Can a Woman Using Nexplanon Take Ozempic?
Yes, a woman using a Nexplanon (etonogestrel) implant can safely take Ozempic (semaglutide) without compromising the effectiveness of either medication.
No Clinically Significant Drug Interaction
Semaglutide does not reduce the bioavailability of progestin-based contraceptives. Studies demonstrate that semaglutide does not interfere with levonorgestrel pharmacokinetics, maintaining contraceptive efficacy 1, 2.
In clinical trials, semaglutide co-administration with levonorgestrel showed an AUC ratio of 1.06 (90% CI: 0.97-1.17), meeting bioequivalence criteria and confirming no reduction in contraceptive hormone exposure 1.
A separate study found levonorgestrel AUC increased by 20% with semaglutide (ratio 1.20 [1.15-1.26]), which represents a slight increase rather than a decrease in exposure—this does not compromise contraceptive effectiveness 2.
Mechanism Considerations
Nexplanon works systemically through continuous etonogestrel release, achieving contraceptive efficacy through ovulation suppression, cervical mucus thickening, and endometrial changes 3.
Unlike combined oral contraceptives that require gastrointestinal absorption at specific times, the implant's subcutaneous delivery bypasses any potential GI effects of semaglutide 3.
Semaglutide's mechanism (GLP-1 receptor agonism causing delayed gastric emptying) does not affect systemically absorbed contraceptive implants 1, 2.
Safety Profile in Relevant Populations
Etonogestrel implants have been studied specifically in women with metabolic conditions (including diabetes requiring insulin), showing no adverse effects on metabolic control or vascular complications over 24 months 4.
The implant demonstrates no clinically significant effects on lipid metabolism or liver function, making it suitable for patients with chronic metabolic conditions who may be prescribed semaglutide 5.
Contraceptive Efficacy Maintained
The Nexplanon implant maintains its exceptional effectiveness (<0.05% pregnancy failure rate over 3 years) regardless of co-administered medications, except for hepatic enzyme-inducing agents 3.
Semaglutide is not a hepatic enzyme inducer and does not fall into the category of medications that reduce etonogestrel effectiveness 3.
Clinical Caveats
Monitor for overlapping side effects: Both medications can cause nausea and gastrointestinal symptoms, particularly during semaglutide initiation 2, 6.
Weight changes may occur: Semaglutide produces sustained weight loss (mean -10.2% at 208 weeks), while Nexplanon typically has minimal weight effects 6.
Bleeding pattern counseling remains important: Nexplanon commonly causes amenorrhea (22%) or irregular bleeding (34% infrequent spotting), which is unrelated to semaglutide use 7.