Similar effects are expected for other CYP3A4 inducers, but it is not known whether these are clinically relevant. The opposite is true of CYP3A4 inhibitors such as ketoconazoleitraconazole and clarithromycin : they might increase etonogestrel concentrations in the body. Insertion and removal[ edit ] Play media Implantation of Implanon An experienced clinician must perform the insertion of implants to ensure proper insertion and minimize the risk of nerve damage or misplacement, which could result in pregnancy.
Bruising and mild discomfort are common after insertion. If a woman receives an implant outside the first five days of her period, she should wait to have sex or use a backup method of contraception such as a condomfemale condomdiaphragmsponge, or emergency contraception for the following week after insertion to prevent pregnancy. However, if the implant is inserted during the first five days of a woman's period, she is protected for that cycle and beyond.
The rod must also be removed by an experienced clinician. At removal, a local anesthetic is again used around the implant area at the distal end. A small incision is made in the skin over the end of the implant site.
In some cases, a fibrous sheath may have formed around the implant, in which case the sheath must be incised. The removal procedure lasts, on average, 3 to 3. Ovulation was not observed in studies of Implanon in the first two years of use and only rarely in the third year with no pregnancies.
A secondary mechanism of action is the progestogenic increase in cervical mucus viscosity which inhibits sperm penetration.