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Ternelin 2mg dosage and should continue to use Nexplanon for the remainder of 10-year course. However, for women who have unprotected sex within the last 14 weeks and are at low risks of pregnancy, the most recent cumulative dose of levonorgestrel may be reduced until 3 months after discontinuation of Nexplanon. At this time, the woman should use current dose to maintain the effectiveness of Nexplanon. patient must continue the same contraceptive methods she was using before the most recent dose was discontinued to reduce the possibility of pregnancy during interval after discontinuation of Nexplanon. However, the patient may change only methods of contraception she was using before discontinuation with the lowest efficacy compared most recent combined estrogen and progestin dose. After 5 years of use, women where to buy diflucan in uk may take an additional 0.625 mg/day of levonorgestrel. The additional dose should only be administered if all previous doses of Nexplanon have failed to prevent pregnancy. Nexplanon Contraceptive Risks Nexplanon is highly effective and very widely used. In fact, approximately 2.3 million U.S. women will use the implant for contraceptives throughout their reproductive life, including both male and female sterilization. The implant is less effective than combined oral contraceptives.1,2 However, because Nexplanon is less effective, Nexplanon's contraceptive efficacy is significantly lower than that of a combined oral contraceptive.3-6 The implant has been shown to increase the risk of cervical disease during the first year of use, including ectopic pregnancy and an increased risk of thrombosis.7,8 In a 12-month clinical trial, substantial number of implant-induced pregnancy occurred.3 the 1.6 million women with implant-induced pregnancy between January 2006 and December 2010, 622 women had 3 or more implant-associated ectopic pregnancies, and 17 (2.4%) women had 5 or more implant-associated ectopic pregnancies.1,89 In women who discontinued Nexplanon or in the first year, an estimated 30 pregnancies would have occurred in the combined-use group and 4 in the women who did not use Nexplanon because of its lower efficacy (1.36 pregnancy per 100 woman-years).1,90 The risk of an unintended pregnancy with implant is approximately 4%-6%.1,2 The risk for unintended pregnancy by combining the contraceptive method is higher. For example, the estimated risk an unwanted pregnancy among all female contraceptive users combined during a single year in the U.S. is 11%, based on 2 trials and a review.91,92 The FDA, based on a systematic review, reviewed the studies and found that risk of an unintended pregnancy within the first year after a combination birth control pill use was about 15% for combined use and approximately 24% for the use of a single method. The same FDA database shows that an additional 1% of women best drugstore shampoo hair loss in the combined-use group or 1% of those who did not use Nexplanon could experience an unintended pregnancy each year in the prior to their contraceptive method discontinuation.91 Thus, the risk of a combination birth control pill