Update information 2019 In March 2019 NICE revised the decision on how to implement the recommendations of the October 2017 review. Although no new evidence was identified, NICE noted significant changes in how to commission and provide contraceptive services in England. NICE have removed the recommendations in the short version of the guideline that no longer fit with current practice, and have deleted or redacted the content related to those removed recommendations in this guideline. There are also many new LARC products now available.
Long-acting Reversible Contraception
NICE Clinical Guidelines, No. 30
Authors
National Collaborating Centre for Women’s and Children’s Health (UK).Excerpt
Contraception can be divided into two broad categories: hormonal and nonhormonal. There are two categories of hormonal contraception: combined oestrogen and progestogen and progestogen-only. Long-acting reversible contraception (LARC) is defined in this guideline as methods that require administering less than once per cycle or month.
Included in the category of LARC are the copper intrauterine devices (nonhormonal) and three progestogen-only methods of contraception (intrauterine system, injectables and the implants). The combined vaginal ring is not licensed in the UK and is therefore excluded from this guideline.
In 2003/04, about 8% of women aged 16–49 years in Great Britain used LARC as a method of contraception. [EL = 3]
Update 2013: The progestogen-only subdermal implant, Implanon, recommended in this guideline is no longer available. Implanon was replaced by Nexplanon. Nexplanon contains the same amount of the same drug as Implanon, but the summaries of product characteristics for the two devices are not identical. In the light of the change in the implant available, NICE will review the evidence and update the section of the guideline that makes recommendations on progestogen-only subdermal implants.
All recommendations that refer to Implanon should be accompanied by a footnote which states the following: “The progestogen-only subdermal implant (Implanon) recommended in this guideline is no longer available. Healthcare professionals considering offering the replacement device, Nexplanon, should refer to the summary of product characteristics.”
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