Since August 2001, the Australian Adverse Reactions Advisory Committee (ADRAC) has received 130 adverse reaction reports for Implanon® (subdermal etonogestrel contraceptive implant), including 37 reports of vaginal bleeding, most of which described prolonged bleeding (duration 2-26 weeks; median 8 weeks). The bleeding generally started soon after insertion, but the time to onset was up to 16 weeks. Thirty-three of the 37 patients required implant removal. One patient was hospitalized, and transfused 4 units of packed red blood cells.
In a published 3-year study, 2.8% of patients experienced heavy or prolonged bleeding with Implanon® (1). Unacceptable vaginal bleeding may occasionally occur and often requires implant removal.
Extracted from Australian Adverse Drug Reaction Bulletin, Volume 22, Number 3, 2003.
Reference: Croxatto, H.B. Clinical profile of Implanon®: a single-rod etonogestrel contraceptive implant. European Journal of Contraception and Reproductive Health Care, 5(Suppl 2): 21-28 (2000).