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This document provides essential safety and warning information regarding the use of Nexplanon (etonogestrel). Please read it carefully and consult your healthcare provider if you have any questions or concerns.

• Insertion and Removal Issues: Nexplanon is implanted just beneath the skin, and you should be able to feel it at all times. Incorrect insertion can damage nearby muscles, tissues, and blood vessels, potentially leading to infections or unintended pregnancies. If the implant has migrated or if you cannot feel it, contact your healthcare provider immediately and use an alternative contraceptive method until its position is confirmed.

• Menstrual Changes: Users may experience alterations in their menstrual cycle, such as absence of periods, spotting, or prolonged bleeding. These patterns often stabilize after the first three months. If you have concerns, discuss them with your healthcare provider.

• Ectopic Pregnancy and Ovarian Cysts: Although rare, pregnancy while on Nexplanon can result in an ectopic pregnancy. Additionally, the risk of ovarian cysts may increase, though they typically resolve without treatment. Seek medical advice if you experience severe abdominal pain.

• Blood Clot Risks: While Nexplanon contains only progestin, its risk of blood clots is not well understood. Discuss your medical history with your provider, particularly if you have a history of blood clots, have recently given birth, or have conditions requiring prolonged immobility.

• Cancer Concerns: There is uncertainty about the risk of breast cancer with hormonal contraceptives. If you have a personal or family history of breast cancer, consult your provider to determine if Nexplanon is suitable for you. Perform regular breast self-exams and report any changes.

• Return to Fertility: Fertility generally returns quickly after Nexplanon is removed, with ovulation resuming within two weeks. Consider alternative contraception methods immediately post-removal to avoid unintended pregnancy.

• Liver Conditions: Discontinue use and contact your provider if you notice symptoms indicative of liver issues, such as jaundice or dark urine. Individuals with liver disease or tumors should avoid using Nexplanon.

• Blood Pressure: If you have uncontrolled hypertension, Nexplanon is not recommended. Regular monitoring of blood pressure may be necessary, and any symptoms like headaches or vision changes should be addressed with your provider.

• Blood Sugar and Cholesterol: Nexplanon may elevate blood sugar and cholesterol levels. Regular monitoring may be necessary if you have a history of high blood sugar.

• Weight Concerns: Weight gain is a possible side effect. Monitor your weight and discuss any significant changes with your healthcare provider.

• Gallbladder Issues: Although rare, Nexplanon can exacerbate gallbladder problems. Inform your provider of any history with gallbladder disease and watch for symptoms such as severe abdominal pain or jaundice.

• Vision Changes: Report any changes in vision to your provider, especially if you wear contact lenses, as a specialist evaluation may be needed.

Contraindications: Nexplanon should not be used if you are pregnant, have a history of breast or other hormone-sensitive cancers, unexplained vaginal bleeding, a history of blood clots, or liver tumors or acute liver disease. Always consult your healthcare provider if any of these conditions apply to you.

When taking this medication, you may encounter some common side effects, which are usually mild. These include headaches, absence of periods, more frequent or prolonged vaginal bleeding, vaginal pain or itching, weight gain, acne, breast tenderness, stomach pain, and sore throat. You might also experience vaginal discharge, dizziness, menstrual cramps, back pain, and flu-like symptoms. If these effects persist or worsen, it's important to consult a healthcare provider for guidance.

There are also other side effects that have been reported, such as mood swings, nervousness, and depression. Some individuals have experienced nausea, general body pain, and pain at the site where the medication is administered. While these effects can be uncomfortable, they are generally manageable with proper advice from healthcare professionals.

However, there are rare but serious side effects that require immediate medical attention. These include severe mental or mood changes, lumps in the breast, unwanted facial or body hair, and significant changes in urine color or jaundice. Additionally, some users have experienced ectopic pregnancies, which manifest as severe pelvic pain and unusual vaginal bleeding. Serious cardiovascular events such as heart attacks, strokes, and blood clots in the lungs have also been reported. Symptoms of these include chest pain, sudden difficulty speaking or walking, and severe headaches. In the event of these severe symptoms, seek urgent medical care.

While a very serious allergic reaction is rare, it's critical to get medical help right away if you notice symptoms like rash, severe dizziness, or trouble breathing. Always stay vigilant for any side effects and contact your healthcare provider if you notice any that are concerning or not listed here.

Certain medications can reduce the effectiveness of hormonal birth control by lowering the levels of contraceptive hormones in your body, potentially leading to pregnancy. These include medications such as griseofulvin, modafinil, rifamycins (like rifampin and rifabutin), ritonavir, St. John's wort, and drugs used for seizures (such as barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate), as well as some HIV medications (such as nelfinavir and nevirapine). It is important to inform your doctor when you begin any new medication and discuss whether you should use an additional form of reliable birth control. If you experience new spotting or breakthrough bleeding, notify your doctor, as these could indicate reduced effectiveness of your birth control.

Nexplanon (etonogestrel) may also interact with other medications or supplements. It is crucial to inform your healthcare provider about all medications and supplements you are taking, including prescription, over-the-counter, vitamins, and herbal products. Some medications, such as Tranexamic Acid, should not be used with Nexplanon. Others, like Amobarbital, Carbamazepine, Griseofulvin, and St. John's Wort, may require dose adjustments or additional monitoring if used together. Additionally, using Nexplanon with medications like Atazanavir or Efavirenz may increase the risk of side effects, so your doctor might adjust your treatment regimen accordingly.

Lastly, this medication may affect certain laboratory tests, potentially causing inaccurate results, so ensure that all laboratory personnel and your doctors are aware that you are using this drug.