LEVONORGESTREL intrauterine device

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    Last updated: October 2021

     

    Prescription under medical supervision

     

    Therapeutic action

    • Hormonal contraceptive, progestogen

    Indications

    • Long-acting contraception
    • Long-term treatment of functional uterine bleeding

    Forms and strengths

    • Intrauterine device (IUD) containing 52 mg of levonorgestrel and releasing 20 micrograms daily on insertion

    Dosage

    The IUD may be inserted at any moment of the cycle if it is reasonably certain the woman is not pregnant, including when switching from another form of contraception.

    • For contraception, use condoms for 7 days after the insertion of the IUD if it is inserted:
      • over 7 days after the start of menstrual period;
      • over 28 days postpartum if not breastfeeding; 
      • over 7 days after an abortion.

    Duration

    • Contraception: as long as this method of contraception is desired and well tolerated, for max. 5 years, after which the IUD must be changed. 
    • Long-term treatment of functional uterine bleeding: according to clinical response.

    Contra-indications, adverse effects, precautions

    • Do not use in patients with breast cancer, cervical cancer, severe or recent hepatic disease, genital infection, active thromboembolic disorders, hydatidiform mole or other gestational trophoblastic disease.
    • May cause:
      • changes in bleeding patterns: amenorrhoea, irregular lighter bleeding; rarely: heavy prolonged bleeding;
      • abdominal pain, headache, nausea, breast tenderness, acne, weight gain, mood change.
    • IUD insertion-related complications: expulsion of IUD, pelvic infection, risk of uterine perforation during insertion.
    • The contraceptive efficacy of levonorgestrel-releasing IUD does not seem to be reduced in women taking enzyme-inducing drugs.
    • Pregnancy: CONTRA-INDICATED
    • Breast-feeding: no contra-indication

    Remarks

    • Fertility returns rapidly after removal of the IUD.
    • The IUD can be inserted into the uterus within 48 hours after childbirth. If not inserted within 48 hours, delay insertion until after 28 days postpartum.
    • For details on insertion and removal of IUD, read manufacturer’s instructions carefully.

    Storage

     
    –  Below 25 °C