Nexplanon (etonogestrel) is a prescription birth control device that’s used to help prevent pregnancy. Nexplanon comes as an implant that a healthcare professional inserts under the skin of your arm.
Nexplanon is used to help prevent pregnancy in certain females.* To learn more, see the “Is Nexplanon used for preventing pregnancy?” section below.
* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Nexplanon contains the active drug etonogestrel. (An active drug is the ingredient that makes a medication work.) It belongs to a group of drugs called progestins.
Nexplanon is a brand-name drug that’s not currently available as a generic.
Like most drugs, Nexplanon may cause mild or serious side effects. The lists below describe some of the more common side effects that Nexplanon may cause. These lists do not include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
To learn more about the side effects of Nexplanon, refer to this article. Your doctor or pharmacist can tell you more about the potential side effects of Nexplanon. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a short list of some of the mild side effects that Nexplanon can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Nexplanon’s prescribing information.
Mild side effects of Nexplanon that have been reported include:
- back pain
- abdominal pain
- breast pain
- vaginitis (inflammation of the vagina)
- sore throat
- mild implant site reactions, including bruising with Nexplanon insertion or removal
- change in menstrual patterns, including irregular bleeding or spotting
- weight gain
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Nexplanon can occur, but they aren’t common. If you have serious side effects from Nexplanon, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Nexplanon that have been reported include:
- blood clots
- changes in metabolism, which may cause:
- depression or other mood changes
- ectopic pregnancy, in which a fertilized egg attaches to an area other than the uterus, such as the fallopian tube
- high blood pressure
- ovarian cysts
- serious complications with Nexplanon insertion or removal
- allergic reaction
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Nexplanon. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Your doctor will explain how Nexplanon will be inserted and removed. Below is some general information about these procedures.
Having Nexplanon inserted or removed
A healthcare professional will place the Nexplanon implant at a doctor’s office or a clinic. They’ll insert Nexplanon under your skin on the inner side of your nondominant arm. For example, if you’re right-handed, the implant will go into your left arm. They’ll numb the area first to help prevent pain.
Before inserting Nexplanon, your doctor will order a pregnancy test for you. You should not have Nexplanon inserted if you’re pregnant.
The ideal time for having Nexplanon inserted depends on the kind of birth control you’re switching from, as described below.
|Previous kind of birth control
|When you should receive Nexplanon
|a method that isn’t hormonal birth control
|between days 1 and 5 of your menstrual cycle
|combination birth control pills
|the day after you take the last active pill, or at the latest, the day after your usual tablet-free interval
|combination birth control vaginal rings or skin patches
|the day you have the vaginal ring or skin patch removed, or at the latest, the day after your usual ring-free or patch-free interval
|progestin-only birth control minipills
|within 24 hours of last taking a dose
|the day your next injection would have been due
|progestin intrauterine device (IUD) or other progestin implant
|the day you have the IUD or implant removed
If you have Nexplanon inserted at a time other than what’s listed in the chart, it’s recommended that you use a backup birth control method. Specifically, you should use a barrier method of birth control for 7 days after you have Nexplanon inserted.
After giving birth, you’ll need to wait 21 to 28 days before you can have Nexplanon implanted.
If you’re planning on breastfeeding, you’ll need to wait 28 days after giving birth before you can have Nexplanon implanted. You should use a barrier method of birth control for 7 days after you receive the implant.
You’ll need to have a healthcare professional remove your implant at a doctor’s office or a clinic. When inserting the implant, they’ll numb the area first to help prevent pain. If you’d like to continue with Nexplanon, they can insert a new implant after removing the old one. This can be done during the same visit.
Nexplanon insertion and removal side effects
Insertion and removal side effects are possible with Nexplanon.
Implant site reactions reported in studies of Nexplanon include the following:
Itchy skin at the insertion site has also been reported since Nexplanon became available on the market.
In rare cases, it’s possible for serious complications to happen with Nexplanon insertion and removal, including:
- broken or bent Nexplanon implant
- movement of the Nexplanon implant away from the insertion site
- numbness or tingling in the arm Nexplanon is inserted in
To learn more about Nexplanon insertion or removal side effects, talk with your doctor.
Questions for your doctor
You may have questions about Nexplanon and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will Nexplanon affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.
Find answers to some commonly asked questions about Nexplanon.
How effective is Nexplanon? What’s the pregnancy rate with this birth control method?
Nexplanon has been found to be highly effective at preventing pregnancy. To learn more about the pregnancy rate with Nexplanon, visit the drugmaker’s website. You can also view the drug’s full prescribing information or talk with your doctor or pharmacist.
What’s to know about Nexplanon vs. Implanon? And what about Nexplanon vs. IUDs?
Implanon was a birth control implant that contained etonogestrel, the same active drug as Nexplanon. (An active drug is the ingredient that makes a medication work.) But Implanon has been discontinued by its drugmaker.
Intrauterine devices (IUDs) are small devices placed inside the uterus. Like Nexplanon, IUDs provide long lasting, reversible birth control. According to the
If you’d like to learn more about how Nexplanon compares with other birth control methods, talk with your doctor or pharmacist.
