In women of all ages, careful re-evaluation of the risks and benefits of treatment should be carried out in those who wish to continue use of injectable contraception for more than 2 years.^2,3

NEXPLANON^® provides contraception for up to 3 years.^1*

Consider using a LARC such as NEXPLANON^® that provides highly effective, reversible contraception for up to 3 years.^1†

Studies conducted in the UK show a range of discontinuation rates for women on NEXPLANON^®. Continuation rates vary based on the population studied.

• At Year 1 discontinuation rates range from 10%-30%^4,5
• At Year 2 discontinuation rates range from 20%-56%^4,5
• At Year 3 discontinuation rates range from 47%-53%^6,7

*HCPs may consider earlier replacement of the implant in heavier women.^1
†The frequency and nature of further periodic checks should be adapted to the individual woman, guided by clinical judgement.¹

Consider a longer term LARC such as NEXPLANON^®, the effectiveness of which does not rely on the user remembering to take their contraception.¹

In addition, the frequency of administration of NEXPLANON^® is once every 3 years^1* vs once every 12 weeks² for the injectable DMPA. The minimum number of appointments needed over 3 years is 3^1† for NEXPLANON^® and 13² for the injectable DMPA.

*HCPs may consider earlier replacement of the implant in heavier women.^1
†The frequency and nature of further periodic checks should be adapted to the individual woman, guided by clinical judgement.¹
DMPA: depot medroxyprogesterone acetate

If the patient is not on any form of contraception, the implant should be inserted between Day 1 (first day of menstrual bleeding) and Day 5 of the menstrual cycle, even if the woman is still bleeding.¹

If inserted as recommended, back-up contraception is not necessary. If deviating from the recommended timing of insertion, the woman should be advised to use a barrier method until 7 days after insertion. If intercourse has already occurred, pregnancy should be excluded.¹

If the patient is switching her contraceptive, post-partum or had an abortion or miscarriage, please refer to the Summary of Product Characteristics for full details.¹

Placebos can be ordered from www.medisa.com. Palpators and rulers can be ordered from the nurse team at ntspfeedback@organon.com

The contraceptive effect of NEXPLANON^® is related to the plasma levels of etonogestrel, which are inversely related to body weight, and decrease with time after insertion. The clinical experience in heavier women in the third year of use is limited. Therefore, it cannot be excluded that the contraceptive effect in these women during the third year of use may be lower than for women of normal weight. HCPs may therefore consider earlier replacement of the implant in heavier women.¹

During the use of NEXPLANON^®, women are likely to have changes in their menstrual bleeding pattern which are unpredictable beforehand. These may include the occurrence of an irregular bleeding pattern (absent, less frequent, more frequent or continuous), and changes in bleeding intensity (reduced or increased) or duration. Amenorrhea was reported in about 1 in 5 women while another 1 in 5 women reported frequent and/or prolonged bleeding. Occasionally, heavy bleeding has been reported. The bleeding pattern experienced during the first 3 months is broadly predictive of future bleeding patterns for many women.¹ Information, counselling and the use of the selfplanon flow diary app can improve the woman’s acceptance of a new bleeding pattern. Organon can provide support materials in the form of patient diary cards and selfplanon business cards from www.medisa.com. For more educational information, please contact the NEXPLANON^® Training Support Programme nurse team at: ntspfeedback@organon.com.

Non-palpable and deeply inserted implants should be removed by HCPs familiar with the anatomy of the arm and removal of deeply-inserted implants. Exploratory surgery without knowledge of the exact location of the implant is strongly discouraged.¹ A non-palpable implant should always be first located prior to attempting removal. Suitable methods for localisation include X-ray computer tomography, ultrasound scanning with a high-frequency linear array transducer (10 MHz or greater), two-dimensional X-ray or magnetic resonance imaging.¹

Referral to an expert implant removal centre is recommended.⁸

The Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists offers two training options:^9,10

• Letter of Competence Subdermal Contraceptive Implants Techniques Insertion and Removal (LoC SDI-IR) - For doctors, nurses, midwives and physician associates already working in general practice and community sexual health services. Find out more >
• Letter of Competence Subdermal Contraceptive Implant Techniques Insertion Only (LoC SDI-IO) - For doctors, nurses, midwives and physician associates already working in general practice and community sexual health services working in abortion or maternity services only. Find out more >

Common side effects: increased appetite, affect lability, depressed mood, nervousness, libido decreased, dizziness, hot flush, abdominal pain, nausea, flatulence, alopecia, dysmenorrhoea, ovarian cyst, implant site pain, implant site reaction, fatigue, influenza like illness, pain, weight decreased.¹

Very common side effects: vaginal infection, headache, acne, breast tenderness, breast pain, menstruation irregular, weight increased.¹

There have been reports of implant migration and rare postmarketing reports of implants located within the vessels of the arm and the pulmonary artery, which may refer to deep insertions or intravascular insertion. Please refer to the Summary of Product Characteristics for correct insertion technique.¹

Yes, women can 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

Insertion of the implant involves a procedure that takes little time for an appropriately trained and experienced HCP to perform.^11,12

Women should be given a local anaesthetic to numb the area while the insertion procedure takes place. The insertion will be performed by a trained HCP. 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

To remove the implant a trained HCP 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. Please refer to the NEXPLANON^® Summary of Product Characteristics for details of the implant's removal.¹

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.¹² Please refer to the NEXPLANON^® Summary of Product Characteristics for details of the implant’s removal.¹