LEVONORGESTREL intrauterine device

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 -