Do not use NEXPLANON if you:

• Are pregnant or think you may be pregnant
• Have, or have had blood clots, such as blood clots in your leg (deep venous thrombosis), lungs (pulmonary embolism), eyes (total or partial blindness), heart (heart attack), or brain (stroke).
• Have liver disease or a liver tumor
• Have unexplained vaginal bleeding
• Have breast cancer or any other cancer that is sensitive to progestin (a female hormone), now or in the past
• Are allergic to anything in NEXPLANON

Tell your health care provider if you have or have had any of the conditions listed above. You health care provider can suggest a different method of birth control.

In addition, talk to your health care provider about using NEXPLANON if you:

• Have diabetes
• Have high cholesterol or triglycerides
• Have headaches
• Have gallbladder or kidney problems
• Have a history of depressed mood
• Have high blood pressure
• Have an allergy to numbing medicines (anesthetics) or medicines used to clean your skin (antiseptics). These medicines will be used when the implant is placed into or removed from your arm.

The most common side effect of NEXPLANON is a change in your normal menstrual bleeding pattern. In studies, one out of ten women stopped using the implant because of an unfavorable change in their bleeding pattern. You may experience longer or shorter bleeding during your periods or have no bleeding at all. The time between periods may vary, and in between periods you may also have spotting.

Tell your health care provider right away if:

• You think you may be pregnant
• Your menstrual bleeding is heavy and prolonged

Besides changes in menstrual bleeding patterns, other frequent side effects that cause women to stop using the implant include:

• Mood swings
• Weight gain
• Headache
• Acne
• Depressed mood

Other common side effects include:

• Headache
• Vaginitis (inflammation of the vagina)
• Weight gain
• Acne
• Breast pain
• Viral infections such as sore throats or flu-like symptoms
• Stomach pain
• Painful periods
• Mood swings, nervousness, or depressed mood
• Back pain
• Nausea
• Dizziness
• Pain
• Pain at the site of insertion

This is not a complete list of possible side effects. For more information, ask your health care provider for advice about any side effects that concern you.

The implant may not be placed in your arm at all due to a failed insertion. If this happens, you may become pregnant. Immediately after insertion, and with help from your health care provider, you should be able to feel the implant under your skin. If you can’t feel the implant, tell your health care provider.

Removal of the implant may be very difficult or impossible because the implant is not where it should be. Special procedures, including surgery in the hospital, may be needed to remove the implant. If the implant is not removed, then the effects of NEXPLANON will continue for a longer period of time.

Other problems related to insertion and removal are:

• Pain, irritation, swelling, or bruising at the insertion site
• Scarring, including a thick scar called a keloid around the insertion site
• Infection
• Scar tissues may form around the implant making it difficult to remove
• The implant may come out by itself. You may become pregnant if the implant comes out by itself. Use a backup birth control method and call your health care provider right away if the implant comes out
• The need for surgery in the hospital to remove the implant
• Injury to nerves or blood vessels in your arm
• The implant breaks making removal difficult

If you become pregnant while using NEXPLANON, you have a slightly higher chance that the pregnancy will be ectopic (occurring outside the womb) than do women who do not use birth control. Unusual vaginal bleeding or lower stomach (abdominal) pain may be a sign of ectopic pregnancy. Ectopic pregnancy is a medical emergency that often requires surgery. Ectopic pregnancies can cause serious internal bleeding, infertility, and even death. Call your health care provider right away if you think you are pregnant or have unexplained lower stomach (abdominal) pain.

Cysts may develop on the ovaries and usually go away without treatment but sometimes surgery is required to remove them.

It is not known whether NEXPLANON use changes a woman’s risk for breast cancer. If you have breast cancer now, or have had it in the past, do not use NEXPLANON because some breast cancers are sensitive to hormones.

NEXPLANON may increase you chance of serious blood clots, especially if you have other risk factors such as smoking. It is possible to die from a problem caused by a blood clot, such as a heart attack or a stroke.

Some examples of serious blood clots are blood clots in the:

• Legs (deep vein thrombosis)
• Lungs (pulmonary embolism)
• Brain (stroke)
• Heart (heart attack)
• Eyes (total or partial blindness)

The risk of serious blood clots is increased in women who smoke. If you smoke and want to use NEXPLANON, you should quit. Your health care provider may be able to help.

Tell your health care provider at least 4 weeks before if you are going to have surgery or will need to be on bed rest. You have an increased chance of getting blood clots during surgery or bed rest.

A few women who use birth control that contains hormones may get:

• High blood pressure
• Gallbladder problems
• Rare cancerous or noncancerous liver tumors

For Questions & Answers about NexPlanon, visit Merck HERE