Implantable Contraceptives

Question 1

What is the difference between Implanon and Nexplanon?

Answer 1

• Implanon has been replaced by Nexplanon.
• They are pharmacologically the same BUT:
• The Nexplanon applicator has been redesigned to prevent ‘deep’ injections (subcut/intramuscular)
• It is radiopaque and easier to locate on x-ray.

Question 2

What compound do implantable contraceptives release/

Answer 2

Etonogestrel

Question 3

Where are they inserted?

Answer 3

In the non-dominant arm just overlying the tricep

Question 4

What is the MOA of the implantable contraceptive?

Answer 4

• It prevents ovulation
  
  • But also thickens the cervical mucus to some degree
    *

Question 5

How effective is the implantable contraceptive?

Answer 5

Failure rate of 0.07/100 women/year

Question 6

How long does Nexplanon last for/

Answer 6

3 years

Question 7

If someone has a termination of pregnancy, when can an implantable contraceptive be inserted?

Answer 7

Immediately after

Question 8

When should the implantable contraceptive be inserted and if not during this time how long should additional contraceptives be used?

Answer 8

It should be inserted on Day 1 to 5 of the menstrual cycle.

If not inserted during this period then use alternative contraception for 7 days.

Question 9

What are some adverse effects of the implantable contraceptive?

Answer 9

Irregular/heavy bleeding is the main problem.

Progestogen effects: headaches, breast pain, nausea.

Question 10

What can Nexplanon interact with?

Answer 10

• Enzyme inducing drugs - can reduce its efficacy

Question 11

If a woman is taking an enzyme inducing drug and has Nexplanon, how long should they use additional contraception?

Answer 11

Until 28 days after stopping the treatment.

Question 12

What are some UKMEC 3 conditions that contraindicate the implantable contraceptive being used?

Answer 12

• IHD
• Stroke
• Suspicious vaginal bleeding
• Past breast cancer.
• Severe liver cirrhosis
• Liver cancer
• Positive antiphospholipid antibodies.

Question 13

What are some UKMEC 4 conditions that contraindicate the implantable contraceptive being used?

Answer 13

Current Breast Cancer