Etonogestrel implant

• NEXPLANON is a small, flexible rod placed under the skin of your upper arm to prevent pregnancy.
• One implant keeps working for a few years before it needs to be removed or replaced.

• This medicine is not a pill — it is a small rod inserted just under the skin of your upper arm by a trained healthcare professional.
• Food timing does not apply, since this is not a medicine you swallow.
• You can check the implant is in place by gently feeling for it under your skin with your fingers; if you cannot feel it, contact your healthcare professional.

If you miss a dose

• There is no daily dose to miss with this implant, since it works continuously once inserted.
• Make sure you have the implant removed or replaced by the date your healthcare professional gives you, since it eventually stops preventing pregnancy.

• Do not use this implant if you are pregnant or think you might be pregnant.
• If you become pregnant while using this implant and wish to continue the pregnancy, it should be removed.
• This implant can generally be used while breastfeeding; talk to your healthcare professional about the right timing after delivery.

• Tell your healthcare professional if you have ever had a blood clot, liver disease or liver tumours, unexplained vaginal bleeding, or breast cancer.
• Tell your healthcare professional if you have high blood pressure, diabetes, high cholesterol, epilepsy, or a history of depression.
• This implant does not protect against sexually transmitted infections, so use condoms if you need that protection too.

Important warnings

• Blood clots can form in your legs, lungs, or eyes with this medicine, and rarely these have been fatal. Tell your healthcare professional about any leg pain or swelling, chest pain, or sudden shortness of breath.
• This medicine can rarely increase the risk of stroke or heart attack.
• Severe allergic reactions, including swelling of the face, lips, or throat, can occur.
• The implant can move from its original position. Deep or incorrect insertion has, rarely, led to it moving into a blood vessel, which may need a special procedure to remove.
• The implant can occasionally break or bend.
• Liver tumours and liver problems, including yellowing of the skin or eyes, have been reported.
• This medicine can raise blood pressure and can worsen or trigger depression in some people.
• Rarely, this medicine has been linked to increased pressure around the brain, causing headaches, vision changes, or ringing in the ears.

• Headache
• Weight gain
• Acne
• Breast tenderness
• Mood swings
• Dizziness
• Stomach pain
• Changes in your periods, including spotting, irregular bleeding, or periods stopping altogether, especially in the first few months
• Nausea
• Gas
• Painful periods, though this often improves over time
• Ovarian cysts, which usually go away on their own
• Hot flushes
• Pain, bruising, or a reaction where the implant was inserted
• Lower interest in sex
• Vaginal infection
• Thinning hair

When to get emergency help

• Sudden chest pain or trouble breathing
• Pain or swelling in one leg, especially the calf
• A sudden, severe headache, vision changes, or weakness on one side of your body
• Signs of a severe allergic reaction, such as swelling of your face or throat, or trouble breathing
• Lower stomach pain that could suggest a pregnancy outside the womb

When to contact a healthcare professional

• If you cannot feel the implant under your skin.
• If you notice significant changes in your mood or feel very low.
• If your blood pressure readings are high.
• If you think you might be pregnant.
• If you have questions about when your implant needs to be removed or replaced.

• Tell the Care365 care team about all medicines you take. Some medicines, including certain seizure medicines, the antibiotic rifampin, and herbal products like St. John's wort, can make this implant less effective at preventing pregnancy.
• If you're prescribed one of these medicines, ask the Care365 care team whether you need a backup method of birth control.
• Grapefruit juice can raise the levels of this medicine in your body.

• This medicine is inserted and removed by a trained healthcare professional, so there is nothing for you to store at home.