you think that it has broken, bent, or moved while in your arm, contact your healthcare professional.
• Until the presence of the implant has been confirmed, you may not be protected against pregnancy and must use a non-hormonal contraceptive method (e.g. condoms).