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Implantable Contraceptives

The FDA has recently approved levonorgestrel implants (Norplant, Wyeth-Ayerst Laboratories, Philadelphia, Pennsylvania) as a long-term, reversible contraceptive system.[169] According to the manufacturer's promotional information, the product is highly effective with few side effects. Initially it is contraindicated in most physiologic conditions that are contraindications for oral contraceptives. It must be implanted by a physician or nurse who has received special training by the manufacturer.

The product comes with a detailed consent form that should be adequate for most situations. Since this is a new product without an established history of use in the United States, we advise physicians to be scrupulous about using a detailed consent form with this product. In addition, physicians should use the same tracking system for patients with implantable contraceptives as for patients with IUDs. These patients should be seen at least once a year for evaluation of potential side effects and must be seen at the end of five years to remove or replace the implants. While implantable contraceptives do not facilitate pelvic infections as do IUDs, they do nothing to prevent the spread of sexually transmitted diseases (STDs), including HIV. Physicians should be careful to counter the idea that using an implantable contraceptive means not having to think about contraception for five years.

[169]Nightingale SL: From the Food and Drug Administration. JAMA 1991; 265:847.


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