Last update March 24, 2022

Etonogestrel

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Progestin, active metabolite of desogestrel. It is used as a progestogen-only contraceptive in the form of a subcutaneous implant for 3 years or associated with ethinylestradiol in the form of a vaginal ring 3 out of 4 weeks.

It is excreted in breast milk in negligible amount (Reinprayoon 2000) and no problems were observed in infants whose mothers used this medication. (Carmo 2017, Bahamondes 2013, Brito 2009, Taneepanichskul 2006)

Although it is considered safer to start using it after 4-6 postnatal weeks (Berens 2015), there have been studies that found that implants applied early in the first days or hours after birth does not affect either production or milk composition and growth of infants. (SMFM 2019, Carmo 2017, Lopez 2015, Braga 2015, Phillips 2015, WHO/OMS 2015, Mwalwanda 2013, CDC 2013, Gurtcheff 2011)

One in 100 women using etonogestrel implants may have a significant decrease in milk production, so it is advisable to monitor the growth of the infant. (Stuebe 2016)

During lactation progestin-only contraceptives are preferable to combined with estrogen and, in this case, those with a lower dose of estrogen. (CDC 2016, 2013 y 2010, WHO/OMS 2015, Altshuler 2015, Berens 2015, CLM 2012)

For the first 4-6 weeks postpartum, non-hormonal methods are the first choice, followed by IUDs and progestogen implants. (Berens 2015, Mwalwanda 2013, Rowe 2013, CLM 2012)


See below the information of this related product:

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Etonogestrel is also known as


Etonogestrel in other languages or writings:

Group

Etonogestrel belongs to this group or family:

Tradenames

Main tradenames from several countries containing Etonogestrel in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight 325 daltons
Protein Binding 96 - 99 %
VD 3.1 l/Kg
Tmax 200 hours
25 hours
M/P ratio 0.5 -
Theoretical Dose 0.00003 mg/Kg/d
Relative Dose 2.2 %

