Levonorgestrel (IUD

Adult Medication

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Kyleena; Liletta (52 MG); Mirena (52 MG); Skyla

Brand Names: Canada

Kyleena; Mirena

What is this drug used for?

  • It is used to prevent pregnancy.
  • It is used to treat heavy bleeding during monthly periods (menstruation).

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you are pregnant or may be pregnant. Do not use this drug if you are pregnant.
  • If you have an IUD (intrauterine device) in place.
  • If you have any of these health problems: Active liver disease, chlamydia or gonorrhea, endometritis after a birth, genital tract infection, infected abortion in the last 3 months, liver tumor, pelvic infection, uterine or cervical tumor or growth, uterine problems like uterine fibroids, or untreated cervicitis or vaginitis.
  • If you have unexplained vaginal bleeding.
  • If you have ever had any of these health problems: Breast cancer, cancer where hormones make it grow, or pelvic inflammatory disease.
  • If you have a weak immune system, you use or abuse IV drugs, or you have a disease that may cause a weak immune system like HIV.
  • If you or your partner have sex with more than one person.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Ovarian cysts may rarely happen. Most of the time, these go back to normal in 2 to 3 months. Sometimes, ovarian cysts can cause pain and the need for surgery. Talk with the doctor.
  • If you get pregnant while taking this drug, the chance of pregnancy outside of the uterus (ectopic pregnancy) may be raised. Talk with your doctor.
  • This drug does not stop the spread of diseases like HIV or hepatitis that are passed through having sex. Do not have any kind of sex without using a latex or polyurethane condom. If you have questions, talk with your doctor.
  • If you are having an MRI, talk with your doctor.
  • Life-threatening infection can happen within a few days after this drug was put in. Call your doctor right away if you have fever or pain where this drug was placed.
  • Very bad health problems and the need for surgery can happen if this drug goes through the uterus. Most of the time, this happens when this drug is put in but can happen at any time during use. The chance is raised if this drug is put in while you are breast-feeding. This drug may also not prevent pregnancy if this happens. If you have questions, talk with your doctor.
  • This drug may raise the chance of a health problem called pelvic inflammatory disease (PID). The chance may be higher if you or your partner have sex with other partners. PID can lead to other health problems like not being able to get pregnant, surgery, or rarely death. Talk with your doctor.
  • Tampons or menstrual cups may be used with this drug. Change these with care to avoid pulling the threads of this drug. If you think you may have pulled this drug out of place, use a non-hormone type of birth control like condoms or spermicide or do not have sex, and call your doctor.
  • If you cannot feel the string or you think the IUD has come out, call your doctor. You may get pregnant if this drug comes out. Use another kind of birth control like a condom until you see your doctor. If you think the IUD has come out and you had sex within the last week, call your doctor. You may be at risk to get pregnant.
  • Menstrual periods may stop in some people after 1 year of using this drug. Periods will go back to normal when this drug is taken out. If you do not have a period for 6 weeks when this drug is in place, call your doctor.
  • You may need to have a pregnancy test before this drug is put in. If you have questions, talk with your doctor.
  • If you think you may be pregnant while this drug is in place, call your doctor right away. Severe and sometimes deadly health problems can happen when this drug is removed or if it needs to be left in place during pregnancy. This includes loss of fertility, infections, and loss of the unborn baby.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
  • Chest pain or pressure.
  • Stomach pain.
  • Pelvic pain.
  • Vaginal bleeding that is not normal.
  • Vaginal itching or discharge.
  • Fever or chills.
  • A lump in the breast or breast soreness.
  • Painful sex.
  • Yellow skin or eyes.
  • Depression or other mood changes.
  • Genital sores.
  • Some pain, bleeding, dizziness, or other reactions may happen when the IUD is put in or taken out. Talk with your doctor right away if these are severe, do not go away within 30 minutes after the IUD is put in, or happen after it is taken out. Talk with your doctor right away if you have other reactions like seizures, slow heartbeat, or passing out.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Acne or greasy skin.
  • Headache.
  • Upset stomach or throwing up.
  • Painful periods.
  • Back pain.
  • Weight gain.
  • Vaginal bleeding and spotting between menstrual periods may happen, especially during the first 3 to 6 months. Cramping may also happen during the first few weeks. Call your doctor if the bleeding stays heavier than normal or if it gets heavier after it has been light for a while.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • This drug will be given to you by a doctor.
  • Follow up with the doctor as you have been told.
  • Check to see if this drug is in place as you have been told by your doctor or read the package insert.
  • Based on when this drug is put in, you may need to use a non-hormone type of birth control like condoms to prevent pregnancy for some time. Follow what your doctor has told you to do about when to have this drug put in and using a non-hormone type of birth control.
  • If this drug is being removed and you do not want to get pregnant, talk with your doctor. You will need to use another kind of birth control like a condom the week before it is removed.
  • This drug is not for use as emergency birth control. Talk with the doctor.

What do I do if I miss a dose?

  • Call your doctor to find out what to do.

How do I store and/or throw out this drug?

  • If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

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Last Updated

Monday, December 12, 2022