The NEXPLANON implant should be removed if blood pressure rises significantly and becomes uncontrolled.
Studies suggest a small increased relative risk of developing gallbladder disease among combination hormonal contraceptive users. It is not known whether a similar risk exists with progestin-only methods like NEXPLANON.

Localization guidance

Palpate after insertion

NEXPLANON (etonogestrel implant) 68 mg should be inserted subdermally in the arm
Always verify the presence of the implant in the woman’s arm immediately after insertion by palpation
- The patient should also be able to palpate the implant
If the implant is not palpable or there is doubt about its presence, check the applicator and use 1 of the 4 available methods to confirm its presence
Until the presence of the implant has been verified, the woman should be advised to use a nonhormonal contraceptive method, such as condoms

The exact location of the implant in the arm should be verified by palpation before removal procedure
A nonpalpable implant should always be first located prior to removal using 1 of the 4 available localization methods

The NEXPLANON implant is radiopaque, providing 4 methods for confirming the presence after insertion and localizing before removal:

1-3-4 Localization guidance

Prediabetic and diabetic women using NEXPLANON should be carefully monitored.
Women with a history of depressed mood should be carefully observed. Consideration should be given to removing NEXPLANON in patients who become significantly depressed.
In clinical trials with the non-radiopaque etonogestrel implant (IMPLANON), the etonogestrel levels in blood decreased below sensitivity of the assay by one week after removal of the implant. In addition, pregnancies were observed to occur as early as 7 to 14 days after removal. Therefore, a woman should re-start contraception immediately after removal of the implant if continued contraceptive protection is desired.