Nexplanon (Merck), a modified version of the contraceptive implant Implanon (Merck), is now available in the US. Nexplanon contains 68 mg of the progestin etonogestrel and is bioequivalent to Implanon. Both products are single-rod subdermal contraceptives implanted into the inside of the upper arm; both provide reversible effective contraception for up to 3 years.1 Nexplanon has a redesigned preloaded applicator intended to make insertion easier and reduce the risk of improperly placed devices. Proper placement is necessary to ensure adequate contraceptive efficacy and to facilitate future removal of the implant. Unlike Implanon, Nexplanon is radiopaque (contains barium sulfate) and can be located using an X-ray or CT scan when the device is not palpable. Providers should receive training before inserting or removing Nexplanon. Nexplanon will replace Implanon once all registered providers have completed the training program. The wholesale acquisition cost of a single Nexplanon implant is $659.42.2

1. A new progestin implant (Implanon) for long-term contraception. Med Lett Drugs Ther 2006; 48:83.

2. Wholesale acquisition cost (WAC) for one implant (administration cost not included). Source: PricePointRx™. Reprinted with permission by FDB (First Databank, Inc.). All rights reserved. ©2012. http://www.firstdatabank.com/support/drug-pricing-policy.aspx. Accessed January 26, 2012.

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Combination oral contraceptives increase the risk of venous thromboembolism (VTE). Their benefits, in addition to preventing pregnancy, include lowering the risk of ovarian and endometrial cancer, reducing dysfunctional uterine bleeding and increasing serum hemoglobin concentrations. Are these benefits worth the risk? And are some combination oral contraceptives safer than others?

Implanon (Organon), an implantable contraceptive containing the progestin etonogestrel, has been approved by the FDA. Two other implantable contraceptives, Norplant and Jadelle, which both contain levonorgestrel, are FDA-approved but not marketed in the US.