Nexplanon vs. Kyleena
See how Nexplanon and Kyleena compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Nexplanon is a matchstick-sized rod placed under the skin of the upper arm and lasts up to 3 years, while Kyleena is a small T-shaped device placed in the uterus and lasts up to 5 years.
Both release a progestin hormone, but Nexplanon works throughout the body while Kyleena acts mostly locally in the uterus, which shapes their different side effect patterns.
Kyleena requires a pelvic insertion procedure, while Nexplanon is placed and removed through a small incision in the arm.
Nexplanon vs. Kyleena Drug Summary
Nexplanon
Nexplanon is a progestin-only contraceptive implant, a single flexible rod inserted just under the skin of the upper arm. It continuously releases etonogestrel to prevent pregnancy for up to 3 years and requires no daily or monthly action once placed.
Kyleena
Kyleena is a hormonal intrauterine device that releases levonorgestrel directly into the uterus to prevent pregnancy. It is placed by a clinician in a single office procedure and stays effective for up to 5 years.
Nexplanon vs. Kyleena Side Effects
Nexplanon
Kyleena
Nexplanon vs. Kyleena Dosage
Nexplanon
Kyleena
| 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 | 19.5 mg IUS, one device | At the start |
| Maximum dose | 19.5 mg IUS, one device | 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 |
Kyleena
| STAGE | DOSE | WHEN |
| Starting dose | 19.5 mg IUS, one device | At the start |
| Maximum dose | 19.5 mg IUS, one device | Same as starting |
| Dose changes | None | Fixed dose |
Nexplanon vs. Kyleena Indications
Nexplanon
Nexplanon is FDA-approved solely for preventing pregnancy as a long-acting reversible contraceptive. A single implant provides continuous protection for up to 3 years. It is not approved for use beyond 3 years without replacement or for contraception in men.
Prevention of pregnancy for up to 3 years
Long-acting reversible contraception (LARC)
No daily or weekly action needed
Reversible soon after removal
Kyleena
Kyleena is FDA-approved to prevent pregnancy for up to 5 years from a single insertion. It is not approved for emergency contraception or for use before a person's first period. Its contraceptive effect is mainly local to the uterus rather than systemic.
Prevention of pregnancy for up to 5 years
Long-acting reversible contraception (LARC)
One-time insertion, no daily action needed
Hormone effect mostly localized to the uterus
Nexplanon vs. Kyleena Pros and Cons
Nexplanon
Nexplanon avoids any pelvic procedure since it's placed and removed through a small arm incision under local anesthetic. It requires a clinician trained through the FDA's REMS program for both insertion and removal. Because it works systemically, its side effects center on bleeding changes rather than local uterine effects.
Pros
Inserted and removed via small arm incision, no pelvic exam
No risk of uterine perforation or expulsion
Systemic delivery may suit those preferring effects outside the uterus
Fertility typically returns quickly after removal
Cons
Requires a REMS-certified clinician for insertion and removal
May leave a visible or palpable bump under the skin
Contraindicated with liver tumors or active liver disease
Roughly $1,030 to $1,275 per month before savings programs
Kyleena
Kyleena is placed directly into the uterus in a single office visit, and its hormone stays mostly local rather than acting throughout the body. It involves a pelvic insertion procedure that some patients find uncomfortable, along with monitoring for perforation or expulsion. Because one device lasts up to 5 years, its cost per month works out lower than Nexplanon's over the device's lifespan.
Pros
Lasts up to 5 years, longer than Nexplanon's 3-year lifespan
Roughly $20 to $24 per month over its 5-year lifespan
Hormone effect stays mostly local to the uterus
May lighten menstrual bleeding over time
Cons
Requires a pelvic insertion procedure that can cause cramping
Small risk of uterine perforation during placement
Higher risk of pelvic infection in first 20 days after insertion
Not approved for use before first period or as emergency contraception
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