Nexplanon Duration of Use
Nexplanon is now FDA-approved for up to 5 years of continuous use, and must be removed by the end of the fifth year. 1
Current FDA-Approved Duration
The etonogestrel implant (Nexplanon) provides contraceptive protection for up to 5 years from insertion, representing an extension from the previous 3-year approval. 1
The implant must be removed by the end of the fifth year and may be replaced with a new implant at the time of removal if continued contraceptive protection is desired. 1
When removal is performed at the approved duration endpoint, the implant can be replaced immediately with a new device without requiring backup contraception. 2
Contraceptive Efficacy Throughout Approved Duration
Nexplanon demonstrates exceptional effectiveness with a failure rate of less than 0.05% during the approved duration, making it one of the most effective reversible contraceptive methods available. 2
Both typical-use and perfect-use failure rates remain below 1% throughout the entire approved period. 2
Supporting Evidence for Extended Duration
Research data corroborate the extended efficacy, with no documented pregnancies occurring during the fourth and fifth years of use in clinical studies. 2, 3, 4
Serum etonogestrel levels remain above the ovulation threshold of 90 pg/mL through 5 years of use across all body mass index categories, with median levels of 111-153 pg/mL at year 5. 4, 1
The median etonogestrel level at 5 years was 153.0 pg/mL (range 72.1-538.8 pg/mL), well above the concentration needed to suppress ovulation. 4
Important Clinical Considerations
Off-label use beyond 5 years is not recommended, as the FDA approval explicitly states removal must occur by the end of the fifth year. 1
Backup contraception (condoms or abstinence) should be used for 7 days after initial insertion if the implant is placed more than 5 days after the start of menstrual bleeding. 2, 1
The 84% continuation rate at 1 year reflects high user satisfaction despite common irregular bleeding patterns. 2
For patients on hepatic enzyme-inducing medications (efavirenz, nevirapine, or most protease inhibitors), contraceptive efficacy may be reduced throughout the duration of use, and alternative or additional contraceptive methods should be employed. 2