Subdermal ImplantsDonJayricDepalobos

Subdermal Implants

•Made of polydimetylsiloxane (Silastic)•Norplant – contains lenonorgestrel•Long-acting, reversible, effective•Trials were initiated on 1975•FDA approval on 1990•Started to be marketed on 1991

Norplant

•The rate of delivery is proportional to the surface area of the capsule.

•Duration of action is dependent on the amount of steroid within the capsule.

• Effective blood level• 6 capsule filled with

crystalline levonorgestrel

• Each capsule contains 36mg of crystalline levonorgestrel

• 215 mg in each capsule set

Norplant

•Insertion (Out-patient Setting)1. Infiltration of skin with local anesthesia.2. Incision of 3mm.

Usually upper arm but other areas are used like lower arm, inguinal, scapular, and gluteal.

3. Radial pattern in a 10- to 12-guage trocar.4. Incision is closed.

Sutures are not necessary. Removed after 5 years.

Norplant

•Removal▫Clinic Area▫Local Anesthesia▫Small Incision▫Remove fibrous tissue if present▫Implants are implanted superficially

Norplant II• Next Generation Implant

▫Homologous mixture of Silastic and crystalline levonorgestrel extruded as solid rod and covered with Silastic tubing to limit diffusion of steroid.

▫Higher blood levels of levonorgestrel are achieved with a smaller total surface area.

• Two 4cm covered rods achieve same release rate for levonorgestrel (about 50mcg/day) as six 3cm capsules.

• 3 years duration• 2-rod system “Jadelle”