Formulary
Etonogestrel: Indications, Dosing, Side Effects and Interactions
Etonogestrel clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Etonogestrel: Indications, Dosing, Side Effects and Interactions
Etonogestrel clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Contraception [no hormonal contraceptive use in previous month] for etonogestrel**
- **Females of childbearing potential** (By subdermal implantation): 1 implant, which can be left in place for up to 3 years, when inserted during the first 5 days of cycle, no additional contraceptive precautions are needed, when inserted at any other time, additional precautions (e.g. barrier methods) advised for next 7 days.
**Contraception [postpartum] for etonogestrel**
- **Females of childbearing potential** (By subdermal implantation): 1 implant, which can be left in place for up to 3 years, when inserted within 20 days after delivery (or up to 6 months postpartum if fully breast-feeding and amenorrhoeic), no additional contraceptive precautions are needed, when inserted at any other time, additional precautions (e.g. barrier methods) advised for next 7 days.
**Contraception [following abortion or miscarriage] for etonogestrel**
- **Females of childbearing potential** (By subdermal implantation): 1 implant, which can be left in place for up to 3 years, when inserted within 5 days after abortion or miscarriage, no additional contraceptive precautions are needed, when inserted at any other time, additional precautions (e.g. barrier methods) advised for next 7 days.
**Contraception [changing from other hormonal contraceptive] for etonogestrel**
- **Females of childbearing potential** (By subdermal implantation): 1 implant, which can be left in place for up to 3 years, consult product literature for advice on when to insert and additional contraceptive precautions.
Cautions
Cardiac dysfunction; cervical cancer; diabetes (progestogens can decrease glucose tolerance-monitor patient closely); history of breast cancer-seek specialist advice before use; history of stroke (including transient ischaemic attack); history of venous thromboembolism; ischaemic heart disease; liver tumours-seek specialist advice before use; migraine; multiple risk factors for cardiovascular disease; positive antiphospholipid antibodies; rheumatoid arthritis; systemic lupus erythematosus; undiagnosed vaginal bleeding-seek specialist advice before use
Contraindications
Acute porphyrias ; current breast cancer
Side effects
Common or very common Abdominal pain; alopecia; anxiety; appetite increased; breast abnormalities; depressed mood; dizziness; emotional lability; fatigue; flatulence; headaches; hot flush; increased risk of infection; influenza like illness; libido decreased; menstrual cycle irregularities; nausea; ovarian cyst; pain; skin reactions; weight changes Uncommon Arthralgia; constipation; diarrhoea; drowsiness; dysuria; fever; galactorrhoea; genital abnormalities; hypertrichosis; insomnia; myalgia; oedema; vomiting; vulvovaginal discomfort Frequency not known Abscess; angioedema; embolism and thrombosis; haemorrhage; insulin resistance; neoplasms; paraesthesia; seborrhoea Side-effects, further information The benefits of using progestogen-only contraceptives (POCs), such as etonogestrel, should be weighed against the possible risks for each individual woman. There is a possible small increase in the risk of breast cancer in women using, or who have recently used, progestogen-only contraception. Causal association is not clearly established, and absolute risk remains very small, and is like that of current or recent use of combined hormonal contraception. The most important risk factor for breast cancer appears to be the age the contraceptive is stopped rather than the duration of use; the risk gradually disappears during the 10 years after stopping.
Interactions
**Other interactions (4):**
- The following interactions have been reported in the literature (mainly with combined contraceptives but occasionally also with progestagen-only contraceptives including Nexplanon): Substances...
- Substances with variable effects on the clearance of hormonal contraceptives When co-administered with hormonal contraceptives, many combinations of HIV protease inhibitors and non-nucleoside...
- Substances decreasing the clearance of hormonal contraceptives (enzyme inhibitors) Concomitant administration of strong (e.g.
- Accordingly, plasma and tissue concentrations may either increase (e.g.
Pregnancy
Not known to be harmful, remove implant if pregnancy occurs.
Breast feeding
Progestogen-only contraceptives do not affect lactation.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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