NOTE: Depending on the supplier/strength selected, the products shipped may have different packaging.

Why is Mirena prescribed?

The Mirena (Levonorgestrel) intrauterine system, which releases 52 mg of levonorgestrel, is approved for pregnancy prevention for up to 8 years; it should be replaced after this period. Additionally, Mirena is indicated for the management of heavy menstrual bleeding for up to 5 years in women opting for intrauterine contraception; if continued treatment for heavy menstrual bleeding is necessary, it should be replaced after 5 years.

What does it do?

It is used by women seeking a long-lasting reversible birth control method (effective for up to 8 years). Also, it is utilized to manage heavy menstrual bleeding in women who prefer this form of contraception. The device gradually releases levonorgestrel, a hormone similar to one naturally produced by women, which aids in preventing pregnancy. However, this product does not protect against sexually transmitted infections (STIs) such as gonorrhea, HIV, or chlamydia.

How should I take it?

This device is inserted into your uterus by a doctor during an office visit and can remain in place for up to 8 years. It is important to schedule a follow-up appointment 4 to 6 weeks after insertion to ensure it is positioned correctly.

Occasionally, this device may shift or dislodge on its own. After each menstrual period, verify that it is still in the correct position. You can learn how to check the position of the device by referring to the Patient Information Leaflet or consulting your doctor. If the device becomes dislodged or if you cannot feel the threads, contact your doctor immediately and use a backup method of non-hormonal contraception (such as condoms or spermicide) to prevent pregnancy until you receive further instructions from your doctor.

What if I missed a dose?

This is not applicable for Mirena.

What are the special precautions before taking Mirena?

You should avoid using Mirena if you have abnormal vaginal bleeding, a pelvic infection, specific issues with your uterus or cervix, or if you have breast or liver disease, uterine cancer, liver tumors, or a compromised immune system.

Before taking this medicine, Mirena IUD may raise your risk of developing a serious pelvic infection, which could endanger your life or affect your future fertility. Consult your doctor to discuss this risk.

You should not use Mirena if you are allergic to levonorgestrel, silicone, silica, silver, barium, iron oxide, or polyethylene, or if you have:

• Unusual vaginal bleeding.
• An untreated or unmanaged pelvic infection.
• Endometriosis or a severe pelvic infection that occurred within the last 3 months following a pregnancy or abortion.
• If you gave birth within the last 6 weeks.
• If you had an abortion or miscarriage within the last 6 weeks.
• If you have another intrauterine device (IUD) currently inserted.
• A condition that compromises your immune system, such as AIDS, intravenous drug use, or a leukemia
• Liver disease or liver tumors (whether benign or malignant).
• A history of or current cancer of the breast, cervix, or uterus.
• Uterine fibroids
• Pelvic inflammatory disease (PID)
To ensure that Mirena is safe for you, inform your doctor if you have:
• High blood pressure, a heart attack, heart problems or a stroke
• Migraine or headaches
• A vaginal infection, sexually transmitted disease, pelvic infection, or
• Bleeding problems
Does it have any side effects?

Seek emergency medical assistance if you experience signs of an allergic reaction to Mirena, such as difficulty breathing, hives or swelling of the face, tongue, or throat.

If you experience severe pain in your lower abdomen or side, get an emergency help as this could indicate a tubal pregnancy.

The IUD may become embedded in the uterine wall or perforate the uterus, which could prevent the device from effectively preventing pregnancy. It may also shift outside the uterus, leading to scarring, infection, or damage to surrounding organs. In such cases, your doctor may need to surgically remove the device.

Common side effects may include:
• Puffiness in your face, hands, ankles, or feet
• Weight gain, acne, oily skin, changes in hair growth
• Breast tenderness or pain
• Migraine, mood changes
• Ovarian cysts
• Temporary pain, bleeding
• Dizziness during insertion of the IUD
• Itching or infection
• Painful or irregular menstrual periods

Contact your doctor immediately if you experience any of the following conditions:

• Extreme dizziness
• Severe migraine headache
• Yellowing of the skin or eyes (jaundice)
• Sudden numbness or weakness
• Problems with vision, sensitivity to light
• Severe cramps or pelvic pain
• Vaginal discharge that is watery, foul-smelling discharge
• Heavy or continuous vaginal bleeding

This is not a full list of side effects, and others may occur. Contact your doctor for medical advice regarding side effects.

Is it safe to take it with another drug?

Medications or herbal products that induce or inhibit LNG-metabolizing enzymes, such as CYP3A4, may lower or raise serum concentrations of LNG (Levonorgestrel) while using Mirena. However, the contraceptive effect of Mirena is primarily due to the direct release of LNG (Levonorgestrel) into the uterine cavity, and it is unlikely to be impacted by drug interactions caused by enzyme induction or inhibition.

Inform your doctor about all the medications you are currently taking and any that you begin or discontinue.

How should I store it?

Store in the original packaging at room temperature. Ensure that all medications and medical devices are kept out of reach of children and pets.

Do not open the Mirena package; this should only be done by your doctor or nurse. Mirena should not be used after the expiration date indicated on the outer carton and foil packaging marked as “EXP.”

What action should I take in case of overdose?

This medication device can be harmful if ingested. If someone has swallowed it and experiences severe symptoms like difficulty in breathing, seek immediate medical attention or go to the nearest emergency department.

Is it safe for pregnant or breastfeeding women?

Pregnancy- Mirena should not be used during pregnancy or if you suspect that you may be pregnant. If you become pregnant or suspect that you might be pregnant, inform your doctor immediately.

Breastfeeding- Very small amounts of the hormone in Mirena are present in breast milk, but these levels are lower than those associated with other hormonal contraceptive methods. If you wish to breastfeed while using Mirena, please consult your doctor for guidance.

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