Which combined oral contraceptive pill (COCp) is suitable for combination with Implanon (etonogestrel implant)?

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The FDA Drug Labels for etonogestrel (IM), ethinyl estradiol (PO) do not address this question.

From the Research

Suitable Combined Oral Contraceptive Pill (COCp) for Combination with Implanon (Etonogestrel Implant)

  • A study published in 2020 1 found that a COCP containing 20 mcg ethinyl estradiol/150 mg desogestrel was effective in managing bleeding irregularities among etonogestrel implant users.
  • The study compared the COCP with nonsteroidal anti-inflammatory drugs (NSAID) and found that the COCP was more efficient in stopping bleeding and reducing the mean duration of bleeding and spotting days.
  • Another study published in 2015 2 recommended prescribing a pill with the lowest effective dose of oestrogen and progestogen, and suggested that pills containing levonorgestrel or norethisterone in combination with ethinyloestradiol 35 microgram or less are considered first-line.
  • However, a study published in 2019 3 noted that older COCs with norethisterone or levonorgestrel have a lower risk for venous thromboembolism (VTE) than newer COCs with desogestrel, drospirenone, or gestodene.
  • Based on the available evidence, a COCP containing 20 mcg ethinyl estradiol/150 mg desogestrel may be a suitable option for combination with Implanon (etonogestrel implant), but the choice of COCP should be individualized and take into account the patient's medical history and risk factors for VTE, as well as other factors such as acne, hirsutism, and polycystic ovary syndrome 4.

Key Considerations

  • The patient's medical history and risk factors for VTE should be taken into account when choosing a COCP to combine with Implanon (etonogestrel implant) 3.
  • The choice of COCP should be individualized and consider factors such as acne, hirsutism, and polycystic ovary syndrome 4.
  • The patient should be informed about the potential risks and benefits of the chosen COCP, including the risk of VTE and other side effects 2, 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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