Nexplanon Duration of Effectiveness
Nexplanon provides effective contraception for 3 years from the time of insertion and must be replaced after this period if continued contraceptive protection is desired. 1, 2
FDA-Approved Duration
- The etonogestrel implant (Nexplanon) is approved for 3 years of use, after which it should be removed and replaced with a new implant if ongoing contraception is needed 1, 2
- This 3-year timeframe represents the standard duration supported by both the FDA approval and major medical organizations including the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists 1, 2
Contraceptive Efficacy During the 3-Year Period
- Nexplanon demonstrates exceptional effectiveness with a failure rate of less than 0.05% during the approved 3-year duration, making it one of the most effective reversible contraceptive methods available 2
- Both typical-use and perfect-use failure rates remain less than 1% throughout the entire 3-year period 1, 2
- Real-world data from the large NORA study (7,364 users) confirmed a Pearl Index of 0.02 for during-use pregnancies, validating the clinical trial efficacy 3
Important Timing Considerations
- Backup contraception (condoms or abstinence) must be used for at least the first 7 days after insertion to ensure full contraceptive protection 1, 2
- Fertility returns rapidly after removal—pregnancies can occur immediately once the implant is removed 1, 4
Extended Use Evidence (Not Currently Recommended)
- While emerging evidence suggests the implant may remain effective for up to 4 years with no documented pregnancies during the fourth year in recent studies, this extended duration is not FDA-approved or recommended for standard clinical practice 2
- The device should still be removed by the end of the third year per current guidelines 4
Critical Drug Interactions That Reduce Duration of Effectiveness
- Hepatic enzyme-inducing drugs can significantly impair Nexplanon's contraceptive efficacy throughout its use 1, 2
- Patients taking efavirenz, nevirapine, or most protease inhibitors should use alternative or additional contraceptive methods for the entire duration of both the medication and the implant 2
- Standard oral antibiotics do not interfere with Nexplanon effectiveness 2