Is Nexplanon considered hormonal birth control?
Yes, Nexplanon is a kind of hormonal birth control.
Hormonal birth control alters levels of estrogen, progestin, or both. These are two hormones your body naturally makes. Altering levels of these hormones makes it harder for you to become pregnant.
To learn more about hormonal and nonhormonal birth control, talk with your doctor or pharmacist.
How long does Nexplanon last once it’s inserted?
Once a Nexplanon implant is inserted, it’s approved by the Food and Drug Administration (FDA) for up to 3 years of use. Research suggests the implant may still be effective in preventing pregnancy for up to 5 years.
You may have Nexplanon removed sooner than 3 years. For example, you might want to remove the implant if you’re planning a pregnancy or having bothersome side effects. But it’s recommended that you have it removed by the end of the third year after insertion.
For more about when to have a Nexplanon implant removed, talk with your doctor or pharmacist.
Will I have hair loss with Nexplanon?
But there have been a few reports of hair loss since Nexplanon became available on the market. Because these reports happened outside controlled studies, it’s hard to say whether hair loss was due to Nexplanon or another cause.
If you have hair loss after having Nexplanon implanted, talk with your doctor or pharmacist. They can review your medical history and any medications you may take to try to determine what’s causing the hair loss.
Your doctor may recommend treatment for hair loss. They may also discuss removing your Nexplanon implant if this side effect is bothersome to you.
Nexplanon is a hormonal birth control implant prescribed to females* who want to prevent pregnancy. It’s a long-term, reversible form of birth control. The implant is approved by the Food and Drug Administration (FDA) for up to 3 years of use. But you can have the implant removed before that time if you wish.
To help prevent pregnancy, Nexplanon may be prescribed to anyone of reproductive age. A female should not get Nexplanon before their first period.
Nexplanon helps prevent pregnancy by:
- preventing ovulation, which refers to an ovary releasing an egg
- thickening cervical mucus, which makes it harder for sperm to reach an egg
- changing the lining of your endometrium, which makes it harder for pregnancy to occur
* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and the healthcare facility where you have Nexplanon inserted.
To find current prices for Nexplanon in your area, talk with your doctor. You can also visit this page for more information about cost and to learn about usual insurance coverage for the drug.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist.
Your doctor will recommend the dosage of Nexplanon that’s right for you. Below are commonly prescribed dosages, but the dosage you receive will be determined by your doctor. To find out more about Nexplanon’s dosage, see this article.
Form and strength
Nexplanon comes as an implant placed just under the skin. It’s available in one strength: 68 milligrams (mg).
The Nexplanon device is approved by the Food and Drug Administration (FDA) for up to 3 years of use. If you’d like to continue with Nexplanon, your doctor can insert a new device after removing your old one.
It’s recommended that you see your doctor to have Nexplanon removed 3 years after it was inserted. You should do this regardless of whether you wish to keep using Nexplanon. If you’re interested in having Nexplanon removed sooner than this, talk with your doctor.
Questions about Nexplanon’s dosage
Below are some common questions about Nexplanon’s dosage.
- Will I need to use Nexplanon long term? Nexplanon is approved by the Food and Drug Administration (FDA) for up to 3 years of use. You can continue treatment with Nexplanon by having a new implant inserted.
- How long does Nexplanon take to work? Nexplanon begins working right away after it’s inserted. But you may need to use another kind of birth control for a short time, depending on a few factors. To learn more, see the “Ask a pharmacist” section below.
Certain factors can affect whether Nexplanon is a good birth control option for you. These include your overall health, any medical conditions you may have, and any medications you may take. Below are some of the factors to discuss with your doctor when deciding whether to get Nexplanon.
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before receiving Nexplanon, be sure to tell your doctor about all medications you take, including prescription and over-the-counter kinds. Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Nexplanon.
Interactions with drugs or supplements
Nexplanon can interact with several kinds of drugs. These drugs include:
- certain antifungals, including ketoconazole and itraconazole (Sporanox)
- certain antibiotics, including griseofulvin (Gris-PEG) and rifampin (Rimactane)
- certain HIV medications, including efavirenz (Sustiva) and the combination drug lopinavir and ritonavir (Kaletra)
- certain seizure medications, including carbamazepine (Tegretol, Equetro), phenytoin (Dilantin), and topiramate (Topamax)
- the pulmonary arterial hypertension drug bosentan (Tracleer)
- the nausea and vomiting medication aprepitant (Emend)
- the herbal supplement St. John’s wort
This list does not contain all kinds of drugs that may interact with Nexplanon. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Nexplanon.
Nexplanon may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you receive Nexplanon. Factors to consider include those in the list below.
- Blood clots. Hormonal birth control such as Nexplanon may increase the risk of blood clots. It may also raise the risk of serious events involving the heart or blood vessels, such as a heart attack or stroke. If you’ve had a blood clot in the past, you may have a higher risk of these side effects with Nexplanon. Your doctor can let you know whether Nexplanon is a safe option for you.
