Nexplanon (etonogestrel) is a brand-name prescription birth control implant prescribed to help prevent pregnancy. As with other forms of birth control, Nexplanon can cause side effects. These include weight gain and menstrual spotting.

Nexplanon belongs to a drug class called progestins. The drug is not available in a generic version.

Read on to learn about potential common, mild, and serious side effects of the Nexplanon implant. For a general overview of the device, including details about its uses, see this article.

Nexplanon can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Nexplanon in clinical trials:

* For more information about this side effect, see “Side effect specifics” below.
† For more information about this side effect, see the “Nexplanon and weight gain” section below.

Mild side effects can occur with Nexplanon use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Nexplanon’s prescribing information.

Mild side effects that have been reported with Nexplanon include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Nexplanon and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.
† For more information about this side effect, see the “Nexplanon and weight gain” section below.
‡ To learn more, see the “Side effect specifics” section below.

Nexplanon may cause serious side effects. However, this isn’t common. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Nexplanon’s prescribing information.

If you develop serious side effects while taking Nexplanon, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

* For more information about this side effect, see the “Side effect specifics” section below.

Nexplanon may cause weight gain. In clinical trials, weight gain was one of the most common side effects of Nexplanon.

In trials, people using Nexplanon gained an average of 2.8 pounds (lb) after 1 year and 3.7 lb after using Nexplanon for 2 years. It’s not known how much of this weight gain was specifically because of Nexplanon implants. In rare cases, a few people in these trials chose to have Nexplanon removed due to weight gain.

Talk with your doctor if you’re concerned about your weight, including whether Nexplanon could be affecting it. Your doctor can work with you to find a healthy way to manage your weight.

It’s possible that you may experience side effects of removing Nexplanon if you have your implant removed.

Some side effects from Nexplanon removal may include:

  • pain or soreness, which can be severe
  • numbness or tingling sensations in your arm, hand, or fingers
  • bleeding
  • hematoma
  • scarring
  • infection
  • weakness or difficulty moving your arm

Cramps after Nexplanon removal were not reported in the drug’s clinical trials.

Talk with your doctor if you’d like to learn more about Nexplanon removal, including side effects you may experience. You can also refer to this article for more information.

Nexplanon may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Should I expect breakthrough bleeding with Nexplanon?

It’s possible that breakthrough bleeding, including spotting, can occur with Nexplanon. This is a known side effect of the drug reported in clinical trials.

To learn more, see the “Spotting and changes in menstrual bleeding” in the “Side effect specifics” section below. Your doctor or pharmacist can also tell you more about breakthrough bleeding and Nexplanon.

Can Nexplanon cause a low libido?

Maybe. Low libido (sex drive) wasn’t a side effect reported in Nexplanon’s clinical trials. However, this side effect has been reported by a few people who have used Nexplanon since the drug was approved for use.

Because low libido has only been reported by people after clinical trials had been performed, it’s not known whether this was caused by Nexplanon or other factors.

If you’re concerned or have questions about your libido, talk with your doctor or healthcare professional.

Learn more about some of the side effects that Nexplanon may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Nexplanon.

Bruising

Nexplanon insertion or removal may cause bruising. However, this side effect wasn’t common in the drug’s clinical trials.

This bruising would occur in the arm where you have Nexplanon implanted.

What you can do

Bruising caused by Nexplanon insertion or removal shouldn’t last more than a few hours or days. In most cases, this side effect goes away on its own.

If you have bruising after Nexplanon removal or insertion that doesn’t go away or bothers you, talk with your doctor. They may want to examine your symptoms closely to see if something else could be causing your reaction.

Spotting and changes in menstrual bleeding

After having Nexplanon inserted, you may notice spotting and changes in menstrual bleeding. This is common, according to the drug’s clinical trials. In these trials, this was the most common side effect that caused people to stop using Nexplanon.

Specifically, you may experience:

Your menstrual pattern in the first 3 months after you receive Nexplanon typically predicts the pattern of future periods. However, it’s still possible for you to have changes in menstrual bleeding or your period throughout treatment. For example, you may experience spotting on Nexplanon after 1 year or after 2 years, even if you didn’t have this side effect at first.

What you can do

Talk with your doctor if you’re concerned about changes in menstrual bleeding while using Nexplanon. Your doctor may want to order tests to check for other causes, such as ovarian cancer. (Nexplanon isn’t thought to cause ovarian cancer. However, menstrual or bleeding changes can be a sign of ovarian cancer in rare cases.)

