What is the effective duration of Nexplanon (etonogestrel implant)

Nexplanon Duration of Effectiveness

Nexplanon (etonogestrel implant) is FDA-approved and effective for 3 years, after which it should be removed and replaced if continued contraception is desired. 1, 2

Effectiveness and Duration

• Nexplanon is a single-rod subdermal implant containing 68 mg of etonogestrel, the active metabolite of desogestrel 3
• It is the most effective reversible contraceptive method available with:
  • 0.05% failure rate (typical use) 1, 2
  • 84% continuation rate at 1 year (highest among reversible methods) 2
• Duration of effectiveness:
  • FDA-approved for 3 years 4, 1
  • Must be removed by the end of the third year of use for continued contraceptive protection 4

Clinical Evidence on Extended Use

Recent research suggests potential extended effectiveness:

• A 2016 study demonstrated 100% efficacy during years 4 and 5 of Nexplanon use with no pregnancies occurring during extended use 5
• This study included over 200 women who used the ENG implant for at least 5 years 5

However, despite this promising research, current guidelines and FDA approval still recommend replacement after 3 years 1, 2.

Practical Considerations

• Nexplanon contains barium sulfate, making it visible on X-ray for easier localization if non-palpable 3
• After removal, there is rapid return to fertility 4
• Insertion and removal procedures:
  • Must be performed by trained healthcare providers 4
  • Removal typically takes about 2 minutes 6
  • Fibrosis around the implant is the most common removal complication (4.4%) 6

Special Considerations

• Drug interactions: Efficacy may be reduced with hepatic enzyme-inducing medications like efavirenz 2, 1
• For patients on certain antiretroviral medications (efavirenz, nevirapine, or most protease inhibitors), additional contraceptive methods may be recommended 2
• Most common side effect: changes in menstrual bleeding patterns 4, 1

Bottom Line

While research suggests Nexplanon may be effective beyond 3 years, current guidelines and FDA approval limit its use to 3 years. Patients should have their implant removed and replaced after 3 years to ensure continued contraceptive protection.