| Choice | Drug | Dosage |
|---|---|---|
| 1st choice | Kyleena® 19.5mg intrauterine device | Dose: Insert into uterine cavity within 7 days of the onset of menstruation (anytime if replacement); effective for 5 years |
| Or | ||
| Mirena® 20 micrograms/24 hours intrauterine delivery system | Dose: Insert tube into uterine cavity within 7 days of the onset of menstruation (anytime if replacement); effective for 5 years |
Prescribing Notes
- Refer to NICE Guidance CG 30 Long Acting Reversible Contraception and FSRH guidance.
- Levonorgestrel-releasing intrauterine systems should always be prescribed by brand name, see MHRA guidance.
- IUS insertions should be performed by trained healthcare staff who are regularly updated and who perform frequent insertions (recommendation is 12 or more per year).
- Levonorgestrel intrauterine system products are highly effective methods of contraception.
- Kyleena® has a lower levonorgestrel content. Unlike Mirena®, it is not licensed for the management of heavy menstrual bleeding or to provide endometrial protection as part of HRT. It has been suggested that a narrower introducer and smaller device could make Kyleena® more suitable for nulliparous or young women.
- Many women experience quite frequent and prolonged spotting for the first 3–6 months, thereafter amenorrhoea is common. Patients should be counselled accordingly.
- Mirena® has a beneficial effect on dysmenorrhoea and menorrhagia.