Itching

Having Nexplanon inserted or removed may cause itching at the site where it’s implanted. However, this wasn’t a common side effect in the drug’s clinical trials.

What you can do

If you experience itching after having Nexplanon inserted or removed, it should go away on its own. This side effect typically lasts a few hours or days at most.

If you experience itching after Nexplanon removal or insertion that doesn’t go away or bothers you, talk with your doctor. They may want to monitor your symptoms closely to see if another factor could be causing your reaction.

Allergic reaction

As with most drugs, it’s possible to have an allergic reaction to Nexplanon. However, this side effect wasn’t common in clinical trials.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your lips, eyelids, feet, or hands
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep the Nexplanon implant. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you receive Nexplanon. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

Blood clots. Nexplanon can increase your risk of developing blood clots. You may be at higher risk if you have a blood clot or have had blood clots in the past. If this is the case, your doctor may recommend a different form of birth control for you.

Breast cancer or other hormone-sensitive cancer. Nexplanon may raise the risk of hormone-sensitive cancers, including breast cancer, coming back, if you’ve had them in the past. If you have or have had a hormone-sensitive cancer, your doctor will likely recommend a different birth control option for you.

Depression. Treatment with Nexplanon can cause mood changes, including depression. If you already have depression, using Nexplanon could worsen your condition. Your doctor can help determine whether Nexplanon is safe for you. They may want to monitor your mental health closely if they decide to prescribe the drug to you.

Liver disease, such as alcohol-related liver disease. Doctors typically won’t prescribe Nexplanon if you have liver disease, such as alcohol-related liver disease. This is because liver disease can cause your body to have problems breaking down Nexplanon. Your doctor can discuss safer birth control options with you.

High blood pressure. Nexplanon can raise blood pressure as a side effect. If you already have high blood pressure, Nexplanon may not be safe for you to receive. Your doctor can help determine whether Nexplanon is safe to prescribe for you. This may depend on whether your blood pressure is managed using medications. If your blood pressure becomes unmanageable during treatment, they may suggest switching to a different birth control option.

High cholesterol or diabetes. Nexplanon can increase your cholesterol or blood sugar levels. If you already have high cholesterol or diabetes, this means that using Nexplanon could worsen your condition. While it’s typically still safe to use Nexplanon, your doctor may want to monitor your blood sugar or cholesterol levels closely during treatment.

Kidney problems. Tell your doctor if you have kidney problems, such as chronic kidney disease, before you start using Nexplanon. Having kidney problems may raise your risk of high blood pressure as a side effect of Nexplanon. Due to this risk, your doctor may recommend a different form of birth control for you instead of Nexplanon.

Allergic reaction. If you’ve had an allergic reaction to Nexplanon or any of its ingredients, your doctor will likely not prescribe Nexplanon. Ask your doctor what other medications may be better options for you.

Alcohol with Nexplanon

There are no known interactions between Nexplanon and alcohol.

If you drink alcohol and have questions about it while using Nexplanon, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Nexplanon

Nexplanon is a type of birth control used to help prevent pregnancy, so you should not use it during pregnancy.

However, no birth control is 100% effective at preventing pregnancy. While Nexplanon is over 99% effective at preventing pregnancy, there’s still a very small risk you could become pregnant while using it if you’re sexually active. Nexplanon should be removed if you become pregnant while using it.

If you have questions about Nexplanon and pregnancy, talk with your doctor.

Nexplanon is thought to be safe to use while breastfeeding. Although the active drug, etonogestrel, does appear in breast milk, it’s not known to cause problems in a child who is breastfed. However, it may decrease the amount of milk you produce.

If you have concerns about how much breast milk you are producing, talk with your doctor. You and your doctor can determine whether Nexplanon is right for you.

Side effects are possible with Nexplanon. You may be more likely to experience side effects when Nexplanon is inserted or removed.

If you’d like to learn more about Nexplanon, talk with your doctor or pharmacist. They can help answer any questions you have about side effects of the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Nexplanon. For details about other aspects of Nexplanon, refer to this article.
  • Cost. If you’d like to learn about Nexplanon and cost, see this article.
  • Dosage. For information about the dosage of Nexplanon, view this article.
  • A look at birth control options. For information about the types of birth control available, you can see this article.
  • A look at your health. For more information about sexual and reproductive health, see our hubs on sexual health and women’s health.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.