7.3.2.3. Intrauterine progesterone: levonorgestrel-releasing intrauterine system (LNG IUS)
| Choice | Drug |
|---|
| Formulary choices | Levonorgestrel 20micrograms/24 hours intrauterine device: |
| Benilexa one handed 20micrograms/24 hours intrauterine delivery system |
| or |
| Levosert 20micrograms/24 hours intrauterine system |
| or |
| Mirena® 20micrograms/24hours intrauterine device |
| Or |
| Levonorgestrel 19.5mg intrauterine device: |
| Kyleena® (levonorgestrel 19.5mg intrauterine device) |
| |
Prescribing Notes
- Refer to NICE CG30 Long Acting Reversible Contraception and FSRH guidance.
- LNG IUS should always be prescribed by brand name, see MHRA.
- LNG IUS are highly effective methods of contraception.
- Many women experience quite frequent and prolonged spotting for the first 3–6 months; thereafter amenorrhoea is common. Patients should be counselled accordingly.
- See 7.1.2 for LNG-IUS options for the treatment of heavy menstrual bleeding.
- Kyleena® is licensed for contraception only (not recommended for endometrial protection as part of HRT or for heavy menstrual bleeding). The narrower introducer and smaller device makes Kyleena® more suitable for nulliparous or young women.
- IUS insertions should be performed by healthcare staff who are fully trained in the technique, regularly updated and who perform frequent insertions (recommendation is 12 or more per year).
- The Faculty of Sexual and Reproductive Healthcare (FSRH) produce eligibility criteria for contraceptive use see UKMEC.
- The MHRA have issued advice on the risk factors for uterine perforation with intra-uterine contraception, including copper intra-uterine devices and LNG IUS, see MHRA.
