Prescription medication · Progestin (Implant)
etonogestrel
Also sold as Nexplanon. This vaginal ring is used by women of reproductive age to prevent pregnancy.
Data updated 2026-05-15
- 46,939
- FDA reportsOften reported
- 29
- InteractionsSeveral interactions
- Rx
- Availability
What the data shows
etonogestrel (Nexplanon) is a prescription Progestin (Implant), reported at a middle-of-the-pack volume (46,939 FDA reports), with 29 documented drug interactions.
Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.
etonogestrel (Nexplanon) is a prescription Progestin (Implant). This vaginal ring is used by women of reproductive age to prevent pregnancy.
Etonogestrel and ethinyl estradiol vaginal ring is a birth control ring. It prevents pregnancy by releasing hormones into your body.
Verify with FDA → · CMS NADAC pricing →
What it does
This vaginal ring is used by women of reproductive age to prevent pregnancy.
Common side effects
Vaginal infection, Headache (including migraine), Mood changes (like depression or mood swings)
Key warnings
Cigarette smoking increases your risk of serious heart problems from this medicine.
The sections below are summarized in plain English from etonogestrel's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.
How It Works
The ring releases etonogestrel and ethinyl estradiol into your body. These hormones prevent ovulation (the release of an egg from the ovary). They also change the lining of your uterus, making it harder for a fertilized egg to implant.
How to Take It
Insert one ring into your vagina. Keep the ring in place for 3 weeks. Remove it for 1 week, and you will likely have a period. Insert a new ring 1 week after removing the old one, even if you are still bleeding.
This is a plain-language summary of etonogestrel's FDA labeling, not individualized dosing advice. Ask a pharmacist or prescriber before changing how you take this medication.
Pregnancy & Breastfeeding
Do not use this ring if you are pregnant. Small amounts of the hormones in this ring can pass into breast milk. This medicine may also reduce milk production.
This is a plain-language summary of etonogestrel's FDA labeling, not individualized advice. Ask a pharmacist or prescriber about pregnancy or breastfeeding on this medication.
Missed Dose
If the ring is out of your vagina for more than 3 hours during the second or third week, you may not be protected from pregnancy. Refer to the full prescribing information for detailed instructions.
This is a plain-language summary of etonogestrel's FDA labeling, not individualized advice. Ask a pharmacist or prescriber what to do about your specific missed dose.
Storage
Before you get the ring, it should be stored in the refrigerator. After you get it, you can store it at room temperature for up to 4 months, away from direct sunlight and high heat.
Side Effects (from patient reports)
Based on 46,939 FDA adverse event reports.
Most-reported reactions
Adverse reactions in FAERS for etonogestrel, by number of reports
- Problem with the product's quality
Problem with the product's quality
5,554 reports
- Problem related to the device
Problem related to the device
5,228 reports
- Device is hard to use
Device is hard to use
4,562 reports
- Device broke
Device broke
4,501 reports
- Used the product for the wrong amount of time
Used the product for the wrong amount of time
3,644 reports
- Got pregnant when trying to prevent it
Got pregnant when trying to prevent it
3,449 reports
- Problem inserting the device
Problem inserting the device
3,370 reports
- Problem removing the device
Problem removing the device
3,270 reports
- Problem inserting the device
Problem inserting the device
3,249 reports
- Pregnant while using the implant
Pregnant while using the implant
3,147 reports
What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.
Reports over time
Adverse-event reports filed for etonogestrel each year to the FDA Adverse Event Reporting System (FAERS).
Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.
Where etonogestrel sits
etonogestrel has more FDA adverse-event reports than 72% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.
Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is etonogestrel; the line is the median (50th percentile).
FDA Adverse Event Report Analysis
Detailed analysis of 46,939 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
46,939
Reports Mentioning Death
94
0.2% of reports — not proof of cause
Hospitalization Reports
1,645
Top Indication
Contraception
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 2 | PRODUCT QUALITY ISSUE | 5,554 |
| 3 | COMPLICATION ASSOCIATED WITH DEVICE | 5,228 |
| 4 | DEVICE DIFFICULT TO USE | 4,562 |
| 5 | DEVICE BREAKAGE | 4,501 |
| 6 | INCORRECT PRODUCT ADMINISTRATION DURATION | 3,644 |
| 7 | UNINTENDED PREGNANCY | 3,449 |
| 8 | DEVICE DEPLOYMENT ISSUE | 3,370 |
| 9 | COMPLICATION OF DEVICE REMOVAL | 3,270 |
| 10 | COMPLICATION OF DEVICE INSERTION | 3,249 |
| 11 | PREGNANCY WITH IMPLANT CONTRACEPTIVE | 3,147 |
| 12 | DEVICE DISLOCATION | 2,662 |
| 13 | IMPLANT SITE PAIN | 2,575 |
| 14 | MENORRHAGIA | 2,443 |
| 15 | VAGINAL HAEMORRHAGE | 2,280 |
| 16 | DEVICE EXPULSION | 2,167 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Cigarette smoking increases your risk of serious heart problems from this medicine. This risk is higher if you are over 35 and smoke. If you are over 35 and smoke, you should not use this ring.
