Mirena

Generic name: Levonorgestrel Intrauterine System

Usage of Mirena

The Mirena intrauterine device (IUD) contains levonorgestrel, a female hormone that can cause changes in your cervix and uterus. Mirena is a T-shaped plastic intrauterine device that is placed in the uterus where it slowly releases the hormone.

Mirena IUD is used to prevent pregnancy for up to 8 years. You may use this IUD whether you have children or not. Mirena is also used for up to 5 years to treat heavy menstrual bleeding in women who choose to use an intrauterine form of birth control.

Levonorgestrel is a progestin hormone and does not contain estrogen. The Mirena IUD releases levonorgestrel in the uterus, but only small amounts of the hormone reach the bloodstream.

Mirena should not be used as emergency birth control.

Mirena side effects

Get emergency medical help if you have signs of an allergic reaction to Mirena: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have severe pain in your lower stomach or side. This could be a sign of a tubal pregnancy.

The IUD may become embedded into the wall of the uterus, or may perforate (form a hole) in the uterus. If this occurs, the device may no longer prevent pregnancy, or it may move outside the uterus and cause scarring, infection, or damage to other organs. Your doctor may need to surgically remove the device.

Call your doctor at once if you have:

severe cramps or pelvic pain, pain during sexual intercourse;

extreme dizziness or light-headed feeling;

severe migraine headache;

heavy or ongoing vaginal bleeding, vaginal sores, vaginal discharge that is watery, foul-smelling discharge, or otherwise unusual;

pale skin, weakness, easy bruising or bleeding, fever, chills, or other signs of infection;

jaundice (yellowing of the skin or eyes); or

sudden numbness or weakness (especially on one side of the body), confusion, problems with vision, sensitivity to light.

Common Mirena side effects may include:

pelvic pain, painful or irregular menstrual periods, changes in bleeding patterns or flow;

vaginal swelling, itching or infection;

temporary pain, bleeding, or dizziness during insertion of the IUD;

ovarian cysts (pelvic pain that disappears within 3 months);

stomach pain, nausea, vomiting, bloating;

headache, migraine, depression, mood changes;

back pain, breast tenderness or pain;

weight gain, acne, oily skin, changes in hair growth, loss of interest in sex; or

puffiness in your face, hands, ankles, or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before taking Mirena

The Mirena IUD can increase your risk of developing a serious pelvic infection, which may threaten your life or your future ability to have children. Ask your doctor about this risk.

Do not use Mirena during pregnancy. If left in place during pregnancy, this IUD could cause severe infection, miscarriage, premature birth, or death of the mother. The hormone in the Mirena IUD may also cause unwanted effects in a female newborn.

Tell your doctor right away if you become pregnant. If you continue the pregnancy, watch for signs such as fever, chills, cramps, vaginal bleeding or discharge.

You should not use Mirena if you are allergic to levonorgestrel, silicone, silica, silver, barium, iron oxide, or polyethylene, or if you have:

abnormal vaginal bleeding that has not been checked by a doctor;

an untreated or uncontrolled pelvic infection (vaginal, cervical, uterine);

endometriosis or a serious pelvic infection following a pregnancy or abortion in the past 3 months;

pelvic inflammatory disease (PID), unless you had a normal pregnancy after the infection was treated and cleared;

uterine fibroid tumors or conditions that affect the shape of the uterus;

past or present cancer of the breast, cervix, or uterus;

liver disease or liver tumor (benign or malignant);

a condition that weakens your immune system, such as AIDS, leukemia, or IV drug abuse;

if you have another intrauterine device (IUD) in place;

if you had an abortion or miscarriage in the past 6 weeks; or

if you gave birth to a baby in the past 6 weeks.

To make sure Mirena is safe for you, tell your doctor if you have:

high blood pressure, heart problems, a heart attack, or a stroke;

bleeding problems;

migraine headaches; or

a vaginal infection, pelvic infection, or sexually transmitted disease.

You may use Mirena when you are breastfeeding. Levonorgestrel is not likely to affect the quality or amount of your breast milk or the health of your nursing baby. However, isolated cases of decreased milk production have been reported. The risk of uterine complications from IUD insertion is greater while you are breastfeeding.

How to use Mirena

Usual Adult Dose for Contraception:

Intrauterine Device (IUD) insertion should be performed by a trained healthcare provider thoroughly familiar with product; product manufacturer labeling should be consulted: Insert 1 Mirena IUD (52 mg) into uterus Timing of insertion: -For women who are not currently using hormonal or intrauterine contraception: Insertion may occur at any time the woman is not pregnant; if inserted after the first 7 days of menstrual cycle, an additional method of contraception should be used for 7 days after insertion -Switching from an oral, transdermal, or vaginal hormonal contraceptive: Insertion may occur at any time; if inserted during the hormone phase, continue use for 7 days after insertion or until the end of the current treatment cycle -Switching from an injectable progestin contraceptive: Insertion may occur at any time; if inserted more than 3 months after the last injection, an additional method of contraception should be used for 7 days after insertion -Switching from a contraceptive implant or another IUD: Insertion should occur on the same day the implant or IUD is removed -Inserting after abortion or miscarriage: --First trimester: May insert IUD immediately after a first trimester abortion or miscarriage --Second trimester: Insertion of IUD should be delayed a minimum of 4 weeks or until the uterus is fully involuted; if involution is delayed, insertion should be delayed until involution is complete; consider the possibility of ovulation and conception occurring prior to insertion and advise patient on need for an additional method of contraception for 7 days after insertion -After childbirth: Insertion of IUD should be delayed a minimum of 4 weeks after delivery, or until the uterus is fully involuted; if involution is delayed, insertion should be delayed until involution is complete; consider the possibility of ovulation and conception occurring prior to insertion and advise patient on need for an additional method of contraception for 7 days after insertion Replacement: Mirena should be replaced after 8 years; a new IUD may be inserted for continued use. Comments: -IUD may be removed at any time but must be removed by the end of the prescribed time; if continued use is desired, replace with a new IUD.

Warnings

Do not use Mirena during pregnancy. Tell your doctor right away if you become pregnant.

You should not use Mirena if you have abnormal vaginal bleeding, a pelvic infection, certain other problems with your uterus or cervix, or if you have breast or uterine cancer, liver disease or liver tumor, or a weak immune system.

What other drugs will affect Mirena

Some drugs can affect your blood levels of levonorgestrel, which could make this form of birth control less effective. Tell your doctor about all your other medicines, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Disclaimer

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