Mirena



 
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Mirena - Basic Information

 

Indication of Mirena:

Mirena IUD is used for contraception, hormone replacement therapy adjunct to oestrogen and menorrhagia.

Action of Mirena:

Mirena intrauterine device (IUD) releases levonorgestrel which has a local effect on the endometrium. Thickening of the cervical mucus inhibits sperm motility and thus prevents implantation. Ovulation is also suppressed in some women.

Dose Advice of Mirena:

Mirena IUD is inserted within first 7 days after start of menstrual cycle or 6 weeks after delivery. It may be replaced by new IUD at any time in the cycle and lasts for 5 years.For specific insertion and removal instructions, you may refer to product information in the package. The insertion technique differs to that for other intrauterine devices. However, the insertion process will be carried out by an experienced physician or gynaecologist. Before insertion, you should discuss with your doctor regarding the efficacy, risk and side effects of Mirena IUD. A physical examination including pelvic examination, examination of the breasts and a cervical smear will be performed These standard testing procedures are used to exclude pregnancy, sexually transmitted diseases and genital infections. You will be re-examined 4 to 12 weeks after insertion and once a year thereafter or more frequently if required Use in Pregnancy (Category B3): Mirena IUD should not be used in existing or suspected pregnancy. Removal of Mirena IUD is recommended if pregnancy occurs as the device may increase the risk of abortion and preterm labour. However, removal of Mirena or probing of the uterus may result in spontaneous abortion. If the intrauterine contraceptive device cannot be gently removed, you should consider terminating the pregnancy. If you wish to continue the pregnancy and the system cannot be withdrawn, you should consider the potential risks and the possible consequences of premature birth to the infant. Use in Lactation: Levonorgestrel has been identified in small quantities in the breast milk despite the daily dose of levonorgestrel released from Mirena IUD is considerably low. However, the plasma level does not appear to affect the quantity or quality of breast milk when using Mirena IUD after 6 weeks postpartum.

Schedule of Mirena:

Schedule 4

Common side effects of Mirena:

Adverse reactions are most frequently seen during the first few months after insertion and subside during prolonged use. The following adverse reactions have occurrence of greater than 1%: 1,2 Change in menstrual bleeding patterns which include spotting, shorter or longer bleeding periods, dysmenorrhoea, amenorrhoea, heavy flow, back pain. Other urogenital symptoms such as vaginal discharge, vaginitis and reversible ovarian cysts are also common.Nausea and vomitingAcneBreast tenderness and oedemaWeight changesNeurological symptoms such as fatigue, depressive moods and headaches.

Uncommon side effects of Mirena:

The following adverse drug reactions are less common. They were reported in 0.1% to


GN: Levonorgestrel

Con: Dysmenorrhoea