Subdermal Single implant can be left in place for 3 yr. Remove no later than 3 yr after date of insertion. No preceding hormonal contraceptive use in the past mth Insert between day 1 & 5 of menstrual cycle. Changing from combined OC (COC), vag ring or transdermal patch Insert preferably on the day after the last active tab of previous COC, but at the latest on the day following usual tab-free or placebo tab interval of previous COC. Vag ring or transdermal patch: Insert preferably on the day of removal, but at the latest when the next application would have been due. Changing from progestagen-only method [eg, progestagen-only pill, injectable, implant or intrauterine system (IUS)] Injectable contraceptives: Insert on the day the next inj is due. Progestagen-only pill: Insert w/in 24 hr after the last tab. Implant or IUS: Insert on the day the previous implant/IUS is removed. Following abortion or miscarriage Insert w/in 5 days following 1st trimester abortion or miscarriage. Insert between 21-28 days following 2nd trimester abortion or miscarriage. Postpartum Breastfeeding: Insert after 4th postpartum wk. Non-breastfeeding: Insert between 21-28 days postpartum. If implant is inserted later than 28 days postpartum, use additional barrier method until 7 days after insertion.
Hypersensitivity. Active venous thromboembolic disorder. Known or suspected sex steroid sensitive malignancies. Undiagnosed vag bleeding. Presence or history of benign or malignant liver tumours; severe hepatic disease as long as liver function values have not returned to normal. Known or suspected pregnancy.
Remove implant in the event of confirmed thrombosis; if sustained HTN develops or if significant increase in BP inadequately responds to antihypertensive therapy. Consider removal of implant in case of long-term immobilization due to surgery or illness. Not for protection against HIV (AIDS) & other STD. Increased risk of breast cancer w/ increasing age. Increased incidence of VTE, DVT & pulmonary embolism. Follicular development. Expulsion if not inserted accordingly. Migration of implant w/in arm from insertion site; remove implant if it cannot be palpated. Broken or bent implants; when implant is removed, remove in its entirety. Women w/ history of thromboembolic disorders; chloasma gravidarum. Carefully observe diabetic women & those being treated for hyperlipidemia. Consider earlier replacement of implant in heavier women. Take complete medical history (including family history) & exclude pregnancy; measure BP & perform physical exam prior to initiation or reinstitution of therapy. Evaluate vag bleeding pattern on ad hoc basis. Avoid exposure to sun or UV radiation in women w/ tendency to chloasma. Concomitant use w/ drugs decreasing plasma conc. Acute or chronic liver function disturbances. Ectopic pregnancy. Not indicated during pregnancy. Lactation (should be inserted after 4th postpartum wk).
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