Mirena

Generic Name: Levonorgestrel

  • What is Mirena?

    Mirena is a birth control system called an intrauterine device (IUD). Mirena is placed in your uterus to prevent pregnancy for up to 5 years. It can also reduce menstrual blood loss in women who have a heavy menstrual flow and who also want to use an IUD to prevent pregnancy.

    Mirena is recommended for women who have had at least one child.

  • What is the most important information I should know about Mirena?

    Mirena does not protect against HIV infection (AIDS) and other sexually transmitted diseases (STDs).

    Tell your doctor immediately if you think you are pregnant, or if you are experiencing unusual bleeding and abdominal pain.

    Possible complications with Mirena include severe pelvic infections. Tell your doctor if you have symptoms of pelvic inflammatory disease (an infection of the uterus) such as prolonged or heavy bleeding, unusual discharge from the vagina, abdominal or pelvic pain or tenderness, painful intercourse, chills, or fever.

    Mirena may become attached to the uterine wall or cause a hole in the uterus. Keep all follow-up visits with your doctor, who will monitor for complications.

    Call your doctor if you develop severe pain within a few hours after Mirena is placed.

    For the first 3-6 months, your monthly period may become irregular and the number of bleeding days may increase at first. You may also have frequent spotting or light bleeding. After your body adjusts, the number of bleeding days is likely to lessen.

    Call your doctor if you think you might be exposed to STDs, cannot feel Mirena's threads, develop severe migraine headaches, have yellowing of the skin or whites of the eyes (which may be signs of liver problems), have a stroke or heart attack, or have severe vaginal bleeding or bleeding that lasts a long time.

    Mirena must be removed after 5 years. Your doctor can insert a new Mirena during the same office visit if you choose to continue using it. If you change your mind about birth control and want to become pregnant in less than 5 years, your doctor can remove Mirena at any time.

  • Who should not take Mirena?

    Do not use Mirena if you have ever had an allergic reaction or sensitivity to it or any of its ingredients. Do not use Mirena if you may be pregnant; have an untreated pelvic infection or can get infections easily; have or may have cancer of the uterus, cervix, or breast; have unexplained vaginal bleeding; have liver disease; have an IUD in your uterus already; or have a condition of the uterus that changes its shape.

  • What should I tell my doctor before I take the first dose of Mirena?

    Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Mirena. Also, talk to your doctor about your complete medical history, especially if you have had a heart attack or stroke, were born with a heart disease, have problems with blood clotting or take medicines to reduce clotting, have high blood pressure, recently had a baby or if you are breastfeeding, have diabetes, use corticosteroid medications on a long-term basis, have severe migraine headaches, are at an increased risk of infection (because of leukemia, AIDS, or IV drug abuse), have a history of STDs, irregular bleeding, endometrial polyps (growth on the inner lining of the uterus), or cancer.

  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

    Your doctor will place Mirena in your uterus for you.

  • How should I take Mirena?

    Your doctor will place Mirena in your uterus.

    You should check that Mirena is in proper position by feeling the removal threads. Do this after each menstrual period. First, wash your hands with soap and water. Feel for the threads at the top of your vagina with your clean fingers. The threads are the only part of Mirena you should feel when Mirena is in your uterus. Be careful not to pull on the threads. If you feel more than just the threads, Mirena is not in the right position and may not prevent pregnancy. Call your doctor to have it removed. If you cannot feel the threads at all, ask your doctor to check that Mirena is still in the right place. In either case, use a nonhormonal birth control method (condoms or spermicide) until otherwise advised by your doctor.

  • What should I avoid while taking Mirena?

    Do not pull on the threads when checking if Mirena is in the proper position. If Mirena is misplaced, you may get pregnant if you have intercourse.

  • What are possible food and drug interactions associated with Mirena?

    If you take certain other drugs while using Mirena, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Mirena with the following: barbiturates (such as phenobarbital), bosentan, carbamazepine, medications used to treat HIV (AIDS)(such as non-nucleoside reverse transcriptase inhibitors and protease inhibitors), felbamate, griseofulvin, oxcarbazepine, phenytoin, rifampin, St. John's wort, or topiramate.

  • What are the possible side effects of Mirena?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects may include: bleeding, dizziness, or pain during and after placement of Mirena (alert your doctor if these symptoms do not stop 30 minutes after placement); changes in bleeding (such as spotting); expulsion (Mirena may come out by itself); missed menstrual periods; ovarian cysts (fluid-filled sac in the ovary)

  • Can I receive Mirena if I am pregnant or breastfeeding?

    Tell your doctor immediately if you think you are pregnant or notice symptoms including unusual vaginal bleeding or abdominal pain.

    You may use Mirena when you are breastfeeding if more than 6 weeks have passed since you had your baby. If you are breastfeeding, Mirena is not likely to affect the quality or amount of your breast milk, or the health of your nursing baby.

  • What should I do if I miss a dose of Mirena?

    Mirena should be placed under special circumstances as determined by your doctor.

  • How should I store Mirena?

    Your doctor will properly store Mirena for you.

Meet the Pharmacists

I'm Shereen A. Gharbia, PharmD. Welcome to PDR Health!

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