This is a soft, flexible, T-shaped contraceptive (birth control) device that is placed inside the uterus (intrauterine device or IUD). The medication is continuously released over a period of 5 years to prevent pregnancy.

It is also used to treat heavy menstrual bleeding. Levonorgestrel is a progestin, which is a hormone produced by the ovaries. Mirena (Levonorgestrel-intra-uterine) prevents the lining of the uterus (endometrium) from building up, which makes it very difficult for an egg to be implanted and also helps to manage heavy menstrual bleeding. It also changes the cervical mucus, making it harder for sperm to swim through the cervix.

Levonorgestrel IUD starts to work as soon as it is inserted. However, it is advised to wait 24 to 48 hours before having sexual intercourse.

Mirena (Levonorgestrel-intra-uterine) may be available under multiple brand names and/or in several different forms. Any specific brand name of Mirena (Levonorgestrel-intra-uterine) may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Mirena (Levonorgestrel-intra-uterine) may not be used for all of the conditions discussed here.

Your doctor may have suggested Mirena (Levonorgestrel-intra-uterine) for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given Mirena (Levonorgestrel-intra-uterine), speak to your doctor.

Do not give this contraceptive device to anyone else. It can be harmful for people to use this contraceptive device if their doctor has not prescribed it. Do not try to remove this contraceptive device without consulting your doctor.

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This device is placed inside the uterus by your doctor within 7 days after the start of your period. Your doctor will most likely perform a gynecological examination before the device is inserted to examine your uterus for correct placement and to rule out pregnancy or other gynecological conditions that would make using levonorgestrel undesirable.

The device is inserted during a routine office visit with your doctor and only takes a few minutes. You may have to go back to your doctor's office about 4 to 12 weeks after the device is inserted to ensure it is in the right position, and then once a year thereafter or as directed by your doctor. The device can be left in place for up to 5 years, after which a decision must be made whether to replace the device with a new one or simply to remove the old device.

It is important to use this contraceptive device exactly as prescribed by your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Mirena (Levonorgestrel-intra-uterine). If you are concerned about side effects, discuss the risks and benefits of Mirena (Levonorgestrel-intra-uterine) with your doctor.

The following side effects have been reported by at least 1% of people taking Mirena (Levonorgestrel-intra-uterine). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• Acne (usually less common after 3 months of treatment, and may improve if acne already exists)
• breast pain, tenderness, or swelling
• changes in the menstrual pattern, such as:
• breakthrough bleeding or spotting between periods
• complete lack of menstrual flow for several months in a row
• decreased bleeding during periods
• occasional stopping of menstrual bleeding
• prolonged bleeding during periods
• decreased sex drive
• feeling of fullness or tightness in the abdomen
• headache
• nausea
• weight gain

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:

• back pain
• dizziness
• expulsion of the device
• mood changes
• nervousness
• persistent or severe lower abdominal pain along with Fever or unusual vaginal discharge
• severe Headaches or migraines (headaches may lessen in many users, or they may increase in number or become worse for other users)
• signs of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of a liver problem (e.g., yellow skin or eyes, dark urine, pale stools, abdominal pain, or itchy skin)
• skin rash, Hives, or itchy skin
• symptoms of pregnancy (e.g., abdominal pain, nausea, breast tenderness)
• vaginal discharge
• vaginal infection with vaginal itching or irritation, or thick, white, or curd-like discharge

Stop taking the medication and seek immediate medical attention if any of the following occur:

• abdominal or stomach pain (sudden, severe, or continuing)
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of a blood clot in the leg (e.g., sudden unexplained pain in the leg, especially in the calf)
• signs of a blood clot in the lungs (e.g., sudden or unexplained shortness of breath, chest pain, coughing up of blood)
• signs of a Heart Attack (e.g., pain or discomfort in the chest or upper body, shortness of breath, nausea, cold sweats, or lightheadedness)
• signs of a Stroke (e.g., sudden slurring of speech; sudden unexplained weakness, numbness, or pain in the arm or leg; sudden loss of coordination; sudden, severe headache)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Mirena (Levonorgestrel-intra-uterine).

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Mirena® is supplied as a soft, flexible, T-shaped device about the size of a quarter. It contains 52 mg of levonorgestrel in a cylindrical-shaped reservoir. The reservoir is mounted on a T-shaped frame and covered with a rate-controlling membrane of polydimethylsiloxane and silica. The T-frame is coloured with barium sulfate. The polyethylene removal threads attached to the T-frame are coloured with black iron oxide.