Etonogestrel
Pronunciation: ee-toe-noe-JES-trel.
- Generic name
- etonogestrel
- Brand names
- NuvaRing, Implanon NXT, Nexplanon, Jadelle, Implanon
- Drug class
- Progestin contraceptive
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What etonogestrel is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how etonogestrel works
Etonogestrel is a synthetic progestin that inhibits ovulation by suppressing the mid-cycle surge of luteinizing hormone (LH). It also thickens cervical mucus, impeding sperm penetration, and alters the endometrial lining, reducing the likelihood of implantation. (1) (2)
What etonogestrel is used for
Contraception
Contraception (2)
Before taking etonogestrel
Do not take / not appropriate for
- known or suspected pregnancy, active or history of thromboembolic disorders, liver tumors or severe hepatic impairment, known or suspected breast cancer, and hypersensitivity to etonogestrel. (Contraindication) (2)
Tell your clinician about
(2)How to take etonogestrel
- General Instructions: The implant is inserted under the skin of your upper arm by a healthcare professional. The vaginal ring is inserted into the vagina and left in place for 3 weeks, followed by a 1-week ring-free interval.. Adult Dosing: Implant: One rod (68 mg) inserted subdermally; approved for up to 5 years in the US (extended from 3 years by the FDA in January 2026) — confirm the approved duration for your specific product with your prescriber. Vaginal ring: Insert one ring for 3 weeks, then remove for 1 week.. Pediatric Dosing: Not recommended for use before menarche. Safety and efficacy have not been established in children under 18 years.. Administration: Implant: Inserted and removed by a trained healthcare provider. Vaginal ring: Self-inserted into the vagina; follow package instructions.. When To Stop: Remove the implant by the end of its approved duration or sooner if you wish to become pregnant or experience unacceptable side effects. If you become pregnant or develop a contraindication, seek medical advice promptly and let the clinician you see advise on whether to continue or stop using the ring.. Storage: Store implants and rings at room temperature, away from moisture and heat. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If the implant is not replaced by the end of its approved duration, you may not be protected from pregnancy. For the vaginal ring, if it has been out for more than 3 hours, contact your prescribing clinic promptly for guidance on reinsertion and whether you need backup contraception.
Overdose
Overdose is unlikely with the implant or ring. If multiple rings are used at once or if the implant is not removed as scheduled, contact your healthcare provider. Symptoms may include nausea, vomiting, or vaginal bleeding. Seek emergency care if severe symptoms occur. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Headache
Incidence: Reported in the clinician-authored database; frequency not established
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Breast tenderness/pain
Incidence: Reported in the clinician-authored database; frequency not established
Irregular vaginal bleeding
Incidence: Common; the leading reason for discontinuation (about 11% of trial participants)
Weight gain
Incidence: Reported in the clinician-authored database; frequency not established
Mood changes
Incidence: Reported in the clinician-authored database; frequency not established
Ovarian cysts
Incidence: Reported in the clinician-authored database; frequency not established
Venous thromboembolism
Incidence: Reported in the clinician-authored database; frequency not established
Vaginitis (vaginal infection)
Incidence: Common in clinical trials
Acne
Incidence: Common in clinical trials
Abdominal pain
Incidence: Common in clinical trials
Pharyngitis (sore throat)
Incidence: Common in clinical trials
Serious warnings
May increase the risk of blood clots, especially in smokers over 35 — serious
Symptoms: May increase the risk of blood clots, especially in smokers over 35. Not recommended for women with active or recent breast cancer. May cause irregular menstrual bleeding. Does not protect against HIV or other STIs. Use caution in patients with liver disease or history of depression.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindications include known or suspected pregnancy, active or history of thromboembolic disorders, liver tumors or severe hepatic impairment, known or suspected breast cancer, and hypersensitivity to etonogestrel. Use with caution in women with diabetes, hypertension, hyperlipidemia, migraines with aura, or depression.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Insertion and removal complications — serious
Symptoms: Insertion and removal complications: improper placement of the implant significantly increases the risk of nerve or blood vessel injury, implant migration (including rare cases to the blood vessels of the lungs), pain, numbness, infection, and scarring. Deep insertion may make removal difficult. Make sure the implant is inserted and removed only by a clinician trained in the procedure.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
The etonogestrel implant is available only through a restricted program requiring the inserting healthcare provider to complete specific training and certification before performing the procedure — serious
Symptoms: The etonogestrel implant is available only through a restricted program requiring the inserting healthcare provider to complete specific training and certification before performing the procedure.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Etonogestrel may interact with medications that induce hepatic enzymes, such as some anticonvulsants (phenytoin, carbamazepine), rifampin, and herbal supplements like St. John's wort. These can decrease contraceptive effectiveness. Always inform your healthcare provider about all medications and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Etonogestrel is not recommended during pregnancy. If pregnancy is confirmed, consult your healthcare provider promptly to discuss next steps, including whether to continue or discontinue use. (2)
Breastfeeding
Small amounts of etonogestrel pass into breast milk. Hormonal contraceptives like this one may reduce milk production in some people, though no significant adverse effects on breastfed infants have been observed in the published literature reviewed. Discuss breastfeeding plans with your healthcare provider. (2)
Children
Frequency: One implant provides contraception for its approved duration (up to 5 years in the US, per the FDA's January 2026 label update; confirm the duration for your product).. Weight Based: Not applicable.. Max Daily Dose: Not applicable; continuous release.. Max Single Dose: One implant (68 mg).. Age Restrictions: Not recommended for pediatric use. (2)
Renal_impairment
Hepatic: the FDA label for NEXPLANON (etonogestrel implant) states that no studies were conducted to evaluate the effect of hepatic disease on etonogestrel disposition, and the implant is contraindicated in women with active liver disease, including liver tumors. Renal: the FDA label does not include a dedicated renal-impairment section; no dose adjustment is specified, and renal status should be assessed by the prescriber rather than adjusted from a published table. (2)
Hepatic_impairment
Hepatic: the FDA label for NEXPLANON (etonogestrel implant) states that no studies were conducted to evaluate the effect of hepatic disease on etonogestrel disposition, and the implant is contraindicated in women with active liver disease, including liver tumors. Renal: the FDA label does not include a dedicated renal-impairment section; no dose adjustment is specified, and renal status should be assessed by the prescriber rather than adjusted from a published table. (2)
Monitoring
(2)Storage
Store at 20-25°C (68-77°F); avoid temperatures above 30°C (86°F). Keep out of reach of children.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Contraception
Dose summary: Insert 68 mg etonogestrel implant subdermally in the upper arm; approved for up to 5 years of use in the US following the FDA's January 2026 label update (previously 3 years). Confirm the approved duration for the specific product/country.
