Generic Name and Formulations:
Levonorgestrel 52mg; intrauterine system (IUD).
Indications for LILETTA:
Prevention of pregnancy for up to 4yrs.
See full labeling. Insert into uterine cavity as directed. Reexamine and evaluate 4–6wks after insertion; then yearly or more if needed. Remove or replace after 4yrs.
Pre-menarche: not recommended.
Post-coital contraception. Congenital or acquired uterine anomaly including fibroids. Acute or history of pelvic inflammatory disease (PID) unless there has been a subsequent intrauterine pregnancy. Acute endometritis. Infected abortion in past 3 months. Uterine or cervical neoplasia. Breast or other hormone-sensitive cancer. Uterine bleeding of unknown etiology. Untreated acute cervicitis or vaginitis. Active liver disease or tumor. Conditions associated with increased susceptibility to pelvic infections. Retained IUD. Pregnancy.
History or risk of ectopic pregnancy. Assure suitable uterine anatomy before inserting. Risk of spontaneous abortion, miscarriage, sepsis, premature labor or delivery, congenital anomalies: remove if pregnant. Consider risks of PID before using. Bleeding pattern alterations: exclude endometrial pathology prior to insertion in women with persistent bleeding. Risk of perforation, expulsion and ovarian cysts. Increased risk of perforation in lactating women or if inserted in women with fixed retroverted uteri or during postpartum period; delay insertion a minimum ≥6wks, until involution is complete after delivery or a second trimester abortion. Breast cancer. Evaluate and consider patients' clinical conditions prior to use risk (eg, leukemia, AIDS, IV drug abuser). Anticoagulant therapy or coagulopathies. Cervical stenosis. Predisposition to syncope, bradycardia, other vasovagal reactions. Remove device if any of these occur: uterine or cervical perforation, embedment, pregnancy, symptomatic actinomycosis, pelvic infection, endometritis, any sign of expulsion. Consider removal if coagulopathy, migraine, transient cerebral ischemia, severe or frequent headache, marked increase in BP, severe arterial disease, uterine/cervical malignancy, or jaundice occurs. Nursing mothers.
Caution with anticoagulants; consider removal.
Vaginal and vulvovaginal infections, acne, headache/migraine, nausea/vomiting, dyspareunia, abdominal pain, breast tenderness/pain, pelvic discomfort/pain, depression; irregular bleeding, ectopic pregnancy, sepsis, PID, perforation, expulsion, ovarian cysts.
Clinical Pain Advisor Articles
- Virtual Reality May Effectively Reduce Sensory, Affective, and Cognitive Pain During Labor
- Suprazygomatic Sphenopalatine Ganglion Block May Quickly Relieve Status Migrainosus Pain
- Reducing Mortality After Overdose: Is Treatment for Opioid Use Disorder Effective?
- A Physician's Guide to Incorporating Patient Spirituality in Practice
- Low Literacy Self-Management Program for Chronic Pain May Be Effective
- Neuropathic Pain Medications
- Higher Buprenorphine Dose May Not Increase Severity of Neonatal Abstinence Syndrome
- Terms Used for Addiction May Be Associated With Explicit, Implicit Bias
- Ketamine Infusions May Be Effective for Refractory Headache
- Physical, Psychosocial Activity May Be Protective Against Development of Chronic Pain in Older Adults
- The Challenge of Compassion in Modern Healthcare Settings
- Republican Opposition to Obamacare: What's Done, What's to Come
- Lowering Default Pill Counts in EMRs May Effectively Reduce Postoperative Opioid Prescription Numbers
- Steps Taken to Increase Use of Electronic Tools in Medicine
- Daily and Retrospective Pain Measurements Comparable in Hip Osteoarthritis