Pregnancy should be excluded before insertion of NEXPLANON^®. The implant should be inserted subdermally just under the skin. If the implant is not inserted in accordance with the instructions and not on the correct day, this may result in an unintended pregnancy.

• The basis for successful use and subsequent removal of the NEXPLANON^® implant is a correct and carefully performed subdermal insertion of the implant in accordance with the instructions
• Deep or incorrect insertions have been associated with paraesthesia (due to neural damage) and migration of the implant (due to intramuscular or fascial insertion, and in rare cases with intravascular insertion, including rare cases of migration to the chest wall
• Always verify the presence of the implant in the woman's arm immediately after insertion by palpation
• Find out what to do if the implant is not palpable >

Refer to the Summary of Product Characteristics for guidance on when to insert NEXPLANON^® and further information regarding complications of insertion.

Insertion of NEXPLANON^® should be performed under aseptic conditions and only by a qualified HCP who has completed training for the insertion and removal of the NEXPLANON^® implant. Insertion of the implant should only be performed with the preloaded applicator.

WATCH THE NEXPLANON^® INSERTION PROCEDURE

Duration: 5m 21s. Includes subtitles.

Removal of the implant should only be performed under aseptic conditions by an HCP who is familiar with the removal technique. If you are unfamiliar with the removal technique, contact the local representative of the Marketing Authorisation Holder for more information.*

Before initiating the removal procedure, the HCP should assess the location of the implant. Verify the exact location of the implant in the arm by palpation.

• If the implant is not palpable, consult the Patient Alert Card or medical record to verify the arm which contains the implant
• If the implant cannot be palpated, it may be deeply located or have migrated. View instructions on localisation and removal of a non-palpable implant >

WATCH THE REMOVAL PROCEDURE FOR AN IMPLANT THAT IS PALPABLE

Duration: 3m 47s. Includes subtitles.

Immediate replacement can be done after removal of the previous implant and is similar to the insertion procedure described in the section 'HOW TO INSERT NEXPLANON^®’.

• The new implant may be inserted in the same arm, and through the same incision from which the previous implant was removed as long as the site is in the correct location, ie 8-10 cm from the medial epicondyle of the humerus and 3-5 cm posterior to (below) the sulcus
• If the same incision is being used to insert a new implant, anaesthetise the insertion site by injecting an anaesthetic (eg 2 mL lidocaine (1%)) just under the skin commencing at the removal incision along the ‘insertion canal’ and follow the subsequent steps in the insertion instructions