Nexplanon: rare reports of implant migration

Nexplanon (etonogestrel) contraceptive implants have been found rarely in the vasculature and lungs, the manufacturer has advised in a letter to healthcare professionals.

Nexplanon should only be inserted and removed by healthcare professionals who have completed training. | SCIENCE PHOTO LIBRARY
Nexplanon should only be inserted and removed by healthcare professionals who have completed training. | SCIENCE PHOTO LIBRARY

No definitive risk factors have been identified for migration of Nexplanon implants; however, deep insertion, insertion at an inappropriate site or insertion into thin arms may increase the likelihood of migration. 

Advice for prescribers

Further information
View Nexplanon drug record
Letter to healthcare professionals
MHRA Drug Safety Update
MIMS Women's Health Clinic

An implant that cannot be palpated at its insertion site in the arm should be located and removed as soon as possible. Chest imaging is advised if the implant cannot be located within the arm. Surgical or endovascular procedures may be required to remove an implant from the chest.

Prescribers should:

  • only insert Nexplanon subdermally and if they have been appropriately trained and accredited 
  • avoid inserting over the sulcus (groove) between the biceps and triceps
  • avoid insertion close to any blood vessels or nerve bundles
  • verify the presence of the implant by palpation immediately after insertion
  • show the patient how to locate the implant and to check frequently for the first few months after insertion
  • use the updated instructions on how to correctly insert the implant.

Expert removers' network

A network of healthcare professionals experienced in implant localisation and difficult removals is available for consultation, and can be contacted by calling 01992 467272.

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