Selected Safety Information
- Complications related to insertion and removal procedures, such as pain, paresthesias, bleeding, hematoma, scarring, or infection, may occur. If NEXPLANON is inserted too deeply (intramuscular or in the fascia), neural or vascular injury may occur. Implant removal may be difficult or impossible if the implant is not inserted correctly, inserted too deeply, not palpable, encased in fibrous tissue, or has migrated. Deep insertions may lead to difficult localization of the implant and may also result in the need for a surgical procedure in an operating room in order to remove the implant.
Insertion of NEXPLANON
The basis for successful use and subsequent removal of NEXPLANON is a correct and carefully performed subdermal insertion of the single, rod-shaped implant in accordance with the instructions. Both the health care provider and the woman should be able to feel the implant under the skin after placement.
All health care providers performing insertions and/or removals of NEXPLANON should receive instructions and training prior to inserting or removing the implant. Information concerning the insertion and removal of NEXPLANON will be sent upon request free of charge [1-877-467-5266].
Before insertion of NEXPLANON, the health care provider should confirm that:
The woman is not pregnant nor has any other contraindication for the use of NEXPLANON (see Contraindications)
The woman has had a medical history and physical examination including a gynecologic examination, performed
The woman understands the benefits and risks of NEXPLANON
The woman has received a copy of the Patient Labeling included in packaging
The woman has reviewed and completed a consent form to be maintained with the woman’s chart
The woman does not have allergies to the antiseptic and anesthetic to be used during insertion
The following equipment is needed for the implant insertion:
An examination table for the woman to lie on
Sterile surgical drapes, sterile gloves, antiseptic solution, sterile marker (optional)
Local anesthetic, needles, and syringe
Sterile gauze, adhesive bandage, pressure bandage
You can best see movement of the needle if you are seated and are looking at the applicator from the side and NOT from above. In this position, you can clearly see the insertion site and the movement of the needle just under the skin.
If you cannot feel the implant or are in doubt of its presence,
Check the applicator. The needle should be fully retracted and only the purple tip of the obturator should be visible.
Use other methods to confirm the presence of the implant. Suitable methods are: two-dimensional x-ray, x-ray computerized tomography (CT scan), ultrasound scanning (USS) with a high-frequency linear array transducer (10 MHz or greater) or magnetic resonance imaging (MRI). If these methods fail, call 1-877-467-5266 for information on the procedure for measuring etonogestrel blood levels.