contraindications to insertion of etonogestrel contraceptive implant

Last edited 03/2021 and last reviewed 03/2021

  • Consent not given. 
  • Individuals under 16 years of age and assessed as not competent using Fraser Guidelines.
  • Individuals 16 years of age and over and assessed as lacking capacity to consent.
  • Known hypersensitivity to the active ingredient or to any constituent of the product - see Summary of Product Characteristics (SPC)
  • Unexplained vaginal bleeding (suspicious of serious condition) before evaluation
  • Acute porphyria

Cardiovascular Disease

  • Current or past history of ischaemic heart disease, vascular disease, stroke or transient ischaemic first attack only if these events first occurred during use of the etonogestrel implant.

Cancers

  • Current or past history of breast cancer.

Gastro-intestinal conditions

  • Severe decompensated cirrhosis.
  • Benign liver tumour (hepatocellular adenoma).
  • Malignant liver tumour (hepatocellular carcinoma).

Interacting medicines

  • Individuals using enzyme-inducing drugs/herbal products or within 28 days of stopping them.
Interacting medicines other than enzyme inducers – see current British National Formulary (BNF) or individual product SPC

Reference:

  1. Patient Group Direction (PGD) (NHS Specialist Pharmacy Service). Insertion of etonogestrel (e.g. Nexplanon®) 68mg subdermal implant for contraception . (Accessed 17th March 2021)