Nexplanon Duration of Effectiveness
Nexplanon (etonogestrel implant) is FDA-approved and effective for 3 years of contraceptive use. 1
Standard FDA-Approved Duration
The etonogestrel implant maintains contraceptive efficacy with failure rates of less than 1% (0.05% typical use) throughout the full 3-year approved period. 1
The American Academy of Pediatrics confirms that both Implanon and Nexplanon may remain in place for 3 years with highly effective contraception throughout this duration. 1
The implant should be replaced at 3 years as per FDA approval and standard clinical guidelines. 2
Evidence for Extended Use Beyond 3 Years
While the FDA-approved duration is 3 years, emerging research suggests potential extended effectiveness:
A multicenter randomized trial demonstrated 100% contraceptive efficacy in years 4 and 5 of etonogestrel implant use, with no pregnancies occurring during the additional 2 years of follow-up. 3
The 5-year cumulative pregnancy rate in this extended-use study was 0.6 per 100 woman-years (95% CI: 0.2-1.8), comparable to the approved 5-year levonorgestrel implant. 3
Pharmacokinetic data show that etonogestrel levels remain elevated at 3 years, with one case report documenting positive serum etonogestrel levels even 6 years after insertion. 4
Clinical Recommendation
Despite research evidence supporting extended efficacy, the implant should be removed and replaced at 3 years according to current FDA labeling and clinical guidelines. 1, 2
Important Caveats:
The extended-use studies had limited numbers of women ≥70 kg, so efficacy beyond 3 years in higher-weight individuals remains uncertain. 3
Off-label extended use beyond 3 years is not currently recommended in standard clinical practice, though this may change as additional evidence accumulates. 3
Women should be counseled that the approved duration is 3 years, and replacement should be planned accordingly to ensure continuous contraceptive protection. 1