Known Drug Interactions
Counsel women to use an alternative non-hormonal method of contraception or a back-up method when enzyme inducers are used with Etonogestrel and ethinyl estradiol vaginal ring, and to continue back-up non-hormonal contraception for 28 days after discontinuing the enzyme inducer to ensure contraceptive reliability. Note: Etonogestrel and ethinyl estradiol vaginal ring may interfere with the correct placement and position of certain female barrier methods such as a diaphragm or female condom. These methods are not recommended as back-up methods with Etonogestrel and ethinyl estradiol vaginal...
Mechanism: Certain medications can speed up how the body breaks down birth control hormones. This makes the birth control less effective and increases the risk of pregnancy.
What to do: Use a backup birth control method, like condoms, while taking these drugs. Keep using backup for 28 days after you stop the interacting medication.
Concomitant use with some other HCV antiviral medicinal products, such as those containing glecaprevir/pibrentasvir, may increase the risk of ALT elevations [see Warnings and Precautions (5.4)].
Mechanism: Taking these medicines together can cause your liver enzymes to rise, which is a sign of liver stress. This happens because both drugs affect how the liver functions at the same time.
What to do: Your doctor should monitor your liver health closely with blood tests if you take these together. They may need to adjust your treatment if your liver enzyme levels become too high.
Substances increasing the plasma concentrations of CHCs Co-administration of atorvastatin and certain CHCs containing ethinyl estradiol increase AUC values for ethinyl estradiol by approximately 20-25%.
Mechanism: Atorvastatin can cause the levels of the hormones in your birth control to increase in your bloodstream.
What to do: Your healthcare provider may monitor you for increased side effects from your birth control.
The serum concentrations of etonogestrel and ethinyl estradiol were not affected by concomitant administration of oral amoxicillin or doxycycline in standard dosages during 10 days of antibiotic treatment.
Mechanism: This antibiotic does not change the levels of birth control hormones in your blood.
What to do: You can take these two medications together without needing to adjust your doses or use extra protection.
A significant decrease in the plasma concentrations of lamotrigine has been shown, likely due to induction of lamotrigine glucuronidation. This may reduce seizure control; therefore, dosage adjustments of lamotrigine may be necessary.
Mechanism: The birth control causes your body to clear the seizure medicine more quickly, which lowers its levels in your blood.
What to do: Your doctor may need to increase your dose of seizure medicine to ensure it stays effective.
This is a plain-language summary of interactions documented in FDA labeling, not individualized advice. Ask a pharmacist or prescriber before combining medications.
Common Questions
What if the ring comes out?
Can I reuse the ring?
What if I have trouble inserting the ring?
Will I still get my period?
What if I don't get my period?
Can I use other vaginal products with the ring?
What should I do with the used ring?
Can certain medicines affect the ring?
What if I want to stop using the ring?
How often do I need to replace the ring?
What are the common side effects of etonogestrel?
Does etonogestrel interact with other medications?
What drug class is etonogestrel?
Is etonogestrel safe during pregnancy?
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clomiphene
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What the FDA Data Shows for etonogestrel
The FDA label for etonogestrel (sold under brand names such as Nexplanon) classifies it as a prescription-only medication in the Progestin (Implant) class. This vaginal ring is used by women of reproductive age to prevent pregnancy. Official labeling lists 13 commonly reported side effects, including Vaginal infection, Headache (including migraine), Mood changes (like depression or mood swings).
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 46,939 voluntary reports. The database also lists 29 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. Acquisition-cost data is surveyed weekly by CMS and updated as manufacturers report changes.
Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice, always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: July 8, 2024
Read our methodology - how this data is sourced, computed, and verified.
Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled and last refreshed May 2026. See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a correction.
All federal data sources used on this page
- FDA Orange Book - approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed - NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) - post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm - standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files - federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database - current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages