Etonogestrel (e-toe-noe-JES-trel)

Prevents pregnancy.

Brand Name(s):

When This Medicine Should Not Be Used:

How to Use This Medicine:

Implant

• A nurse or other trained health professional will give you this medicine.
• This medicine is an implant. It will be surgically placed under the skin of your upper, inner arm.
• Gently press your fingertips over the skin where this medicine was inserted. You should be able to feel the implant.
• You might have to use another form of birth control for 7 days after the implant is inserted. Your doctor will tell you if this is needed.
• The implant must be removed after 3 years. However, your doctor can remove it at any time if you want to stop using this medicine. You may have a new one inserted if you still want to use this form of birth control.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and medicines can affect how etonogestrel works. Tell your doctor if you are using any of the following:
  • Aprepitant, bosentan, carbamazepine, cyclosporine, efavirenz, etravirine, felbamate, fluconazole, griseofulvin, itraconazole, ketoconazole, lamotrigine, oxcarbazepine, phenobarbital, phenytoin, nevirapine, rifabutin, rifampicin, rifampin, rufinamide, St John's wort, tipranavir/ritonavir, topiramate, voriconazole
  • Medicine for HIV/AIDS (including atazanavir/ritonavir, boceprevir, darunavir/ritonavir, fosamprenavir/ritonavir, indinavir, lopinavir/ritonavir, nelfinavir, ritonavir, telaprevir)
• Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor right away if you think you have become pregnant. The implant will need to be removed.
• Tell your doctor if you are breastfeeding, or if you have recently given birth. Tell your doctor if you have kidney disease, cancer, blood circulation problems, high blood pressure, diabetes or prediabetes, high cholesterol, or a history of depression. Tell your doctor if you smoke.
• This medicine may cause the following problems:
  • Ectopic (tubal) pregnancy
  • Increased risk of heart attack, stroke, or blood clots
  • Cysts in the ovaries
  • Increased risk of breast cancer
  • Liver cancers or tumors
  • High blood pressure
• This medicine may change your usual menstrual cycle. You might have irregular bleeding, or your periods may be lighter, shorter, heavier, or longer. You might not have a period in some cycles. Call your doctor if you think you are pregnant or if you have severe pain or changes that worry you.
• This medicine will not protect you from HIV/AIDS or other sexually transmitted diseases.
• You might need to have the implant removed if you will be inactive for a period of time (after major surgery) because of the risk of blood clots.
• Call your doctor if you feel that the implant may have broken or bent while it is in your arm.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain, trouble breathing, coughing up blood
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Double vision or trouble seeing
• Numbness or weakness on one side of your body, sudden or severe headache, problems with vision, speech, or walking
• Pain in your lower leg (calf)
• Severe or ongoing pain, tingling, bleeding, bruising, redness, itching, or swelling where the implant is placed
• Unusual or severe pain in your abdomen
• Unusual or unexpected vaginal bleeding or heavy bleeding

If you notice these less serious side effects, talk with your doctor:

• Acne or pimples
• Mild headache
• Mild pain, tingling, bleeding, bruising, redness, itching, or swelling where the implant is placed
• Mood changes
• Weight gain

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088