Jadelle (levonorgestrel implant)

What levonorgestrel (subdermal implant) is and how it works

Jadelle is a prescription-only contraceptive implant: two small, flexible rods inserted just under the skin of the upper arm by a trained clinician, releasing a steady low dose of the hormone levonorgestrel to prevent pregnancy for up to 5 years. (1) (3)

Jadelle must be inserted and removed by a clinician trained in the specific technique -- it is not something you place or remove yourself. Changes to your monthly bleeding pattern are common and expected, especially in the first year; discuss any bleeding changes that concern you with your prescriber rather than assuming something is wrong.

Mechanism of action: how levonorgestrel (subdermal implant) works

Levonorgestrel is a synthetic progestin released continuously from the silicone rods, suppressing the luteinising hormone surge (inhibiting ovulation) and thickening cervical mucus to impede sperm penetration; endometrial changes may also contribute to contraceptive effect. (1)

What levonorgestrel (subdermal implant) is used for

Before taking levonorgestrel (subdermal implant)

Do not take / not appropriate for

• Do not have Jadelle inserted if you are pregnant or think you might be pregnant. (all countries where marketed) (1)
• Do not have Jadelle inserted if you have current or past blood clots (such as deep vein thrombosis or pulmonary embolism), acute liver disease or liver tumours, undiagnosed abnormal vaginal bleeding, or known or suspected breast cancer. (all countries where marketed) (1)

Tell your clinician about

• Any history of blood clots, liver disease, or breast cancer.
• Any unexplained vaginal bleeding that has not been diagnosed.
• All other medicines and supplements you take, especially rifampin, certain anticonvulsant medicines (such as phenytoin or carbamazepine), some HIV medicines, or St John's Wort -- these can reduce how well Jadelle prevents pregnancy.
• Your body weight, since evidence reviewed by New Zealand's regulator suggests efficacy may decline somewhat with higher body weight over the full 5-year period.
• Pregnancy plans or breastfeeding.

How to take levonorgestrel (subdermal implant)

• Jadelle is inserted by a clinician trained in the specific technique, typically within the first 7 days after the start of your period, into the inner upper arm.
• The implant provides continuous contraception for up to 5 years; your clinician will advise you on your specific removal or replacement date.
• If you weigh more than about 60 kg, discuss with your clinician whether removal after 4 years, rather than waiting the full 5 years, may be a reasonable option based on New Zealand regulatory safety review findings.
• Use an additional barrier method (such as condoms) if you are told your current medicines might reduce Jadelle's effectiveness.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4)

Missed dose

There is no daily dose to miss with an implant. Contact your clinician if you are due for removal or replacement and are unsure of the correct timing, or if you are concerned the implant may no longer be effective (for example, after taking a medicine that can reduce its effectiveness).

Overdose

Overdose in the usual sense does not apply to an implant, since it releases a steady low dose. Contact your clinician if you have concerns about the implant's position, or seek urgent medical attention for any severe symptoms such as significant arm pain, numbness, or signs of infection at the insertion site. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Serious warnings

Interactions

• Rifampin (an antibiotic) can significantly reduce Jadelle's contraceptive effectiveness. (1)
• Certain anticonvulsant (anti-seizure) medicines, such as phenytoin and carbamazepine, can reduce effectiveness. (1)
• Some HIV medicines and the herbal supplement St John's Wort can also reduce effectiveness by increasing the breakdown of levonorgestrel in the liver. (1)
• If you are prescribed any of these interacting medicines, discuss with your clinician whether you need an additional or alternative contraceptive method. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Pregnancy test if there is any possibility of pregnancy
• Review of personal/family history of blood clots, liver disease, and breast cancer
• Review of current medicines for hepatic-enzyme-inducing interactions
• Body weight, given the New Zealand regulatory signal about efficacy duration

During treatment

• Periodic review of bleeding pattern and any concerns.
• Checking the insertion site for signs of infection, migration, or difficulty locating the rods.
• Discussion of replacement or removal timing, including possible earlier removal (around 4 years) for women weighing more than 60 kg.

Storage

Jadelle rods are stored and handled by the clinician/pharmacy before insertion, per the product's specific storage instructions (typically room temperature, protected from excessive heat). Patients do not store the medicine themselves once it is inserted.

Frequently asked questions

References

1. JADELLE (levonorgestrel implants) for subdermal use -- FDA-approved labeling, NDA 020544s010U.S. Food and Drug Administration (accessdata.fda.gov), approved labeling · United States · dated 2016-01-01 · accessed 2026-07-29 · source 1
2. Jadelle US market availability statusWikipedia summary of FDA/manufacturer history, cross-checked against rxlist.com and Federal Register · United States · dated 2026-01-01 · accessed 2026-07-29 · source 2
3. Jadelle New Zealand Data Sheet and Consumer Medicine InformationMedsafe (New Zealand regulator) · New Zealand · dated 2025-11-21 · accessed 2026-07-29 · source 3
4. Jadelle and the Impact of WeightMedsafe Prescriber Update -- Medicines Adverse Reactions Committee (MARC) · New Zealand · dated 2016-06-01 · accessed 2026-07-29 · source 4

Brand names by country

Single-ingredient levonorgestrel (subdermal implant) names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries