What Type of Contraceptive is Nexplanon?
Nexplanon is a long-acting reversible contraceptive (LARC) consisting of a single subdermal etonogestrel implant that provides highly effective contraception for 3 years. 1, 2
Device Composition and Mechanism
- Nexplanon contains 68 mg of etonogestrel (the active metabolite of the progestin desogestrel) in a single, flexible, rod-shaped implant that is 4 cm long 1, 3
- The implant is made of ethylene vinyl acetate copolymer (a non-absorbable material) and contains 15 mg of barium sulfate to make it visible on X-ray 3
- It is inserted subdermally into the inside of the upper arm by a trained clinician 1
- The hormone diffuses out slowly at a stable rate, providing contraceptive effectiveness primarily by suppressing ovulation 4
Classification as Long-Acting Reversible Contraception (LARC)
- Nexplanon is categorized as a LARC method alongside intrauterine devices (IUDs), distinguishing it from short-acting hormonal methods like pills, patches, and rings 1
- The American College of Obstetricians and Gynecologists (ACOG) recommends offering LARC methods to all appropriate candidates due to their superior efficacy compared to short-acting methods 1
Contraceptive Efficacy
- Nexplanon demonstrates exceptional effectiveness with a failure rate of less than 0.05%, making it one of the most effective reversible contraceptive methods available 1, 2
- Both typical-use and perfect-use failure rates are less than 1%, as the method does not depend on user adherence after insertion 1, 2
- The 84% continuation rate at 1 year reflects high user satisfaction despite common irregular bleeding patterns 2
Duration and Reversibility
- The implant provides FDA-approved contraceptive protection for 3 years from insertion 1, 2
- After 3 years, the device must be replaced with a new implant if continued contraceptive protection is desired 2
- Fertility returns rapidly after removal, making it easily reversible when pregnancy is desired 1
Important Clinical Considerations
- Backup contraception (condoms or abstinence) should be used for at least the first week after insertion for full contraceptive efficacy 1, 2
- The most common adverse reaction is unpredictable bleeding or spotting, which is the primary reason for discontinuation 1
- All healthcare providers must complete requisite training before performing insertions or removals 1, 4