Fluconazole Interaction With Nexplanon

In our latest question and answer, our pharmacist discusses the interaction between Nexplanon (etonogestrel) and fluconazole.

Dec 11, 2017

Ash asked

Will the fluconazole affect the Nexplanon? If so, how many days will the effects last.

Answer

There is a mild interaction between Nexplanon (etonogestrel) and fluconazole, but it wouldn't necessarily preclude the use of both together.

Taking fluconazole while on therapy with Nexplanon can cause increased concentrations of etonogestrel, the progestin hormone that is contained in the product. This could potentially cause side effects that are associated with high progestin levels such as:

  • Breast tenderness
  • Headache
  • Fatigue
  • Changes in mood

The interaction occurs as fluconazole can inhibit the metabolism of etonogestrel. Therefore, the interaction will potentially occur for as long as fluconazole is present in the system. Fluconazole has a long half life (time it takes for 50% of the drug to be metabolized) and can take 5-7 days to completely eliminate from the body. If you are experiencing side effects due to this interaction, they may take about a week to subside.

The side effects listed above generally are mild and relatively uncommon. Most sources list the potential interaction as minor. If you are experiencing any of the above side effects and they are more than mild in severity, please reach out to your doctor.

It is important to note that etonogestrel is also the hormone used in Implanon, a similar implant that is designed to release the hormone over a 3-year period. Nexplanon is considered bioequivalent to Implanon but is easier to insert by the physician. Nexplanon can also be located on a X-ray/CT-scan, unlike Implanon.     

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