MIRENA
Generic name not specified · by BAYER
Composition
IUS: Levonorgestrel 52 mg; T-shaped intrauterine system.
Indications & Dosage
Contraception: Adult females of childbearing potential: To be inserted into the uterine cavity within 7 days of the onset of menstruation. Replace after 5 yr. Delay post-partum use until 6 weeks after delivery. Idiopathic menorrhagia: Adult females of childbearing potential: To be inserted into the uterine cavity within 7 days of the onset of menstruation. Remove if significant reduction in blood loss is not achieved in 3-6 months. Replace after 5 yrs. Delay post-partum use until 6 week after delivery.
Contraindications
Pregnancy, undiagnosed genital bleeding, uterine abnormality, genital or pelvic infection, current or recurrent pelvic inflammatory disease, postpartum endometritis disease, infected abortion, cervicitis, cervical dysplasia, uterine or cervical. malignancy, history of bacterial endocarditis or severe pelvic infection in women with an anatomical heart lesion or valve replacement, severe arterial disease, liver tumour, liver disease, increased susceptibility to infections, blood malignancy, leukaemia, recent trophoblastic disease. With intra-uterine (IUS) use: Active trophoblastic disease; until return to normal of urine- and plasma-gonadotrophin concentration, acute cervicitis, acute vaginitis, distorted uterine cavity, established immune-suppression, genital malignancy, history of breast cancer but can be considered for a woman in long-term remission who has menorrhagia and requires effective contraception, infected abortion during the previous three months, pelvic inflammatory disease or perforation, postpartum endometritis, severe anaemia, small uterine cavity, unexplained uterine bleeding.
Precautions
Hormone dependent neoplasia, diabetes, chronic corticosteroid therapy, unusually severe headaches, history of ovarian cysts or ectopic pregnancy, lacta-tion. With intra-uterine use: Disease-induced immune-suppression, anaemia, anticoagulant therapy, diabetes, endometriosis, epilepsy, fertility problems, history of pelvic inflammatory disease, increased risk of expulsion if inserted before uterine involution, menorrhagia, nulliparity, severe cervical stenosis, severe primary dysmenorrhea, severely scarred uterus, young age, should only be fitted by trained practitioners.
Interactions
Liver enzyme inducing drugs.
Side Effects
Altered menstrual patterns, headache, lower abdominal pain, back pain, skin disorders, vaginal discharge, mastalgia, vaginitis, mood changes, nausea, oedema, ovarian cysts, pelvic inflammatory disease, weight gain, hair loss, greasy hair. Delayed follicular atresia; monitor with ultrasound.