Etonogestrel is a long-acting birth control implant. This medicine is used to prevent pregnancy.
Etonogestrel is contained inside a tiny, flexible plastic rod which will be inserted by your doctor under the skin at the inner side of your non-dominant upper arm.
Your doctor will give you a local anaesthetic (medicine that blocks pain and sensation) before making a small incision in the skin when inserting this medicine. He will then place the implant in the correct position for you. You may need to regularly palpate (feel the implant under your skin) if the implant is in place. Inform your doctor immediately if you cannot feel the implant.
Each Etonogestrel implant may be left in place for 3 years. The implant should be removed by your doctor not later than 3 years from the date of insertion. Remember to see your doctor on the date of implant removal.
Alert your doctor if you have the following conditions:
- current, suspected or history of breast cancer or sex hormone-sensitive cancers
- with or a history of blood clot disorders
- unexplained or unusual vaginal bleeding
- with or a history of liver disease e.g. liver tumours
as Etonogestrel may not be suitable for you.
Do not use this medicine if you are pregnant. If you become pregnant while being treated with Etonogestrel, alert your doctor immediately. This medicine may cause harm to your unborn child.
Inform your doctor if you have the following conditions:
- high blood pressure
- high cholesterol levels in the blood
- history of depression
- history of chloasma gravidarum (discolouration of the skin especially on the face or neck during pregnancy)
- conditions which increase the risk of heart disease e.g. overweight, smoking
- gallbladder problems
- kidney disease
Let your doctor know if you are breastfeeding.
Etonogestrel does not reduce your risk of getting HIV infection or any other sexually transmitted diseases. Ensure that you use proper precautions to avoid getting these diseases.
If you are going to have an operation or certain laboratory tests (e.g. test for cholesterol levels or blood sugar tolerance), inform your doctor that you are using this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before treatment to know if Etonogestrel is suited for you to use.
- Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure before and regularly during the treatment.
- Regular monitoring for signs of blood clots, changes in vision, depression, and unusual vaginal bleeding may also be needed.
Etonogestrel may cause any of the following side effects: headache, dizziness, nausea, abdominal pain, hot flushes, nervousness, hair loss, acne, back pain, breast tenderness and pain, increased appetite, weight gain or loss, and pain at the site of the implant.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- pain, swelling and tenderness in your leg accompanied by redness and warmth
- sudden shortness of breath, sharp chest pain or coughing up blood
- yellowing of the skin or eyes, dark coloured urine, tiredness, swelling in the legs and ankles
- unusual vaginal bleeding, changes in menstrual bleeding patterns e.g. irregular menstruation
- new lump or mass in the breast
- visual disturbances e.g. unexplained loss of vision, double vision
- unusual changes in mood or behaviour e.g. being too depressed
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine, barbiturates, lamotrigine
- medicines for HIV infection e.g. ritonavir, efavirenz, nevirapine
- medicines to treat fungal infection e.g. ketoconazole, voriconazole, fluconazole, griseofulvin
- certain antibiotics e.g. clarithromycin, erythromycin
- rifampicin (medicine to treat tuberculosis or TB)
- ciclosporin (medicine used in organ transplant or certain immune disorders)
- diltiazem (medicine for high blood pressure or chest pain)
- St. John’s wort (herbal medicine)
This list does not include all medicines that may interact with Etonogestrel.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.