Individual generic drug information

etonogestrel

Reference monograph

Part of registered formulation

ETONOGESTREL

Reference record: Etonogestrel
Source: BNF 80 (2020–2021)
Printed source pages: 877
Age groups indexed: Not recorded

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Etonogestrel only.

Indications And Dose

Contraception (no hormonal contraceptive use in previous month) ▶BY SUBDERMAL IMPLANTATION ▶Females of childbearing potential: 1 implant inserted during ﬁrst 5 days of cycle, implant should be removed within 3 years of insertion Contraception (postpartum) ▶BY SUBDERMAL IMPLANTATION ▶Females of childbearing potential: 1 implant to be inserted 21–28 days after delivery (delay until 28 days postpartum if breast-feeding), implant should be removed within 3 years of insertion Contraception following abortion or miscarriage in the second trimester ▶BY SUBDERMAL IMPLANTATION ▶Females of childbearing potential: 1 implant to be inserted 21–28 days after abortion or miscarriage, implant should be removed within 3 years of insertion Contraception following abortion or miscarriage in the first trimester ▶BY SUBDERMAL IMPLANTATION ▶Females of childbearing potential: 1 implant to be inserted within 5 days after abortion or miscarriage, implant should be removed within 3 years of insertion Contraception (changing from other hormonal contraceptive) ▶BY SUBDERMAL IMPLANTATION ▶Females of childbearing potential: Implant should be removed within 3 years of insertion (consult product literature) l UNLICENSED USE Nexplanon ® not licensed for use in females outside of the age range 18–40 years.

Source page 877

Contra Indications

Acute porphyrias p. 1120. history of breast cancer but can be used after 5 years if no evidence of disease and non-hormonal contraceptive methods unacceptable. severe arterial disease. undiagnosed vaginal bleeding

Source page 877

Cautions

Active trophoblastic disease (until return to normal of urine- and plasma-gonadotrophin concentration)—seek specialist advice. arterial disease. disturbances of lipid metabolism. history during pregnancy of deterioration of otosclerosis. history during pregnancy of pruritus. history of jaundice in pregnancy. Genito-urinary system malabsorption syndromes. possible risk of breast cancer. sex-steroid dependent cancer. systemic lupus erythematosus with positive (or unknown) antiphospholipid antibodies

Source page 877

Safety

Extracted information for Etonogestrel only.

Important Safety Information

MHRA/CHM ADVICE (UPDATED FEBRUARY 2020): NEXPLANON ® (ETONOGESTREL) CONTRACEPTIVE IMPLANTS: NEW INSERTION SITE TO REDUCE RARE RISK OF NEUROVASCULAR INJURY AND IMPLANT MIGRATION There have been reports of neurovascular injury and migration of Nexplanon ® implants from the insertion site to the vasculature, including the pulmonary artery in rare cases. Correct subdermal insertion by an appropriately trained and accredited healthcare professional is recommended to reduce the risk of these events. Healthcare professionals are advised to review the updated guidance from the manufacturer and the statement from the Faculty of Sexual and Reproductive Healthcare (FSRH) on how to correctly insert the implant. Patients should be advised on how to locate the implant, informed to check this occasionally and report any concerns. An implant that cannot be palpated at its insertion site should be located and removed as soon as possible; if unable to locate implant within the arm, the MHRA recommends using chest imaging. Implants inserted at a previous site that can be palpated should not pose a risk and should only be replaced if there are issues with its location or if a routine replacement is due.

Source page 877

Interactions

→Appendix 1: etonogestrel

Source page 877

Side Effects

▶Common or very common Abdominal pain. alopecia. anxiety. appetite increased. breast abnormalities. depressed mood. dizziness. emotional lability. fatigue. ﬂatulence. headaches. hot ﬂush. increased risk of infection. inﬂuenza like illness. libido decreased. menstrual cycle irregularities. nausea. ovarian cyst. pain. skin reactions. weight changes ▶Uncommon Arthralgia. constipation. diarrhoea. drowsiness. dysuria. fever. galactorrhoea. genital abnormalities. hypertrichosis. insomnia. myalgia. oedema. vomiting. vulvovaginal discomfort ▶Frequency not known Abscess. angioedema. embolism and thrombosis. haemorrhage. insulin resistance. neoplasms. paraesthesia. seborrhoea SIDE-EFFECTS, FURTHER INFORMATION The beneﬁts of using progestogen-only contraceptives (POCs), such as etonogestrel, should be weighed against the possible risks for each individual woman. There is a small increase in the risk of having breast cancer diagnosed in women using a combined oral contraceptive pill (COC); this relative risk may be due to an earlier diagnosis, biological effects of the pill or a combination of both. This increased risk is related to the age of the woman using the COC rather than the duration of use and disappears gradually within 10 years after discontinuation. The risk of breast cancer in users of POCs is possibly of similar magnitude as that associated with COCs, however the evidence is less conclusive.

Source page 877

Pregnancy

Not known to be harmful, remove implant if pregnancy occurs.

Source page 877

Breast Feeding

Progestogen-only contraceptives do not affect lactation.

Source page 877

Dose and formulations

Extracted information for Etonogestrel only.

Directions For Administration

The doctor or nurse administering (or removing) the system should be fully trained in the technique and should provide full counselling reinforced by the patient information leaﬂet.

Source page 877

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Implant ▶Nexplanon (Merck Sharp & Dohme Ltd) Etonogestrel 68 mg Nexplanon 68mg implant | 1 device P £83.43 DT = £83.43

Source page 877

Clinical care

Extracted information for Etonogestrel only.

Patient And Carer Advice

Full counselling backed by patient information leaﬂet required before administration.

Source page 877

Dose text by age group

Filter the extracted dose blocks for this individual drug.

No dose block was identified for this age filter. This does not establish whether the drug is suitable for that age group.

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.

Individual generic drug information

etonogestrel

Reference monograph

Part of registered formulation

ETONOGESTREL

Reference record: Etonogestrel
Source: BNF 80 (2020–2021)
Printed source pages: 877
Age groups indexed: Not recorded

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Etonogestrel only.

Indications And Dose

Source page 877

Contra Indications

Source page 877

Cautions

Source page 877

Safety

Extracted information for Etonogestrel only.

Important Safety Information

Source page 877

Interactions

→Appendix 1: etonogestrel

Source page 877

Side Effects

Source page 877

Pregnancy

Not known to be harmful, remove implant if pregnancy occurs.

Source page 877

Breast Feeding

Progestogen-only contraceptives do not affect lactation.

Source page 877

Dose and formulations

Extracted information for Etonogestrel only.

Directions For Administration

The doctor or nurse administering (or removing) the system should be fully trained in the technique and should provide full counselling reinforced by the patient information leaﬂet.

Source page 877

Medicinal Forms

Source page 877

Clinical care

Extracted information for Etonogestrel only.

Patient And Carer Advice

Full counselling backed by patient information leaﬂet required before administration.

Source page 877

Dose text by age group

Filter the extracted dose blocks for this individual drug.

No dose block was identified for this age filter. This does not establish whether the drug is suitable for that age group.

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.