References

  1. Society for Maternal-Fetal Medicine (SMFM). Electronic address: pubs@smfm.org., Vricella LK, Gawron LM, Louis JM. Society for Maternal-Fetal Medicine (SMFM) Consult Series #48: Immediate postpartum long-acting reversible contraception for women at high risk for medical complications. Am J Obstet Gynecol. 2019 May;220(5):B2-B12. Abstract
  2. Carmo LSMP, Braga GC, Ferriani RA, Quintana SM, Vieira CS. Timing of Etonogestrel-Releasing Implants and Growth of Breastfed Infants: A Randomized Controlled Trial. Obstet Gynecol. 2017 Abstract
  3. Phillips SJ, Tepper NK, Kapp N, Nanda K, Temmerman M, Curtis KM. Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception. 2016;94:226-52. Abstract Full text (link to original source) Full text (in our servers)
  4. Stuebe AM, Bryant AG, Lewis R, Muddana A. Association of Etonogestrel-Releasing Contraceptive Implant with Reduced Weight Gain in an Exclusively Breastfed Infant: Report and Literature Review. Breastfeed Med. 2016 Abstract
  5. CDC - Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, Simmons KB, Pagano HP, Jamieson DJ, Whiteman MK. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. CDC - MMWR Recommendations & Reports. 2016 Abstract Full text (link to original source) Full text (in our servers)
  6. OMS. Criterios médicos de elegibilidad para el uso de anticonceptivos Quinta edición. Who Library. 2015 Full text (link to original source) Full text (in our servers)
  7. Berens P, Labbok M; Academy of Breastfeeding Medicine. Protocolo clínico de la ABM n.º 13: Anticoncepción durante la lactancia, revisado en 2015. Breastfeed Med. 2015 Full text (link to original source) Full text (in our servers)
  8. WHO. Department of Reproductive Health and Research World Health Organization. Medical eligibility criteria for contraceptive use: 20 years of global guidance. WHO/RHR/15.07. 2015 Abstract Full text (link to original source) Full text (in our servers)
  9. Berens P, Labbok M; Academy of Breastfeeding Medicine. ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. Breastfeed Med. 2015 Abstract Full text (link to original source) Full text (in our servers)
  10. Lopez LM, Grey TW, Stuebe AM, Chen M, Truitt ST, Gallo MF. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2015 Abstract
  11. Braga GC, Ferriolli E, Quintana SM, Ferriani RA, Pfrimer K, Vieira CS. Immediate postpartum initiation of etonogestrel-releasing implant: A randomized controlled trial on breastfeeding impact. Contraception. 2015 Abstract
  12. Merk. Implanon. Product Monograph. 2015 Full text (in our servers)
  13. Altshuler AL, Gaffield ME, Kiarie JN. The WHO's medical eligibility criteria for contraceptive use: 20 years of global guidance. Curr Opin Obstet Gynecol. 2015 Abstract Full text (link to original source) Full text (in our servers)
  14. AEMPS-Merk. Implanon. Ficha técnica. 2014 Full text (in our servers)
  15. Mwalwanda CS, Black KI. Immediate post-partum initiation of intrauterine contraception and implants: a review of the safety and guidelines for use. Aust N Z J Obstet Gynaecol. 2013 Abstract
  16. Bahamondes L, Bahamondes MV, Modesto W, Tilley IB, Magalhães A, Pinto e Silva JL, Amaral E, Mishell DR Jr. Effect of hormonal contraceptives during breastfeeding on infant's milk ingestion and growth. Fertil Steril. 2013 Abstract Full text (link to original source) Full text (in our servers)
  17. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  18. CDC. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Abstract Full text (link to original source) Full text (in our servers)
  19. CLM - Comité de Lactancia Materna de la AEP. Preguntas frecuentes sobre lactancia materna. Folleto. 2012 Full text (link to original source) Full text (in our servers)
  20. Gurtcheff SE, Turok DK, Stoddard G, Murphy PA, Gibson M, Jones KP. Lactogenesis after early postpartum use of the contraceptive implant: a randomized controlled trial. Obstet Gynecol. 2011 Abstract
  21. Duvan Cİ, Gözdemir E, Kaygusuz I, Kamalak Z, Turhan NÖ. Etonogestrel contraceptive implant (Implanon): analysis of patient compliance and adverse effects in the breastfeeding period. J Turk Ger Gynecol Assoc. 2010 Abstract
  22. Centers for Disease Control and Prevention (CDC). U S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm Rep. 2010 Abstract Full text (link to original source) Full text (in our servers)
  23. Hohmann H. Examining the efficacy, safety, and patient acceptability of the etonogestrel implantable contraceptive. Patient Prefer Adherence. 2009 Abstract Full text (link to original source)
  24. Brito MB, Ferriani RA, Quintana SM, Yazlle ME, Silva de Sá MF, Vieira CS. Safety of the etonogestrel-releasing implant during the immediate postpartum period: a pilot study. Contraception. 2009 Abstract
  25. Taneepanichskul S, Reinprayoon D, Thaithumyanon P, Praisuwanna P, Tosukhowong P, Dieben T. Effects of the etonogestrel-releasing implant Implanon and a nonmedicated intrauterine device on the growth of breast-fed infants. Contraception. 2006 Abstract
  26. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  27. Díaz S. Contraceptive implants and lactation. Contraception. 2002 Abstract
  28. Reinprayoon D, Taneepanichskul S, Bunyavejchevin S, Thaithumyanon P, Punnahitananda S, Tosukhowong P, Machielsen C, van Beek A. Effects of the etonogestrel-releasing contraceptive implant (Implanon on parameters of breastfeeding compared to those of an intrauterine device. Contraception. 2000 Abstract
  29. Moretti ME, Lee A, Ito S. Which drugs are contraindicated during breastfeeding? Practice guidelines. Can Fam Physician. 2000 Sep;46:1753-7. Review. Abstract Full text (link to original source) Full text (in our servers)
  30. WHO. Progestogen-only contraceptives during lactation: II. Infant development. World Health Organization, Task Force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development, and Research Training in Human Reproduction. Contraception. 1994 Abstract
  31. World Health Organization (WHO) Task Force on Oral Contraceptives. Effects of hormonal contraceptives on breast milk composition and infant growth. Stud Fam Plann. 1988 Abstract

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