Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Blood Pressure: Levonorgestrel can cause an increase in blood pressure. If you have high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience an increase in your blood pressure after having this device inserted, contact your doctor.
Depression: Hormones, such as progestins, are known to contribute to mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication contact your doctor as soon as possible.
Diabetes: Low-dose contraceptives such as this device have very little effect on blood sugar control. However, people with diabetes or those with a family history of diabetes should monitor their blood sugar closely to detect any worsening of blood sugar control.
Ectopic pregnancy: If you have a history of ectopic pregnancy (when a fertilized egg implants itself outside of the uterus), have had surgery on the fallopian tubes, or have had a pelvic infection, you should speak to your doctor or pharmacist before using this device. If you experience lower abdominal pain along with a missed period or unexpected bleeding while using this medication, contact your doctor.
Expulsion of device: Bleeding or pain may indicate that the device has either moved out of position or has been expelled from the uterine cavity. A device that is out of position is less effective and should be removed and replaced by a new device.
Eye problems: Some women may experience a change in vision or contact lens tolerance. If this occurs, contact your eye doctor.
Headache: Levonorgestrel, like other hormones, may cause severe headache or migraine. If you have a history of migraine, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you notice increasing numbers or severity of headaches after the device has been inserted, contact your doctor as soon as possible.
Heart disease: Levonorgestrel may increase the risk of developing blood clots, causing reduced blood flow to organs or the extremities. If you have a history of clotting you may be at increased risk of experiencing blood clot-related problems such as heart attack, stroke, or clots in the deep veins of your leg. Cigarette smoking increases the risk of serious adverse effects on the heart and blood vessels. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision or difficulty speaking, contact your doctor immediately.
Heart valve disorders: This medication can increase your risk of getting an infection in your heart valves if you were born with or have acquired a heart valve defect. You may need to take antibiotics before the insertion and removal of this medication to prevent the infection.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Menstrual Bleeding: Some women may experience some pain and bleeding when the device is inserted or removed. Irregular menstrual bleeding is common for the first few months after the device is inserted. Over time, menstrual bleeding decreases and may stop completely while the device is inserted.
Ovarian cysts: This medication can cause the development of ovarian cysts. Most of these don't have any symptoms and disappear on their own within 2 to 3 months. However, if you experience pain in the pelvic area, contact your doctor.
Perforation: The chance of the device puncturing the cervix or uterus is very rare (between 1 in 1,000 and 1 in 10,000). If it were to occur, it would most likely be when the device is being inserted. If this happens, the device should be removed as soon as possible.
Removal of the device: If you experience any of the following, check with your doctor to see if you should have your device removed:
- confirmed or suspected breast or endometrial cancer
- migraines or severe headaches
- recurrent inflammation of the lining of the uterus
- recurrent pelvic infections
- significantly elevated blood pressure
- stroke or heart attack
Sexually transmitted infections (STIs): This device does not protect against STIs, including HIV/AIDS. For protection against STIs, use latex condoms.
Pregnancy: This device should not be used during pregnancy. You should have this device removed as soon as possible if you become pregnant. If it is left in place during pregnancy, the chances of having a miscarriage or premature delivery are increased. The effects of levonorgestrel on a developing infant are not well known, and the risk of harm to the baby cannot be completely ruled out. Removal of this device or probing of the uterus may result in spontaneous abortion. You should check with your doctor about risks to your unborn child.
Breast-feeding: Hormonal birth control, such as this device, is not the first choice of birth control for women who are breast feeding. This medication passes into breast milk. If you are a breast-feeding mother and are using levonorgestrel, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: Levonorgestrel-releasing intrauterine system is not intended to be used by children. The safety and effectiveness of using this medication have not been established for children.