Renal context: The FDA label reviewed for this page (NEXPLANON prescribing information) states no renal-impairment guidance for etonogestrel — there is no dedicated renal-impairment dosing section in the label. No dose adjustment is specified; renal status should be assessed by the prescriber. (1) (2)
Hepatic guidance
The FDA label states that no studies were conducted to evaluate the effect of hepatic disease on the disposition of etonogestrel, and NEXPLANON is contraindicated in women with active liver disease, including benign or malignant liver tumors.
Frequently asked questions
How effective is the etonogestrel implant?
The etonogestrel implant is over 99% effective at preventing pregnancy when inserted correctly and used as directed.
Can I get pregnant after removing the implant?
Yes, fertility returns quickly after removal of the implant. Most women can become pregnant within a few weeks to months.
What should I do if my period becomes irregular?
Irregular bleeding is common, especially in the first 6-12 months. If bleeding is heavy or persistent, contact your healthcare provider.
Can I use etonogestrel if I am breastfeeding?
Small amounts of etonogestrel pass into breast milk, and hormonal contraceptives like this one may reduce milk production in some people, though no significant adverse effects on breastfed infants have been observed in the literature reviewed. Discuss your individual situation with your healthcare provider.
What happens if the implant moves or cannot be felt?
If you cannot feel the implant or suspect it has moved, contact your healthcare provider promptly for assessment.
Are there any long-term risks with etonogestrel?
Long-term use is generally safe, but there is a small increased risk of blood clots and, rarely, liver or breast tumors. Discuss risks with your provider.
Does etonogestrel protect against sexually transmitted infections?
No, etonogestrel does not protect against HIV or other STIs. Use condoms for STI protection.
What happens if I take too much Etonogestrel?
Taking too much Etonogestrel is unlikely to cause severe harm, but it may lead to symptoms such as nausea, vomiting, and vaginal bleeding. If you suspect an overdose or experience unusual symptoms, it is important to seek emergency medical attention immediately. Always adhere to your prescribed dosage.
Can I drink alcohol while taking Etonogestrel?
Generally, moderate alcohol consumption does not directly interfere with the effectiveness of Etonogestrel. However, excessive alcohol intake can impair judgment and may lead to missed doses or other health concerns. It's always best to discuss your alcohol consumption habits with your healthcare provider to ensure it aligns with your overall health and treatment plan.
Is Etonogestrel safe during pregnancy?
Etonogestrel is not recommended for use during pregnancy and falls under a pregnancy category that advises against its use when pregnancy is confirmed or suspected. If you become pregnant while using Etonogestrel, or are planning to conceive, it is crucial to consult your healthcare provider immediately to discuss the best course of action and potential risks.
What is the mechanism of action of etonogestrel?
Etonogestrel is a synthetic progestin that inhibits ovulation by suppressing the mid-cycle surge of luteinizing hormone (LH). It also thickens cervical mucus, impeding sperm penetration, and alters the endometrial lining, reducing the likelihood of implantation. (1) (2)
What is the generic name of Etonogestrel?
The generic name is etonogestrel. It is sold under brand names including NuvaRing, Implanon NXT, Nexplanon, Jadelle, Implanon.
What class of drug is etonogestrel?
Etonogestrel is classed as: Progestin contraceptive.
References
- Etonogestrel clinician-authored medicine recordMedGuideGlobal · International · accessed 2026-08-06 · source 1
- NEXPLANON (etonogestrel implant) - consumer labelingU.S. Food and Drug Administration · United States · accessed 2026-08-06 · source 2
- ETONOGESTREL AND ETHINYL ESTRADIOL VAGINAL RING [AVKARE] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Etonogestrel Implant — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- Etonogestrel and Ethinyl Estradiol Vaginal — FDA approval record (Drugs@FDA ANDA211157)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- etonogestrel — RxNorm normalized drug concept (RXCUI 14584)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient etonogestrel names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Nexplanon68 mg · organon llc