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

Most common
Change in menstrual bleeding pattern (up to 11%)
Headache (≥10%)
Vaginitis (≥10%)
Weight increase (≥10%)

Kyleena

Most common
Vulvovaginitis (up to 24%)
Ovarian cysts (up to 22%)
Abdominal/pelvic pain (up to 21%)
Headache/migraine (up to 15%)

Nexplanon vs. Kyleena Dosage

Nexplanon

Dosage
Dosage Table
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

Dosage
Dosage Table
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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