Questions women may ask about the Nexplanon implant

The implant is a long-acting, reversible contraceptive in the form of a small, flexible rod, which is inserted just under the skin on the inside of the upper arm. It contains the hormone progestogen, a small amount of which is released into the body each day and prevents the monthly release of eggs from the ovaries. If there are no eggs to fertilise, the women cannot become pregnant.1 Go to the About Nexplanon section of this website for more information.

No method of contraception is 100% effective. However, the implant is more than 99% effective, and women can be reassured that it is therefore considered to be one of the most reliable methods of contraception.1 Go to the Efficacy of Nexplanon section of this website for more information.

Yes, it’s easy to switch to the contraceptive implant from another method of contraception such as a combined oral contraceptive pill, a progestogen-only pill, an intrauterine device or an injectable contraceptive. Please refer to the Nexplanon Summary of Product Characteristics for details of when women can start using the implant.1 Go to the Starting or switching to Nexplanon page of this website for more information.

Timing of insertion depends on the woman's recent contraceptive history (e.g. no preceding hormonal contraceptive use in the past month, following abortion or miscarriage, postpartum) and will vary according to the type of contraceptive women may already be using at the time (e.g. COC, progestagen-only pill, implant, or intrauterine system). Please refer to the Nexplanon Summary of Product Characteristics for details of when women can start using the implant.1 Go to the Starting or switching to Nexplanon page of this website for more information.

Insertion of the implant involves a relatively simple procedure that takes little time for an appropriately trained and experienced healthcare professional to perform.5,31

The implant starts to work as soon as it is inserted, providing the procedure is conducted at the appropriate point in the menstrual cycle. Please refer to the Nexplanon Summary of Product Characteristics for details of when women can start using the implant.1 Go to the Starting or switching to Nexplanon page of this website for more information.

Women should be given a local anaesthetic to numb the area while the insertion procedure takes place. They should be advised that the area may be a little tender and bruised when the anaesthetic has worn off but that this should ease relatively quickly. Please refer to the Nexplanon Summary of Product Characteristics for details of how to insert the implant.1 Go to the Inserting Nexplanon page of this website for more information.

You can advise women that the implant is unlikely to be visible. However, you and the user should be able to feel the rod with your fingertips once it is inserted correctly. It is important for the healthcare provider to be able to feel the implant in position when it is time for it to be removed. Please refer to the Nexplanon Summary of Product Characteristics for details of how to remove Nexplanon.1 Go to the Inserting Nexplanon page of this website for more information.

When correctly inserted, the implant lies in the tissue just below the surface of the skin. This holds it in position and it should not get lost. Because the implant is made of a flexible plastic, it is unlikely to break inside the user’s arm. Please refer to the Nexplanon Summary of Product Characteristics for details of how to insert Nexplanon.1 Go to the Inserting Nexplanon page of this website for more information.

Some medicines may affect the efficacy of the contraceptive implant. This includes drugs used to treat epilepsy, some antibiotics, treatments for tuberculosis and the herbal remedy St. John’s Wort. It is important to advise women to let other healthcare providers know that they are using the implant before other medications are prescribed or bought over the counter. They should also be told to tell any doctor or nurse who may attend to them if they have to receive hospital treatment. Please refer to the Nexplanon Summary of Product Characteristics for details of possible drug interactions with the implant.1 Go to the Efficacy of Nexplanon page of this website for more information.

Yes. Because the implant is a subdermal implant and is not taken orally, women can be reassured that it will continue to work should they become sick and vomit or have diarrhoea. Go to the Efficacy of Nexplanon page of this website for more information.

No, the implant has no known adverse effect on the density of a woman’s bones.38 Go to the Tolerability of Nexplanon page of this website for more information about the side effects of the implant.

The implant cannot protect women against sexually transmitted infections. Women should be advised to use condoms if they are concerned that they may be at risk.

As with most medicines, there is a possibility of some side effects with the implant. Those most commonly reported include acne, breast tenderness and pain, headaches, irregular vaginal bleeding, vaginal infection and weight changes. However, not all women will experience these side effects or to the same degree. Advise women to read the Nexplanon Patient Information Leaflet for more detail on possible side effects, and discuss any concerns that they may have with you or another healthcare professional at any time. Please refer to the Nexplanon Summary of Product Characteristics for full details of all possible side effects of the implant.1 Go to the Tolerability of Nexplanon page of this website for more information.

