Lo Loestrin Fe vs. Nexplanon

See how Lo Loestrin Fe and Nexplanon compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Lo Loestrin Fe is a daily pill with the lowest estrogen dose of any approved oral contraceptive, while Nexplanon is a matchstick-sized implant that works for up to 3 years.

  • Both carry warnings about blood clot risk, but Lo Loestrin Fe has a boxed warning specific to smokers over 35 who use combined hormonal contraceptives.

  • Nexplanon removes the need to remember a daily pill, but it requires a minor in-office procedure for both insertion and removal.

Lo Loestrin Fe vs. Nexplanon Drug Summary

Lo Loestrin Fe

Lo Loestrin Fe is a combination oral contraceptive containing the lowest estrogen dose of any FDA-approved pill along with a progestin and iron supplement. It is taken once a day in a 28-day pack to prevent pregnancy. It is also sometimes used off-label to help manage acne or other hormone-related symptoms.

Nexplanon

Nexplanon is a progestin-only contraceptive implant placed just under the skin of the upper arm. A trained clinician inserts the single flexible rod, which releases a steady dose of hormone to prevent pregnancy for up to 3 years. No daily or weekly action is needed once it is in place.

Lo Loestrin Fe vs. Nexplanon Side Effects

Lo Loestrin Fe

Most common
headache (up to 7%)
nausea/vomiting (up to 7%)
bleeding irregularities (up to 5%)
dysmenorrhea (up to 4%)

Nexplanon

Most common
change in menstrual bleeding pattern (up to 11%)
headache (≥10%)
vaginitis (≥10%)
weight increase (≥10%)

Lo Loestrin Fe vs. Nexplanon Dosage

Lo Loestrin Fe

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 mg/10 mcg once daily Days 1-24
Maximum dose 75 mg ferrous fumarate daily Days 27-28
Dose changes 2 increases As tolerated

Nexplanon

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 implant, 68 mg subdermal Day 1
Maximum dose 1 implant, 68 mg subdermal Same as starting
Dose changes None Fixed dose

Lo Loestrin Fe vs. Nexplanon Indications

Lo Loestrin Fe

Lo Loestrin Fe is FDA-approved to prevent pregnancy in women who choose a daily oral contraceptive. It pairs a very low estrogen dose with a progestin, taken once a day in a 28-day pack that includes iron tablets during the last two days. Some clinicians also prescribe it off-label to help manage acne or other hormone-related symptoms.

  • Prevention of pregnancy in women choosing a daily pill

  • Off-label: management of acne or hormonal symptoms

  • Contains the lowest estrogen dose among approved pills

  • Requires consistent daily dosing to stay effective

Nexplanon

Nexplanon is FDA-approved for long-acting reversible contraception. A clinician inserts a single flexible rod under the skin of the upper arm, where it releases a steady dose of progestin for up to three years. It is not approved for use beyond three years without being replaced.

  • Long-acting reversible contraception for up to 3 years

  • Inserted and removed through a minor in-office procedure

  • Effectiveness does not depend on daily or weekly action

  • Not approved for use beyond 3 years without replacement

Lo Loestrin Fe vs. Nexplanon Pros and Cons

Lo Loestrin Fe

Lo Loestrin Fe suits people who want a non-invasive method they can start or stop on their own without a procedure. Its estrogen dose is the lowest of any approved pill, which may reduce estrogen-related side effects for some users. It does require daily attention and carries specific smoking-related warnings.

Pros

  • Non-invasive; no procedure needed to start or stop

  • Can be discontinued immediately by simply not taking it

  • Lowest estrogen dose of any approved pill, which may ease estrogen-related side effects

  • Substantially lower list price ($171 to $1,017/month) than Nexplanon

Cons

  • Requires taking a pill at the same time every day

  • Not recommended for women over 35 who smoke

  • Boxed warning for blood clot and stroke risk tied to smoking

  • Missed doses meaningfully reduce effectiveness

Nexplanon

Nexplanon appeals to people who want reliable contraception without remembering a daily task. It is placed once and works for up to three years, but getting it in and out both require a clinician visit. It also contains no estrogen, which matters for some medical histories.

Pros

  • Works for up to 3 years without any daily or weekly action

  • Contains no estrogen, an option for those who cannot take it

  • Fertility typically returns quickly after removal

  • Efficacy is not affected by missed doses

Cons

  • Requires an in-office procedure for both insertion and removal

  • Available only through a REMS program due to insertion risks

  • Irregular bleeding is the most common reason people stop using it

  • Higher list price ($1,030 to $1,275/month) than Lo Loestrin Fe

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