NICE reviews contraception guideline

NICE has updated its clinical guideline on the use of long-acting reversible contraception to reflect the availability of Nexplanon instead of Implanon as the progestogen-only subdermal implant.

The NICE guideline recommends that long-acting reversible contraception should be offered to all women as part of their contraceptive choices | SCIENCE PHOTO LIBRARY
The NICE guideline recommends that long-acting reversible contraception should be offered to all women as part of their contraceptive choices | SCIENCE PHOTO LIBRARY

Nexplanon contains the same drug as Implanon (etonogestrel) at the same dose, but it includes barium to make it radio-opaque and it also has a different insertion device.

The updated guideline notes that Nexplanon is not licensed for use in women under 18 years or over 40 years. If an implant is considered for use outside of the licensed age range, the prescriber should follow relevant professional guidance, take full responsibility for the decision and obtain documented and informed consent from the patient.

When discussing progestogen-only subdermal implants, prescribers should inform women that:

  • the failure rate is very low (less than 1 pregnancy per 1000 implants fitted over 3 years
  • vaginal bleeding patterns are likely to change; bleeding may stop, become more or less frequent or become prolonged
  • dysmenorrhoea may be reduced
  • there is no evidence of a delay in return to fertility after the implant is removed, and 
  • complications of insertion and removal are uncommon.

The guidance recommends the prescriber refer to the SPC for further information about the use of Nexplanon.

A quick-reference MIMS summary of the updated guideline is available online and will be included in the December print edition of MIMS.

View Nexplanon drug record

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