Implanon NXT

Implanon NXT

etonogestrel

Manufacturer:

Merck Sharp & Dohme

Distributor:

Zuellig
Concise Prescribing Info
Contents
Etonogestrel
Dosage/Direction for Use
Subdermal insertion of implant. 1 administration is effective for 3 yr. No preceding hormonal contraceptive use in the past mth Insert on day 1-5 of the menstrual cycle. If beyond recommended period, use barrier method until 7 days after insertion. If intercourse has already occurred, pregnancy should be excluded. Changing from a combined oral contraceptive (COC), vag ring or transdermal patch Insert preferably on the day after the last active tab of the previous COC, but at the latest on the day following the usual tab-free interval or last placebo tab of the previous COC. Changing from a progestagen-only contraceptive method [eg, progestagen-only pill, injectable, implant or intrauterine system (IUS)] Injectable contraceptives: Insert when the next inj is due. Progestagen-only pill: Insert w/in 24 hr after the last tab. Implant or IUS: Insert on the day of its removal. Following 1st trimester abortion or miscarriage Insert implant w/in 5 days after 1st trimester abortion or miscarriage. Following 2nd trimester abortion or miscarriage Insert on day 21-28 after 2nd trimester abortion or miscarriage. Postpartum Breastfeeding: Insert after the 4th postpartum wk. Non-breastfeeding: Insert between 21-28 days postpartum. Use a barrier method until 7 days after insertion. When implant is inserted later than 28 days postpartum, use additional barrier method until 7 days after insertion.
Contraindications
Hypersensitivity. Active venous thromboembolic disorder; known or suspected sex steroid-sensitive malignancies; presence or history of benign or malignant liver tumours & severe hepatic disease; undiagnosed vag bleeding. Known or suspected pregnancy.
Special Precautions
Risk of breast cancer; acute or chronic disturbances of liver function; VTE, DVT & pulmonary embolism; history of thromboembolic disorders; venous & arterial thromboembolism. Women w/ history of thromboembolic disorders. Remove implant if thrombosis occurs. Discontinue use if sustained HTN develops or if a significant increase in BP does not adequately respond to antihypertensive therapy. Carefully observe diabetic women & those being treated for hyperlipidemia. Chloasma (avoid sun & UV radiation exposure). Consider early replacement of implant in heavier women. Expulsion may occur if implant is not inserted accordingly. Follicular development may occur in low-doses. Ectopic pregnancy. Jaundice &/or pruritus related to cholestasis, gallstone formation, porphyria, SLE, hemolytic uraemic syndrome, Sydenham's chorea, herpes gestationis, ostsclerosis-related hearing loss & (hereditary) angioedema. Measure BP & perform physical exam prior to initiation or reinstitution of therapy. Concomitant use w/ drugs that decrease plasma conc of etonogestrel. Monitor for changes in vag bleeding pattern. Lactation.
Adverse Reactions
Implant site reactions eg, erythema, hematoma, bruising, pain & swelling. Vag infection; headache; acne; breast tenderness; breast pain, irregular menstruation; increased wt. Increased appetite; affect lability, depressed mood, nervousness, decreased libido, dizziness; hot flush; abdominal pain, nausea, flatulence; alopecia; dysmenorrhoea, ovarian cyst; implant site pain & reaction, fatigue, flu-like illness, pain; decreased wt.
Drug Interactions
Increased clearance of sex hormones w/ phenytoin, phenobarb, primidone, bosentan, carbamazepine, rifampicin, oxcarbazepine, topiramate, felbamate, griseofulvin, HIV PIs (eg, ritonavir), NNRIs (eg, efavirenz). St. John's wort. Increased or decreased plasma conc w/ nelfinavir, nevirapine, boceprevir, telaprevir. Increased serum conc w/ CYP3A4 inhibitors eg, ketoconazole, itraconazole, clarithromycin, fluconazole, diltiazem, erythromycin. Increase plasma & tissue conc of cyclosporin. Decrease plasma & tissue conc of lamotrigine.
ATC Classification
G03AC08 - etonogestrel ; Belongs to the class of progestogens. Used as systemic contraceptives.
Presentation/Packing
Form
Implanon NXT subdermal implant 68 mg
Packing/Price
1's
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