- Breast cancer or other cancers that are hormone sensitive. If you’ve had breast cancer that is hormone sensitive or another hormone-sensitive cancer in the past, your doctor likely won’t prescribe Nexplanon. This is because Nexplanon may increase the risk of the cancer coming back. Tell your doctor whether you have had a hormone-sensitive cancer. They can suggest a safer birth control option for you instead.
- Depression. Nexplanon can cause depression or other changes in mood. If you have depression, Nexplanon may worsen your condition. Talk with your doctor about whether Nexplanon or a different birth control drug is right for you.
- Diabetes. Nexplanon can raise your blood sugar level. So Nexplanon may worsen diabetes in people who have this condition. If you have diabetes, ask your doctor whether Nexplanon is right for you. They may monitor your blood sugar closely if they prescribe the drug.
- Genital bleeding. Your doctor likely won’t prescribe Nexplanon if you have irregular genital bleeding with no known cause. Tell your doctor whether you have this kind of bleeding. They can discuss other birth control options as well as check for causes of your bleeding.
- Liver problems, including liver tumors. If you have liver problems, including liver tumors, your doctor likely won’t prescribe Nexplanon. This drug could worsen your condition. Let your doctor know whether you have any liver problem. This will help them determine other birth control options that may be safer for you.
- High blood pressure. Nexplanon can increase your blood pressure. If you have high blood pressure, Nexplanon could worsen your condition. If your doctor prescribes Nexplanon, they’ll likely have you closely monitor your blood pressure. You may need to have your Nexplanon implant removed if your blood pressure becomes too high.
- Allergic reaction. If you’ve had an allergic reaction to Nexplanon or any of its ingredients, your doctor will likely not prescribe Nexplanon. Ask them what other medications are better options for you.
Nexplanon and alcohol
There are no known interactions between Nexplanon and alcohol.
If you have questions about Nexplanon and alcohol, talk with your doctor.
Pregnancy and breastfeeding
The Nexplanon implant is used to help prevent pregnancy. You should not receive it during pregnancy.
Nexplanon is highly effective for preventing pregnancy. But there’s still a very small risk that you could become pregnant while you have Nexplanon implanted. If you do become pregnant after receiving Nexplanon, your doctor will remove the implant.
Nexplanon is likely safe to have implanted while breastfeeding. Small amounts of the drug have been found in breast milk. But the drug is not known to cause side effects in a child who is breastfed.
Note that Nexplanon can decrease the amount of milk you produce.
If you have questions about Nexplanon and pregnancy or breastfeeding, talk with your doctor.
Overdose can occur if you have more than one Nexplanon implant inserted at a time. But this is unlikely to happen when Nexplanon is inserted by a healthcare professional.
If you think you have more than one Nexplanon implant inserted, immediately notify your doctor.
If you’re considering Nexplanon for birth control, talk with your doctor or pharmacist. Asking them questions may help you feel comfortable about choosing this method of birth control. Here are some examples to get you started:
- What should I know about other birth control options besides Nexplanon?
- If I get sick, what medications are OK to use if I have the Nexplanon implant?
- Is Nexplanon safe to get if I have ovarian cysts?
- If I need surgery, will I have to get my Nexplanon implant removed?
To learn more about Nexplanon, see these articles:
- Nexplanon and Cost: What You Need to Know
- Dosage Details for Nexplanon
- Side Effects of Nexplanon: What You Need to Know
- Nexplanon Interactions: Alcohol, Medications, and Others
To learn more about choosing a birth control method that’s best for you, check out this article:
To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.
Will I need to use another kind of birth control with Nexplanon?Anonymous
You may need to use another kind of birth control for a few days after you have Nexplanon inserted. But long term, you won’t need backup birth control with Nexplanon in most cases.
Right after you receive a Nexplanon implant, you may need to use short-term backup birth control. This depends on whether you were previously using birth control and the kind you were using.
- If you weren’t previously using hormonal birth control: You don’t need backup birth control if you have Nexplanon inserted on Days 1 through 5 of your menstrual cycle.
- If you were previously using a combination birth control pill, vaginal ring, or skin patch: You don’t need backup birth control if you have Nexplanon inserted:
- the day after you take the last active birth control pill, or at the latest, the day after your usual tablet-free interval
- the day you have the vaginal ring or skin patch removed, or at the latest, the day after your usual ring-free or patch-free interval
- If you previously used a progestin-only birth control: Whether you need backup birth control after you have Nexplanon inserted depends on the form you used. You will not need it if:
- You were taking progestin minipills, and you have Nexplanon inserted within 24 hours of your last dose.
- You received progestin injections, and you have Nexplanon inserted the day your next injection is due.
- You had a progestin intrauterine device (IUD) or implant, and you have Nexplanon inserted the day the device is removed.
Otherwise, you should use a barrier method of birth control for 7 days after you have Nexplanon inserted.
If you have more questions about backup birth control and Nexplanon, talk with your doctor or pharmacist.The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.