Implanon NXT

Etonogestrel

Contraception.

Subdermal insertion 1 implant can be left in place for 3 yr. Remove the implant no later than 3 yr after the date of insertion. No preceding hormonal contraceptive use in the past mth Insert between day 1 & 5 of menstrual cycle, even if the woman is still bleeding. Changing from a combined hormonal contraceptive method [combined oral contraceptive (COC), vag ring or transdermal patch] Insert preferably on the day after the last active tab of the previous COC or on the day of removal of vag ring or transdermal patch. At the latest, on the day following the usual tab-free, ring-free, patch-free or placebo tab interval of the previous COC when the next application would have been due. Changing from a progestagen-only contraceptive method [eg, progestagen-only pill, injectable, implant or intrauterine system (IUS)] Injectable contraceptive: Insert on the day the next inj is due. Progestagen-only pill: Insert w/in 24 hr after the last tab. Implant/IUS: Insert on the same day the previous implant/IUS is removed. Following abortion or miscarriage 1st trimester: Insert w/in 5 days following 1st trimester abortion or miscarriage. 2nd trimester: Insert between day 21-28 following 2nd trimester abortion or miscarriage. Postpartum Breastfeeding: Insert after the 4th postpartum wk. Use a barrier method until 7 days after insertion. Non-breastfeeding: Insert between 21-28 days postpartum. If implant is inserted later than 28 days postpartum, use barrier method until 7 days after insertion.

Hypersensitivity. Active venous thromboembolic disorder. Known or suspected sex steroid sensitive malignancies. Presence or history of liver tumours (benign or malignant); severe hepatic disease as long as liver function values have not returned to normal. Undiagnosed vag bleeding.

Prior to the initiation or reinstitution, a complete medical history (including family medical history) should be taken & pregnancy should be excluded; BP should be measured & a physical exam should be performed. Women should be advised that Implanon NXT does not protect against HIV (AIDS) & other STDs. Risk of breast cancer; liver disease; thrombotic & other vascular events; ovarian cysts; depressed mood & depression. Remove implant in the event of a thrombosis. Consider removal of implant in case of long-term immobilisation due to surgery or illness. Discontinue use if a sustained HTN develops, or if a significant increase in BP inadequately responds to antihypertensive therapy. Carefully monitor diabetic women during the 1st mth of use. Women w/ a tendency to chloasma should avoid exposure to the sun or UV radiation during use. Clinical experience in heavier women in the 3rd yr of use is limited, therefore, it cannot be excluded that the contraceptive effect in these women during the 3rd yr of use may be lower than for women of normal wt. Migration or expulsion of the implant may occur. Remove implant in its entirety when broken. Protection w/ traditional progestagen-only contraceptives against ectopic pregnancies is not as good as w/ combined OCs. Changes in menstrual bleeding pattern during use. Reduced efficacy w/ concomitant medications that decrease the plasma conc of etonogestrel. Not indicated during pregnancy. Safety & efficacy in adolescents <18 yr have not been established.

Vag infection; headache; acne; breast tenderness/pain, irregular menstruation; increased wt. Increased appetite; affect lability, depressed mood, nervousness, decreased libido; dizziness; hot flush; abdominal pain, nausea, flatulence; alopecia; dysmenorrhoea, ovarian cyst; implant site pain/reaction, fatigue, flu-like illness, pain; decreased wt.

Diminished efficacy w/ enzyme inducers eg, barbiturates, bosentan, carbamazepine, phenytoin, primidone, rifampicin, & HIV/HCV medication like ritonavir, efavirenz, boceprevir, nevirapine & possibly also felbamate, griseofulvin, oxcarbazepine, topiramate & products containing St. John's wort. Increased or decreased plasma conc w/ combinations of HIV PIs & NNRTIs, including combinations w/ HCV inhibitors. Increased serum conc w/ strong (eg, ketoconazole, itraconazole, clarithromycin) or moderate (eg, fluconazole, diltiazem, erythromycin) CYP3A4 inhibitors. Increased plasma & tissue conc of ciclosporin. Decreased plasma & tissue conc of lamotrigine. Data obtained w/ combined OCs have shown that contraceptive steroids may affect some lab parameters, including biochemical parameters of liver, thyroid, adrenal & renal function, serum levels of (carrier) proteins, eg, corticosteroid binding globulin & lipid/lipoprotein fractions, parameters of carbohydrate metabolism & parameters of coagulation & fibrinolysis.

Depot Contraceptives

G03AC08 - etonogestrel ; Belongs to the class of progestogens. Used as systemic contraceptives.

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