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Nexplanon
etonogestrel subdermal
Black Box Warnings .
Appropriate Use
available only through restricted program (Nexplanon REMS) because of risk of complications due to improper insertion and removal; healthcare providers must be certified and complete training on proper insertion and removal prior to first use; pharmacies must be certified and only dispense to certified healthcare providers; distributors must register and only distribute to certified pharmacies and healthcare providers; healthcare providers, pharmacies, and distributors must enroll at 1-833-697-7367 or www.nexplanonrems.com
Insertion and Removal Risks
improper insertion incr. risk of complications, such as pain, paresthesia, bleeding, hematoma, scarring, or infection; proper training prior to first use can minimize risk of improper insertion
Adult Dosing .
Dosage forms: IMPLANT: 68 mg
Dosage Form Details
- [formulation clarification]
- Info: implant contains radiopaque barium 15 mg for visualization purposes
Restricted Distribution in US
- [1-833-697-7367 or www.nexplanonrems.com for more info]
- Info: providers must receive training prior to obtaining product
Special Note
- [strength clarification]
- Info: release rate of etonogestrel declines from 60-75 mcg per day at wk 5-6 to 45-50 mcg per day after 1 year and 15-20 mcg per day after 5 years
contraception
- [1 implant subdermally q5y]
- Start: between days 1 and 5 of menstrual cycle; start within 5 days after 1st trimester abortion/miscarriage, between 21 and 28 days postpartum if not breastfeeding or after 2nd trimester abortion/miscarriage, or >4wk postpartum if breastfeeding; Info: see pkg insert if switching from another contraceptive; use barrier method x7 days after insertion if postpartum while breastfeeding or if deviating from other insertion timing recommendations
renal dosing
- [see below]
- renal disease: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- active hepatic disease: contraindicated
Peds Dosing .
- Dosage forms: IMPLANT: 68 mg
Dosage Form Details
- [formulation clarification]
- Info: implant contains radiopaque barium 15 mg for visualization purposes
Restricted Distribution in US
- [1-833-697-7367 or www.nexplanonrems.com for more info]
- Info: providers must receive training prior to obtaining product
Special Note
- [strength clarification]
- Info: release rate of etonogestrel declines from 60-75 mcg per day at wk 5-6 to 45-50 mcg per day after 1 year and 15-20 mcg per day after 5 years
contraception
- [postmenarchal patients]
- Dose: 1 implant subdermally q5y; Start: between days 1 and 5 of menstrual cycle; start within 5 days after 1st trimester abortion/miscarriage, between 21 and 28 days postpartum if not breastfeeding or after 2nd trimester abortion/miscarriage, or >4wk postpartum if breastfeeding; Info: see pkg insert if switching from another contraceptive; use barrier method x7 days after insertion if postpartum while breastfeeding or if deviating from other insertion timing recommendations
renal dosing
- [see below]
- renal disease: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- active hepatic disease: contraindicated