Ortho Tri-Cyclen vs. Nexplanon

See how Ortho Tri-Cyclen and Nexplanon compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Ortho Tri-Cyclen is a daily triphasic pill that also treats moderate acne, while Nexplanon is a single implant that prevents pregnancy for up to 3 years without daily effort.

  • Nexplanon has a lower real-world failure rate because it does not rely on remembering a daily dose, but it requires a clinician to insert and remove it.

  • Ortho Tri-Cyclen generics cost far less per month out of pocket than Nexplanon's upfront implant price, though insurance often covers both.

Ortho Tri-Cyclen vs. Nexplanon Drug Summary

Ortho Tri-Cyclen

Ortho Tri-Cyclen is a triphasic combination oral contraceptive containing norgestimate and ethinyl estradiol. It is taken once daily for 28 days, with three weeks of active tablets at rising hormone doses followed by a week of placebo. It is also FDA-approved to treat moderate acne in women who want oral contraception.

Nexplanon

Nexplanon is a progestin-only contraceptive implant containing etonogestrel. A clinician places a single flexible rod just under the skin of the upper arm, and it prevents pregnancy continuously for up to 3 years. It requires no daily, weekly, or monthly action once inserted.

Ortho Tri-Cyclen vs. Nexplanon Side Effects

Ortho Tri-Cyclen

Most common
Headache (rate n/a)
Vaginal infection (rate n/a)
Breast tenderness (rate n/a)
Abdominal pain (rate n/a)

Nexplanon

Most common
Irregular bleeding (11.1%)
Headache (10%+)
Vaginitis (10%+)
Weight increase (10%+)

Ortho Tri-Cyclen vs. Nexplanon Dosage

Ortho Tri-Cyclen

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.180 mg/0.035 mg daily Days 1-7
Maximum dose Placebo tablet daily Days 22-28
Dose changes 3 increases Every 7 days

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

Ortho Tri-Cyclen vs. Nexplanon Indications

Ortho Tri-Cyclen

Ortho Tri-Cyclen is FDA-approved to prevent pregnancy and to treat moderate acne in females at least 15 years old who also want oral contraception. It is not approved for emergency contraception or for protection against sexually transmitted infections.

  • Prevents pregnancy when taken daily

  • Treats moderate acne in females 15 and older

  • Not approved for emergency contraception

  • Not intended to prevent STIs

Nexplanon

Nexplanon is FDA-approved only for the prevention of pregnancy, using continuous release of etonogestrel from a subdermal implant. It is not approved for use beyond 3 years without replacement, and it does not treat any other condition.

  • Prevents pregnancy for up to 3 years

  • Requires no daily or weekly action

  • Not approved for use past 3 years without replacement

  • Does not treat acne or other conditions

Ortho Tri-Cyclen vs. Nexplanon Pros and Cons

Ortho Tri-Cyclen

Ortho Tri-Cyclen offers a familiar, low-cost daily pill with the added benefit of treating acne, but it depends on remembering a dose every day and carries estrogen-related cardiovascular risks.

Pros

  • Also treats moderate acne

  • Roughly $10 to $25 per month for generics, before insurance

  • Can be stopped at any time without a procedure

  • Cycle can be timed or adjusted with clinician guidance

Cons

  • Requires taking a pill at the same time every day

  • Higher risk of blood clots due to the estrogen component

  • Not recommended for smokers over 35

  • Typical-use failure rate is higher than long-acting methods

Nexplanon

Nexplanon removes the daily-adherence problem entirely, since one insertion protects against pregnancy for up to 3 years, but it costs far more upfront and requires a clinician for insertion and removal.

Pros

  • No daily or weekly action required

  • One of the most effective reversible contraceptives available

  • Fertility returns quickly after removal

  • Lasts up to 3 years per insertion

Cons

  • Requires an in-office procedure for insertion and removal

  • Roughly $1,030 to $1,275 per implant, before insurance

  • Irregular bleeding is a common reason for early removal

  • No generic version currently available

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