Nexplanon vs. Depo-Provera
See how Nexplanon and Depo-Provera compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Nexplanon is a matchstick-sized rod placed under the skin of the arm that prevents pregnancy for up to 3 years with no ongoing action needed.
Depo-Provera is an injection given every 3 months, either by a provider or, in the subcutaneous form, at home.
Both are progestin-only options, but Depo-Provera carries a boxed warning for bone density loss with long-term use that Nexplanon does not.
Nexplanon vs. Depo-Provera Drug Summary
Nexplanon
Nexplanon is a progestin-only contraceptive implant, a thin rod placed under the skin of the upper arm that prevents pregnancy for up to 3 years. It releases a steady low dose of etonogestrel and requires no daily or weekly action once inserted.
Depo-Provera
Depo-Provera is a progestin injection given every 3 months to prevent pregnancy. It contains medroxyprogesterone acetate and is delivered by injection into the muscle or, in a lower-dose version, under the skin.
Nexplanon vs. Depo-Provera Side Effects
Nexplanon
Depo-Provera
Nexplanon vs. Depo-Provera Dosage
Nexplanon
Depo-Provera
| STAGE | DOSE | WHEN |
| Starting dose | 1 implant, 68 mg | Day 1 |
| Maximum dose | 1 implant, 68 mg | Same as starting |
| Dose changes | None | Fixed dose |
| STAGE | DOSE | WHEN |
| Starting dose | 150 mg injection | At the start |
| Maximum dose | 150 mg injection | Same as starting |
| Dose changes | None | Fixed dose |
Nexplanon
| STAGE | DOSE | WHEN |
| Starting dose | 1 implant, 68 mg | Day 1 |
| Maximum dose | 1 implant, 68 mg | Same as starting |
| Dose changes | None | Fixed dose |
Depo-Provera
| STAGE | DOSE | WHEN |
| Starting dose | 150 mg injection | At the start |
| Maximum dose | 150 mg injection | Same as starting |
| Dose changes | None | Fixed dose |
Nexplanon vs. Depo-Provera Indications
Nexplanon
Nexplanon is FDA-approved for long-acting reversible contraception. It is placed once and works continuously for up to 3 years without any action from the patient.
Prevention of pregnancy for up to 3 years
No daily, weekly, or monthly action required
Reversible by removal at any time
Depo-Provera
Depo-Provera is FDA-approved for prevention of pregnancy through repeat injections. It is not recommended as a long-term method beyond 2 years unless other options are inadequate, due to bone loss risk.
Prevention of pregnancy, given every 3 months
Available as intramuscular or subcutaneous injection
Not recommended for continuous use beyond 2 years
Nexplanon vs. Depo-Provera Pros and Cons
Nexplanon
Nexplanon offers the longest stretch of set-it-and-forget-it protection among hormonal methods, but it requires a brief in-office procedure for placement and removal. Its higher upfront list price can be a barrier without insurance coverage.
Pros
Lasts up to 3 years with no user action needed
No boxed warning for bone density loss
Fertility typically returns quickly after removal
Cons
Requires a minor in-office insertion and removal procedure
Rod may be visible or palpable under the skin
Higher list price, roughly $1,030 to $1,275 per month equivalent
Only available through providers trained under a REMS program
Depo-Provera
Depo-Provera offers a lower-cost option that avoids any visible device, but it carries a boxed warning for bone density loss with prolonged use. Return to fertility after stopping can also take longer than with other methods.
Pros
Lower cost, roughly $20 to $45 per month equivalent
No visible or palpable device
Subcutaneous version can be self-administered at home
Cons
Boxed warning for bone density loss with long-term use
Return to fertility can take several months after stopping
Requires a new injection every 3 months to stay effective
Not recommended for continuous use beyond 2 years
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