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
Nexplanon
Lo Loestrin Fe vs. Nexplanon Dosage
Lo Loestrin Fe
Nexplanon
| 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 |
| 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
| 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
| 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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