Implanon NXT

Implanon NXT - Interactions | Side effects

This article was medically reviewed by M.Pharm, Marko Tanaskovic on August 12, 2018. To read more about an author, click here.

Implanon NXT is a medicine containing etonogestrel as an active substance at a dose of 68 mg and it comes in the form of subcutaneous implant. It works by preventing the release of the eggs from the ovary. It is used as a contraception (birth control) in women aged 18-40 years. It is inserted under the skin and gradually releases the active substance-etonogestrel during the period of three years (protects you against pregnancy for a period of three years).

Insertion of the implant can only be carried out by trained medical personnel, and insertion must not be done by yourself, because incorrect insertion can lead to complications during the implant removal. After proper insertion, the implant will be palpable.

Studies have shown that this drug is less effective in overweight women as well as in women taking potent inductors of cytochrome P450 enzyme.

Contraindications and Precautions

If the implant is not removed as instructed by your doctor, it can lead to infertility and ectopic pregnancy! Insertion of Implanon NXT can only be performed by medical personnel trained to insert this implant. If the implant is inserted deep into the skin, surgical intervention may be required.

Sometimes infection may occur at the insertion site. In these situations, your doctor will probably prescribe you appropriate therapy. However, this infection sometimes does not respond to the prescribed therapy, and in these situations Implanon NXT must be removed.

Implanon NXT is contraindicated in women who have or have had thrombosis or thromboembolic events. Cases of severe forms of thromboembolic events (such as: stroke, heart attack, and pulmonary embolism) have been reported. Implanon NXT should be removed in case of thrombosis. Risk of unwanted thromboembolic events is higher in women who smoke, overweight women and in women above the age of 35. For this reason, the use of this medicine is not recommended in overweight patients and in patients who smoke. The risk of heart attack, stroke or blood clots is highest during the first year.

Implanon NXT is contraindicated in women who have or have had severe liver damage, jaundice or benign/malignant liver tumors. Study conducted in the UK has shown that long-term administration of etonogestrel (over 8 years) increases the risk of hepatocellular carcinoma, while this risk in US patients is estimated to be extremely low by the FDA. Tell your doctor if you have or have had any liver problems. If you notice symptoms of liver damage (e.g. jaundice), contact your doctor immediately.

The use of this drug is contraindicated in patients who have or have had breast cancer, because this type of cancer is usually sensitive to the use of hormonal medications, such as Implanon NXT.

Implanon NXT is also contraindicated in the following situations:

  • Vaginal bleeding of an unknown cause.
  • Pregnancy. Cases of ectopic pregnancy were reported in patients who used this medicine. If you notice pain in the lower part of the abdomen, contact your doctor.

Implanon NXT must be applied very cautiously in the following conditions:

  • Diabetes. Since this medicine can cause insulin resistance, which may further cause changes in blood sugar levels, it is recommended to avoid use of this medication in diabetics.
  • Hypertension. Studies have shown that there is a risk of developing hypertension in women who are taking this medicine. Women who already have hypertension or kidney problems should avoid use of this medicine. Usually, blood pressure returns to normal once implant is removed.
  • Tuberculosis. Some antituberculotic drugs are potent inducers of the cytochrome P450 enzyme, and may speed up the metabolism of etonogestrel and decrease its efficacy.
  • Epilepsy. Some antiepileptic drugs act as potent inducers of the cytochrome P450 enzyme, and may can decrease the efficacy of Implanon NXT. Tell your doctor if you have epilepsy or you are taking antiepileptic medications.
  • High cholesterol or high triglyceride levels. Implanon NXT can affect lipid metabolism and lead to increased levels of LDL cholesterol in the blood. Tell your doctor if you have high levels of cholesterol or triglycerides.
  • Chloasma (epidermal hypermelanosis characterized by darker skin color, especially on the forehead and chin). Patients who have chloasma should avoid exposure to sunlight.
  • Depression.

If you wear contact lenses and notice any vision changes or lens intolerance, you should inform your ophthalmologist immediately.

Implanone NXT, Pregnancy and Breastfeeding

Implanone NXT should not be used during pregnancy and Implanon NXT should be removed in case of pregnancy.

Although it is excreted into breast milk in small amounts, studies have shown that this medicine can be used during breastfeeding, as it does not affect growth and development of infants. Consult your doctor if you are breastfeeding.


The following drugs can reduce the effectiveness of Implanon NXT:

  • Medications used to treat tuberculosis, such as: rifampicin, rifampin, and rifabutin.
  • Medications used to treat HIV, such as: amprenavir, fosamprenavir, ritonavir, efavirenz, nelfinavir, etc.
  • Medicines used to treat hepatitis C, such as: boceprevir and teleprevir.
  • Medicines used to treat epilepsy, such as: carbamazepine, eslicarbazepine, fosphenytoin, phenytoin, phenobarbital, oxcarbazepine, etc.
  • Bexarotene - medicine used to treat cutaneous T-cell lymphoma.
  • Bosentan - medicine used to treat pulmonary hypertension.
  • Brigatinib - medicine used to treat non-small cell lung carcinoma.
  • Sugammadex - medicine used to accelerate muscle recovery after surgery.
  • Carfilzomib - medicine used to treat multiple myeloma.
  • St John's wort preparations (commonly used to relieve depression symptoms).

Tell your doctor about all medications and the herbal remedies you are taking.

Side effects

Implanon NXT can cause the following side effects:

  • Weight gain.
  • Depression.
  • Emotional liability.
  • Nervousness.
  • Acne.
  • Headache.
  • Dizziness.
  • Heavy, prolonged menstrual bleeding.
  • Dysmenorrhea.
  • Back pain.
  • Inflammation of the pharynx.
  • Inflammation of the sinuses.
  • Upper respiratory tract infection.
  • Nausea.
  • Pain at the insertion site.
  • Chest pain.
  • Alopecia.
  • Anorexia.
  • Bone pain.
  • Constipation.
  • Diarrhea.
  • Itching.
  • Skin rash.
  • Vision changes.
  • Decreased libido.

Tell your doctor if you notice any side effects.


  1. FDA

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