Women can be reassured that, once the contraceptive implant is removed their fertility should return to a level that was normal for them before they had the implant inserted and for their age at the time of the implant’s removal. Go to the Return of fertility and Nexplanon page of this website for more information.

As with all hormonal contraceptives, some women may notice changes in their weight while using the contraceptive implant.1 Please refer to the Nexplanon Summary of Product Characteristics for details of side effects of the implant.1 Go to the Tolerability of Nexplanon page of this website for more information.

As with other progestogen-only methods of contraception, some women find their periods happen only occasionally, or may stop completely, when using the implant. This is quite normal. Others find that their periods become heavier or last longer. It’s also possible that their bleeding pattern may change the longer they use the contraceptive implant. It is impossible to predict these changes and, although they may be inconvenient, they are not harmful and do not mean that the implant is not working. If they have concerns about their bleeding patterns, they should be advised to talk to the healthcare professional who fitted the implant. Please refer to the Nexplanon Summary of Product Characteristics for details of side effects of the implant.1 Go to the Bleeding changes and Nexplanon page of this website for more information.

Instances of mood change have been reported with all forms of hormonal contraception. Women should be advised to consult their doctor or family planning nurse if they are concerned.1 Please refer to the Nexplanon Summary of Product Characteristics for details of side effects of the implant.1 Go to the Tolerability of Nexplanon page of this website for more information.

The implant must be removed after 3 years or sooner if they are above average weight.1 When the contraceptive implant is inserted they will be given a card that states the date by which the contraceptive implant should be removed. They should be advised to keep the card somewhere safe, and make an appointment for removal well before this date. They can also sign up for our free e-mail alert service to help them remember when they should think about having the implant removed. Please refer to the Nexplanon Summary of Product Characteristics for details of the  implant’s removal.1 Go to the Removing Nexplanon page of this website for more information.

To remove the implant a trained healthcare professional will first feel the position of the implant with their fingertips. A local anaesthetic will then be used to numb the area before a tiny incision is made in the skin at one end of the implant. The implant will then be gently pushed through the incision and removed. After the implant is removed, a pressure bandage may be applied to minimise any bruising.1 Please refer to the Nexplanon Summary of Product Characteristics for details of the implant removal.1 Go to the Removing Nexplanon page of this website for more information.

Removal of the implant has been reported to take an average of 3.6 minutes to perform, with the speed and ease of removal dependent upon the correct insertion procedure being used.1,5 Please refer to the Nexplanon Summary of Product Characteristics for details of the implant’s removal.1 Go to the Removing Nexplanon page of this website for more information.

Yes. If the user decides to continue to use an implant, a new one may be inserted at the same time as the old one is removed. If they prefer not continue to use an implant, they will need to start using another form of contraception immediately if they do not wish to get pregnant. Please refer to the Nexplanon Summary of Product Characteristics for details of replacing the implant.1 Go to the Removing Nexplanon page of this website for more information.

The implant should only be fitted and removed by healthcare professionals who are specially trained in this procedure. Please refer to the Nexplanon Summary of Product Characteristics for details of inserting and removing the implant.1 Go to the Training to insert and remove Nexplanon page of this website for more information.

There is a slight possibility that a small scar may be left by the incision used to remove the implant. Please refer to the Nexplanon Summary of Product Characteristics for details of the implant removal.1 Go to the Removing Nexplanon page of this website for more information.

Women should be advised to talk to a doctor or family planning nurse if they have any questions about using the implant and contraception. They can also visit the Information for Women and My Nexplanon sections of this website.

View the Nexplanon Summary of Product Characteristics

Click here to view the Nexplanon Patient Information Leaflet

Request a visit from a Schering-Plough representative to learn more about Nexplanon, including how to train to insert and remove the contraceptive implant.
Information for the general public about the contraceptive implant, Nexplanon.

 


 
 

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Date of Preparation March 2014
03-16 WOMN-1113627-0000

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